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CPT 16030: Dressing/Debridement of Large Partial-Thickness Burn
CPT code 16030 identifies the dressing and/or debridement of large partial‑thickness burns (more than one extremity or >10% total body surface area), billed for either initial or subsequent care. Nationally, this code captures a critical category of acute wound care for moderate-to-severe burns that often requires multidisciplinary management and may involve inpatient or specialized outpatient services. It is relevant to hospital billing, surgical services, and burn‑center workflows.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the code, typical sites of service, and the payer landscape. The publication outlines common billing relationships for similar burn procedures, how this code relates to smaller-area burn codes, and practical considerations for coding large partial‑thickness burns.
This summary provides benchmarks and billing context useful for coding teams, revenue cycle managers, and clinical staff seeking clarity on when to use CPT code 16030 versus related codes for smaller burn areas. It also highlights documentation points and clinical circumstances that commonly accompany use of this code. Data not available in the input prevents payer-specific allowance or utilization details from being included.
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Billing Code Overview
CPT code 16030 covers the dressing and/or debridement of a partial–thickness burn when the burn is large (involving more than one extremity or greater than 10% of total body surface area). This procedure code applies to either the initial or a subsequent dressing/debridement event.
Service type: Wound care / burn management procedure
Typical site of service: Hospital inpatient or outpatient burn clinic; emergency department or ambulatory surgical setting depending on clinical severity and need for monitoring
National Reimbursement Benchmarks
Nationally, Medicare’s mean rate of $219.9 sits below BUCA’s average commercial mean of $323.5, indicating that commercial arrangements represented by BUCA pay materially more on average than the Medicare locality benchmark. The gap between those means is $103.6, which highlights the common commercial premium above government payment levels for CPT 16030.
Dispersion across payers varies: compute P75–P25 ranges to compare concentration. Blue Cross Blue Shield shows the widest interquartile spread at $147.8 ($487.9–$284.1), followed by UnitedHealth Group with $181.3 ($355.7–$177.4) and Cigna with $165.7 ($331.4–$167.7). Aetna is comparatively tighter with a range of $110.0 ($161.7–$51.7), while BUCA’s IQR is $180.0 ($400.0–$219.0). Medicare’s IQR is narrow at $23 ($229–$206), reflecting the most compressed distribution among the listed payers.