CPT 15740Surgery

Island pedicle flap graft

CPT code 15740 covers an island pedicle flap graft, a reconstructive surgery where a piece of skin and tissue remains attached to its original blood supply while being moved to cover a nearby defect or wound. The tissue stays connected by a "pedicle" (stalk) containing blood vessels that keep it alive during healing.

Showing rates for

National Average

Base Medicare rate

$993.68

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

11.8

PE RVU (NF)

17.05

MP RVU

1.87

Total RVU

30.72

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Document exact defect dimensions (length × width in cm²) and flap size in the operative report, as some payers require defect size >10 cm² to justify island pedicle flap over simpler advancement flaps
Impact: Prevents downcoding to 14000-14350 series (local flaps) which reimburse $400-600 less; protects full $993.68 reimbursement
Clearly identify and document the named vascular pedicle (specific artery/vein) in operative notes, as CPT 15740 requires preservation of identifiable blood supply rather than random pattern perfusion
Impact: Critical for differentiating from CPT 15574-15576 (formation of direct/tubed pedicle) which have different global periods and payment rates
Bill in non-facility setting when performed in office-based surgical suite with proper accreditation to capture additional $168.20 per procedure
Impact: Non-facility rate $993.68 vs facility rate $825.48 = $168.20 additional revenue per case
When performed with tumor excision, ensure separate documentation of excision margins and reconstruction necessity; bill excision code separately with modifier 59 if criteria met
Impact: Can add $200-800 for excision codes 11600-11646 when properly documented as distinct procedures
For bilateral or multiple flaps in same session, append modifier 50 or bill units appropriately based on payer policy; most require separate line items with RT/LT rather than units
Impact: Bilateral procedures can yield 150% payment ($1,490.52) vs inappropriate single-side billing
Submit claim within 90-day global period awareness; do not bill separately for routine follow-up visits but do bill for complicated wound management with appropriate E/M codes and modifier 24

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 15740?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the difference between CPT 15740 and adjacent tissue transfer codes 14000-14350?

CPT 15740 (island pedicle flap) requires identification and isolation of a specific named vascular pedicle (artery and vein) that supplies the flap, whereas codes 14000-14350 describe adjacent tissue transfers with random pattern blood supply. Island pedicle flaps allow greater mobility and reliability because the tissue island is completely isolated except for the vascular pedicle, which can be tunneled under skin bridges. This distinction must be clearly documented in the operative report to justify the higher reimbursement of 15740 ($993.68) versus 14000-series codes ($400-700).

How much does Medicare pay for CPT 15740 in 2025?

Medicare pays $993.68 for CPT 15740 in non-facility settings and $825.48 in facility settings based on the 2025 national average rates. The code has a work RVU of 11.8, non-facility PE RVU of 17.05, facility PE RVU of 11.85, and malpractice RVU of 1.87, totaling 30.72 RVUs. Actual payment varies by geographic locality due to GPCI adjustments. These rates are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

Can CPT 15740 be billed bilaterally or with multiple units?

Yes, CPT 15740 can be billed bilaterally when island pedicle flaps are performed on both sides of paired anatomic structures (such as both cheeks or both hands). Use modifier 50 for bilateral procedures or bill as two separate line items with RT and LT modifiers, depending on payer requirements. Medicare typically requires separate line items with laterality modifiers. When multiple non-paired flaps are performed in the same session, bill each separately with modifier 59 if at distinct anatomic sites, though the second and subsequent procedures will be subject to multiple procedure payment reduction (modifier 51).

What modifiers are most commonly used with CPT 15740?

The most common modifiers for CPT 15740 are: modifier 22 (increased procedural services) when complexity significantly exceeds typical cases, requiring detailed documentation and potentially increasing payment 20-50%; modifier 58 (staged or related procedure) for planned secondary procedures like pedicle division during the global period; modifier 78 (return to OR) for complications requiring surgical intervention; modifier RT/LT for laterality; and modifier 59 or XS (distinct procedural service) when performed with other procedures that might otherwise be bundled. Modifier 51 applies when billed as a secondary procedure with another major surgery.

What documentation is required to prevent denials for CPT 15740?

Essential documentation includes: exact defect measurements in centimeters, specific identification of the named vascular pedicle (e.g., 'radial artery pedicle' or 'superficial temporal artery'), flap design with pivot point description, justification for why simpler techniques were inadequate, donor site management details, and intraoperative perfusion assessment. Pre- and post-operative photographs are strongly recommended. The operative report must clearly differentiate island pedicle technique from random pattern local flaps. Without explicit documentation of isolated vascular pedicle preservation, claims are commonly downcoded to adjacent tissue transfer codes (14000-14350 series), resulting in $400-600 payment reduction.

Can CPT 15740 be billed with skin graft codes on the same day?

Yes, but only when the skin graft is performed at a completely separate anatomic site or on the island pedicle flap donor site if primary closure is not possible. When a skin graft (15100-15261) is used to close the donor defect created by harvesting the island pedicle flap, it can be billed separately with modifier 59. However, if the skin graft is performed at the same recipient site or is considered inherent to the flap procedure, it will be bundled and denied. Documentation must clearly specify separate sites and medical necessity for both procedures. Include anatomic diagrams and distinct descriptions in the operative report.

What is the global period for CPT 15740 and what services are included?

CPT 15740 has a 90-day global period, meaning routine follow-up care for 90 days after surgery is included in the payment and cannot be billed separately. Included services are: pre-operative evaluation on day of or day before surgery, the surgical procedure itself, normal post-operative pain management, routine wound checks, suture removal, and management of expected post-operative course. Services that CAN be billed separately include: evaluation for unrelated problems (modifier 24), return to OR for complications (modifier 78), staged procedures (modifier 58), and treatment of complications requiring more than routine care. New patients seen during the global period for unrelated issues can be billed without modifier restrictions.