No office rate
20972 represents a metatarsal flap with bone and skin. 20957 is the metatarsal free bone-graft code when skin is not transferred as part of the flap.
On this page
CMS RVU26D · Effective 2026-10-01
20972 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$2451.37
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Reconstructive surgery
About 20972: Free metatarsal osteocutaneous flap
Reports microsurgical transfer of metatarsal bone with attached skin to reconstruct a defect requiring both tissue types and vascular connection.
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.
CMS billing rules for 20972
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU43.40 · 57%
- Practice expense (office) RVU23.14 · 31%
- Malpractice RVU9.26 · 12%
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.
20972 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
Both represent free osteocutaneous flap reconstruction with microvascular connection; 20970 identifies iliac crest as the donor source, while 20972 identifies metatarsal.
No office rate
Both are osteocutaneous flap codes, but 20973 uses great toe donor tissue rather than metatarsal.
The same code, a different location
How does Wyoming** compare?
20972 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 20972
Office
Unavailable
Facility
$2300.94
No comparable office rate is available.
Arkansas
Arkansas · 20972
Office
Unavailable
Facility
$2272.80
No comparable office rate is available.
Arizona
Arizona · 20972
Office
Unavailable
Facility
$2463.29
No comparable office rate is available.
Bakersfield
California · 20972
Office
Unavailable
Facility
$2512.60
No comparable office rate is available.
Chico
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
El Centro
California · 20972
Office
Unavailable
Facility
$2488.66
No comparable office rate is available.
Fresno
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Hanford-Corcoran
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Madera
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Merced
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Modesto
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Napa
California · 20972
Office
Unavailable
Facility
$2716.72
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 20972
Office
Unavailable
Facility
$2596.44
No comparable office rate is available.
Redding
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Rest Of California
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 20972
Office
Unavailable
Facility
$2586.61
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 20972
Office
Unavailable
Facility
$2566.44
No comparable office rate is available.
Salinas
California · 20972
Office
Unavailable
Facility
$2556.10
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 20972
Office
Unavailable
Facility
$2585.11
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 20972
Office
Unavailable
Facility
$2819.06
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 20972
Office
Unavailable
Facility
$2808.54
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 20972
Office
Unavailable
Facility
$2889.35
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 20972
Office
Unavailable
Facility
$2846.36
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 20972
Office
Unavailable
Facility
$2520.35
No comparable office rate is available.
Santa Cruz-Watsonville
California · 20972
Office
Unavailable
Facility
$2584.89
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 20972
Office
Unavailable
Facility
$2557.17
No comparable office rate is available.
Santa Rosa-Petaluma
California · 20972
Office
Unavailable
Facility
$2607.99
No comparable office rate is available.
Stockton
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Vallejo
California · 20972
Office
Unavailable
Facility
$2701.57
No comparable office rate is available.
Visalia
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Yuba City
California · 20972
Office
Unavailable
Facility
$2487.12
No comparable office rate is available.
Colorado
Colorado · 20972
Office
Unavailable
Facility
$2530.91
No comparable office rate is available.
Connecticut
Connecticut · 20972
Office
Unavailable
Facility
$2685.24
No comparable office rate is available.
Delaware
Delaware · 20972
Office
Unavailable
Facility
$2498.52
No comparable office rate is available.
Fort Lauderdale
Florida · 20972
Office
Unavailable
Facility
$2791.74
No comparable office rate is available.
Rest Of Florida
Florida · 20972
Office
Unavailable
Facility
$2653.35
No comparable office rate is available.
Atlanta
Georgia · 20972
Office
Unavailable
Facility
$2610.67
No comparable office rate is available.
Rest Of Georgia
Georgia · 20972
Office
Unavailable
Facility
$2507.70
No comparable office rate is available.
Hawaii, Guam
Hawaii · 20972
Office
Unavailable
Facility
$2507.46
No comparable office rate is available.
Iowa
Iowa · 20972
Office
Unavailable
Facility
$2279.59
No comparable office rate is available.
Idaho
Idaho · 20972
Office
Unavailable
Facility
$2306.96
No comparable office rate is available.
East St. Louis
Illinois · 20972
Office
Unavailable
Facility
$2783.58
No comparable office rate is available.
Rest Of Illinois
Illinois · 20972
Office
Unavailable
Facility
$2638.68
No comparable office rate is available.
Suburban Chicago
Illinois · 20972
Office
Unavailable
Facility
$2801.58
No comparable office rate is available.
Indiana
Indiana · 20972
Office
Unavailable
Facility
$2316.39
No comparable office rate is available.
Kansas
Kansas · 20972
Office
Unavailable
Facility
$2304.18
No comparable office rate is available.
Kentucky
Kentucky · 20972
Office
Unavailable
Facility
$2419.71
No comparable office rate is available.
New Orleans
Louisiana · 20972
Office
Unavailable
Facility
$2528.25
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 20972
Office
Unavailable
Facility
$2429.91
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 20972
Office
Unavailable
Facility
$2707.14
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 20972
Office
Unavailable
Facility
$2533.16
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 20972
Office
Unavailable
Facility
$2684.71
No comparable office rate is available.
Rest Of Maryland
Maryland · 20972
Office
Unavailable
Facility
$2530.20
No comparable office rate is available.
Rest Of Maine
Maine · 20972
Office
Unavailable
Facility
$2353.04
No comparable office rate is available.
Southern Maine
Maine · 20972
Office
Unavailable
Facility
$2410.70
No comparable office rate is available.
Detroit
Michigan · 20972
Office
Unavailable
Facility
$2716.91
No comparable office rate is available.
Rest Of Michigan
Michigan · 20972
Office
Unavailable
Facility
$2504.44
No comparable office rate is available.
Minnesota
Minnesota · 20972
Office
Unavailable
Facility
$2336.46
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 20972
Office
Unavailable
Facility
$2477.53
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 20972
Office
Unavailable
Facility
$2495.31
No comparable office rate is available.
Rest Of Missouri
Missouri · 20972
Office
Unavailable
Facility
$2417.09
No comparable office rate is available.
Mississippi
Mississippi · 20972
Office
Unavailable
Facility
$2343.63
No comparable office rate is available.
Montana**
Montana · 20972
Office
Unavailable
Facility
$2531.17
No comparable office rate is available.
North Carolina
North Carolina · 20972
Office
Unavailable
Facility
$2368.35
No comparable office rate is available.
North Dakota**
North Dakota · 20972
Office
Unavailable
Facility
$2348.07
No comparable office rate is available.
Nebraska
Nebraska · 20972
Office
Unavailable
Facility
$2279.90
No comparable office rate is available.
New Hampshire
New Hampshire · 20972
Office
Unavailable
Facility
$2524.82
No comparable office rate is available.
Northern Nj
New Jersey · 20972
Office
Unavailable
Facility
$2767.81
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 20972
Office
Unavailable
Facility
$2690.88
No comparable office rate is available.
New Mexico
New Mexico · 20972
Office
Unavailable
Facility
$2529.81
No comparable office rate is available.
Nevada**
Nevada · 20972
Office
Unavailable
Facility
$2480.91
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 20972
Office
Unavailable
Facility
$3035.70
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 20972
Office
Unavailable
Facility
$2735.40
No comparable office rate is available.
Queens
New York · 20972
Office
Unavailable
Facility
$2901.94
No comparable office rate is available.
Rest Of New York
New York · 20972
Office
Unavailable
Facility
$2401.28
No comparable office rate is available.
Ohio
Ohio · 20972
Office
Unavailable
Facility
$2467.02
No comparable office rate is available.
Oklahoma
Oklahoma · 20972
Office
Unavailable
Facility
$2380.12
No comparable office rate is available.
Portland
Oregon · 20972
Office
Unavailable
Facility
$2561.59
No comparable office rate is available.
Rest Of Oregon
Oregon · 20972
Office
Unavailable
Facility
$2436.84
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 20972
Office
Unavailable
Facility
$2649.26
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 20972
Office
Unavailable
Facility
$2451.40
No comparable office rate is available.
Puerto Rico
Puerto Rico · 20972
Office
Unavailable
Facility
$2535.65
No comparable office rate is available.
Rhode Island
Rhode Island · 20972
Office
Unavailable
Facility
$2551.43
No comparable office rate is available.
South Carolina
South Carolina · 20972
Office
Unavailable
Facility
$2426.65
No comparable office rate is available.
South Dakota**
South Dakota · 20972
Office
Unavailable
Facility
$2326.42
No comparable office rate is available.
Tennessee
Tennessee · 20972
Office
Unavailable
Facility
$2318.25
No comparable office rate is available.
Austin
Texas · 20972
Office
Unavailable
Facility
$2544.26
No comparable office rate is available.
Beaumont
Texas · 20972
Office
Unavailable
Facility
$2440.27
No comparable office rate is available.
Brazoria
Texas · 20972
Office
Unavailable
Facility
$2468.38
No comparable office rate is available.
Dallas
Texas · 20972
Office
Unavailable
Facility
$2497.82
No comparable office rate is available.
Fort Worth
Texas · 20972
Office
Unavailable
Facility
$2494.12
No comparable office rate is available.
Galveston
Texas · 20972
Office
Unavailable
Facility
$2484.78
No comparable office rate is available.
Houston
Texas · 20972
Office
Unavailable
Facility
$2654.27
No comparable office rate is available.
Rest Of Texas
Texas · 20972
Office
Unavailable
Facility
$2462.37
No comparable office rate is available.
Utah
Utah · 20972
Office
Unavailable
Facility
$2453.87
No comparable office rate is available.
Virginia
Virginia · 20972
Office
Unavailable
Facility
$2427.72
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 20972
Office
Unavailable
Facility
$2535.65
No comparable office rate is available.
Vermont
Vermont · 20972
Office
Unavailable
Facility
$2371.27
No comparable office rate is available.
Rest Of Washington
Washington · 20972
Office
Unavailable
Facility
$2517.68
No comparable office rate is available.
Seattle (King Cnty)
Washington · 20972
Office
Unavailable
Facility
$2723.12
No comparable office rate is available.
Wisconsin
Wisconsin · 20972
Office
Unavailable
Facility
$2285.30
No comparable office rate is available.
West Virginia
West Virginia · 20972
Office
Unavailable
Facility
$2563.84
No comparable office rate is available.
See how rates vary across the country
20972 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 20972 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2696.51
$2451.37 × 110% = $2696.51
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 20972 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
1,827
- Code
- 20972
- Physician work
- 43.40
- Practice expense
- 23.14
- Malpractice
- 9.26
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 43.40 | × 1.000 | 43.4000 |
| Practice expense | 23.14 | × 1.000 | 23.1400 |
| Malpractice | 9.26 | × 0.740 | 6.8524 |
| Total RVUs | 73.3924 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$2451.37
Open 20972 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 43.4 | 1 |
| Practice expense | 23.14 | 1 |
| Malpractice | 9.26 | 0.74 |
(43.4 × 1 + 23.14 × 1 + 9.26 × 0.74) × $33.4009 = $2451.37
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2451.37 | RVU26D |
| 2026-07-01 | Not available in this setting | $2451.37 | RVU26C |
| 2026-04-01 | Not available in this setting | $2451.37 | RVU26B |
| 2026-01-01 | Not available in this setting | $2451.37 | RVU26A |
| 2025-10-01 | Not available in this setting | $2692.60 | RVU25D |
| 2025-07-01 | Not available in this setting | $2692.60 | RVU25C |
| 2025-04-01 | Not available in this setting | $2692.60 | RVU25B |
| 2025-01-01 | Not available in this setting | $2692.60 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,82420962,,Other bone graft microvasc,A,,38.23,26.32,NA,26.32,,8.15,72.70,72.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82520969,,Bone/skin graft microvasc,A,,44.29,18.42,NA,18.42,,6.82,69.53,69.53,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82620970,,Bone/skin graft iliac crest,A,,43.47,23.32,NA,23.32,,9.28,76.07,76.07,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82720972,,Bone/skin graft metatarsal,A,,43.40,23.14,NA,23.14,,9.26,75.80,75.80,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82820973,,Bone/skin graft great toe,A,,46.09,24.00,NA,24.00,,9.86,79.95,79.95,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,82920974,,Estim aid bone healg n-invas,A,,0.60,2.09,,0.76,,0.16,2.85,1.52,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83020975,,Estim aid bone healg invasiv,A,,2.54,1.76,NA,1.76,,0.75,5.05,5.05,0,000,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,