No office rate
15734 reports a trunk flap procedure; 15860 reports the intravenous agent injection and blood-flow test performed on a flap or graft.
On this page
CMS RVU26D · Effective 2026-10-01
15860 Flap perfusion test Medicare reimbursement rates in Pennsylvania
Reports an intravenous dye test used during flap or graft surgery to assess blood flow and help evaluate tissue perfusion. Compare 15860 office and facility rates across CMS payment localities in Pennsylvania.
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 15860 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$91.08–$97.43
2 of 2 localities have a supported rate.
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 15860: Intravenous flap perfusion test
Reports an intravenous dye test used during flap or graft surgery to assess blood flow and help evaluate tissue perfusion.
During reconstructive surgery, the surgeon injects an intravenous agent, such as fluorescein or indocyanine green, to assess blood flow through a flap or graft. The test may help evaluate tissue perfusion during procedures involving transferred tissue, including breast reconstruction or flap repair of the head, trunk, or extremity. Plastic and reconstructive surgeons most often perform it in an operating room.
Report 15860 when the agent injection and vascular-flow assessment are performed, with documentation identifying the flap or graft and the test performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, Medicare’s standard multiple-procedure reduction applies: the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 15860
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.90 · 68%
- Practice expense (office) RVU0.52 · 19%
- Malpractice RVU0.37 · 13%
6.2K
Medicare services in 2024 · #1734 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.
15860 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
15738 reports a lower-extremity flap procedure. Use 15860 for the separate perfusion test, not for creating or transferring the flap.
No office rate
19364 reports breast reconstruction with a free flap. 15860 describes the intravenous vascular-flow test that may be performed during that reconstruction.
Compare 15860 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$97.43
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$91.08
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15860 billing questions
Is 15860 the flap reconstruction itself?
No. It reports the intravenous agent injection and blood-flow test; the flap or graft reconstruction is reported with its own procedure code.
What should the operative note document?
Identify the flap or graft and describe the intravenous agent injection and vascular-flow assessment performed.
Can 15860 be reported with the flap procedure?
It may be reported with a flap procedure when the injection and test are performed. The same-session multiple-procedure reduction may affect payment.
Should modifier 50 be used for testing both sides?
No. The CMS bilateral adjustment does not apply to 15860, and modifier 50 is inappropriate.
Does 15860 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
When is assistant-at-surgery payment allowed?
Only when medical necessity for the assistant is documented. Co-surgeons and team surgery are 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 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.
1,58515852,,Dressing change not for burn,A,,0.84,0.20,NA,0.20,,0.12,1.16,1.16,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,58615853,,Removal sutr/stapl xreq anes,A,,0.00,0.39,,0.39,NA,0.01,0.40,0.40,5,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,58715854,,Removal sutr&stapl xreq anes,A,,0.00,0.52,,0.52,NA,0.01,0.53,0.53,5,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,58815860,,Iv njx tst vasc flo flap/grf,A,,1.90,0.52,NA,0.52,,0.37,2.79,2.79,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,58915876,,Suction lipectomy head&neck,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59015877,,Suction lipectomy trunk,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59115878,,Suction lipectomy upr extrem,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00