CPT code 20103: Wound exploration2026 Medicare rate & RVUs in Nevada
Surgical exploration of a penetrating wound in an arm or leg to assess its depth and injured structures, reported when exploration is distinct.
Medicare pays $586.84 for 20103 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
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 20103 covers
A surgeon explores a penetrating injury in an arm or leg, such as a stab or gunshot wound, to assess the wound track and identify damage to underlying structures or retained material. The service may be performed by a trauma, orthopedic, hand, or vascular surgeon in an operating room or other appropriate procedure setting. It is more than inspecting or gently probing a wound during an initial examination.
Report the code when operative exploration is a distinct service; exploration that is integral to a more extensive repair of the same injury is generally not separately reported. The operative note should identify the extremity, wound location, reason for exploration, and findings or structures assessed. Medicare assigns a 10-day global period, including related postoperative visits during that period. When multiple procedures are performed in one 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. Assistant-at-surgery payment requires medical-necessity documentation; 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.
20103 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $586.84 | $311.00 |
How the 20103 rate is calculated
Each of 20103’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 · 20103
RVUs × geographic indexes × conversion factor
Work5.21
5.21 RVUs× 1.000 GPCI
Practice expense11.49
11.49 RVUs× 1.000 GPCI
Malpractice1.03
1.03 RVUs× 1.000 GPCI
Adjusted RVUs
17.7300
Conversion factor
$33.4009
Medicare rate
$592.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 20103
20103 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20103
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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| 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 · 20103
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 51 · payment effect
With and without the modifier
20103 without 51 · national office
$592.20
Wound exploration
20103-51 · Second procedure: 50%
$296.10
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%).
20103 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20100Wound exploration
- Choose 20100 for a penetrating wound in the neck; this code is for an extremity wound.
- 20101Wound exploration
- Choose 20101 for a penetrating wound in the chest. This code applies to an arm or leg.
- 20102Wound exploration
- Choose 20102 for a penetrating wound of the abdomen, flank, or back; this code applies to an extremity.
20103 billing questions
When should this code be selected instead of a wound code for another body region?
Use it for operative exploration of a penetrating wound in an arm or leg. Codes 20100 through 20102 designate wounds in the neck, chest, or abdomen/flank/back, respectively.
Can exploration be billed separately from repair of the same wound?
Usually not when the exploration is integral to a more extensive repair of that injury during the same session. Report it when the exploration is a distinct service rather than a routine step in definitive treatment.
Does this code include related postoperative visits?
Yes. Medicare includes related postoperative visits for 10 days in the global period.
Should modifier 50 be used for wounds on both limbs?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports assistant-at-surgery payment?
The record must support the medical necessity of the assistant's participation. Medicare does not permit co-surgeon or team-surgery payment for this code.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
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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