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Billing code 15736: Flap reconstructionMedicare rate & RVUs

Reports transfer of a muscle, muscle-and-skin, or fascia-and-skin flap to cover an upper-extremity defect while maintaining its blood supply.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.7K Medicare services in 2024

Medicare pays $1,111.25 for 15736 nationally in a facility.

Medicare rate · 15736

Flap reconstruction

Work RVUs
16.61
Total RVUs
33.27
Global days
090

National rate · 2026

$1,111.25

Facility setting, before claim adjustments.

See every locality for 15736 →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.

On this page 10 sections
  1. Medicare rate
  2. What 15736 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 15736 covers

Use 15736 for moving a muscle, muscle-and-skin, or fascia-and-skin flap to cover a defect in the upper extremity while maintaining its vascular connection. Plastic or reconstructive, hand, and orthopedic surgeons may perform this reconstruction after trauma, tumor removal, or another operation leaves exposed structures or inadequate soft-tissue coverage. It is a flap transfer, not a free flap requiring microvascular reconnection.

Choose the code by recipient anatomy and the flap technique documented in the operative report. Record the defect, flap composition and source, retained blood supply, and transfer performed. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. 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 15736 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

15736 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,007.53
Alaska*Unavailable$1,367.99
ArizonaUnavailable$1,081.50
ArkansasUnavailable$994.76
AtlantaUnavailable$1,142.27
AustinUnavailable$1,125.62
BakersfieldUnavailable$1,121.37
Baltimore/Surr. CntysUnavailable$1,178.88
BeaumontUnavailable$1,063.27
BrazoriaUnavailable$1,087.35

15736 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
15736 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 15736 rate is calculated

Each of 15736’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 · 15736

RVUs × geographic indexes × conversion factor

Work16.61

16.61 RVUs× 1.000 GPCI

Practice expense13.35

13.35 RVUs× 1.000 GPCI

Malpractice3.31

3.31 RVUs× 1.000 GPCI

Adjusted RVUs

33.2700

Conversion factor

$33.4009

Medicare rate

$1,111.25

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

Payment rules and modifiers for 15736

15736 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15736

Flap reconstruction

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)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 15736

Flap reconstruction

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

15736 without 51 · national facility

$1,111.25

Flap reconstruction

15736-51 · Second procedure: 50%

$555.63

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

15736 compared with similar codes

Compare codes · National

5 codes, side by side

  • 15736

    Flap reconstruction16.61 wRVU

    Not priced

  • 15734

    Trunk flap22.43 wRVU

    Not priced

  • 15738

    Lower-extremity flap18.56 wRVU

    Not priced

  • 15756

    Free tissue flap36.02 wRVU

    Not priced

  • 15740

    Island flap11.51 wRVU

    $1,049.46

How to choose

15734Trunk flap
15734 is the regional flap code for the trunk; 15736 is for upper-extremity reconstruction.
15738Lower-extremity flap
15738 applies to lower-extremity flap reconstruction. Use 15736 when the recipient defect is in the upper extremity.
15756Free tissue flap
15756 describes a free muscle or myocutaneous flap with microvascular transfer. 15736 describes a flap that retains its vascular connection.
15740Island flap
15740 identifies an island pedicle flap. Select 15736 when the operative technique and flap composition match the upper-extremity muscle, myocutaneous, or fasciocutaneous flap service.

Codes related to 15736

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

Codes related to 15736
CodeHow it relatesNational office range
Same family
15734Trunk flapRegional counterpart for muscle, myocutaneous, or fasciocutaneous flap work on the trunk.No office rate
15738Lower-extremity flapRegional counterpart for muscle, myocutaneous, or fasciocutaneous flap work on the lower extremity.No office rate
Used instead
15756Free tissue flapFor free muscle or myocutaneous flap transfer requiring microvascular anastomosis.No office rate
15740Island flapFor an island pedicle flap when that flap type, rather than the 15736 flap, is performed.$934.55–$1,330.00

15736 billing questions

How is 15736 distinguished from a free flap code?

15736 describes an upper-extremity flap that retains its vascular connection. A free muscle or myocutaneous flap with microvascular transfer is reported with 15756.

Which nearby code applies to a trunk or leg flap?

Use 15734 for the corresponding muscle, myocutaneous, or fasciocutaneous flap work on the trunk, and 15738 for the lower extremity. The recipient site determines which regional code fits.

Should modifier 50 be appended for work on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

What operative details support reporting 15736?

Document the upper-extremity defect, the flap’s tissue composition and source, its maintained blood supply, and the transfer used to provide coverage.

How do assistant and co-surgeon services affect payment?

Medicare does not pay an assistant-at-surgery service for this code. Co-surgeon payment requires supporting documentation, and 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
RVUs for 15736PPRRVU2026_Oct_nonQPP.csv, line 1,533 (RVU26D)

Open CMS sourceHow we calculate rates

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