CPT code 14020: Tissue rearrangement, scalp, arm, or leg; up to 10 sq cm2026 Medicare rate & RVUs in Missouri
Reports local skin and tissue rearrangement to close a defect on the scalp, arm, or leg when the total defect area is 10 sq cm or less.
Medicare pays $654.63–$695.97 for 14020 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 14020 covers
This code covers rearrangement of skin and nearby tissue to close a defect on the scalp, an arm, or a leg when the applicable area is no more than 10 sq cm. The surgeon advances, rotates, or transposes tissue next to the wound rather than bringing in a distant graft. It may be performed after lesion or tumor removal, or for a traumatic or other cutaneous defect when local tissue is rearranged. Dermatologic, plastic, general, and other surgeons may perform the procedure in an office procedure room, ambulatory surgery center, or hospital.
Select the size level using the total defect area, including the primary defect and the secondary defect created by the tissue transfer, rather than the lesion’s dimensions alone. The operative report should identify the site, flap or rearrangement performed, and documented defect measurements. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. When multiple procedures occur in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this descriptor. 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.
Where 14020 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$654.63 to $695.97
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $689.30 | $489.51 |
| Metropolitan St. Louis, MO | $695.97 | $493.42 |
| Rest of Missouri | $654.63 | $471.23 |
How the 14020 rate is calculated
Each of 14020’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 · 14020
RVUs × geographic indexes × conversion factor
Work7.04
7.04 RVUs× 1.000 GPCI
Practice expense13.44
13.44 RVUs× 1.000 GPCI
Malpractice1.00
1.00 RVUs× 1.000 GPCI
Adjusted RVUs
21.4800
Conversion factor
$33.4009
Medicare rate
$717.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 14020
14020 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 14020
Tissue rearrangement, scalp, arm, or leg; up to 10 sq cm
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 14020
Tissue rearrangement, scalp, arm, or leg; 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
14020 without 51 · national office
$717.45
Tissue rearrangement, scalp, arm, or leg; up to 10 sq cm
14020-51 · Second procedure: 50%
$358.73
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%).
14020 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 14021Tissue transferScalp, arms, or legs
- Use 14021 for a scalp, arm, or leg defect in the next size range. This code is for a total area of 10 sq cm or less.
- 14000Tissue transferTrunk, defect up to 10 sq cm
- The area threshold is similar, but 14000 is for trunk sites; this code is for the scalp, arms, or legs.
- 14040Tissue rearrangementDefined sites, 10 cm² or less
- 14040 covers specified face and other listed sites such as the hand or foot. This code is for scalp, arm, or leg sites.
- 14060Local flap repairEyelid, nose, ear, or lip up to 10 cm²
- 14060 covers specified eyelid, nose, ear, or lip sites. Use this code for an eligible scalp, arm, or leg defect.
14020 billing questions
How is this code distinguished from 14021?
Both cover scalp, arm, or leg tissue rearrangement. Choose this code for a total defect area of 10 sq cm or less; 14021 is for the next size level.
Can the lesion excision be billed separately?
When lesion removal and adjacent tissue rearrangement are performed together to close the same defect, the excision is included in the tissue-transfer service.
What area should the operative report support?
Document the defect measurements after removal and include the secondary defect created by the rearrangement when determining the total area.
Should modifier 50 be reported for two sides?
No. Modifier 50 is inappropriate for this descriptor; the anatomy and service definition do not support a bilateral adjustment.
How does the global period affect postoperative visits?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code, and 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
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