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10121

Incision and removal of foreign body, subcutaneous tissues; complicated

Surgery General Surgery 9.60 Total RVUs
Quick Reference
For complicated incision and removal of foreign body requiring extensive procedure

Relative Value Units (RVUs)

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Work RVU
4.00
Physician effort
PE RVU
5.20
Practice expense
MP RVU
0.40
Malpractice
Total RVU
9.60
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

For complicated incision and removal of foreign body requiring extensive procedure

Time Requirement
30-60 minutes typical procedure time

Common Scenarios

Removal of deeply embedded foreign body
Removal of foreign body requiring extensive dissection
Removal of foreign body with extensive tissue damage
Removal of foreign body requiring exploration
Removal of foreign body with infection or abscess

Documentation Requirements

  • Location and depth of foreign body
  • Type and size of foreign body
  • Complexity of removal
  • Extent of tissue dissection
  • Any complications

Coding Guidelines

Common Modifiers

51 Multiple procedures performed same session
59 Distinct procedural service if performed separately
LT Left side procedure
RT Right side procedure

Bundling Rules

  • Includes incision and removal
  • Includes local anesthesia
  • Extensive dissection bundled when performed same session
  • Wound closure bundled when performed same session
  • Debridement bundled when performed same session

Exclusions

  • 10120 (simple foreign body removal)
  • 20520 (removal of foreign body from muscle)
  • 28190 (removal of foreign body from foot)

Coding Notes

Complicated removal requiring extensive procedure
Document complexity and extent
Extensive dissection may be required
Global period is 10 days

Clinical scenarios

Removal of deeply embedded foreign body
Removal of deeply embedded foreign body
When to use:For complicated incision and removal of foreign body requiring extensive procedure
  • Location and depth of foreign body
  • Type and size of foreign body
  • Complexity of removal
Removal of foreign body requiring extensive dissection
Removal of foreign body requiring extensive dissection
When to use:For complicated incision and removal of foreign body requiring extensive procedure
  • Location and depth of foreign body
  • Type and size of foreign body
  • Complexity of removal
Removal of foreign body with extensive tissue damage
Removal of foreign body with extensive tissue damage
When to use:For complicated incision and removal of foreign body requiring extensive procedure
  • Location and depth of foreign body
  • Type and size of foreign body
  • Complexity of removal

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Code Details

Code 10121
Category Surgery
Subcategory General Surgery
Total RVUs 9.60

Medicare Pricing

PFS
2025 National Rate
$257.15
Facility
$179.52
Non-Facility
$257.15
RVU Breakdown
Work RVU:2.74PE RVU:4.82MP RVU:0.39Total RVU:7.95CF:$32.3465Global Days:010
OPPS Details
APC:5072Status:J1Copayment:
Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 10121?

CPT 10121 is the billing code for "Incision and removal of foreign body, subcutaneous tissues; complicated". For complicated incision and removal of foreign body requiring extensive procedure

How much does Medicare pay for CPT 10121?

Medicare pays approximately $257.15 for CPT 10121 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

What are the RVUs for CPT 10121?

CPT 10121 has a total RVU of 9.60, broken down as: Work RVU 4.00, Practice Expense RVU 5.20, and Malpractice RVU 0.40. RVUs (Relative Value Units) determine Medicare reimbursement rates.

What documentation is required for CPT 10121?

Key documentation requirements for CPT 10121 include: Location and depth of foreign body; Type and size of foreign body; Complexity of removal; Extent of tissue dissection. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 10121 be billed with other codes?

Bundling considerations for CPT 10121: Includes incision and removal. Includes local anesthesia Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 10121?

Common modifiers for CPT 10121 include: 51 (Multiple procedures performed same session), 59 (Distinct procedural service if performed separately), LT (Left side procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

What is the time requirement for CPT 10121?

The typical time requirement for CPT 10121 is 30-60 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.

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