CPT code 13160: Wound closure, extensive or complicated2026 Medicare rate & RVUs in California
Report this service when a surgeon performs extensive or complicated secondary closure of a previously open surgical wound or a dehisced incision.
CMS doesn’t publish an office rate for 13160 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 13160 covers
A surgeon closes a surgical wound that was left open or an incision that separated after surgery. The closure must be extensive or complicated; routine closure of a fresh operative incision is a different service. These procedures may occur in an operating room or another setting where the surgeon can manage the wound and perform the needed closure. The clinical record should identify the prior operation, the wound’s open or dehisced status, and the features that make the secondary closure extensive or complicated.
Select this code based on the nature and complexity of the secondary closure, not a wound-length range. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery 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.
Where 13160 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $747.60 |
| Chico, CA | Unavailable | $741.69 |
| El Centro, CA | Unavailable | $742.05 |
| Fresno, CA | Unavailable | $741.69 |
| Hanford, CA | Unavailable | $741.69 |
| Los Angeles, CA | Unavailable | $784.32 |
| Madera, CA | Unavailable | $741.69 |
| Marin County, CA | Unavailable | $854.35 |
| Merced, CA | Unavailable | $741.69 |
| Modesto, CA | Unavailable | $741.69 |
| Napa, CA | Unavailable | $819.61 |
| Oxnard, CA | Unavailable | $776.07 |
| Redding, CA | Unavailable | $741.69 |
| Rest of California | Unavailable | $741.69 |
| Riverside, CA | Unavailable | $764.32 |
| Sacramento, CA | Unavailable | $767.81 |
| Salinas, CA | Unavailable | $764.73 |
| San Benito County, CA | Unavailable | $874.55 |
| San Diego, CA | Unavailable | $775.07 |
| San Francisco, CA | Unavailable | $851.96 |
| San Luis Obispo, CA | Unavailable | $753.67 |
| Santa Clara County, CA | Unavailable | $864.80 |
| Santa Cruz, CA | Unavailable | $776.41 |
| Santa Maria, CA | Unavailable | $765.51 |
| Santa Rosa, CA | Unavailable | $783.56 |
| Stockton, CA | Unavailable | $741.69 |
| Vallejo, CA | Unavailable | $816.17 |
| Visalia, CA | Unavailable | $741.69 |
| Yuba City, CA | Unavailable | $741.69 |
How the 13160 rate is calculated
Each of 13160’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 · 13160
RVUs × geographic indexes × conversion factor
Work11.74
11.74 RVUs× 1.000 GPCI
Practice expense8.34
8.34 RVUs× 1.000 GPCI
Malpractice2.10
2.10 RVUs× 1.000 GPCI
Adjusted RVUs
22.1800
Conversion factor
$33.4009
Medicare rate
$740.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 13160
13160 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 13160
Wound closure, extensive or complicated
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 13160
Wound closure, extensive or complicated
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
13160 without 51 · national facility
$740.83
Wound closure, extensive or complicated
13160-51 · Second procedure: 50%
$370.42
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%).
13160 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 12020Wound dehiscenceSimple closure
- Choose 12020 for treatment of superficial surgical-wound dehiscence. Choose this code when the secondary closure is extensive or complicated.
- 12021Wound dehiscence careWith packing
- Code 12021 addresses superficial surgical-wound dehiscence with packing. This code describes extensive or complicated secondary closure.
- 13100Complex repairTrunk, 1.1–2.5 cm
- Code 13100 is for complex repair of a fresh trunk wound in its specified length range. This code is for secondary closure of a previously open or dehisced surgical wound.
13160 billing questions
How is this different from codes for superficial wound dehiscence?
This code is for extensive or complicated secondary closure. Codes 12020 and 12021 address treatment of superficial surgical-wound dehiscence, with 12021 used when packing is involved.
Should the closure be coded by wound length?
No length ranges distinguish this service. Documentation should support that the secondary closure is extensive or complicated.
Does the global period include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral wounds?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple procedure reduction.
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
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