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    OpenPayerBilling CodesIncision and Drainage Procedures on the Skin, Subcutaneous and Accessory StructuresCPT cpt-10120-foreign-body-removal-subcutaneous
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    CPT 10120: Incision and Removal of Subcutaneous Foreign Body

    Medicare pays $163 and commercial payers pay $358 on average nationally for this procedure.

    CPT code 10120 describes incision and removal of a foreign body (for example, a thorn, wood splinter, glass sliver, or fishhook) from the subcutaneous or lower layer of the skin; service type: minor surgical foreign body removal; typical site of service: outpatient clinic, urgent care, or emergency department procedure room.

    For related coverage guidance, see recent payer policy updates: Mohs Micrographic Surgery, Mohs Micrographic Surgery, Mohs Micrographic Surgery.

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    National Reimbursement Benchmarks

    National means show a clear split: Medicare’s mean is $163.10 compared with BUCA’s commercial average of $357.90, so BUCA averages about $194.80 higher than Medicare for CPT 10120. Blue Cross Blue Shield and UnitedHealth Group have means closer to the higher commercial side ($487.90 and $218.60 respectively), while Aetna and Cigna sit between Medicare and the highest commercial averages. This frames Medicare as the lower-cost anchor and BUCA as a representative higher-cost commercial benchmark.

    Dispersion measured as the interquartile spread (P75 minus P25) highlights where rates cluster or diverge. Blue Cross Blue Shield has the widest IQR at $175.20 (from $408.10 to $576.30), indicating the greatest midspread variability, while Aetna’s IQR is $99.70 and Cigna’s is $130.70. UnitedHealth Group’s IQR is $141.30. BUCA’s IQR is $149.80 and Medicare’s IQR is $19.00, making Medicare the tightest and Blue Cross Blue Shield the widest by this midquartile measure.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old patient presents to an urgent care clinic after stepping on a splintered wooden board while gardening. The patient reports localized pain and minor bleeding at the dorsum of the foot. On exam there is a palpable subcutaneous foreign body with surrounding erythema but no signs of systemic infection. After local anesthesia, the provider palpates and makes a small incision to explore and remove the splinter from the lower layer of skin, irrigates the wound, and applies a sterile dressing. The clinical workflow includes triage and focused history, informed consent for minor procedure, application of local anesthetic, removal of the foreign body from subcutaneous tissue, wound cleansing, tetanus status check and documentation, wound care instructions, and scheduling follow-up if needed. Typical documentation captures the foreign body type, depth (subcutaneous), technique, local anesthetic used, estimated time, complications (if any), and site of service.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    10121Incision and removal of foreign body, subcutaneous tissues; complicatedUsed when foreign body removal requires more extensive dissection or is complicated beyond a simple subcutaneous removal coded with 10120.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207XS0117X
    208600000X
    207Q00000X
    363LX0106X
    207NP0225X
    156FX1700X
    2081P0010X
    2279G0305X

    Related ICD-10-CM Codes

    32 rows

    ICD-10-CM CodeDescription
    S00.83XAContusion of other part of head, initial encounter
    S40.219AAbrasion of unspecified shoulder, initial encounter
    S50.20XA
    S51.801AUnspecified open wound of right forearm, initial encounter
    S51.802AUnspecified open wound of left forearm, initial encounter
    S51.811ALaceration without foreign body of right forearm, initial encounter
    S51.811DLaceration without foreign body of right forearm, subsequent encounter
    S51.811SLaceration without foreign body of right forearm, sequela
    S51.821ALaceration with foreign body of right forearm, initial encounter
    S51.822ALaceration with foreign body of left forearm, initial encounter

    Showing 1–10 of 32

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    FilsuvezCigna2026-11-01
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Hyperhidrosispriority_health_medicare2026-09-01
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01

    Related Codes

    CPT-10040-LESION-EXTRACTION-DRAINAGE-REMOVAL

    CPT 10040: Extraction of Skin Lesion (Incision and Drainage)

    CPT-10060-INCISION-AND-DRAINAGE-SIMPLE-ABSCESS

    CPT 10060: Incision and Drainage of Simple Skin Abscess

    CPT-10061-COMPLICATED-INCISION-AND-DRAINAGE-ABSCESS

    CPT 10061: Incision and Drainage, Complicated Abscess

    CPT-10080-PILONIDAL-CYST-INCISION-AND-DRAINAGE

    CPT 10080: Incision and Drainage of Pilonidal Cyst

    CPT-10081-PILONIDAL-CYST-INCISION-DRAINAGE-PROCEDURE

    CPT 10081: Incision and Drainage of Pilonidal Cyst, Complex

    CPT-10121-DEEP-FOREIGN-BODY-REMOVAL-SOFT-TISSUE

    CPT 10121: Incision and Removal of Deep Foreign Body

    CPT-10140-INCISION-AND-DRAINAGE-HEMATOMA-SEROMA-FLUID-EVACUATION

    CPT 10140: Incision and Drainage of Hematoma/Seroma

    CPT-10160-PERCUTANEOUS-ASPIRATION-SKIN-FLUID-COLLECTION-CULTURE

    CPT 10160: Needle Aspiration of Skin Fluid or Pus

    CPT-10180-INCISION-DRAINAGE-INSTRUMENT-ASSISTED-INFECTION

    CPT 10180: Incision and Drainage of Complex Infected Area

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    12001
    Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.5 cm or less
    May be performed if a small laceration requires simple closure after foreign body removal.
    11042Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or lessApplicable when removal requires debridement of devitalized tissue in addition to foreign body extraction.
    99213Established patient office or other outpatient visit, typically 15 minutesRepresents a common E/M level when an established patient is evaluated for foreign body removal and a separate E/M is reported with appropriate documentation (see modifier 25).