CPT Code 15922Complete Billing & Coding Guide (2026)Exc coccygl pr ulc flap clsr
About CPT 15922
CPT 15922 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Exc coccygl pr ulc flap clsr". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
Major surgical codes carry a 90-day global period that bundles all related post-operative care. Improper billing of post-op E/M (without modifier 24 for unrelated care) is a common audit finding. Documentation of medical necessity for the procedure itself remains the foundation of any successful claim.
CPT 15922 has a 90-day global period. Any E/M visit within that window for the same condition is bundled into the procedure payment. Use modifier 24 for unrelated E/M, modifier 79 for unrelated procedures, and modifier 78 for related returns to the OR.
Code Properties
RVU Breakdown
Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.
Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.
Medicare Payment by State
Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.
Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.
NCCI Bundling Edits
10 pairsThese codes trigger National Correct Coding Initiative edits when billed with 15922. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.
15922 + 0213T: hard bundle (indicator 0)
The most-asked bundling question on this code. Verdict pulled from the current NCCI quarterly file.
Modifier indicator 0 means this edit cannot be bypassed. Do not append modifier 59 or X-modifiers. The bundled code must be written off, or, if clinically inappropriate, the entire claim reconsidered.
Misuse of Column Two code with Column One code
Billing 15922 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Standards of medical/surgical practice
Standards of medical/surgical practice
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Bundling denials on 15922 are recoverable when the edit indicator is 1 and the chart documents a distinct, separately identifiable service. Our coders verify the indicator and pick the precise X-modifier (XE, XS, XP, XU) instead of defaulting to modifier 59.
Got a CO-97 on 15922 and 0213T? Send us the EOB before you write it off.
Indicator 0 means no modifier bypasses the edit. A real coder should confirm before the charge is written off. Some look-alike edits get appealed successfully on documentation grounds.
Remove patient name, DOB, and member ID before pasting.
Applicable Modifiers
Modifiers commonly paired with 15922 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.
Modifier audits catch what scrubbers miss. Our AAPC-certified team reviews every modifier choice on 15922 against the chart documentation before submission, surfacing missed and misapplied modifiers across the practice.
Find the revenue leakage in your 15922 claims.
Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Anesthesia claims. Our AAPC-certified team audits your last 90 days of 15922 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.
Losing revenue on CPT 15922? We’ll find it.
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Related CPT Codes
Codes in the same family as 15922
Everything about CPT 15922
What does CPT code 15922 cover?
CPT 15922 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Exc coccygl pr ulc flap clsr". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
What is the Medicare payment for CPT 15922?
The national average Medicare payment for CPT 15922 is approximately $731.15 in a non-facility setting and $731.15 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 21.89 with a conversion factor of $33.4009.
What is the global period for CPT 15922?
CPT 15922 has a 90-day global period (indicator 090). Routine post-op care for the next 90 days is bundled into the procedure payment, including all related E/M visits. Bill modifier 24 for unrelated E/M, modifier 79 for unrelated procedures, or modifier 78 for related returns to the OR during this window.
What codes bundle with CPT 15922?
CPT 15922 has NCCI Procedure-to-Procedure edits with 10+ codes including 0213T, 0216T, 0596T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.
CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.
Free 90-Day AR Recovery Audit
We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.