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Billing code 20100: Wound explorationMedicare rate & RVUs

Operative exploration of a penetrating neck wound is reported when a surgeon examines the wound and underlying tissues to assess injury.

CMS RVU26DEffective Oct 1, 2026109 payment localities173 Medicare services in 2024

Medicare pays $545.77 for 20100 nationally in a facility.

Medicare rate · 20100

Wound exploration

Swap in your local Medicare rate.

Work RVUs
10.12
Total RVUs
16.34
Global days
010

National rate · 2026

$545.77

Facility setting, before claim adjustments.

See every locality for 20100 → · 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
  1. Medicare rate
  2. What 20100 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 20100 covers

billing code 20100 describes operative exploration of a penetrating wound in the neck, such as a stab or gunshot wound. The surgeon examines the wound tract and underlying tissues to assess the extent of injury and identify affected structures. Trauma or general surgeons commonly perform this work in a hospital operating room. Routine inspection, cleaning, or closure of a superficial wound is not the same service as operative exploration.

Select the code based on the wound’s neck location and the documented operative exploration, not simply the mechanism or apparent wound size. The operative report should identify the site, exploration performed, findings, and any injuries or repairs. Related postoperative visits are included in the 10-day global period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral performance with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 20100 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

20100 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$496.89
Alaska*Unavailable$690.17
ArizonaUnavailable$530.95
ArkansasUnavailable$490.97
AtlantaUnavailable$563.83
AustinUnavailable$545.74
BakersfieldUnavailable$536.03
Baltimore/Surr. CntysUnavailable$578.51
BeaumontUnavailable$528.48
BrazoriaUnavailable$530.96

20100 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.

View every state and territory as a table
20100 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 20100 rate is calculated

Each of 20100’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 · 20100

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.12Practice expense 4.00Malpractice 2.22

16.3400 adjusted RVUs×$33.4009 conversion factor=$545.77

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 20100

20100 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 20100

Wound exploration

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
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 · 20100

Wound exploration

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 50 · payment effect

With and without the modifier

20100 without 50 · national facility

$545.77

Wound exploration

20100-50 · Bilateral: 150%

$818.66

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

20100 compared with similar codes

Compare codes

20100 vs 20101 vs 20102 vs 20103: national Medicare rates

Swap in your local Medicare rate.

  • 20100
    Wound exploration · 10.12 wRVU
    —
  • 20101
    Wound exploration · 3.15 wRVU
    $626.27
  • 20102
    Wound exploration · 3.88 wRVU
    $662.01
  • 20103
    Wound exploration · 5.21 wRVU
    $592.20

How to choose

20101Wound exploration
20101 is for a penetrating wound in the chest; 20100 is for a wound in the neck.
20102Wound exploration
20102 applies to the abdomen, flank, or back, rather than the neck.
20103Wound exploration
20103 applies to an extremity wound; use 20100 when the explored penetrating wound is in the neck.

Codes related to 20100

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

Codes related to 20100
CodeHow it relatesNational office range
Same family
20101Wound explorationExploration of a penetrating wound in the chest.$543.15–$842.73
20102Wound explorationExploration of a penetrating wound in the abdomen, flank, or back.$575.56–$881.63
20103Wound explorationExploration of a penetrating wound in an extremity.$521.40–$765.01

20100 billing questions

How is 20100 distinguished from the other penetrating-wound exploration codes?

Use 20100 for a penetrating wound in the neck. The related codes distinguish chest, abdomen/flank/back, and extremity locations.

Does a penetrating mechanism alone support 20100?

No. The record should support operative exploration of a penetrating neck wound; the mechanism alone does not establish that the exploration was performed.

Are postoperative visits separately reported during the global period?

Related postoperative visits during the 10-day global period are included in the procedure.

How is 20100 paid when other procedures are performed in the same session?

The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard 50% multiple-procedure reduction.

Can modifier 50 or an assistant-at-surgery payment apply?

For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made, but co-surgeons and team surgery 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 20100PPRRVU2026_Oct_nonQPP.csv, line 1,716 (RVU26D)

Open CMS sourceHow we calculate rates

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