Summary & Overview
CPT 15941: Excision of Hip Pressure Sore with Bone Removal and Closure
CPT code 15941 covers surgical excision of a pressure sore in the hip region with removal of exposed or infected bone and primary wound closure. This procedure addresses osteomyelitis or deep-seated infection when a decubitus ulcer has tracked to bone and requires surgical debridement beyond soft tissue. Nationally, the code is important for hospitals and surgical practices managing complex wound care, infection control, and postoperative reconstruction.
Payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the code, typical sites of service, and the kinds of claims activity tied to deep pressure ulcer management in the hip area. The publication outlines common billing practices surrounding this surgical service, summarizes relevant benchmarks where available, and highlights policy or coverage factors that commonly affect authorization and reimbursement for deep debridement with bone removal.
The report provides practical context for coding teams, surgical departments, and revenue cycle staff: what the code represents clinically, how it maps to surgical service lines, and which payers commonly adjudicate these claims. Data not available in the input will be identified explicitly in relevant sections.
Billing Code Overview
CPT code 15941 describes surgical removal of a pressure sore (decubitus ulcer) and the underlying bone in the hip region when the wound infection has extended to bone, followed by primary closure with suturing. This procedure is a surgical debridement and partial ostectomy focused on an infected pressure ulcer of the hip.
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Service type: Surgical debridement with bone removal and wound closure
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Typical site of service: Operating room (inpatient or outpatient surgical setting depending on clinical status)
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult or debilitated individual with a chronic, deep pressure ulcer over the hip (ischial tuberosity or greater trochanter) complicated by osteomyelitis of the underlying pelvic or proximal femoral bone. The patient often presents from a long-term care facility or inpatient medical ward with a nonhealing, draining wound, signs of local infection (erythema, increased drainage, foul odor), elevated inflammatory markers, and imaging (plain radiograph or MRI) consistent with bone involvement. Prior to surgery, the clinical workflow includes wound culture, targeted systemic antibiotics, optimization of medical comorbidities (glycemic control, nutrition, anticoagulation review), and preoperative anesthesia assessment.
During the operative encounter for 15941, the surgical team performs debridement of infected soft tissue and resection of necrotic or infected bone in the hip pressure sore bed, achieves hemostasis, and closes the wound primarily or with local tissue rearrangement as appropriate. Postoperative care includes continued antibiotics guided by cultures, wound surveillance, pressure off-loading, pain management, and coordination with home health or long-term care for dressing changes and rehabilitation to prevent recurrence.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time is substantially greater than typical for 15941 due to extensive debridement or complex closure. |
23 | Unusual anesthesia | Use when general anesthesia is avoided but the procedure is performed under circumstances that would normally require general anesthesia but cannot be used (rare). |
26 | Professional component | Use when billing only the surgeon's professional component separate from facility or technical charges (rare for this global surgical code). |
50 | Bilateral procedure | Use if the same resection/closure is performed on bilateral hip/ischial areas during the same operative session. |
51 | Multiple procedures | Use when 15941 is reported in the same operative session with unrelated additional procedures performed by the same surgeon. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but halted for patient safety before completion. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons on the same operative field for increased complexity. |
73 | Discontinued outpatient procedure prior to anesthesia administration | Use when procedure canceled after patient prepared but before anesthesia for outpatient setting. |
78 | Unplanned return to OR for related procedure during postoperative period | Use when patient returns to operating room for a related complication of 15941 during the global period. |
80 | Assistant surgeon | Use when an assistant surgeon provides intraoperative assistance. |
81 | Minimum assistant surgeon | Use when a minimally involved assistant is required. |
82 | Assistant (when a qualified resident surgeon not available) | Use when an assistant is necessary and no qualified resident is available. |
TC | Technical component | Use when billing only the facility/technical component separate from surgeon's professional fee (if allowed). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
208100000X | General Surgery | General surgeons commonly perform debridement and excision of infected bone and closure for pressure ulcers. |
2080P0208X | Plastic Surgery | Plastic surgeons perform complex soft-tissue reconstruction and flap coverage when primary closure is not feasible. |
207Q00000X | Orthopaedic Surgery | Orthopedic surgeons manage resection of osteomyelitic bone and coordinate with debridement for skeletal involvement. |
207H00000X | General Practice/Family Medicine | Primary care or hospitalists may coordinate pre- and postoperative care in medically complex patients. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M86.172 | Acute osteomyelitis, other specified site, left femur | Osteomyelitis of the femoral bone underlying a hip pressure ulcer requiring bone resection. |
M86.171 | Acute osteomyelitis, other specified site, right femur | Osteomyelitis of the femoral bone underlying a hip pressure ulcer on the right side. |
L89.152 | Pressure ulcer of right hip, stage 4 | Deep pressure ulcer with exposed bone and likely indication for resection and closure with 15941. |
L89.153 | Pressure ulcer of right hip, stage 3 | Deep ulcer potentially progressing to bone involvement; may precede 15941 if osteomyelitis develops. |
L89.154 | Pressure ulcer of right hip, stage 4, with unspecified severity | Represents severe pressure injury involving underlying structures necessitating surgical management. |
L89.151 | Pressure ulcer of right hip, stage 2 | Less severe but included as related severity spectrum; may progress to deeper stages requiring surgery. |
T81.4XXA | Infection following a procedure, initial encounter | Relevant for postoperative infections that could require return to OR or additional debridement after 15941. |
E11.65 | Type 2 diabetes mellitus with poor control, hyperglycemia | Common comorbidity that impairs wound healing and contributes to risk of osteomyelitis in pressure ulcers. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11042 | Debridement, subcutaneous tissue (eg, open wounds, noninfected) | Often performed as initial or adjunct soft-tissue debridement of wound margins before or during resection of infected bone. |
11043 | Debridement, muscle and/or fascia | Used when deeper soft-tissue debridement extending into muscle/fascia is necessary in addition to bone resection. |
11044 | Debridement, bone (includes skin, subcutaneous tissue, muscle and/or fascia, if performed) | May be reported when debridement of necrotic bone is the dominant component; careful coding to avoid unbundling with 15941. |
15271 | Skin graft, full-thickness, trunk, arms, legs; 30.1 sq cm to 60.0 sq cm | Used when primary closure is not possible and skin grafting is required for wound coverage after debridement. |
15734 | Muscle, myocutaneous, or fasciocutaneous flap with microvascular anastomosis | Used for complex reconstructive coverage of large defects following excision of infected bone and soft tissue. |
99024 | Postoperative follow-up visit global period (routine) | Used for routine postoperative care visits within the global surgical period for 15941. |