CPT code 14040: Tissue rearrangement, defined sites, 10 cm² or less2026 Medicare rate & RVUs in Texas
Reports local tissue rearrangement for a defect of 10 cm² or less on specified facial, neck, axillary, genital, hand, or foot sites.
Medicare pays $724.07–$789.88 for 14040 in the office in Texas, from Beaumont, TX to Austin, TX. 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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On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$724.07 to $789.88
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $789.88 | $555.94 |
| Beaumont, TX | $724.07 | $522.86 |
| Brazoria, TX | $757.54 | $538.41 |
| Dallas, TX | $762.86 | $542.63 |
| Fort Worth, TX | $758.81 | $540.79 |
| Galveston, TX | $760.15 | $540.59 |
| Houston, TX | $779.74 | $560.17 |
| Rest of Texas | $740.74 | $530.90 |
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.
How the rate is built · 14040
RVUs × geographic indexes × conversion factor
Work8.39
8.39 RVUs× 1.000 GPCI
Practice expense13.51
13.51 RVUs× 1.000 GPCI
Malpractice1.07
1.07 RVUs× 1.000 GPCI
Adjusted RVUs
22.9700
Conversion factor
$33.4009
Medicare rate
$767.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 14040
14040 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 14040
Tissue rearrangement, defined sites, 10 cm² or less
| 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 · 14040
Tissue rearrangement, defined sites, 10 cm² or less
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
14040 without 51 · national office
$767.22
Tissue rearrangement, defined sites, 10 cm² or less
14040-51 · Second procedure: 50%
$383.61
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%).
14040 compared with similar codes
Compare codes · National
5 codes, side by side
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.
14040 billing questions
When should 14040 be chosen over 14041?
Use 14040 when the total primary and secondary defect area is 10 cm² or less at a site covered by this code. Use 14041 when that area is 10.1–30 cm².
Can the lesion excision be billed separately?
Excision of the lesion and closure of the resulting defect are included in the tissue rearrangement service. Do not separately report the excision or a closure for that same defect.
How should the defect area be documented?
Document the defect dimensions and total area, including the primary defect and the secondary defect created for flap movement. Also identify the anatomic site and flap technique.
Can modifier 50 be used for bilateral sites?
No. The defined anatomy and descriptor make modifier 50 inappropriate for this code.
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 surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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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