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2025 CPT code 15757

Free skin flap with microvascular anastomosis.

Do not report 15757 in conjunction with other codes describing simpler skin grafts or local flaps for the same defect.

Modifiers may be applicable, such as 22 (Increased Procedural Services), 50 (Bilateral Procedure) or 51 (Multiple Procedures), please refer to iFrameAI for latest applicable modifier usage rules.

Medical necessity should be established by documenting the condition requiring the skin flap, failed conservative treatments, and the expected functional and/or cosmetic improvement from the procedure. Documentation should support that the complexity of the defect requires a free flap with microvascular anastomosis rather than a simpler skin graft or local flap.

The physician administers general anesthesia, prepares the donor and recipient sites, excises the skin flap, and places it at the recipient site. They connect the blood vessels under microscopic guidance, check for leaks, and secure the flap with sutures. Finally, they close the donor and recipient sites and apply dressings.

In simple words: The surgeon takes a piece of skin from one area of your body and moves it to another area. They carefully connect the blood vessels of the skin flap to the blood vessels at the new location using a microscope. This ensures the transplanted skin gets enough blood flow to survive and heal.

This code describes a procedure where a free skin flap is transferred to a different part of the body using microvascular techniques. This involves taking a section of skin and underlying tissue, including its blood supply, and moving it to a new location. The blood vessels are then reconnected using specialized techniques under microscopic guidance to ensure proper blood flow to the transplanted tissue. The donor and recipient sites are then closed with sutures.

Example 1: A patient with severe burns on their hand requires a skin graft. A free skin flap is taken from their thigh and transplanted to their hand using microvascular anastomosis (15757)., A patient has a large pressure ulcer on their sacrum that requires a skin flap. A free skin flap is harvested from their abdomen and transferred to the sacrum with microvascular anastomosis (15757)., A patient undergoes breast reconstruction after a mastectomy. A free skin flap from their back is used to create a new breast mound, with the blood vessels connected using microvascular techniques (15757).

Operative report detailing the size and location of the flap, the donor site, the microvascular anastomosis technique used, and any complications encountered. Documentation of the medical necessity for the procedure should also be included.

** “By Report” billing is required, with an operative report attached to the claim.

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