Billing code 14021: Tissue transferMedicare rate & RVUs in Texas
Reports local tissue rearrangement to repair a scalp, arm, or leg defect when the combined defect area measures 10.1 through 30 square centimeters.
Medicare pays $832.66–$908.73 for 14021 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 9 sections
What 14021 covers
A surgeon mobilizes nearby skin and tissue to close a defect on the scalp, arm, or leg, using techniques such as a rotation, advancement, or transposition flap. This reconstruction is common after removal of a skin cancer or another lesion leaves a defect that cannot be closed directly. Plastic surgeons, dermatologic surgeons, and other surgeons may perform it in an office procedure room or operating room. The procedure includes the work of transferring and rearranging the adjacent tissue.
Select this code when the total defect area is 10.1 through 30 square centimeters. Measure the primary defect and any secondary defect created by the tissue movement; document the dimensions and flap technique in the operative note. The lesion excision and closure of the secondary defect are included, so do not separately report lesion removal or a simple repair for that work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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 14021 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$832.66 to $908.73
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $908.73 | $630.97 |
| Beaumont | $832.66 | $593.76 |
| Brazoria | $870.99 | $610.82 |
| Dallas | $877.33 | $615.85 |
| Fort Worth | $872.68 | $613.82 |
| Galveston | $874.14 | $613.44 |
| Houston | $898.11 | $637.42 |
| Rest Of Texas | $851.90 | $602.76 |
How the 14021 rate is calculated
Each of 14021’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 · 14021
RVUs × geographic indexes × conversion factor
Work9.48
9.48 RVUs× 1.000 GPCI
Practice expense15.64
15.64 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
26.4300
Conversion factor
$33.4009
Medicare rate
$882.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 14021
14021 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 14021
Tissue transfer
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 14021
Tissue transfer
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
14021 without 51 · national office
$882.79
Tissue transfer
14021-51 · Second procedure: 50%
$441.40
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%).
14021 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 14020Tissue rearrangement
- Both codes cover adjacent tissue transfer on the scalp, arms, or legs. Choose 14020 for defects of 10 square centimeters or less; 14021 is for 10.1 through 30 square centimeters.
- 14001Tissue transfer
- The area range is the same, but 14001 is for trunk defects. Use 14021 for defects on the scalp, arms, or legs.
- 14041Tissue rearrangement
- The area range is the same, but 14041 covers specified face, ear, eyelid, nose, lip, or mucous membrane sites rather than the scalp, arms, or legs.
- 14301Tissue transfer
- Use 14301 for an adjacent tissue transfer defect measuring 30.1 through 60 square centimeters. Code 14021 is limited to 10.1 through 30 square centimeters at its specified sites.
14021 billing questions
How is 14021 distinguished from 14020?
Use 14020 for a defect of 10 square centimeters or less. Use 14021 when the measured defect area is 10.1 through 30 square centimeters.
What area should the operative note document?
Document the dimensions of the primary defect and any secondary defect created by moving the tissue. The combined defect area determines the code, not the size of the flap alone.
Can the lesion excision be billed separately?
The excision that creates the defect is included in the adjacent tissue transfer. Do not separately report lesion removal for the same work.
Is closure of the donor or secondary defect separately reportable?
The closure associated with transferring the adjacent tissue is part of the procedure. Do not separately report a simple repair for that closure.
What postoperative care is included?
Medicare assigns a 90-day global period. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 14021. 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 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
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