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Official Description

Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A trochanteric pressure ulcer, commonly known as a pressure sore, bedsore, or decubitus ulcer, is a type of wound that develops over the greater trochanter, which is a prominent bony projection located at the proximal end of the femur. This area serves as an attachment point for various muscles in the thigh and buttock. The development of a trochanteric pressure ulcer is often associated with prolonged pressure on the skin, typically occurring in individuals who are immobile or have limited mobility. The procedure described by CPT® Code 15953 involves the excision of the trochanteric pressure ulcer along with a skin flap closure and ostectomy. During this surgical intervention, the physician makes an elliptical incision around the ulcer, excising all necrotic tissue, which includes skin, subcutaneous tissue, and muscle. The procedure also entails inspecting the trochanteric bursa and bone, resecting the bursa, and excising any involved bone or bony protuberances while ensuring the protection of surrounding nerves and blood vessels. The remaining rough bony surfaces are smoothed, and the wound is subsequently closed using a local skin flap, which involves mobilizing adjacent skin and suturing it over the wound to promote healing and restore the integrity of the skin in the affected area.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 15953 is indicated for the treatment of trochanteric pressure ulcers, which may arise due to prolonged pressure on the skin, particularly in patients with limited mobility. The following conditions may warrant this surgical intervention:

  • Trochanteric Pressure Ulcer A localized injury to the skin and underlying tissue over the greater trochanter, typically resulting from prolonged pressure.
  • Necrotic Tissue Presence of dead or dying tissue that requires excision to promote healing and prevent infection.
  • Infection Signs of infection in the ulcer that necessitate surgical intervention to remove infected tissue and prevent further complications.

2. Procedure

The procedure for CPT® Code 15953 involves several critical steps to ensure the effective excision of the trochanteric pressure ulcer and proper closure of the wound:

  • Step 1: Incision The surgeon begins by making an elliptical incision around the trochanteric pressure ulcer. This incision is designed to encompass the entire ulcer and any surrounding necrotic tissue.
  • Step 2: Excision of Necrotic Tissue All necrotic tissue is excised, which includes the removal of skin, subcutaneous tissue, and muscle that are affected by the ulcer. This step is crucial for preventing infection and promoting healing.
  • Step 3: Inspection of Trochanteric Bursa and Bone The surgeon exposes the trochanter and inspects the trochanteric bursa and underlying bone. This inspection is vital to assess the extent of the ulcer and any associated damage.
  • Step 4: Resection of Bursa and Bone The trochanteric bursa is resected, and any involved bone or bony protuberances are excised. Care is taken to protect surrounding nerves and blood vessels during this process.
  • Step 5: Smoothing of Bony Surfaces Any remaining rough bony surfaces are smoothed using a file to ensure a clean and even surface for closure.
  • Step 6: Closure with Local Skin Flap The wound is then closed using a local skin flap. This involves incising skin adjacent to the wound down to the level of subcutaneous fat, mobilizing the skin, and suturing the skin flap over the wound to facilitate healing.

3. Post-Procedure

After the procedure, patients may require specific post-operative care to ensure proper healing of the surgical site. This may include monitoring for signs of infection, managing pain, and ensuring that the surgical site remains clean and dry. Patients may also need to follow specific instructions regarding mobility and pressure relief to prevent the development of new pressure ulcers. Regular follow-up appointments may be necessary to assess the healing process and address any complications that may arise.

Short Descr EXC TRCHNTR PR ULC FLP OSTC
Medium Descr EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY
Long Descr Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 2
CCS Clinical Classification 142 - Partial excision bone
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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