No office rate
16035 represents the first escharotomy incision; 16036 represents each additional incision.
On this page
CMS RVU26D · Effective 2026-10-01
16035 Escharotomy Medicare reimbursement rates in Alabama
Reports the initial incision through constricting burn eschar to relieve pressure and protect circulation or ventilation in a patient with a severe burn. Compare 16035 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 16035 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$164.89
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Burn surgery
About 16035: Escharotomy first incision
Reports the initial incision through constricting burn eschar to relieve pressure and protect circulation or ventilation in a patient with a severe burn.
An escharotomy cuts through stiff, constricting burn tissue to relieve pressure that can impair blood flow to an extremity or limit chest expansion. A surgeon or burn specialist may perform it urgently at the bedside or in an operating room, often for a circumferential deep burn with compromised distal perfusion or restricted ventilation. The code represents the first incision; further incisions are reported separately with the additional-incision code when performed.
Report 16035 for the initial incision, with documentation of the burn site, the constriction or functional threat prompting the procedure, and the incision performed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 16035
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.65 · 68%
- Practice expense (office) RVU1.05 · 20%
- Malpractice RVU0.65 · 12%
134
Medicare services in 2024 · #4642 by national volume
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.
16035 compared with similar codes
Office rates for Alabama, from the same CMS release.
$80.99
16000 describes initial burn treatment, while 16035 is for an incision to release constricting eschar.
$82.89
16020 covers burn dressing or debridement work; 16035 is the operative release of constricting eschar.
Compare 16035 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$164.89
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 16035 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
1,617
- Code
- 16035
- Physician work
- 3.65
- Practice expense
- 1.05
- Malpractice
- 0.65
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.65 | × 1.000 | 3.6500 |
| Practice expense | 1.05 | × 0.875 | 0.9188 |
| Malpractice | 0.65 | × 0.566 | 0.3679 |
| Total RVUs | 4.9366 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$164.89
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.65 | 1 |
| Practice expense | 1.05 | 0.875 |
| Malpractice | 0.65 | 0.566 |
(3.65 × 1 + 1.05 × 0.875 + 0.65 × 0.566) × $33.4009 = $164.89
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
16035 billing questions
When should 16035 be reported instead of 16036?
Use 16035 for the first escharotomy incision. Report 16036 for each additional incision when performed.
What documentation supports an escharotomy?
Document the burn location, the constriction or threatened function that prompted release, and the incision performed. Note relevant findings such as impaired distal perfusion or restricted chest expansion when present.
Can burn dressing or debridement be reported in the same encounter?
A separately performed burn dressing or debridement service may be reportable when its work is distinct from the escharotomy. Document the separate service and the burn area treated.
Should modifier 50 be appended for incisions on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the multiple-procedure reduction affect 16035?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,61416020,,Dress/debrid p-thick burn s,A,,0.69,1.97,,0.82,,0.12,2.78,1.63,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61516025,,Dress/debrid p-thick burn m,A,,1.70,2.99,,1.08,,0.27,4.96,3.05,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61616030,,Dress/debrid p-thick burn l,A,,2.03,3.94,,1.22,,0.43,6.40,3.68,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61716035,,Escharotomy 1st incision,A,,3.65,1.05,NA,1.05,,0.65,5.35,5.35,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61816036,,Escharotomy ea addl incision,A,,1.46,0.38,NA,0.38,,0.36,2.20,2.20,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61917000,,Destruct premalg lesion,A,,0.59,1.34,,0.78,,0.06,1.99,1.43,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,62017003,,Destruct premalg les 2-14,A,,0.04,0.15,,0.01,,0.00,0.19,0.05,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515