Billing code 16025: Burn careMedicare rate & RVUs in Texas
Report this service for dressing and/or debridement of partial-thickness burns when the treated burn area is medium, spanning 5% to 10% of body surface.
Medicare pays $156.04–$170.55 for 16025 in the office in Texas, from Beaumont to Austin. 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 16025 covers
This service covers dressing, debridement, or both for partial-thickness burns involving a medium area: 5% to 10% of total body surface area. Partial-thickness burns extend beyond the outer skin layer into the dermis. Physicians and other qualified clinicians may provide the care in an emergency department, burn clinic, office, or hospital, for initial or subsequent treatment. The code is selected by the burn area treated, not by the number of separate burn sites.
Document burn depth and the total body surface area involved in the treatment, along with the dressing or debridement performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and 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 16025 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$156.04 to $170.55
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $170.55 | $103.05 |
| Beaumont | $156.04 | $97.99 |
| Brazoria | $163.24 | $100.02 |
| Dallas | $164.50 | $100.96 |
| Fort Worth | $163.62 | $100.72 |
| Galveston | $163.87 | $100.52 |
| Houston | $168.81 | $105.47 |
| Rest Of Texas | $159.70 | $99.16 |
How the 16025 rate is calculated
Each of 16025’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 · 16025
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.70Practice expense 2.99Malpractice 0.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 16025
The CMS indicators that decide how 16025 is paid alongside other services.
CMS payment indicators · 16025
Burn care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
16025 without 51 · national office
$165.67
Burn care
16025-51 · Second procedure: 50%
$82.84
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%).
16025 compared with similar codes
Compare codes
16025 vs 16020 vs 16030 vs 16000 vs 16035: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 16020Burn wound care
- Use 16020 for the small-area level of partial-thickness burn dressing or debridement; 16025 represents 5% to 10% of total body surface area.
- 16030Burn dressing
- Use 16030 for the large-area level. Choose 16025 when the treated partial-thickness burn area is 5% to 10% of total body surface area.
- 16000Burn treatment
- 16000 describes initial burn treatment without the dressing or debridement service represented by 16025. Select 16025 for dressing and/or debridement of a medium-area partial-thickness burn.
- 16035Escharotomy
- 16035 is for an escharotomy incision, a release procedure for constricting burn eschar; it is not a substitute for dressing or debridement under 16025.
16025 billing questions
How does 16025 differ from 16020 and 16030?
Choose by the total body surface area involved: 16025 is for 5% to 10%. Code 16020 is the small-area level, and 16030 is the large-area level.
Is 16025 selected by burn depth or burn size?
Both matter: the burn must be partial-thickness, and the area treated must fall within the medium range of 5% to 10% of total body surface area.
Can 16025 be reported for initial or subsequent treatment?
Yes. The code covers dressing and/or debridement during either initial or subsequent treatment of a qualifying partial-thickness burn.
What documentation supports reporting 16025?
Record the partial-thickness depth, the treated area as a percentage of total body surface area, and the dressing or debridement performed.
Can modifier 50 be used for burns on both sides of the body?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does Medicare treat 16025 when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard multiple-procedure reduction. The 0-day global period includes same-day preoperative and postoperative care.
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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