CPT code 49906: Free omental flap, microvascular anastomosis2026 Medicare rate & RVUs in Oregon
Reports a free transfer of omental tissue to a recipient site with microvascular vessel connections for reconstruction.
CMS doesn’t publish an office rate for 49906 in Oregon.
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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On this page 9 sections
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 in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | Unavailable |
| Rest of Oregon | Unavailable | Unavailable |
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
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
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share 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.
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%).
49906 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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