Summary & Overview
CPT 15950: Excision and Closure of Trochanteric Pressure Ulcer
CPT code 15950 represents surgical excision and closure of a pressure ulcer located at the trochanter (hip) region. This code matters nationally because pressure ulcers are common among immobile and medically complex patients and surgical management can be resource-intensive, impacting hospital surgical workload, postoperative care needs, and payer reimbursement patterns. Key payers relevant to national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context for using CPT code 15950, the typical site-of-service and service type, and what to expect in payer coverage patterns and documentation priorities. The publication provides benchmarks and policy-relevant summaries that clarify when this surgical code is reported, common billing considerations, and areas where documentation and coding accuracy influence payment. It also highlights implications for surgical teams, wound care programs, and revenue cycle operations, and outlines gaps where additional documentation or payer-specific guidance is commonly required. Data not available in the input is noted where applicable, including detailed payer-specific rates, associated taxonomies, and related ICD-10 diagnosis codes.
Billing Code Overview
CPT code 15950 describes the surgical removal of a pressure ulcer of the trochanter (hip) area with closure of the wound by suturing. The service type is a surgical debridement and excision with primary closure. The typical site of service is an operating room or procedure suite in an acute care hospital or ambulatory surgical center.
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult or medically complex individual with a chronic pressure ulcer located over the greater trochanter (hip) that has failed conservative wound care. The patient presents to an outpatient surgical clinic or hospital ambulatory surgery center for debridement and excision of the pressure sore with primary closure. Preoperative evaluation documents comorbidities such as diabetes mellitus, peripheral vascular disease, or immobility, and assesses nutritional status and infection risk. The procedure is performed under local anesthesia with sedation or general anesthesia depending on patient factors. The surgeon excises devitalized tissue and undermines healthy margins as needed, achieves hemostasis, and performs layered wound closure with sutures; drains may be placed. Postoperative workflow includes wound care instructions, dressing changes, pain control, possible antibiotics if infected, and scheduled follow-up for suture removal and monitoring for recurrence or wound breakdown. Typical sites of service include an ambulatory surgery center or hospital outpatient department, and the service type is operative surgical wound excision with closure for pressure ulcer of the trochanteric region.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard primary procedure code indicator | Not typically used on claims; reserved for internal billing systems when required |