CPT code 10160: Lesion aspiration, abscess, hematoma, or bulla2026 Medicare rate & RVUs in North Carolina

Needle aspiration of an abscess, hematoma, or bulla is reported when a clinician evacuates the collection without performing incision and drainage.

CMS RVU26DEffective Oct 1, 2026One payment locality47.9K Medicare services in 2024

In North Carolina, Medicare pays $123.94 for 10160 in the office and $86.55 when it’s performed in a hospital or facility.

$123.94Office (non-facility)
$86.55Hospital or facility
−5.8%vs the national office rate ($131.60)

Check a contract rate as a % of Medicare · 10160 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 10160 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 10160 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 10160 covers

A clinician uses a needle to aspirate fluid or material from an abscess, hematoma, or bulla. The service may be performed in an office, clinic, or hospital when aspiration is the chosen treatment for the collection. The record should identify the site and condition treated, the aspiration performed, and the clinical reason for intervention.

Report 10160 for aspiration rather than an incision-and-drainage service when the collection is treated by puncture. The 10-day global period includes related postoperative visits during that period. For multiple procedures in one session, CMS pays the highest-valued procedure in full and applies the standard reduction to the others. Modifier 50 is inappropriate for this code. CMS does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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.

How North Carolina compares for 10160

Across 109 of 109 payment localities, the office rate for 10160 runs from $116.95 in Arkansas to $171.40 in San Benito County, CA. North Carolina pays $123.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

10160 in North Carolina vs other payment areas
  1. North Carolina · this page$123.94
  2. Los Angeles, CA · California$147.12+$23.18
  3. Washington, DC area · District of Columbia$149.62+$25.68
  4. Miami, FL · Florida$143.28+$19.34
  5. Chicago, IL · Illinois$139.23+$15.29
  6. Manhattan, NY · New York$151.19+$27.25
  7. Alaska · Alaska$155.13+$31.19

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

10160 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$118.59$83.52
ArkansasArkansas$116.95$82.52
ArizonaArizona$128.18$89.34
Bakersfield, CACalifornia$138.49$94.56
Chico, CACalifornia$138.02$94.09
El Centro, CACalifornia$138.05$94.12
Fresno, CACalifornia$138.02$94.09
Hanford, CACalifornia$138.02$94.09

10160 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$116.95

$155.13

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
10160 office rate range by state
State / territoryOffice rate rangeLocalities
AK$155.131
AL$118.591
AR$116.951
AZ$128.181
CA$138.02–$171.4029
CO$136.391
CT$140.121
DC$149.621
DE$130.241
FL$130.53–$143.283
GA$123.39–$134.162
GU$141.061
HI$141.061
IA$121.111
ID$121.941
IL$127.17–$139.234
IN$122.611
KS$120.741
KY$121.651
LA$121.54–$127.282
MA$135.70–$149.272
MD$132.59–$149.623
ME$122.74–$128.862
MI$124.85–$132.272
MN$130.321
MO$119.66–$127.513
MS$118.321
MT$131.591
NC$123.941
ND$128.431
NE$121.691
NH$134.441
NJ$141.61–$148.212
NM$125.581
NV$130.791
NY$125.74–$154.955
OH$124.201
OK$121.261
OR$129.67–$140.372
PA$124.29–$136.872
PR$132.461
RI$134.621
SC$124.301
SD$128.051
TN$121.341
TX$123.52–$136.038
UT$125.921
VA$128.57–$149.622
VI$132.461
VT$128.101
WA$135.38–$152.072
WI$124.311
WV$122.701
WY$130.211

See 10160 in every payment locality

How the 10160 rate is calculated

Each of 10160’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 · 10160

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.22

1.22 RVUs× 1.000 GPCI

Practice expense2.56

2.56 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

3.9400

Conversion factor

$33.4009

Medicare rate

$131.60

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,113

Code
10160
Physician work
1.22
Practice expense
2.56
Malpractice
0.16

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 10160 in North Carolina
ComponentRVULocality factorAdjusted
Physician work1.22× 1.0001.2200
Practice expense2.56× 0.9332.3885
Malpractice0.16× 0.6390.1022
Total RVUs3.7107
Conversion factor× 33.4009

Office rate, North Carolina$123.94

Office: (1.22 × 1 + 2.56 × 0.933 + 0.16 × 0.639) × $33.4009 = $123.94

Facility: (1.22 × 1 + 1.36 × 0.933 + 0.16 × 0.639) × $33.4009 = $86.55

Open 10160 in the RVU calculator

Payment rules and modifiers for 10160

10160 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 10160

Lesion aspiration, abscess, hematoma, or bulla

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 10160

Lesion aspiration, abscess, hematoma, or bulla

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

10160 without 51 · national office

$131.60

Lesion aspiration, abscess, hematoma, or bulla

10160-51 · Second procedure: 50%

$65.80

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%).

When to use modifier 51

How 10160 has changed in North Carolina

10160 · Office / nonfacility

$123.94

Effective 2026-10-01

The base rate is $5.18 higher than on 2025-10-01, moving from $118.76 to $123.94 (4.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $118.76changed to$123.94

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.25 changed to 1.22
    • Practice expense RVU 2.50 changed to 2.56
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $122.21changed to$118.76

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $120.22changed to$122.21

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $124.54changed to$120.22

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.48 changed to 2.50
    • Malpractice RVU 0.17 changed to 0.16
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $125.91changed to$124.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.45 changed to 2.48
    • Malpractice RVU 0.14 changed to 0.17
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $126.59changed to$125.91

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.43 changed to 2.45
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $126.74changed to$126.59

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.31 changed to 2.43
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $125.98changed to$126.74

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.30 changed to 2.31
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $126.09changed to$125.98

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $124.91changed to$126.09

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.27 changed to 2.30
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $125.07changed to$124.91

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.28 changed to 2.27
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $125.53changed to$125.07

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $124.90changed to$125.53

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $123.59changed to$124.90

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.25 changed to 2.28
    • Malpractice RVU 0.15 changed to 0.16
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $125.16changed to$123.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.50 changed to 2.25
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $125.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$123.94$86.55RVU26D
2026-07-01$123.94$86.55RVU26C
2026-04-01$123.94$86.55RVU26B
2026-01-01$123.94$86.55RVU26A
2025-10-01$118.76$89.40RVU25D
2025-07-01$118.76$89.40RVU25C
2025-04-01$118.76$89.40RVU25B
2025-01-01$118.76$89.40RVU25A
2024-10-01$122.21$91.39RVU24D
2024-07-01$122.21$91.39RVU24C
2024-04-01$122.21$91.39RVU24B
2024-03-09$122.21$91.39RVU24AR
2024-01-01$120.22$89.90RVU24A
2023-10-01$124.54$92.50RVU23D
2023-07-01$124.54$92.50RVU23C
2023-04-01$124.54$92.50RVU23B
2023-01-01$124.54$92.50RVU23A
2022-10-01$125.91$92.19RVU22D
2022-07-01$125.91$92.19RVU22C
2022-04-01$125.91$92.19RVU22B
2022-01-01$125.91$92.19RVU22A
2021-10-01$126.59$92.26RVU21D
2021-07-01$126.59$92.26RVU21C
2021-04-01$126.59$92.26RVU21B
2021-01-01$126.59$92.26RVU21A
2020-10-01$126.74$93.18RVU20D
2020-07-01$126.74$93.18RVU20C
2020-04-01$126.74$93.18RVU20B
2020-01-01$126.74$93.18RVU20A
2019-10-01$125.98$93.10RVU19D
2019-07-01$125.98$93.10RVU19C
2019-04-01$125.98$93.10RVU19B
2019-01-01$125.98$93.10RVU19A
2018-10-01$126.09$93.24RVU18D
2018-07-01$126.09$93.24RVU18C
2018-04-01$126.09$93.24RVU18B
2018-01-01$126.09$93.24RVU18AR1
2017-10-01$124.91$93.50RVU17D
2017-07-01$124.91$93.50RVU17C
2017-04-01$124.91$93.50RVU17B
2017-01-01$124.91$93.50RVU17A
2016-10-01$125.07$93.44RVU16D
2016-07-01$125.07$93.44RVU16C
2016-04-01$125.07$93.44RVU16B
2016-01-01$125.07$93.44RVU16A
2015-10-01$125.53$93.78RVU15D
2015-07-01$125.53$93.78RVU15C
2015-04-01$124.90$93.31RVU15B
2015-01-01$124.90$93.31RVU15A
2014-10-01$123.59$92.64RVU14D
2014-07-01$123.59$92.64RVU14C
2014-04-01$123.59$92.64RVU14B
2014-01-01$123.59$92.64RVU14A
2013-10-01$125.16$92.04RVU13D
2013-07-01$125.16$92.04RVU13C
2013-04-01$125.16$92.04RVU13B
2013-01-01$125.16$92.04RVU13AR

Price 10160 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

10160 billing questions

When should 10160 be chosen instead of an incision-and-drainage code?

Use 10160 when the abscess, hematoma, or bulla is treated by needle aspiration. If the clinician incises and drains the collection, consider the code describing that procedure instead.

How does 10160 differ from 10140?

10160 describes puncture aspiration of an abscess, hematoma, or bulla. 10140 describes incision and drainage of a hematoma, seroma, or other fluid collection.

Can modifier 50 be reported for bilateral aspiration?

No. CMS identifies bilateral adjustment as inappropriate for 10160.

Are related postoperative visits included?

Yes. The 10-day global period includes related postoperative visits during those 10 days.

Can an assistant, co-surgeon, or surgical team be billed?

CMS does not pay an assistant at surgery for 10160, and co-surgeon and team-surgery billing 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
RVUs for 10160PPRRVU2026_Oct_nonQPP.csv, line 1,113 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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