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 RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 4.47 | 7.02 | 0.62 | 12.11 | $404.48 |
| Facility (hospital, ASC) | 4.47 | 1.76 | 0.62 | 6.85 | $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).
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 code | Short description | Modifier indicator | |
|---|---|---|---|
01951 | Anes 2&3 burn less 4 % tbsa | 0 - no modifier bypass | Check pair |
01952 | Anes 2&3 burn 4-9% tbsa | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
11102 | Tangntl bx skin single les | 1 - modifier may bypass | Check pair |
11104 | Punch bx skin single lesion | 1 - modifier may bypass | Check pair |
11106 | Incal bx skn single les | 1 - modifier may bypass | Check pair |
11400 | Exc tr-ext b9+marg 0.5 cm< | 1 - modifier may bypass | Check pair |
11401 | Exc tr-ext b9+marg 0.6-1 cm | 1 - modifier may bypass | Check pair |
11402 | Exc tr-ext b9+marg 1.1-2 cm | 1 - modifier may bypass | Check pair |
11403 | Exc tr-ext b9+marg 2.1-3cm | 1 - modifier may bypass | Check pair |
11404 | Exc tr-ext b9+marg 3.1-4 cm | 1 - modifier may bypass | Check pair |
11406 | Exc tr-ext b9+marg >4.0 cm | 1 - modifier may bypass | Check pair |
11420 | Exc h-f-nk-sp b9+marg 0.5/< | 1 - modifier may bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
11010 | Debride skin at fx site | 1 | Check pair |
11011 | Debride skin musc at fx site | 1 | Check pair |
11012 | Deb skin bone at fx site | 1 | Check pair |
11451 | Exc skn hdrdnt ax complex | 1 | Check pair |
11463 | Exc skn hdrdnt ing complex | 1 | Check pair |
11471 | Exc skn h/p/p/u complex | 1 | Check pair |
11606 | Exc tr-ext mal+marg >4 cm | 1 | Check pair |
11646 | Exc f/e/e/n/l mal+mrg >4 cm | 1 | Check pair |
26121 | Release palm contracture | 1 | Check pair |
26123 | Release palm contracture | 1 | Check pair |
28340 | Resect enlarged toe tissue | 1 | Check pair |
28345 | Repair webbed toe(s) | 1 | Check pair |
67961 | Revision of eyelid | 1 | Check pair |
67966 | Revision of eyelid | 1 | Check 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.