CPT code 15738: Lower-extremity flap2026 Medicare rate & RVUs in Virginia
Reports reconstruction of a lower-extremity defect with a transferred flap containing muscle, skin, or fascia that retains its blood supply.
CMS doesn’t publish an office rate for 15738 in Virginia.
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 15738 covers
This code covers reconstruction of a lower-extremity defect using a flap that includes muscle, skin, or fascia and remains connected to its blood supply during transfer. Plastic surgeons and other surgeons performing reconstructive procedures may use this approach to provide durable tissue coverage when a defect cannot be adequately managed with a simpler closure. The operative report should identify the flap tissue, its lower-extremity donor and recipient sites, and how the tissue was mobilized and positioned.
Select this code for a pedicled flap reconstruction of the leg, not a free flap moved with microvascular vessel connections. The 90-day global period includes 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. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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 15738 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $1,268.00 |
| Virginia | Unavailable | $1,105.85 |
How the 15738 rate is calculated
Each of 15738’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 · 15738
RVUs × geographic indexes × conversion factor
Work18.56
18.56 RVUs× 1.000 GPCI
Practice expense12.20
12.20 RVUs× 1.000 GPCI
Malpractice3.62
3.62 RVUs× 1.000 GPCI
Adjusted RVUs
34.3800
Conversion factor
$33.4009
Medicare rate
$1,148.32
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15738
15738 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15738
Lower-extremity flap
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 15738
Lower-extremity flap
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
15738 without 51 · national facility
$1,148.32
Lower-extremity flap
15738-51 · Second procedure: 50%
$574.16
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%).
15738 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15734Trunk flap
- Use 15734 when the flap reconstruction is on the trunk; use 15738 for a lower-extremity flap.
- 15736Flap reconstruction
- Use 15736 for an arm flap reconstruction. The site for 15738 is the lower extremity.
- 15756Free tissue flap
- 15756 describes free muscle or myocutaneous tissue transfer with microvascular anastomosis; 15738 is for a flap that retains its blood supply during transfer.
15738 billing questions
How does this differ from a free muscle flap?
This code describes a lower-extremity flap that remains connected to its blood supply during transfer. A free flap, such as the service represented by 15756, is detached and reconnected using microvascular techniques.
Is modifier 50 appropriate when both legs are treated?
No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.
What documentation supports reporting this flap?
Document the defect and recipient site, the lower-extremity donor site, the tissue included in the flap, and the method of mobilization and transfer.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is this code affected when other 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.
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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