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Unlisted Pressure Sore Removal Procedure

Pennsylvania rates for HCPCS 15999

Surgical removal of a pressure sore (bedsore) and the damaged tissue around it, in a form that has no standard named entry of its own. Pressure sores form where sustained pressure over a bony area breaks down skin and the tissue beneath it. The surgeon submits a written report describing what was performed.

Rates data updated July 2026.

How much does Unlisted Pressure Sore Removal Procedure cost?

$5,370

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $5,370 for this service. The price depends on where it is billed: about $7,762 from a physician practice, and about $4,786 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$7,762$1,585 to $64,565
FacilityA hospital or hospital-owned outpatient department$4,786$1,413 to $7,762

How much rates vary

Facilitymedian $4,786 · 10th to 90th $537 to $8,318Professionalmedian $7,762 · 10th to 90th $1,413 to $64,565
$100.0$1.0K$10.0Kfacility $4,786professional $7,762

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$5,754.40
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,584.89
Typical High
$7,762.47
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$2,570.40
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$57,543.99
Median
$64,565.42
Typical High
$64,565.42
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$4,786.30
Typical High
$8,511.38
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$3,162.28
Typical High
$7,762.47
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$48.98
Typical High
$89.13
United
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$1,513.56
Typical High
$3,890.45

Where Pennsylvania sits

The same service costs 3090.3 times more in Wisconsin than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $5,370 · 12th of 50
WI $11,482MD $3.72

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.