Billing code 10160: Lesion aspirationMedicare rate & RVUs
Needle aspiration of an abscess, hematoma, or bulla is reported when a clinician evacuates the collection without performing incision and drainage.
Medicare pays $131.60 for 10160 nationally in the office and $91.52 in a hospital or facility. Local office rates run $116.95–$171.40.
Medicare rate · 10160
Lesion aspiration
- Work RVUs
- 1.22
- Total RVUs
- 3.94
- Global days
- 010
National rate · 2026
$131.60
Office setting, before claim adjustments.
See every locality for 10160 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
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.
Where 10160 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$116.95 to $171.40
109 of 109 payment localities
10160 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $155.13 | 1 |
| AL | $118.59 | 1 |
| AR | $116.95 | 1 |
| AZ | $128.18 | 1 |
| CA | $138.02–$171.40 | 29 |
| CO | $136.39 | 1 |
| CT | $140.12 | 1 |
| DC | $149.62 | 1 |
| DE | $130.24 | 1 |
| FL | $130.53–$143.28 | 3 |
| GA | $123.39–$134.16 | 2 |
| GU | $141.06 | 1 |
| HI | $141.06 | 1 |
| IA | $121.11 | 1 |
| ID | $121.94 | 1 |
| IL | $127.17–$139.23 | 4 |
| IN | $122.61 | 1 |
| KS | $120.74 | 1 |
| KY | $121.65 | 1 |
| LA | $121.54–$127.28 | 2 |
| MA | $135.70–$149.27 | 2 |
| MD | $132.59–$149.62 | 3 |
| ME | $122.74–$128.86 | 2 |
| MI | $124.85–$132.27 | 2 |
| MN | $130.32 | 1 |
| MO | $119.66–$127.51 | 3 |
| MS | $118.32 | 1 |
| MT | $131.59 | 1 |
| NC | $123.94 | 1 |
| ND | $128.43 | 1 |
| NE | $121.69 | 1 |
| NH | $134.44 | 1 |
| NJ | $141.61–$148.21 | 2 |
| NM | $125.58 | 1 |
| NV | $130.79 | 1 |
| NY | $125.74–$154.95 | 5 |
| OH | $124.20 | 1 |
| OK | $121.26 | 1 |
| OR | $129.67–$140.37 | 2 |
| PA | $124.29–$136.87 | 2 |
| PR | $132.46 | 1 |
| RI | $134.62 | 1 |
| SC | $124.30 | 1 |
| SD | $128.05 | 1 |
| TN | $121.34 | 1 |
| TX | $123.52–$136.03 | 8 |
| UT | $125.92 | 1 |
| VA | $128.57–$149.62 | 2 |
| VI | $132.46 | 1 |
| VT | $128.10 | 1 |
| WA | $135.38–$152.07 | 2 |
| WI | $124.31 | 1 |
| WV | $122.70 | 1 |
| WY | $130.21 | 1 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 10160
Lesion aspiration
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
10160 without 51 · national office
$131.60
Lesion aspiration
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%).
10160 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 10140Fluid drainage
- Choose 10160 for needle aspiration of an abscess, hematoma, or bulla; choose 10140 when a hematoma, seroma, or fluid collection is treated by incision and drainage.
- 10060Abscess drainage
- 10160 is for aspiration of an abscess, hematoma, or bulla. 10060 describes incision and drainage of a simple abscess.
- 10061Abscess drainage
- Use 10061 for incision and drainage of a complex or multiple abscesses; use 10160 when the collection is treated by aspiration.
- 10030Fluid drainage
- 10030 describes image-guided catheter drainage of a fluid collection. 10160 describes aspiration by puncture, without that catheter-drainage service.
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
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