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CPT code 14000: Tissue transfer, trunk, defect up to 10 sq cm2026 Medicare rate & RVUs in Puerto Rico

Reports local-flap rearrangement of trunk skin to close a defect whose combined area, including the flap-created secondary defect, is 10 sq cm or less.

CMS RVU26DEffective Oct 1, 2026One payment locality6.1K Medicare services in 2024

In Puerto Rico, Medicare pays $671.46 for 14000 in the office and $467.16 when it’s performed in a hospital or facility.

$671.46Office (non-facility)
$467.16Hospital or facility
+0.6%vs the national office rate ($667.35)

Check a contract rate as a % of Medicare · 14000 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 14000 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 14000 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 14000 covers

An adjacent tissue transfer moves nearby skin and subcutaneous tissue—using an advancement, rotation, or transposition flap, for example—to close a trunk defect. Dermatologic, plastic, and general surgeons commonly perform it after removing a skin lesion or treating a wound when direct closure is unsuitable. The service includes moving the flap and closing the donor area created by that movement.

Select this code by the combined area of the primary defect and the secondary defect created by the flap, not by lesion diameter or flap dimensions; the total must be 10 sq cm or less. Document the trunk location, defect measurements, flap technique, and reason for tissue rearrangement. Excision of the lesion that creates the reconstructed defect and its closure are included. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 14000

Across 109 of 109 payment localities, the office rate for 14000 runs from $589.98 in Arkansas to $860.47 in San Benito County, CA. Puerto Rico pays $671.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

14000 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$671.46
  2. Los Angeles, CA · California$741.13+$69.67
  3. Washington, DC area · District of Columbia$758.05+$86.59
  4. Miami, FL · Florida$740.38+$68.92
  5. Chicago, IL · Illinois$718.07+$46.61
  6. Manhattan, NY · New York$770.57+$99.11
  7. Alaska · Alaska$782.24+$110.78

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

14000 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$598.61$421.79
ArkansasArkansas$589.98$416.39
ArizonaArizona$648.98$453.17
Bakersfield, CACalifornia$697.71$476.24
Chico, CACalifornia$694.64$473.17
El Centro, CACalifornia$694.82$473.35
Fresno, CACalifornia$694.64$473.17
Hanford, CACalifornia$694.64$473.17

14000 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$589.98

$782.24

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
14000 office rate range by state
State / territoryOffice rate rangeLocalities
AK$782.241
AL$598.611
AR$589.981
AZ$648.981
CA$694.64–$860.4729
CO$688.971
CT$711.761
DC$758.051
DE$659.631
FL$667.03–$740.383
GA$628.60–$682.072
GU$710.051
HI$710.051
IA$609.401
ID$614.281
IL$651.00–$718.074
IN$617.721
KS$608.631
KY$617.241
LA$617.12–$647.312
MA$685.72–$754.012
MD$671.52–$758.053
ME$619.71–$650.102
MI$635.20–$677.502
MN$654.001
MO$607.96–$647.093
MS$598.981
MT$667.281
NC$625.831
ND$645.721
NE$612.091
NH$680.161
NJ$718.14–$750.662
NM$639.521
NV$661.691
NY$635.36–$791.875
OH$630.791
OK$613.911
OR$654.84–$708.362
PA$630.62–$695.472
PR$671.461
RI$681.341
SC$629.701
SD$643.181
TN$611.951
TX$626.65–$688.188
UT$638.231
VA$649.45–$758.052
VI$671.461
VT$645.131
WA$683.79–$767.202
WI$624.371
WV$627.561
WY$657.881

See 14000 in every payment locality

How the 14000 rate is calculated

Each of 14000’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 14000

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.21

6.21 RVUs× 1.000 GPCI

Practice expense12.68

12.68 RVUs× 1.000 GPCI

Malpractice1.09

1.09 RVUs× 1.000 GPCI

Adjusted RVUs

19.9800

Conversion factor

$33.4009

Medicare rate

$667.35

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,446

Code
14000
Physician work
6.21
Practice expense
12.68
Malpractice
1.09

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 14000 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work6.21× 1.0006.2100
Practice expense12.68× 1.01112.8195
Malpractice1.09× 0.9851.0736
Total RVUs20.1031
Conversion factor× 33.4009

Office rate, Puerto Rico$671.46

Office: (6.21 × 1 + 12.68 × 1.011 + 1.09 × 0.985) × $33.4009 = $671.46

Facility: (6.21 × 1 + 6.63 × 1.011 + 1.09 × 0.985) × $33.4009 = $467.16

Open 14000 in the RVU calculator

Payment rules and modifiers for 14000

14000 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 14000

Tissue transfer, trunk, defect up to 10 sq cm

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 14000

Tissue transfer, trunk, defect up to 10 sq cm

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

14000 without 51 · national office

$667.35

Tissue transfer, trunk, defect up to 10 sq cm

14000-51 · Second procedure: 50%

$333.68

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 14000

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 14000
CodeHow it relatesOffice range, Puerto Rico
Same family
14001Tissue transfer, trunk, 10.1–30 cm²Trunk adjacent tissue transfer for a combined defect area of 10.1 to 30 sq cm.$862.61
Used instead
14020Tissue rearrangement, scalp, arm, or leg; up to 10 sq cmAdjacent tissue transfer for a defect of 10 sq cm or less on the scalp, arms, or legs.$721.89
14040Tissue rearrangement, defined sites, 10 cm² or lessAdjacent tissue transfer for a defect of 10 sq cm or less at specified facial, neck, axillary, genital, hand, or foot sites.$771.65
14060Local flap repair, eyelid, nose, ear, or lip up to 10 cm²Adjacent tissue transfer for a defect of 10 sq cm or less involving the eyelids, nose, ears, or lips.$776.15
11600Malignant lesion excision, trunk or extremity, 0.5 cm or lessMalignant lesion excision on the trunk or extremities when adjacent tissue transfer is not performed.$199.82

How 14000 has changed in Puerto Rico

14000 · Office / nonfacility

$671.46

Effective 2026-10-01

The base rate is $45.17 higher than on 2025-10-01, moving from $626.29 to $671.46 (7.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $626.29changed to$671.46

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.37 changed to 6.21
    • Practice expense RVU 11.78 changed to 12.68
    • Malpractice RVU 1.15 changed to 1.09
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $641.83changed to$626.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.71 changed to 11.78
    • Malpractice RVU 1.14 changed to 1.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $631.36changed to$641.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $648.44changed to$631.36

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.59 changed to 11.71
    • Malpractice RVU 1.10 changed to 1.14
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $645.89changed to$648.44

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $653.91changed to$645.89

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.36 changed to 11.59
    • Malpractice RVU 1.09 changed to 1.10
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $650.58changed to$653.91

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.17 changed to 11.36
    • Malpractice RVU 1.03 changed to 1.09

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $648.23changed to$650.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.49 changed to 11.17
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $643.69changed to$648.23

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.30 changed to 10.49
    • Malpractice RVU 1.13 changed to 1.03
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $640.46changed to$643.69

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.25 changed to 10.30
    • Malpractice RVU 1.11 changed to 1.13

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $568.23changed to$640.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.23 changed to 10.25
    • Malpractice RVU 1.10 changed to 1.11
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $496.68changed to$568.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.18 changed to 10.23
    • Malpractice RVU 1.11 changed to 1.10
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $498.60changed to$496.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.21 changed to 10.18
    • Malpractice RVU 1.05 changed to 1.11

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $496.12changed to$498.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $487.31changed to$496.12

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.03 changed to 10.21
    • Malpractice RVU 1.08 changed to 1.05
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $486.04changed to$487.31

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.26 changed to 10.03
    • Malpractice RVU 1.13 changed to 1.08
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $486.04

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$671.46$467.16RVU26D
2026-07-01$671.46$467.16RVU26C
2026-04-01$671.46$467.16RVU26B
2026-01-01$671.46$467.16RVU26A
2025-10-01$626.29$497.95RVU25D
2025-07-01$626.29$497.95RVU25C
2025-04-01$626.29$497.95RVU25B
2025-01-01$626.29$497.95RVU25A
2024-10-01$641.83$507.08RVU24D
2024-07-01$641.83$507.08RVU24C
2024-04-01$641.83$507.08RVU24B
2024-03-09$641.83$507.08RVU24AR
2024-01-01$631.36$498.80RVU24A
2023-10-01$648.44$510.44RVU23D
2023-07-01$645.89$508.99RVU23C
2023-04-01$645.89$508.99RVU23B
2023-01-01$645.89$508.99RVU23A
2022-10-01$653.91$512.28RVU22D
2022-07-01$653.91$512.28RVU22C
2022-04-01$653.91$512.28RVU22B
2022-01-01$653.91$512.28RVU22A
2021-10-01$650.58$509.54RVU21D
2021-07-01$650.58$509.54RVU21C
2021-04-01$650.58$509.54RVU21B
2021-01-01$650.58$509.54RVU21A
2020-10-01$648.23$517.63RVU20D
2020-07-01$648.23$517.63RVU20C
2020-04-01$648.23$517.63RVU20B
2020-01-01$648.23$517.63RVU20A
2019-10-01$643.69$519.57RVU19D
2019-07-01$643.69$519.57RVU19C
2019-04-01$643.69$519.57RVU19B
2019-01-01$643.69$519.57RVU19A
2018-10-01$640.46$520.46RVU18D
2018-07-01$640.46$520.46RVU18C
2018-04-01$640.46$520.46RVU18B
2018-01-01$640.46$520.46RVU18AR1
2017-10-01$568.23$468.39RVU17D
2017-07-01$568.23$468.39RVU17C
2017-04-01$568.23$468.39RVU17B
2017-01-01$568.23$468.39RVU17A
2016-10-01$496.68$415.15RVU16D
2016-07-01$496.68$415.15RVU16C
2016-04-01$496.68$415.15RVU16B
2016-01-01$496.68$415.15RVU16A
2015-10-01$498.60$416.02RVU15D
2015-07-01$498.60$416.02RVU15C
2015-04-01$496.12$413.95RVU15B
2015-01-01$496.12$413.95RVU15A
2014-10-01$487.31$408.48RVU14D
2014-07-01$487.31$408.48RVU14C
2014-04-01$487.31$408.48RVU14B
2014-01-01$487.31$408.48RVU14A
2013-10-01$486.04$402.77RVU13D
2013-07-01$486.04$402.77RVU13C
2013-04-01$486.04$402.77RVU13B
2013-01-01$486.04$402.77RVU13AR

Price 14000 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

14000 billing questions

How is the 10 sq cm threshold measured?

Use the combined area of the primary defect and the secondary defect created by the flap. Do not select the code using the lesion diameter or flap dimensions.

Can the lesion excision be reported separately?

The excision that creates the defect being reconstructed is included in the adjacent tissue transfer. Do not separately report that excision or a closure of the same defect.

When is 14001 a better choice?

Use 14001 when the combined defect area on the trunk is 10.1 to 30 sq cm. Code 14000 is for a combined area of 10 sq cm or less.

Should modifier 50 be appended for bilateral trunk defects?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid for this procedure?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 14000PPRRVU2026_Oct_nonQPP.csv, line 1,446 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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