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15004 Wound prep f/n/hf/g

What 15004 is

CMS fee schedule short descriptor: Wound prep f/n/hf/g.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 15004 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)4.477.020.6212.11$404.48
Facility (hospital, ASC)4.471.760.626.85$228.80

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).

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Medically Unlikely Edit (MUE)

Medicare caps 15004 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 15004? These codes are bundled into it

15004 is a Column 1 code in 273 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
01951Anes 2&3 burn less 4 % tbsa0 - no modifier bypassCheck pair
01952Anes 2&3 burn 4-9% tbsa0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair
11047Dbrdmt bone each addl1 - modifier may bypassCheck pair
11102Tangntl bx skin single les1 - modifier may bypassCheck pair
11104Punch bx skin single lesion1 - modifier may bypassCheck pair
11106Incal bx skn single les1 - modifier may bypassCheck pair
11400Exc tr-ext b9+marg 0.5 cm<1 - modifier may bypassCheck pair
11401Exc tr-ext b9+marg 0.6-1 cm1 - modifier may bypassCheck pair
11402Exc tr-ext b9+marg 1.1-2 cm1 - modifier may bypassCheck pair
11403Exc tr-ext b9+marg 2.1-3cm1 - modifier may bypassCheck pair
11404Exc tr-ext b9+marg 3.1-4 cm1 - modifier may bypassCheck pair
11406Exc tr-ext b9+marg >4.0 cm1 - modifier may bypassCheck pair
11420Exc h-f-nk-sp b9+marg 0.5/<1 - modifier may bypassCheck pair

Showing 30 of 273 column 2 codes. Use the pair checker for any specific combination.

15004 is bundled into these codes

15004 appears as a Column 2 code in 14 active edits. Reported with one of these Column 1 codes on the same date of service, 15004 is the code that denies.

Column 1 codeShort descriptionModifier indicator
11010Debride skin at fx site1Check pair
11011Debride skin musc at fx site1Check pair
11012Deb skin bone at fx site1Check pair
11451Exc skn hdrdnt ax complex1Check pair
11463Exc skn hdrdnt ing complex1Check pair
11471Exc skn h/p/p/u complex1Check pair
11606Exc tr-ext mal+marg >4 cm1Check pair
11646Exc f/e/e/n/l mal+mrg >4 cm1Check pair
26121Release palm contracture1Check pair
26123Release palm contracture1Check pair
28340Resect enlarged toe tissue1Check pair
28345Repair webbed toe(s)1Check pair
67961Revision of eyelid1Check pair
67966Revision of eyelid1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.