CPT code 15757: Free flap, skin flap with microvascular hookup2026 Medicare rate & RVUs in Missouri
Reports microsurgical transfer of a skin flap detached from its donor site and reconnected to recipient vessels for reconstructive coverage of a tissue defect.
CMS doesn’t publish an office rate for 15757 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 15757 covers
A surgeon transfers skin from a donor site to cover a defect elsewhere, detaching the flap and reconnecting its blood vessels at the recipient site with microsurgical technique. This approach may be used in reconstructive surgery after trauma, tumor removal, or loss of skin and soft tissue. Plastic and reconstructive surgeons commonly perform the procedure in a hospital operating room.
Select this code when the transferred flap is skin and microvascular reconnection is performed; distinguish it from free flaps containing muscle or fascia and from flaps that remain attached by a vascular pedicle. The operative report should identify the flap tissue, donor and recipient sites, defect, and vascular anastomosis. 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% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment and co-surgeons are permitted; 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 15757 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 | $1,907.96 |
| Metropolitan St. Louis, MO | Unavailable | $1,919.82 |
| Rest of Missouri | Unavailable | $1,865.42 |
How the 15757 rate is calculated
Each of 15757’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 · 15757
RVUs × geographic indexes × conversion factor
Work36.22
36.22 RVUs× 1.000 GPCI
Practice expense16.32
16.32 RVUs× 1.000 GPCI
Malpractice5.71
5.71 RVUs× 1.000 GPCI
Adjusted RVUs
58.2500
Conversion factor
$33.4009
Medicare rate
$1,945.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15757
15757 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15757
Free flap, skin flap with microvascular hookup
| 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 · 15757
Free flap, skin flap with microvascular hookup
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
15757 without 51 · national facility
$1,945.60
Free flap, skin flap with microvascular hookup
15757-51 · Second procedure: 50%
$972.80
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%).
15757 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15756Free tissue flapMuscle or myocutaneous
- Choose 15757 for a free skin flap. Choose 15756 when the transferred flap includes muscle and skin.
- 15758Fascial flapFree flap with microvascular anastomosis
- Choose 15758 for a free fascial flap; 15757 is for a free skin flap.
- 15740Island flapSubcutaneous vascular pedicle
- Code 15740 describes an island flap that retains a vascular pedicle. Code 15757 describes a flap detached from its donor site and reconnected microsurgically.
15757 billing questions
How does 15757 differ from 15756?
Use 15757 for a transferred skin flap. Code 15756 describes a free flap containing muscle and skin.
When is 15758 a closer match?
Use 15758 when the transferred free flap is fascial rather than a skin flap. The operative report should establish the tissue composition.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code because its descriptor or anatomy does not support modifier 50.
What postoperative care is included in the global period?
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 permits assistant-at-surgery payment and co-surgeons for this code. Team surgery is 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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