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See a sample rate comparisonCPT 13160 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Second Closur Of Surg Wound Or Dehiscence Pextensiv Or Compli, Secondary Closure Of Surgical Wound Or Dehiscence Extensive Or Compli
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 13160 |
| Medicaid Fee Schedule | View Medicaid rates for 13160 |
National average reimbursement for CPT 13160 by major payers:
$969.00
$1,027.98
$1,080.13
$1,284.27
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CPT 13160
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Wasilla, LLC
Surgery Center Of Wasilla LLC
$3,159.00Published rateApex Ambulatory Surgery Center Inc
$950.00Published rateNorthwest Ent Surgery Center, LLC
Northwest Ent Surgery Center LLC
$672.00Published rateRuxton Surgicenter LLC
$560.00Published rateGainesville Fl Orthopaedic Asc LLC, Orthopaedic Surgery Center
The Gainesville Fl Orthopaedic A
$400.00Published rate
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See a sample payer proposalCPT 13160 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 13160 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 13160 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 13131-CPT | Moderate | Repair Complex Forehead Che, Repair Complex Forehead Cheeks Chin Mouth Neckaxillae Genitalia Hands Andor Feet 1.1 Cm To 2.5 Cm Repair Complex Forehead Cheeks Chinmouth Neck |
| 13151-CPT | Moderate | Clean And Stitch Wound, Cleaning And Removal Of Damaged Or Infected Tissue For A Wound On The Eyes Nose Or Ears. The Wound Is Stitched Closed. |
| 13160-CPT | Moderate | Second Closur Of Surg Wound Or Dehiscence Pextensiv Or Compli, Secondary Closure Of Surgical Wound Or Dehiscence Extensive Or Compli |
| 14060-CPT | Moderate | Adjacent Tissue Transfer Or Re, Adjacent Tissue Transfer Or Rearrangement Eyelids Noseears Andor Lips Defect 10 Sq Cm Or Less Adjacent Tissue Transfer Or Rearrangement Eyelids Nose |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13160. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13160 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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