CPT code 14040: Tissue rearrangement, defined sites, 10 cm² or less2026 Medicare rate & RVUs

Medicare pays $767.22 for 14040 nationally in the office and $546.10 in a hospital or facility. Local office rates run $686.26–$980.91.

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

What 14040 covers

The surgeon moves and reshapes nearby skin and underlying tissue to repair a surgical defect, using a local flap such as an advancement or rotation flap. Common situations include reconstructing a cheek or forehead defect after skin cancer removal, or closing a defect on the hand or foot when direct closure is unsuitable. The code covers the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and feet; other anatomic groups have separate codes.

Choose this level by the total area of the primary and secondary defects, which must be 10 cm² or less. The operative report should identify the site, defect dimensions, flap design, and tissue movement. Excision of the lesion and closure of that defect are included, not separately reported. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate for this defined service. 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 14040 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

14040 rates by state

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

How the 14040 rate is calculated

Each of 14040’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.

Payment rules and modifiers for 14040

14040 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

14040 compared with similar codes

How to choose

14041Tissue rearrangement10.1–30 sq cm, specified sites

The anatomic group is the same, but 14041 is for a total defect area of 10.1–30 cm²; 14040 is limited to 10 cm² or less.

14020Tissue rearrangementScalp, arm, or leg; up to 10 sq cm

Choose 14020 for a defect on the scalp, arm, or leg. Code 14040 covers its specified facial, neck, axillary, genital, hand, and foot sites.

14060Local flap repairEyelid, nose, ear, or lip up to 10 cm²

Choose 14060 for eyelid, nose, ear, or lip defects. Code 14040 covers other specified sites, including the forehead, cheeks, chin, and mouth.

14000Tissue transferTrunk, defect up to 10 sq cm

Choose 14000 for a trunk defect of 10 cm² or less; 14040 is for its separately defined anatomic sites.

Codes related to 14040

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

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

Open CMS sourceHow we calculate rates