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CPT code 15738: Lower-extremity flap, muscle, myocutaneous, or fasciocutaneous2026 Medicare rate & RVUs

Reports reconstruction of a lower-extremity defect with a transferred flap containing muscle, skin, or fascia that retains its blood supply.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.1K Medicare services in 2024

Medicare pays $1,148.32 for 15738 nationally in a facility.

Medicare rate · 15738

Lower-extremity flap, muscle, myocutaneous, or fasciocutaneous

Office or facility?

Work RVUs
18.56
Total RVUs
34.38
Global days
090

National rate · 2026

$1,148.32

Facility setting, before claim adjustments.

See every locality for 15738 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 15738 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 15738 covers

This code covers reconstruction of a lower-extremity defect using a flap that includes muscle, skin, or fascia and remains connected to its blood supply during transfer. Plastic surgeons and other surgeons performing reconstructive procedures may use this approach to provide durable tissue coverage when a defect cannot be adequately managed with a simpler closure. The operative report should identify the flap tissue, its lower-extremity donor and recipient sites, and how the tissue was mobilized and positioned.

Select this code for a pedicled flap reconstruction of the leg, not a free flap moved with microvascular vessel connections. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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 15738 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

15738 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,044.91
AlaskaUnavailable$1,430.48
ArizonaUnavailable$1,118.28
ArkansasUnavailable$1,032.22
Atlanta, GAUnavailable$1,181.01
Austin, TXUnavailable$1,159.41
Bakersfield, CAUnavailable$1,151.94
Baltimore area, MDUnavailable$1,216.64
Beaumont, TXUnavailable$1,103.06
Brazoria, TXUnavailable$1,123.01

15738 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
15738 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 15738 rate is calculated

Each of 15738’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 · 15738

RVUs × geographic indexes × conversion factor

Office or facility?

Work18.56

18.56 RVUs× 1.000 GPCI

Practice expense12.20

12.20 RVUs× 1.000 GPCI

Malpractice3.62

3.62 RVUs× 1.000 GPCI

Adjusted RVUs

34.3800

Conversion factor

$33.4009

Medicare rate

$1,148.32

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

Payment rules and modifiers for 15738

15738 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15738

Lower-extremity flap, muscle, myocutaneous, or fasciocutaneous

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 15738

Lower-extremity flap, muscle, myocutaneous, or fasciocutaneous

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

15738 without 51 · national facility

$1,148.32

Lower-extremity flap, muscle, myocutaneous, or fasciocutaneous

15738-51 · Second procedure: 50%

$574.16

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

15738 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 15738

    Lower-extremity flap, muscle, myocutaneous, or fasciocutaneous18.56 wRVU

    Not priced

  • 15734

    Trunk flap, muscle, skin, or fascia flap22.43 wRVU

    Not priced

  • 15736

    Flap reconstruction, upper extremity16.61 wRVU

    Not priced

  • 15756

    Free tissue flap, muscle or myocutaneous36.02 wRVU

    Not priced

How to choose

15734Trunk flapMuscle, skin, or fascia flap
Use 15734 when the flap reconstruction is on the trunk; use 15738 for a lower-extremity flap.
15736Flap reconstructionUpper extremity
Use 15736 for an arm flap reconstruction. The site for 15738 is the lower extremity.
15756Free tissue flapMuscle or myocutaneous
15756 describes free muscle or myocutaneous tissue transfer with microvascular anastomosis; 15738 is for a flap that retains its blood supply during transfer.

Codes related to 15738

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

Codes related to 15738
CodeHow it relatesNational office range
Same family
15734Trunk flap, muscle, skin, or fascia flapFlap reconstruction code for the trunk rather than the lower extremity.No office rate
15736Flap reconstruction, upper extremityFlap reconstruction code for the arm rather than the lower extremity.No office rate
Used instead
15756Free tissue flap, muscle or myocutaneousConsider for free muscle or myocutaneous transfer using microvascular anastomosis.No office rate

15738 billing questions

How does this differ from a free muscle flap?

This code describes a lower-extremity flap that remains connected to its blood supply during transfer. A free flap, such as the service represented by 15756, is detached and reconnected using microvascular techniques.

Is modifier 50 appropriate when both legs are treated?

No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.

What documentation supports reporting this flap?

Document the defect and recipient site, the lower-extremity donor site, the tissue included in the flap, and the method of mobilization and transfer.

Can an assistant surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What postoperative care is included?

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

How is this code affected when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.

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 15738PPRRVU2026_Oct_nonQPP.csv, line 1,534 (RVU26D)

Open CMS sourceHow we calculate rates

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