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CPT code 49906: Free omental flap, microvascular anastomosis2026 Medicare rate & RVUs

Reports a free transfer of omental tissue to a recipient site with microvascular vessel connections for reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities59 Medicare services in 2024

Medicare rate · 49906

Free omental flap, microvascular anastomosis

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
090

National rate · 2026

—

Not priced in the facility setting.

See every locality for 49906 →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 49906 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 49906 covers

Code 49906 identifies a free omental flap transfer in which the omentum is moved to a recipient site and connected to recipient blood vessels through microvascular anastomosis. The distinguishing feature is the free transfer with microvascular connection; 49904 and 49905 describe other omental flap approaches, respectively extra-abdominal and intra-abdominal. The operating surgeon reports this reconstructive procedure when the transferred tissue is omentum and the flap is microsurgically revascularized.

Medicare assigns status C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The procedure has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. Standard multiple-procedure reduction applies when procedures are performed in the same session. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeon payment requires 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 49906 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

49906 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

49906 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.

View every state and territory as a table
49906 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 49906 rate is calculated

Each of 49906’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 · 49906

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 49906

49906 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49906

Free omental flap, microvascular anastomosis

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)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49906

Free omental flap, microvascular anastomosis

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

49906 without 51 · national facility

$0.00

Free omental flap, microvascular anastomosis

49906-51 · Second procedure: 50%

$0.00

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

49906 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 49906

    Free omental flap, microvascular anastomosis0 wRVU

    Not priced

  • 49904

    Omental flap, extra-abdominal transfer21.79 wRVU

    Not priced

  • 49905

    Omental flap, intra-abdominal placement6.38 wRVU

    Not priced

  • 15756

    Free tissue flap, muscle or myocutaneous36.02 wRVU

    Not priced

How to choose

49904Omental flapExtra-abdominal transfer
49904 describes an extra-abdominal omental flap. Choose 49906 when omental tissue is transferred as a free flap with microvascular anastomosis.
49905Omental flapIntra-abdominal placement
49905 describes an intra-abdominal omental flap. It is not the free transfer with microvascular anastomosis reported with 49906.
15756Free tissue flapMuscle or myocutaneous
15756 covers a free muscle or myocutaneous flap with microvascular anastomosis. Use 49906 when the transferred tissue is omentum.

Codes related to 49906

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

Codes related to 49906
CodeHow it relatesNational office range
Same family
49904Omental flap, extra-abdominal transferOmental flap approach distinguished as extra-abdominal.No office rate
49905Omental flap, intra-abdominal placementOmental flap approach distinguished as intra-abdominal.No office rate
Used instead
15756Free tissue flap, muscle or myocutaneousFree muscle or myocutaneous flap with microvascular anastomosis.No office rate
15757Free flap, skin flap with microvascular hookupFree skin flap with microvascular anastomosis rather than omental tissue.No office rate

49906 billing questions

How does 49906 differ from the other omental flap codes?

49906 describes a free flap transferred with microvascular connections. Codes 49904 and 49905 describe extra-abdominal and intra-abdominal omental flap approaches, respectively.

What care is included in the 90-day global period?

It includes the day-before preoperative visit and 90 days of related postoperative care.

Can modifier 50 be used for 49906?

No. Bilateral adjustment is inappropriate for this code.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

How does Medicare price 49906?

Its physician fee schedule status is C, or carrier priced. The Medicare Administrative Contractor sets payment for each claim rather than CMS publishing a national payment.

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

Open CMS sourceHow we calculate rates

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