Billing code 20100: Wound explorationMedicare rate & RVUs in Minnesota
Operative exploration of a penetrating neck wound is reported when a surgeon examines the wound and underlying tissues to assess injury.
CMS doesn’t publish an office rate for 20100 in Minnesota.
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 9 sections
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.
20100 in Minnesota
| Payment locality | Office | Facility |
|---|---|---|
| Minnesota | Unavailable | $497.44 |
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
Work10.12
10.12 RVUs× 1.000 GPCI
Practice expense4.00
4.00 RVUs× 1.000 GPCI
Malpractice2.22
2.22 RVUs× 1.000 GPCI
Adjusted RVUs
16.3400
Conversion factor
$33.4009
Medicare rate
$545.77
Every GPCI starts 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
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 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.
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).
20100 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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