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Federal IDR by specialty
Plastic and reconstructive surgery: out-of-network denials and recovery
Reconstructive flap, graft, breast, and soft tissue codes frequently underpaid on an out-of-network basis.
26 disputed plastic and reconstructive surgery codes
Muscle flap, trunk
CPT 15734 · trunk
Muscle flap, lower extremity
CPT 15738 · lower extremity
Free muscle flap with microvascular repair
CPT 15756 · varies
Tissue transfer flap, 30 sq cm or more
CPT 14301 · varies
Complex wound repair, trunk
CPT 13101 · trunk
Breast reconstruction with tissue expander
CPT 19357 · breast
Breast reconstruction with latissimus flap
CPT 19361 · breast
Breast reconstruction with free flap
CPT 19364 · breast
Breast reconstruction with TRAM flap
CPT 19367 · breast
Split thickness skin graft, trunk or extremity
CPT 15100 · trunk/extremity
Full thickness skin graft, face or extremity
CPT 15240 · face/extremity
Free skin flap with microvascular repair
CPT 15757 · varies
Free fascial flap with microvascular repair
CPT 15758 · varies
Neurovascular pedicle flap
CPT 15750 · varies
Island pedicle flap
CPT 15740 · varies
Immediate breast implant placement
CPT 19340 · breast
Delayed breast implant placement
CPT 19342 · breast
Nipple and areola reconstruction
CPT 19350 · breast
Breast implant capsule removal
CPT 19371 · breast
Revision of reconstructed breast
CPT 19380 · breast
Complex wound repair, face
CPT 13132 · face
Tissue transfer, eyelid, nose, or lip
CPT 14060 · face
Trigger finger release
CPT 26055 · hand
Breast lift (mastopexy), reconstruction context
CPT 19316 · breast
Suction-assisted lipectomy, trunk, reconstruction context
CPT 15877 · trunk
Debridement of muscle and fascia
CPT 11043 · varies
Plastic and reconstructive surgery denials by state
Medically & clinically reviewed by Dr. John M. Abrahams, MD
Board-certified neurosurgeon and founder of Sydra · Last reviewed September 2026 · About the author
Sources
Figures reflect the published federal record across all disputes, not a prediction about any individual claim. This is general information, not legal or financial advice.