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CPT code 15740: Island flap, subcutaneous vascular pedicle2026 Medicare rate & RVUs in Puerto Rico

Reports reconstruction of a tissue defect with an island of skin and underlying tissue moved on its attached vascular pedicle.

CMS RVU26DEffective Oct 1, 2026One payment locality2.4K Medicare services in 2024

In Puerto Rico, Medicare pays $1,055.17 for 15740 in the office and $753.62 when it’s performed in a hospital or facility.

$1,055.17Office (non-facility)
$753.62Hospital or facility
+0.5%vs the national office rate ($1,049.46)

Check a contract rate as a % of Medicare · 15740 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 15740 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 15740 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 15740 covers

The surgeon raises an island of skin with underlying tissue while preserving its vascular attachment, then moves it into a nearby defect. The flap provides tissue for coverage after excision, trauma, or another operation when a graft or simple closure would not adequately reconstruct the site. Plastic, facial plastic, otolaryngology, and hand surgeons may perform this procedure in an operating room or, for selected cases, an office procedure setting.

Report the code when the operative note supports transfer of an island flap on a subcutaneous vascular pedicle, rather than a free flap or a different named pedicle flap. Documentation should identify the defect, flap design and tissue transferred, preserved pedicle, and how the flap was inset. CMS assigns a 90-day global period, including 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. CMS restricts assistant-at-surgery payment and does not permit co-surgeons or team surgery for this code.

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 Puerto Rico compares for 15740

Across 109 of 109 payment localities, the office rate for 15740 runs from $934.55 in Arkansas to $1,330.00 in San Benito County, CA. Puerto Rico pays $1,055.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

15740 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$1,055.17
  2. Los Angeles, CA · California$1,155.02+$99.85
  3. Washington, DC area · District of Columbia$1,184.59+$129.42
  4. Miami, FL · Florida$1,168.17+$113.00
  5. Chicago, IL · Illinois$1,134.75+$79.58
  6. Manhattan, NY · New York$1,207.85+$152.68
  7. Alaska · Alaska$1,253.31+$198.14

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

Every other payment area

15740 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$947.34$686.35
ArkansasArkansas$934.55$678.33
ArizonaArizona$1,021.90$732.87
Bakersfield, CACalifornia$1,090.67$763.77
Chico, CACalifornia$1,085.42$758.51
El Centro, CACalifornia$1,085.72$758.82
Fresno, CACalifornia$1,085.42$758.51
Hanford, CACalifornia$1,085.42$758.51

15740 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$934.55

$1,253.31

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

View every state and territory as a table
15740 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,253.311
AL$947.341
AR$934.551
AZ$1,021.901
CA$1,085.42–$1,330.0029
CO$1,079.241
CT$1,116.521
DC$1,184.591
DE$1,037.931
FL$1,053.81–$1,168.173
GA$996.07–$1,072.622
GU$1,106.271
HI$1,106.271
IA$961.101
ID$968.781
IL$1,031.55–$1,134.754
IN$973.811
KS$961.031
KY$977.241
LA$977.47–$1,022.202
MA$1,075.12–$1,175.552
MD$1,055.50–$1,184.593
ME$977.94–$1,021.352
MI$1,004.88–$1,070.492
MN$1,023.691
MO$964.57–$1,020.613
MS$949.521
MT$1,049.331
NC$986.831
ND$1,012.951
NE$964.761
NH$1,066.521
NJ$1,126.32–$1,174.422
NM$1,011.711
NV$1,039.801
NY$1,001.03–$1,240.805
OH$997.441
OK$971.171
OR$1,028.79–$1,106.872
PA$996.58–$1,092.982
PR$1,055.171
RI$1,070.041
SC$994.371
SD$1,008.651
TN$966.081
TX$990.77–$1,078.238
UT$1,006.971
VA$1,021.13–$1,184.592
VI$1,055.171
VT$1,013.061
WA$1,071.75–$1,194.442
WI$981.581
WV$996.881
WY$1,033.481

See 15740 in every payment locality

How the 15740 rate is calculated

Each of 15740’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 · 15740

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.51

11.51 RVUs× 1.000 GPCI

Practice expense18.07

18.07 RVUs× 1.000 GPCI

Malpractice1.84

1.84 RVUs× 1.000 GPCI

Adjusted RVUs

31.4200

Conversion factor

$33.4009

Medicare rate

$1,049.46

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,535

Code
15740
Physician work
11.51
Practice expense
18.07
Malpractice
1.84

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 15740 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work11.51× 1.00011.5100
Practice expense18.07× 1.01118.2688
Malpractice1.84× 0.9851.8124
Total RVUs31.5912
Conversion factor× 33.4009

Office rate, Puerto Rico$1055.17

Office: (11.51 × 1 + 18.07 × 1.011 + 1.84 × 0.985) × $33.4009 = $1055.17

Facility: (11.51 × 1 + 9.14 × 1.011 + 1.84 × 0.985) × $33.4009 = $753.62

Open 15740 in the RVU calculator

Payment rules and modifiers for 15740

15740 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15740

Island flap, subcutaneous vascular pedicle

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 · 15740

Island flap, subcutaneous vascular pedicle

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

15740 without 51 · national office

$1,049.46

Island flap, subcutaneous vascular pedicle

15740-51 · Second procedure: 50%

$524.73

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%).

When to use modifier 51

Codes related to 15740

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

Codes related to 15740
CodeHow it relatesOffice range, Puerto Rico
Used instead
15750Pedicle flap, neurovascular pedicleA neurovascular pedicle flap is a distinct flap technique for reconstructive coverage.No office rate
15731Forehead flap, vascular pedicleA forehead flap is a site-specific pedicled option in facial reconstruction.$1,153.94
15730Midface flap, vascular pedicle preservedA midface flap is a distinct pedicled option for selected facial defects.$1,450.30
14040Tissue rearrangement, defined sites, 10 cm² or lessLocal tissue rearrangement uses adjacent tissue rather than an island flap on a vascular pedicle.$771.65

How 15740 has changed in Puerto Rico

15740 · Office / nonfacility

$1055.17

Effective 2026-10-01

The base rate is $58.71 higher than on 2025-10-01, moving from $996.46 to $1055.17 (5.9%).

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

    $996.46changed to$1055.17

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 11.80 changed to 11.51
    • Practice expense RVU 17.05 changed to 18.07
    • Malpractice RVU 1.87 changed to 1.84
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1019.45changed to$996.46

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 16.92 changed to 17.05
    • Malpractice RVU 1.82 changed to 1.87

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1002.81changed to$1019.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1029.01changed to$1002.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 16.71 changed to 16.92
    • Malpractice RVU 1.75 changed to 1.82
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $1025.43changed to$1029.01

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $1033.19changed to$1025.43

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 16.23 changed to 16.71
    • Malpractice RVU 1.72 changed to 1.75
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $1029.49changed to$1033.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 15.93 changed to 16.23
    • Malpractice RVU 1.67 changed to 1.72

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $1036.56changed to$1029.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 15.18 changed to 15.93
    • Malpractice RVU 1.64 changed to 1.67
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $1042.19changed to$1036.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 15.22 changed to 15.18
    • Malpractice RVU 1.81 changed to 1.64
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $1045.40changed to$1042.19

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 15.34 changed to 15.22

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $938.75changed to$1045.40

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 15.40 changed to 15.34
    • Malpractice RVU 1.83 changed to 1.81
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $829.51changed to$938.75

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 15.36 changed to 15.40
    • Malpractice RVU 1.84 changed to 1.83
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $832.61changed to$829.51

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 15.41 changed to 15.36
    • Malpractice RVU 1.73 changed to 1.84

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $828.47changed to$832.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $815.17changed to$828.47

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 15.17 changed to 15.41
    • Malpractice RVU 1.69 changed to 1.73
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $804.92changed to$815.17

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 16.84 changed to 15.17
    • Malpractice RVU 1.77 changed to 1.69
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $804.92

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,055.17$753.62RVU26D
2026-07-01$1,055.17$753.62RVU26C
2026-04-01$1,055.17$753.62RVU26B
2026-01-01$1,055.17$753.62RVU26A
2025-10-01$996.46$827.08RVU25D
2025-07-01$996.46$827.08RVU25C
2025-04-01$996.46$827.08RVU25B
2025-01-01$996.46$827.08RVU25A
2024-10-01$1,019.45$843.80RVU24D
2024-07-01$1,019.45$843.80RVU24C
2024-04-01$1,019.45$843.80RVU24B
2024-03-09$1,019.45$843.80RVU24AR
2024-01-01$1,002.81$830.03RVU24A
2023-10-01$1,029.01$851.73RVU23D
2023-07-01$1,025.43$849.55RVU23C
2023-04-01$1,025.43$849.55RVU23B
2023-01-01$1,025.43$849.55RVU23A
2022-10-01$1,033.19$853.90RVU22D
2022-07-01$1,033.19$853.90RVU22C
2022-04-01$1,033.19$853.90RVU22B
2022-01-01$1,033.19$853.90RVU22A
2021-10-01$1,029.49$851.52RVU21D
2021-07-01$1,029.49$851.52RVU21C
2021-04-01$1,029.49$851.52RVU21B
2021-01-01$1,029.49$851.52RVU21A
2020-10-01$1,036.56$867.76RVU20D
2020-07-01$1,036.56$867.76RVU20C
2020-04-01$1,036.56$867.76RVU20B
2020-01-01$1,036.56$867.76RVU20A
2019-10-01$1,042.19$876.71RVU19D
2019-07-01$1,042.19$876.71RVU19C
2019-04-01$1,042.19$876.71RVU19B
2019-01-01$1,042.19$876.71RVU19A
2018-10-01$1,045.40$881.18RVU18D
2018-07-01$1,045.40$881.18RVU18C
2018-04-01$1,045.40$881.18RVU18B
2018-01-01$1,045.40$881.18RVU18AR1
2017-10-01$938.75$801.74RVU17D
2017-07-01$938.75$801.74RVU17C
2017-04-01$938.75$801.74RVU17B
2017-01-01$938.75$801.74RVU17A
2016-10-01$829.51$717.18RVU16D
2016-07-01$829.51$717.18RVU16C
2016-04-01$829.51$717.18RVU16B
2016-01-01$829.51$717.18RVU16A
2015-10-01$832.61$719.12RVU15D
2015-07-01$832.61$719.12RVU15C
2015-04-01$828.47$715.54RVU15B
2015-01-01$828.47$715.54RVU15A
2014-10-01$815.17$707.34RVU14D
2014-07-01$815.17$707.34RVU14C
2014-04-01$815.17$707.34RVU14B
2014-01-01$815.17$707.34RVU14A
2013-10-01$804.92$692.12RVU13D
2013-07-01$804.92$692.12RVU13C
2013-04-01$804.92$692.12RVU13B
2013-01-01$804.92$692.12RVU13AR

Price 15740 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

15740 billing questions

How is an island pedicle flap different from local tissue rearrangement?

Use 15740 when the operative technique transfers an island of tissue on an attached vascular pedicle. Local tissue rearrangement codes describe a different advancement, rotation, or transposition approach.

When would 15750 be a better choice?

Compare the operative technique and the type of pedicle documented. 15750 describes a neurovascular pedicle flap; 15740 describes an island flap carried on its vascular pedicle.

Can modifier 50 be appended for flaps on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor or anatomy.

Does the code include related postoperative visits?

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

Can an assistant or co-surgeon be reported?

CMS applies a statutory restriction on assistant-at-surgery payment for 15740 and does not permit co-surgeons or team surgery.

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 15740PPRRVU2026_Oct_nonQPP.csv, line 1,535 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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