CPT code 14021: Tissue transfer, scalp, arms, or legs2026 Medicare rate & RVUs in Houston, TX

Reports local tissue rearrangement to repair a scalp, arm, or leg defect when the combined defect area measures 10.1 through 30 square centimeters.

CMS RVU26DEffective Oct 1, 2026One payment locality21.8K Medicare services in 2024

In Houston, TX, Medicare pays $898.11 for 14021 in the office and $637.42 when it’s performed in a hospital or facility.

$898.11Office (non-facility)
$637.42Hospital or facility
+1.7%vs the national office rate ($882.79)

Check a contract rate as a % of Medicare · 14021 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 14021 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 14021 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 14021 covers

A surgeon mobilizes nearby skin and tissue to close a defect on the scalp, arm, or leg, using techniques such as a rotation, advancement, or transposition flap. This reconstruction is common after removal of a skin cancer or another lesion leaves a defect that cannot be closed directly. Plastic surgeons, dermatologic surgeons, and other surgeons may perform it in an office procedure room or operating room. The procedure includes the work of transferring and rearranging the adjacent tissue.

Select this code when the total defect area is 10.1 through 30 square centimeters. Measure the primary defect and any secondary defect created by the tissue movement; document the dimensions and flap technique in the operative note. The lesion excision and closure of the secondary defect are included, so do not separately report lesion removal or a simple repair for that work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Medicare does not pay an assistant at surgery for this code; 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 Houston, TX compares for 14021

Across 109 of 109 payment localities, the office rate for 14021 runs from $787.91 in Arkansas to $1,128.21 in San Benito County, CA. Houston, TX pays $898.11. The RVUs are the same everywhere; the geographic indexes change the dollars.

14021 in Houston, TX vs other payment areas
  1. Houston, TX · this page$898.11
  2. Austin, TX · Texas$908.73+$10.62
  3. Beaumont, TX · Texas$832.66−$65.45
  4. Brazoria, TX · Texas$870.99−$27.12
  5. Dallas, TX · Texas$877.33−$20.78
  6. Fort Worth, TX · Texas$872.68−$25.43
  7. Galveston, TX · Texas$874.14−$23.97

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

Every other payment area

14021 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$851.90$602.76
Los Angeles, CACalifornia$976.66$666.09
Washington, DC areaDistrict of Columbia$997.81$688.55
Miami, FLFlorida$971.11$697.81
Chicago, ILIllinois$944.28$680.43
Manhattan, NYNew York$1,013.32$708.26
AlaskaAlaska$1,055.42$775.82
AlabamaAlabama$798.50$568.78

14021 rates by state

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

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.

$787.91

$1,055.42

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

View every state and territory as a table
14021 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,055.421
AL$798.501
AR$787.911
AZ$860.291
CA$918.02–$1,128.2129
CO$910.441
CT$938.531
DC$997.811
DE$873.681
FL$881.81–$971.113
GA$834.77–$900.892
GU$935.931
HI$935.931
IA$812.001
ID$817.941
IL$861.97–$944.284
IN$822.161
KS$810.931
KY$821.081
LA$820.87–$857.922
MA$906.66–$992.302
MD$888.63–$997.813
ME$824.46–$861.942
MI$842.98–$894.522
MN$867.131
MO$809.56–$857.803
MS$798.751
MT$882.701
NC$831.991
ND$856.801
NE$815.351
NH$898.731
NJ$947.76–$989.292
NM$848.221
NV$876.001
NY$843.67–$1,039.285
OH$837.691
OK$817.131
OR$867.70–$934.642
PA$837.54–$918.352
PR$887.881
RI$901.321
SC$836.521
SD$853.731
TN$814.991
TX$832.66–$908.738
UT$846.981
VA$861.04–$997.812
VI$887.881
VT$855.951
WA$904.13–$1,009.192
WI$830.571
WV$833.211
WY$871.411

See 14021 in every payment locality

How the 14021 rate is calculated

Each of 14021’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 · 14021

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.48

9.48 RVUs× 1.000 GPCI

Practice expense15.64

15.64 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

26.4300

Conversion factor

$33.4009

Medicare rate

$882.79

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

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,450

Code
14021
Physician work
9.48
Practice expense
15.64
Malpractice
1.31

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 14021 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work9.48× 1.0089.5558
Practice expense15.64× 0.99315.5305
Malpractice1.31× 1.3761.8026
Total RVUs26.8889
Conversion factor× 33.4009

Office rate, Houston, TX$898.11

Office: (9.48 × 1.008 + 15.64 × 0.993 + 1.31 × 1.376) × $33.4009 = $898.11

Facility: (9.48 × 1.008 + 7.78 × 0.993 + 1.31 × 1.376) × $33.4009 = $637.42

Open 14021 in the RVU calculator

Payment rules and modifiers for 14021

14021 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 14021

Tissue transfer, scalp, arms, or legs

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 · 14021

Tissue transfer, scalp, arms, or legs

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

14021 without 51 · national office

$882.79

Tissue transfer, scalp, arms, or legs

14021-51 · Second procedure: 50%

$441.40

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

How 14021 has changed in Houston, TX

14021 · Office / nonfacility

$898.11

Effective 2026-10-01

The base rate is $23.07 higher than on 2025-10-01, moving from $875.04 to $898.11 (2.6%).

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

    $875.04changed to$898.11

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 9.72 changed to 9.48
    • Practice expense RVU 15.22 changed to 15.64
    • Malpractice RVU 1.37 changed to 1.31
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $895.02changed to$875.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 15.07 changed to 15.22
    • Malpractice RVU 1.36 changed to 1.37

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $880.41changed to$895.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $900.89changed to$880.41

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.88 changed to 15.07
    • Malpractice RVU 1.32 changed to 1.36
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409
  5. January 1, 2023

    RVU23A

    $903.88changed to$900.89

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 14.48 changed to 14.88
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $902.35changed to$903.88

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 14.29 changed to 14.48
    • Malpractice RVU 1.25 changed to 1.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $904.20changed to$902.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 13.67 changed to 14.29
    • Malpractice RVU 1.24 changed to 1.25
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $902.74changed to$904.20

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 13.54 changed to 13.67
    • Malpractice RVU 1.53 changed to 1.24
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $902.51changed to$902.74

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.57 changed to 13.54
    • Malpractice RVU 1.52 changed to 1.53

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $898.79changed to$902.51

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.56 changed to 13.57
    • Malpractice RVU 1.53 changed to 1.52
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $893.17changed to$898.79

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 13.48 changed to 13.56
    • Malpractice RVU 1.55 changed to 1.53
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $893.66changed to$893.17

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 13.49 changed to 13.48
    • Malpractice RVU 1.46 changed to 1.55

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $889.22changed to$893.66

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $879.41changed to$889.22

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 13.25 changed to 13.49
    • Malpractice RVU 1.48 changed to 1.46
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $888.95changed to$879.41

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.86 changed to 13.25
    • Malpractice RVU 1.55 changed to 1.48
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $888.95

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$898.11$637.42RVU26D
2026-07-01$898.11$637.42RVU26C
2026-04-01$898.11$637.42RVU26B
2026-01-01$898.11$637.42RVU26A
2025-10-01$875.04$718.34RVU25D
2025-07-01$875.04$718.34RVU25C
2025-04-01$875.04$718.34RVU25B
2025-01-01$875.04$718.34RVU25A
2024-10-01$895.02$732.09RVU24D
2024-07-01$895.02$732.09RVU24C
2024-04-01$895.02$732.09RVU24B
2024-03-09$895.02$732.09RVU24AR
2024-01-01$880.41$720.14RVU24A
2023-10-01$900.89$733.91RVU23D
2023-07-01$900.89$733.91RVU23C
2023-04-01$900.89$733.91RVU23B
2023-01-01$900.89$733.91RVU23A
2022-10-01$903.88$732.59RVU22D
2022-07-01$903.88$732.59RVU22C
2022-04-01$903.88$732.59RVU22B
2022-01-01$903.88$732.59RVU22A
2021-10-01$902.35$731.80RVU21D
2021-07-01$902.35$731.80RVU21C
2021-04-01$902.35$731.80RVU21B
2021-01-01$902.35$731.80RVU21A
2020-10-01$904.20$744.44RVU20D
2020-07-01$904.20$744.44RVU20C
2020-04-01$904.20$744.44RVU20B
2020-01-01$904.20$744.44RVU20A
2019-10-01$902.74$749.20RVU19D
2019-07-01$902.74$749.20RVU19C
2019-04-01$902.74$749.20RVU19B
2019-01-01$902.74$749.20RVU19A
2018-10-01$902.51$751.32RVU18D
2018-07-01$902.51$751.32RVU18C
2018-04-01$902.51$751.32RVU18B
2018-01-01$902.51$751.32RVU18AR1
2017-10-01$898.79$750.32RVU17D
2017-07-01$898.79$750.32RVU17C
2017-04-01$898.79$750.32RVU17B
2017-01-01$898.79$750.32RVU17A
2016-10-01$893.17$745.85RVU16D
2016-07-01$893.17$745.85RVU16C
2016-04-01$893.17$745.85RVU16B
2016-01-01$893.17$745.85RVU16A
2015-10-01$893.66$745.09RVU15D
2015-07-01$893.66$745.09RVU15C
2015-04-01$889.22$741.38RVU15B
2015-01-01$889.22$741.38RVU15A
2014-10-01$879.41$735.54RVU14D
2014-07-01$879.41$735.54RVU14C
2014-04-01$879.41$735.54RVU14B
2014-01-01$879.41$735.54RVU14A
2013-10-01$888.95$733.83RVU13D
2013-07-01$888.95$733.83RVU13C
2013-04-01$888.95$733.83RVU13B
2013-01-01$888.95$733.83RVU13AR

Price 14021 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

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14021 billing questions

How is 14021 distinguished from 14020?

Use 14020 for a defect of 10 square centimeters or less. Use 14021 when the measured defect area is 10.1 through 30 square centimeters.

What area should the operative note document?

Document the dimensions of the primary defect and any secondary defect created by moving the tissue. The combined defect area determines the code, not the size of the flap alone.

Can the lesion excision be billed separately?

The excision that creates the defect is included in the adjacent tissue transfer. Do not separately report lesion removal for the same work.

Is closure of the donor or secondary defect separately reportable?

The closure associated with transferring the adjacent tissue is part of the procedure. Do not separately report a simple repair for that closure.

What postoperative care is included?

Medicare assigns a 90-day global period. It 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 14021. 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 14021PPRRVU2026_Oct_nonQPP.csv, line 1,450 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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