CPT code 15756: Free tissue flap, muscle or myocutaneous2026 Medicare rate & RVUs in Missouri
Report this service for microsurgical transfer of a free muscle or muscle-and-skin flap to reconstruct tissue defects after cancer surgery, trauma, or other tissue loss.
CMS doesn’t publish an office rate for 15756 in Missouri.
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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What 15756 covers
The surgeon harvests muscle, alone or with overlying skin, and transfers it to a separate recipient site as a free flap. Microsurgical anastomosis reconnects the flap’s blood supply to recipient vessels. Plastic and reconstructive surgeons commonly perform these operations in a hospital operating room to address defects after tumor removal, trauma, or other major tissue loss; the recipient site may be in the head and neck, trunk, or an extremity.
Select this code when the transferred tissue is muscle or myocutaneous and the operation includes free-flap microvascular anastomosis. The operative report should identify the flap tissue, donor and recipient sites, and microsurgical vessel connections. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery and co-surgeon payment may be allowed; team-surgery payment 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 15756 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,923.15 |
| Metropolitan St. Louis, MO | Unavailable | $1,935.38 |
| Rest of Missouri | Unavailable | $1,879.28 |
How the 15756 rate is calculated
Each of 15756’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 · 15756
RVUs × geographic indexes × conversion factor
Work36.02
36.02 RVUs× 1.000 GPCI
Practice expense16.83
16.83 RVUs× 1.000 GPCI
Malpractice5.89
5.89 RVUs× 1.000 GPCI
Adjusted RVUs
58.7400
Conversion factor
$33.4009
Medicare rate
$1,961.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15756
15756 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15756
Free tissue flap, muscle or myocutaneous
| 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) | 2 | Paid. |
| Co-surgeons (62) | 2 | 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 · 15756
Free tissue flap, muscle or myocutaneous
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
15756 without 51 · national facility
$1,961.97
Free tissue flap, muscle or myocutaneous
15756-51 · Second procedure: 50%
$980.99
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%).
15756 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 15757Free flapSkin flap with microvascular hookup
- Use 15757 for a free skin flap with microvascular anastomosis. Use 15756 when the transferred flap contains muscle, with or without skin.
- 15758Fascial flapFree flap with microvascular anastomosis
- 15758 describes a free fascial flap with microvascular anastomosis; 15756 describes a muscle or myocutaneous flap.
- 15734Trunk flapMuscle, skin, or fascia flap
- 15734 is for a trunk flap based on a vascular pedicle. 15756 is for free transfer with microvascular anastomosis.
- 19364Free-flap reconstructionAutologous free tissue
- For breast reconstruction using a free flap, compare the breast-specific code 19364 rather than selecting 15756 solely because the operation uses microsurgery.
15756 billing questions
How does this differ from 15757?
15756 is for a free flap containing muscle, with or without skin. 15757 is for a free skin flap with microvascular anastomosis.
When would 15758 be more appropriate?
Use 15758 for a free fascial flap with microvascular anastomosis. Choose 15756 when the transferred flap is muscle or muscle with skin.
Can this be reported for a pedicled flap?
No. This code describes free tissue transfer with microvascular anastomosis. A flap that remains attached to its vascular pedicle may fit a site-specific pedicled flap code instead.
What operative documentation supports 15756?
Document the muscle or myocutaneous tissue transferred, its donor and recipient sites, and the microvascular anastomosis reconnecting the flap’s blood supply.
Can an assistant or co-surgeon be paid for this service?
CMS permits assistant-at-surgery and co-surgeon payment for 15756. Team-surgery payment is not permitted.
How does the 90-day global affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Same-session multiple procedures are subject to the standard reduction, and modifier 50 is inappropriate.
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
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