CPT 13160 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 13160 by major payers:

$969.00

$1,027.98

$1,080.13

$1,313.87
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 13160 | ||||||
United | 13160 | $645.00 | 1679963912 - FERTILITY LAB SCIENCES OF ORANGE COUNTY, LLC | 464731184 - (CA) FERTILITY LAB SCIENCES OF ORAN | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $1873.00 | 1386028439 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL SURGERY CENTER | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $672.00 | 1982978466 - NORTHWEST ENT SURGERY CENTER, LLC | 453307193 - (GA) NORTHWEST ENT SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $1276.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $625.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $541.00 | 1073598066 - UROLOGY SURGERY CENTER LP | 621543096 - (TN) UROLOGY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $456.00 | 1518922541 - VISION SURGICAL CENTER AT SPRINGHILL PSC | 352100428 - (IN) VISION SURGICAL CENTER AT SPRINGHILL PSC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $489.00 | 1104199413 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC SUN CITY | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $935.00 | 1386615912 - PUGET SOUND GASTROENTEROLOGY, PLLC, FREMONT ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $1258.00 | 1386657047 - THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CENTER, LLC | 20594510 - (TX) THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CTR, LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $670.00 | 1922531268 - AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | 814584087 - (MD) AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $691.00 | 1548582463 - CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER, LLC, NONE | 271867311 - (VA) CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $793.00 | 1295713568 - HUTCHINSON AMBULATORY SURGERY CENTER, LLC | 481243738 - (KS) HUTCHINSON AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $1158.00 | 1427144336 - PORTLAND CLINIC, THE PORTLAND CLINIC SURGICAL CENTER | 930400952 - (OR) THE PORTLAND CLINIC LLP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13160 | $3159.00 | 1649534843 - SURGERY CENTER OF WASILLA, LLC | 455023852 - (AK) SURGERY CENTER OF WASILLA LLC | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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.
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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