$572.04
20101 applies to a penetrating wound in the chest. Use 20102 when the wound is in the abdomen, flank, or back.
On this page
CMS RVU26D · Effective 2026-10-01
20102 Wound exploration Medicare reimbursement rates in Idaho
Operative exploration of a penetrating wound in the abdomen, flank, or back to assess the wound tract and underlying injury during acute trauma care. Compare 20102 office and facility rates across CMS payment localities in Idaho.
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 20102 in Idaho?
Idaho 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
$604.63
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$221.14
1 of 1 localities have a supported rate.
Payment area: Idaho
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.
Trauma surgery
About 20102: Penetrating wound exploration, abdomen or back
Operative exploration of a penetrating wound in the abdomen, flank, or back to assess the wound tract and underlying injury during acute trauma care.
A surgeon, often a trauma or general surgeon, explores a penetrating wound in the abdomen, flank, or back to assess the tract and identify injury to underlying structures. This is an operative service, typically performed in a facility during acute trauma care; it is distinct from simply examining or cleaning a wound at the bedside.
Select this code by the wound’s anatomic region, not by the severity of the injury or the structures ultimately found. The operative report should identify the penetrating wound site, describe the exploration performed, and distinguish it from any definitive repair or larger operation. Related postoperative visits are included in the 10-day global period. 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. Modifier 50 is inappropriate for this descriptor. Assistant-at-surgery services are not paid, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 20102
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are 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 RVU3.88 · 20%
- Practice expense (office) RVU14.95 · 75%
- Malpractice RVU0.99 · 5%
189
Medicare services in 2024 · #4366 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.
20102 compared with similar codes
Office rates for Idaho, from the same CMS release.
$543.37
20103 is for penetrating wound exploration of an extremity; 20102 is selected for the specified trunk regions.
No office rate
20102 describes exploration focused on a penetrating wound tract. 49000 describes exploratory laparotomy for a broader intra-abdominal survey.
Compare 20102 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
Idaho →
Office / nonfacility
$604.63
Facility
$221.14
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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 20102 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
1,718
- Code
- 20102
- Physician work
- 3.88
- Practice expense
- 14.95
- Malpractice
- 0.99
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.88 | × 1.000 | 3.8800 |
| Practice expense | 14.95 | × 0.920 | 13.7540 |
| Malpractice | 0.99 | × 0.473 | 0.4683 |
| Total RVUs | 18.1023 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$604.63
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.88 | 1 |
| Practice expense | 14.95 | 0.92 |
| Malpractice | 0.99 | 0.473 |
(3.88 × 1 + 14.95 × 0.92 + 0.99 × 0.473) × $33.4009 = $604.63
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.88 | 1 |
| Practice expense | 2.47 | 0.92 |
| Malpractice | 0.99 | 0.473 |
(3.88 × 1 + 2.47 × 0.92 + 0.99 × 0.473) × $33.4009 = $221.14
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.
20102 billing questions
How do I distinguish this code from 20101?
Choose by the wound location: 20102 is for the abdomen, flank, or back, while 20101 is for the chest.
When is a formal exploratory laparotomy a better fit?
Use 20102 for operative exploration of the penetrating wound tract in its specified region. A broad intra-abdominal exploration through a laparotomy is described by 49000.
Can wound exploration be reported separately from definitive repair?
Do not separately report exploration when it is integral to a more extensive procedure at the same site. The operative documentation should establish a distinct exploration service.
Can modifier 50 be used for wounds on both sides?
No. Modifier 50 is inappropriate for this descriptor and anatomy.
Are assistant, co-surgeon, or team-surgery claims payable?
Assistant-at-surgery services are not paid for this code. Co-surgeons and team surgery are not permitted.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
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.
1,7152004F,,Initial exam involved joints,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,71620100,,Expl pentrg wound neck,A,,10.12,4.00,NA,4.00,,2.22,16.34,16.34,0,010,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,71720101,,Expl pentrg wound chest,A,,3.15,14.76,,2.05,,0.84,18.75,6.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,71820102,,Expl pentrg wnd abd/flnk/bk,A,,3.88,14.95,,2.47,,0.99,19.82,7.34,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,71920103,,Expl pentrg wound extremity,A,,5.21,11.49,,3.24,,1.03,17.73,9.48,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7202010F,,Vital signs recorded,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,7212014F,,Mental status assess,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772