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Billing code 15757: Free flapMedicare rate & RVUs

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 RVU26DEffective Oct 1, 2026109 payment localities2.3K Medicare services in 2024

Medicare pays $1,945.60 for 15757 nationally in a facility.

Medicare rate · 15757

Free flap

Swap in your local Medicare rate.

Work RVUs
36.22
Total RVUs
58.25
Global days
090

National rate · 2026

$1,945.60

Facility setting, before claim adjustments.

See every locality for 15757 → · 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 15757 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 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

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

15757 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,794.69
Alaska*Unavailable$2,500.29
ArizonaUnavailable$1,901.24
ArkansasUnavailable$1,776.24
AtlantaUnavailable$1,996.29
AustinUnavailable$1,957.90
BakersfieldUnavailable$1,946.35
Baltimore/Surr. CntysUnavailable$2,049.95
BeaumontUnavailable$1,883.00
BrazoriaUnavailable$1,908.42

15757 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
15757 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 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

Swap in your local Medicare rate.

Work 36.22Practice expense 16.32Malpractice 5.71

58.2500 adjusted RVUs×$33.4009 conversion factor=$1,945.60

All indexes start 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

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)2Paid.
Co-surgeons (62)2Permitted.
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 · 15757

Free flap

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

15757 without 51 · national facility

$1,945.60

Free flap

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%).

When to use modifier 51

15757 compared with similar codes

Compare codes

15757 vs 15756 vs 15758 vs 15740: national Medicare rates

Swap in your local Medicare rate.

  • 15757
    Free flap · 36.22 wRVU
    —
  • 15756
    Free tissue flap · 36.02 wRVU
    —
  • 15758
    Fascial flap · 35.98 wRVU
    —
  • 15740
    Island flap · 11.51 wRVU
    $1,049.46

How to choose

15756Free tissue flap
Choose 15757 for a free skin flap. Choose 15756 when the transferred flap includes muscle and skin.
15758Fascial flap
Choose 15758 for a free fascial flap; 15757 is for a free skin flap.
15740Island flap
Code 15740 describes an island flap that retains a vascular pedicle. Code 15757 describes a flap detached from its donor site and reconnected microsurgically.

Codes related to 15757

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

Codes related to 15757
CodeHow it relatesNational office range
Same family
15756Free tissue flapRelated free-flap code for a flap containing muscle and skin.No office rate
15758Fascial flapRelated free-flap code for fascial tissue.No office rate
Used instead
15740Island flapDescribes an island pedicle flap rather than a detached free flap with microvascular reconnection.$934.55–$1,330.00
15750Pedicle flapDescribes a neurovascular pedicle flap, a different flap-transfer approach.No office rate

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
RVUs for 15757PPRRVU2026_Oct_nonQPP.csv, line 1,538 (RVU26D)

Open CMS sourceHow we calculate rates

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