$813.99
Use 14040 for area-based adjacent tissue transfer at specified sites, including hands and feet, for defects 10 sq cm or less. Use 14350 when the flap is made from finger or toe tissue.
On this page
CMS RVU26D · Effective 2026-10-01
14350 Digit flap Medicare reimbursement rates in Guam
Reports reconstruction using tissue from a finger or toe as a flap to cover a nearby defect, including preparation of the recipient site. Compare 14350 office and facility rates across CMS payment localities in Guam.
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.
What does Medicare pay for 14350 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$629.18
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Reconstructive surgery
About 14350: Filleted digit flap reconstruction
Reports reconstruction using tissue from a finger or toe as a flap to cover a nearby defect, including preparation of the recipient site.
The surgeon uses tissue from a finger or toe to form a flap that covers a nearby defect. This approach can be useful after traumatic digit loss when tissue from a non-salvageable digit can help cover exposed structures or restore soft-tissue coverage. Hand surgeons, plastic surgeons, and foot and ankle surgeons may perform the service in an operating room, commonly during reconstruction after injury. The code includes preparation of the recipient site.
Documentation should identify the digit providing the flap, the defect being covered, and the flap work performed. This major surgery code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery is paid only when medical necessity is documented; co-surgeon and team-surgery billing are not supported.
CMS billing rules for 14350
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.77 · 59%
- Practice expense (office) RVU6.53 · 35%
- Malpractice RVU1.11 · 6%
642
Medicare services in 2024 · #3339 by national volume
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.
14350 compared with similar codes
Office rates for Guam, from the same CMS release.
$980.92
14041 applies to area-based adjacent tissue transfer at specified sites for defects over 10 through 30 sq cm. It is not the digit-derived flap service described by 14350.
$1,179.30
14301 is selected for adjacent tissue transfer based on a 30.1-to-60-sq-cm defect area. 14350 identifies the flap by its finger or toe tissue source.
$1,106.27
15740 describes an island pedicle flap requiring dissection of an anatomically named axial vessel. 14350 is specific to a flap made from finger or toe tissue.
Compare 14350 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$629.18
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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 14350 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,457
- Code
- 14350
- Physician work
- 10.77
- Practice expense
- 6.53
- Malpractice
- 1.11
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.77 | × 1.000 | 10.7700 |
| Practice expense | 6.53 | × 1.137 | 7.4246 |
| Malpractice | 1.11 | × 0.579 | 0.6427 |
| Total RVUs | 18.8373 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$629.18
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.77 | 1 |
| Practice expense | 6.53 | 1.137 |
| Malpractice | 1.11 | 0.579 |
(10.77 × 1 + 6.53 × 1.137 + 1.11 × 0.579) × $33.4009 = $629.18
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.
14350 billing questions
How does this differ from an area-based adjacent tissue transfer code?
14350 describes a flap made from finger or toe tissue. Codes such as 14040, 14041, and 14301 describe adjacent tissue transfer selected by anatomic site and defect area.
Is recipient-site preparation separately reported?
No. Preparation of the recipient site is included in 14350.
What documentation supports the service?
Document the digit used as the flap, the defect receiving coverage, and the operative steps that create and transfer the flap.
Should modifier 50 be used for procedures on both sides?
No. Modifier 50 is inappropriate for 14350 because of the code's descriptor and anatomy.
When can an assistant at surgery be paid?
CMS pays an assistant at surgery for 14350 only when the medical necessity of the assistant is documented.
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.
1,45414061,,Tis trnfr e/n/e/l10.1-30sqcm,A,,11.19,17.36,,8.40,,1.33,29.88,20.92,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,45514301,,Tis trnfr any 30.1-60 sq cm,A,,12.33,19.17,,8.63,,2.04,33.54,23.00,0,090,0.10,0.71,0.19,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,45614302,,Tis trnfr addl 30 sq cm,A,,3.64,2.35,,1.17,,0.66,6.65,5.47,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,45714350,,Filleted finger/toe flap,A,,10.77,6.53,NA,6.53,,1.11,18.41,18.41,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4581450F,,Symptoms improved/consist,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4591451F,,Sympt show clin import drop,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4601460F,,Qual card diag prior 12 mons,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014