CPT 16020 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 | • 23 - Emergency Room • 11 - Office |
| Common Modifiers | • None • UA • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Low |
National average reimbursement for CPT 16020 by major payers:
$100.43
$104.80
$110.28
$140.09
| 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 16020 | ||||||
United | 16020 | $566.00 | 1952749491 - HAYMARKET SURGERY CENTER, LLC | 462874962 - (VA) HAYMARKET SURGERY CENTER | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $409.00 | 1073763652 - LEBONHEUR EAST SURGERY CENTER II LP, LEBONHEUR EAST SURGERY CENTER LP | 800247391 - (TN) LEBONHEUR EAST SURGERY CENTER II LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $105.00 | 1366635609 - APPLE SURGERY CENTER, INC | 260423287 - (CA) APPLE SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $1831.00 | 1730146861 - CONROE SURGERY CENTER 2, LLC | 760697645 - (TX) CONROE SURGERY CENTER 2 LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $1493.00 | 1467057372 - SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | 852607391 - (CT) SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $111.00 | 1225387640 - PCET SURGERY CENTER LLC | 454288531 - (TN) PCET SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $84.00 | 1043208283 - TRACEY A. SCHMUCKER, M.D., P.A., LOWERY SURGERY CENTER | 262165143 - (AR) TRACEY A SCHMUCKER MD PA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $230.00 | 1730540600 - RICHMOND ASC LLC, RICHMOND PAIN MANAGEMENT ASC | 472882195 - (NY) RICHMOND ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $468.00 | 1902863723 - OAK & MAIN SURGICENTER LLC | 223532371 - (NJ) OAK MAIN SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $64.00 | 1710032842 - MSC AMBULATORY SURGICAL CENTER | 202155076 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $75.00 | 1235165531 - LAKE SURGERY & ENDOSCOPY CENTER LTD | 593325730 - (FL) LAKE SURGERY ENDOSCOPY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $103.00 | 1003816307 - SAGAMORE SURGICAL SERVICES, INC. | 351850819 - (IN) SAGAMORE SURGICAL SERVICES, INC. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $176.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 30527649 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $139.00 | 1548785116 - NEPHROLOGY & INTERNAL MEDICINE, INC., NEPHROLOGY & INTERNAL MEDICINE INC | 351298573 - (IN) NEPHROLOGY & INTERNAL MEDICINE, INC. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 16020 | $2079.00 | 1497312540 - MEMORIAL HERMANN SURGERY CENTER MAIN STREET, LLC | 384114079 | TX | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 16020 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 16020 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 16020 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 |
|---|---|---|
| 16000-CPT | Low | Init Treat 1st Degree Burn Local |
| 16020-CPT | Low | Dressings And/Or Debridement Of Partial-Thickness Burns, Initial Or Subsequent; Small (Less Than 5% Total Body Surface Area) |
| 16025-CPT | Low | Dressings And/Or Debridement Of Partial-Thickness Burns, Initial Or Subsequent; Medium (Eg, Whole Face Or Whole Extremity, Or 5% To 10% Total Body Surface Area) |
| 16030-CPT | Moderate | Dressings And/Or Debridement Of Partial-Thickness Burns, Initial Or Subsequent; Large (Eg, More Than 1 Extremity, Or Greater Than 10% Total Body Surface Area) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 16020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 16020 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 16020) and we'll show you how you compare in 15 minutes or less.