CPT code 20972: Free flap, metatarsal bone and skin2026 Medicare rate & RVUs in New Mexico
Reports microsurgical transfer of metatarsal bone with attached skin to reconstruct a defect requiring both tissue types and vascular connection.
In New Mexico, Medicare pays $2,529.81 for 20972 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 20972 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 20972 covers
A reconstructive surgeon harvests metatarsal bone with an attached skin paddle, transfers the tissue to a recipient defect, and reconnects its blood supply using microsurgical anastomosis. The flap can restore a defect that requires both bone and skin, such as one resulting from tumor removal or trauma. This is generally performed in a hospital operating room by a plastic, orthopedic, or oral and maxillofacial surgeon, depending on the defect and reconstructive plan.
Report the metatarsal flap when the operative record supports transfer of both bone and skin with microvascular connection; the code includes obtaining the graft. Documentation should identify the donor tissue, recipient defect, and flap transfer. CMS 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 procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be allowed; 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.
How New Mexico compares for 20972
Across 109 of 109 payment localities, the facility rate for 20972 runs from $2,272.80 in Arkansas to $3,167.95 in Alaska. New Mexico pays $2,529.81. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$2,529.81
- Los Angeles, CA · California$2,628.74+$98.93
- Washington, DC area · District of Columbia$2,782.59+$252.78
- Miami, FL · Florida$3,036.38+$506.57
- Chicago, IL · Illinois$2,946.33+$416.52
- Manhattan, NY · New York$2,931.02+$401.21
- Alaska · Alaska$3,167.95+$638.14
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,300.94 |
| ArkansasArkansas | — | $2,272.80 |
| ArizonaArizona | — | $2,463.29 |
| Bakersfield, CACalifornia | — | $2,512.60 |
| Chico, CACalifornia | — | $2,487.12 |
| El Centro, CACalifornia | — | $2,488.66 |
| Fresno, CACalifornia | — | $2,487.12 |
| Hanford, CACalifornia | — | $2,487.12 |
| Madera, CACalifornia | — | $2,487.12 |
| Merced, CACalifornia | — | $2,487.12 |
| Modesto, CACalifornia | — | $2,487.12 |
| Napa, CACalifornia | — | $2,716.72 |
| Oxnard, CACalifornia | — | $2,596.44 |
| Redding, CACalifornia | — | $2,487.12 |
| Rest of CaliforniaCalifornia | — | $2,487.12 |
| Riverside, CACalifornia | — | $2,586.61 |
| Sacramento, CACalifornia | — | $2,566.44 |
| Salinas, CACalifornia | — | $2,556.10 |
| San Diego, CACalifornia | — | $2,585.11 |
| Marin County, CACalifornia | — | $2,819.06 |
| San Francisco, CACalifornia | — | $2,808.54 |
| San Benito County, CACalifornia | — | $2,889.35 |
| Santa Clara County, CACalifornia | — | $2,846.36 |
| San Luis Obispo, CACalifornia | — | $2,520.35 |
| Santa Cruz, CACalifornia | — | $2,584.89 |
| Santa Maria, CACalifornia | — | $2,557.17 |
| Santa Rosa, CACalifornia | — | $2,607.99 |
| Stockton, CACalifornia | — | $2,487.12 |
| Vallejo, CACalifornia | — | $2,701.57 |
| Visalia, CACalifornia | — | $2,487.12 |
| Yuba City, CACalifornia | — | $2,487.12 |
| ColoradoColorado | — | $2,530.91 |
| ConnecticutConnecticut | — | $2,685.24 |
| DelawareDelaware | — | $2,498.52 |
| Fort Lauderdale, FLFlorida | — | $2,791.74 |
| Rest of FloridaFlorida | — | $2,653.35 |
| Atlanta, GAGeorgia | — | $2,610.67 |
| Rest of GeorgiaGeorgia | — | $2,507.70 |
| Hawaii, Guam, HIHawaii | — | $2,507.46 |
| IowaIowa | — | $2,279.59 |
| IdahoIdaho | — | $2,306.96 |
| East St. Louis, ILIllinois | — | $2,783.58 |
| Rest of IllinoisIllinois | — | $2,638.68 |
| Suburban Chicago, ILIllinois | — | $2,801.58 |
| IndianaIndiana | — | $2,316.39 |
| KansasKansas | — | $2,304.18 |
| KentuckyKentucky | — | $2,419.71 |
| New Orleans, LALouisiana | — | $2,528.25 |
| Rest of LouisianaLouisiana | — | $2,429.91 |
| Metropolitan Boston, MAMassachusetts | — | $2,707.14 |
| Rest of MassachusettsMassachusetts | — | $2,533.16 |
| Baltimore area, MDMaryland | — | $2,684.71 |
| Rest of MarylandMaryland | — | $2,530.20 |
| Rest of MaineMaine | — | $2,353.04 |
| Southern Maine, MEMaine | — | $2,410.70 |
| Detroit, MIMichigan | — | $2,716.91 |
| Rest of MichiganMichigan | — | $2,504.44 |
| MinnesotaMinnesota | — | $2,336.46 |
| Metropolitan Kansas City, MOMissouri | — | $2,477.53 |
| Metropolitan St. Louis, MOMissouri | — | $2,495.31 |
| Rest of MissouriMissouri | — | $2,417.09 |
| MississippiMississippi | — | $2,343.63 |
| MontanaMontana | — | $2,531.17 |
| North CarolinaNorth Carolina | — | $2,368.35 |
| North DakotaNorth Dakota | — | $2,348.07 |
| NebraskaNebraska | — | $2,279.90 |
| New HampshireNew Hampshire | — | $2,524.82 |
| Northern New JerseyNew Jersey | — | $2,767.81 |
| Rest of New JerseyNew Jersey | — | $2,690.88 |
| NevadaNevada | — | $2,480.91 |
| NYC suburbs and Long Island, NYNew York | — | $3,035.70 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,735.40 |
| Queens, NYNew York | — | $2,901.94 |
| Rest of New YorkNew York | — | $2,401.28 |
| OhioOhio | — | $2,467.02 |
| OklahomaOklahoma | — | $2,380.12 |
| Portland, OROregon | — | $2,561.59 |
| Rest of OregonOregon | — | $2,436.84 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,649.26 |
| Rest of PennsylvaniaPennsylvania | — | $2,451.40 |
| Puerto RicoPuerto Rico | — | $2,535.65 |
| Rhode IslandRhode Island | — | $2,551.43 |
| South CarolinaSouth Carolina | — | $2,426.65 |
| South DakotaSouth Dakota | — | $2,326.42 |
| TennesseeTennessee | — | $2,318.25 |
| Austin, TXTexas | — | $2,544.26 |
| Beaumont, TXTexas | — | $2,440.27 |
| Brazoria, TXTexas | — | $2,468.38 |
| Dallas, TXTexas | — | $2,497.82 |
| Fort Worth, TXTexas | — | $2,494.12 |
| Galveston, TXTexas | — | $2,484.78 |
| Houston, TXTexas | — | $2,654.27 |
| Rest of TexasTexas | — | $2,462.37 |
| UtahUtah | — | $2,453.87 |
| VirginiaVirginia | — | $2,427.72 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,535.65 |
| VermontVermont | — | $2,371.27 |
| Rest of WashingtonWashington | — | $2,517.68 |
| King County, WAWashington | — | $2,723.12 |
| WisconsinWisconsin | — | $2,285.30 |
| West VirginiaWest Virginia | — | $2,563.84 |
| WyomingWyoming | — | $2,451.37 |
20972 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 20972 rate is calculated
Each of 20972’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 · 20972
RVUs × geographic indexes × conversion factor
Work43.40
43.40 RVUs× 1.000 GPCI
Practice expense23.14
23.14 RVUs× 1.000 GPCI
Malpractice9.26
9.26 RVUs× 1.000 GPCI
Adjusted RVUs
75.8000
Conversion factor
$33.4009
Medicare rate
$2,531.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,827
- Code
- 20972
- Physician work
- 43.40
- Practice expense
- 23.14
- Malpractice
- 9.26
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 43.40 | × 1.000 | 43.4000 |
| Practice expense | 23.14 | × 0.917 | 21.2194 |
| Malpractice | 9.26 | × 1.201 | 11.1213 |
| Total RVUs | 75.7406 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$2529.81
Facility: (43.4 × 1 + 23.14 × 0.917 + 9.26 × 1.201) × $33.4009 = $2529.81
Payment rules and modifiers for 20972
20972 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20972
Free flap, metatarsal bone and skin
| 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 20972
Free flap, metatarsal bone and skin
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
20972 without 51 · national facility
$2,531.79
Free flap, metatarsal bone and skin
20972-51 · Second procedure: 50%
$1,265.90
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%).
How 20972 has changed in New Mexico
20972 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2,529.81 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,529.81 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,529.81 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,529.81 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,724.96 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,724.96 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,724.96 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,724.96 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,786.38 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,786.38 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,786.38 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,786.38 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,740.90 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,812.96 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,812.96 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,812.96 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,812.96 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,846.45 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,846.45 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,846.45 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,846.45 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,859.90 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,859.90 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,859.90 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,859.90 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,945.01 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,945.01 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,945.01 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,945.01 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,977.99 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,977.99 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,977.99 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,977.99 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,975.31 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,975.31 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,975.31 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,975.31 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,476.96 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,476.96 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,476.96 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,476.96 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,412.81 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,412.81 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,412.81 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,412.81 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,341.04 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,341.04 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,329.39 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,329.39 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,225.06 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,225.06 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,225.06 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,225.06 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,137.77 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,137.77 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,137.77 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,137.77 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
20972 billing questions
When should this be chosen instead of a metatarsal bone-only flap?
Use this code when the transferred metatarsal tissue includes skin as well as bone and is connected by microsurgical anastomosis. A bone-only metatarsal transfer is represented by 20957.
Does the code include harvesting the graft?
Yes. The code includes obtaining the metatarsal bone and skin used for the flap.
What operative details support reporting this code?
Document the metatarsal donor tissue, the included skin paddle, the recipient defect, and the microsurgical vascular connection.
Can modifier 50 be used when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How does the global period affect postoperative reporting?
The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after 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
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