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

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 Puerto Rico, Medicare pays $132.46 for 10160 in the office and $91.94 when it’s performed in a hospital or facility.

$132.46Office (non-facility)
$91.94Hospital or facility
+0.7%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $132.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

10160 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$132.46
  2. Los Angeles, CA · California$147.12+$14.66
  3. Washington, DC area · District of Columbia$149.62+$17.16
  4. Miami, FL · Florida$143.28+$10.82
  5. Chicago, IL · Illinois$139.23+$6.77
  6. Manhattan, NY · New York$151.19+$18.73
  7. Alaska · Alaska$155.13+$22.67

Other areas in Puerto Rico 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.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 10160 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.22× 1.0001.2200
Practice expense2.56× 1.0112.5882
Malpractice0.16× 0.9850.1576
Total RVUs3.9658
Conversion factor× 33.4009

Office rate, Puerto Rico$132.46

Office: (1.22 × 1 + 2.56 × 1.011 + 0.16 × 0.985) × $33.4009 = $132.46

Facility: (1.22 × 1 + 1.36 × 1.011 + 0.16 × 0.985) × $33.4009 = $91.94

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

Codes related to 10160

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 10160
CodeHow it relatesOffice range, Puerto Rico
Used instead
10140Fluid drainage, hematoma, seroma, or collectionIncision and drainage for a hematoma, seroma, or fluid collection rather than needle aspiration.$175.52
10060Abscess drainage, simple, single abscessSimple abscess incision and drainage when treatment involves an incision rather than aspiration.$129.46
10061Abscess drainage, complex or multipleComplex or multiple abscess incision and drainage, rather than aspiration.$221.37
10030Fluid drainage, image-guided, soft tissueImage-guided catheter drainage of a fluid collection, using a different drainage method.$626.46

How 10160 has changed in Puerto Rico

10160 · Office / nonfacility

$132.46

Effective 2026-10-01

The base rate is $5.51 higher than on 2025-10-01, moving from $126.95 to $132.46 (4.3%).

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

    $126.95changed to$132.46

    • 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 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $130.64changed to$126.95

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $128.51changed to$130.64

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $132.74changed to$128.51

    • 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 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $132.16changed to$132.74

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $133.50changed to$132.16

    • 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 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $134.25changed to$133.50

    • 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.

  8. January 1, 2021

    RVU21A

    $134.49changed to$134.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.31 changed to 2.43
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $133.87changed to$134.49

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.30 changed to 2.31
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $134.08changed to$133.87

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

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $118.28changed to$134.08

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.27 changed to 2.30
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $103.99changed to$118.28

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.28 changed to 2.27
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $104.36changed to$103.99

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $103.84changed to$104.36

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $102.01changed to$103.84

    • 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 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $101.55changed to$102.01

    • 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 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $101.55

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$132.46$91.94RVU26D
2026-07-01$132.46$91.94RVU26C
2026-04-01$132.46$91.94RVU26B
2026-01-01$132.46$91.94RVU26A
2025-10-01$126.95$95.03RVU25D
2025-07-01$126.95$95.03RVU25C
2025-04-01$126.95$95.03RVU25B
2025-01-01$126.95$95.03RVU25A
2024-10-01$130.64$97.12RVU24D
2024-07-01$130.64$97.12RVU24C
2024-04-01$130.64$97.12RVU24B
2024-03-09$130.64$97.12RVU24AR
2024-01-01$128.51$95.54RVU24A
2023-10-01$132.74$97.90RVU23D
2023-07-01$132.16$97.60RVU23C
2023-04-01$132.16$97.60RVU23B
2023-01-01$132.16$97.60RVU23A
2022-10-01$133.50$96.87RVU22D
2022-07-01$133.50$96.87RVU22C
2022-04-01$133.50$96.87RVU22B
2022-01-01$133.50$96.87RVU22A
2021-10-01$134.25$96.96RVU21D
2021-07-01$134.25$96.96RVU21C
2021-04-01$134.25$96.96RVU21B
2021-01-01$134.25$96.96RVU21A
2020-10-01$134.49$98.12RVU20D
2020-07-01$134.49$98.12RVU20C
2020-04-01$134.49$98.12RVU20B
2020-01-01$134.49$98.12RVU20A
2019-10-01$133.87$98.31RVU19D
2019-07-01$133.87$98.31RVU19C
2019-04-01$133.87$98.31RVU19B
2019-01-01$133.87$98.31RVU19A
2018-10-01$134.08$98.55RVU18D
2018-07-01$134.08$98.55RVU18C
2018-04-01$134.08$98.55RVU18B
2018-01-01$134.08$98.55RVU18AR1
2017-10-01$118.28$89.41RVU17D
2017-07-01$118.28$89.41RVU17C
2017-04-01$118.28$89.41RVU17B
2017-01-01$118.28$89.41RVU17A
2016-10-01$103.99$80.01RVU16D
2016-07-01$103.99$80.01RVU16C
2016-04-01$103.99$80.01RVU16B
2016-01-01$103.99$80.01RVU16A
2015-10-01$104.36$80.29RVU15D
2015-07-01$104.36$80.29RVU15C
2015-04-01$103.84$79.89RVU15B
2015-01-01$103.84$79.89RVU15A
2014-10-01$102.01$78.96RVU14D
2014-07-01$102.01$78.96RVU14C
2014-04-01$102.01$78.96RVU14B
2014-01-01$102.01$78.96RVU14A
2013-10-01$101.55$77.33RVU13D
2013-07-01$101.55$77.33RVU13C
2013-04-01$101.55$77.33RVU13B
2013-01-01$101.55$77.33RVU13AR

Price 10160 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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