15740 Island flap Medicare reimbursement rates in Hawaii

The surgeon raises an island of skin with underlying tissue while preserving its vascular attachment, then moves it into a nearby defect. The flap provides tissue for coverage after excision, trauma, or another operation when a graft or simple closure would not adequately reconstruct the site. Plastic, facial plastic, otolaryngology, and hand surgeons may perform this procedure in an operating room or, for selected cases, an office procedure setting.

Report the code when the operative note supports transfer of an island flap on a subcutaneous vascular pedicle, rather than a free flap or a different named pedicle flap. Documentation should identify the defect, flap design and tissue transferred, preserved pedicle, and how the flap was inset. 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% multiple-procedure reduction. Modifier 50 is inappropriate. CMS restricts assistant-at-surgery payment and does not permit co-surgeons or team surgery for this code.