Billing code 16030: Burn dressingMedicare rate & RVUs in Texas
Reports dressing and/or debridement of large partial-thickness burns, generally involving more than 10% of total body surface area.
Medicare pays $200.90–$219.90 for 16030 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 16030 covers
This service covers wound care for a large area of partial-thickness burns, including cleansing, removal of devitalized tissue when needed, and application of appropriate dressings. A physician typically performs or directs the treatment in an emergency department, burn unit, or other setting managing acute or follow-up burn care. The relevant burn area may involve multiple sites; selection is based on the total body surface area affected, not simply the number of wounds.
Select this level when the partial-thickness burn area is large, generally more than 10% of total body surface area. Document burn depth, affected sites, estimated body surface area, and the dressing or debridement performed. The 0-day global period includes same-day preoperative and postoperative care. When other 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; Medicare does not pay 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 16030 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
$200.90 to $219.90
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $219.90 | $123.78 |
| Beaumont | $200.90 | $118.23 |
| Brazoria | $209.96 | $119.93 |
| Dallas | $211.81 | $121.32 |
| Fort Worth | $210.68 | $121.10 |
| Galveston | $210.92 | $120.70 |
| Houston | $218.79 | $128.57 |
| Rest Of Texas | $205.66 | $119.44 |
How the 16030 rate is calculated
Each of 16030’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 · 16030
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.03Practice expense 3.94Malpractice 0.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 16030
The CMS indicators that decide how 16030 is paid alongside other services.
CMS payment indicators · 16030
Burn dressing
| 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
16030 without 51 · national office
$213.77
Burn dressing
16030-51 · Second procedure: 50%
$106.89
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%).
16030 compared with similar codes
Compare codes
16030 vs 16020 vs 16025 vs 16000 vs 16035: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 16020Burn wound care
- This is the small-area sibling for partial-thickness burn dressing and/or debridement; 16030 represents the large-area level.
- 16025Burn care
- This is the medium-area sibling. Use 16030 when the treated partial-thickness burn area meets the large-area threshold.
- 16000Burn treatment
- This represents initial burn treatment rather than the large-area dressing and/or debridement service reported with 16030.
- 16035Escharotomy
- This is an escharotomy code for an incision to release constricting eschar, not burn dressing or debridement.
16030 billing questions
How does 16030 differ from 16025?
Choose by the total body surface area of partial-thickness burns treated. 16030 is the large-area level, generally more than 10%; 16025 is the medium level.
Can 16030 be reported for dressing alone?
Yes. The service may involve dressing, debridement, or both. Document the burn extent and the wound care actually performed.
Can routine wound preparation or dressing work be billed separately?
Do not separately report the cleansing, debridement, or dressing work that is part of the 16030 service.
Should modifier 50 be used for burns on both sides of the body?
No. Modifier 50 is inappropriate for this code; code selection reflects the total burn area treated rather than a bilateral service.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery; 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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