Removal of a foreign object from subcutaneous tissue through an incision when the removal takes more work, such as dissection or a hard-to-find fragment.
- Medicare
- $275.22
- Work RVU
- 2.67
- Global, days
- 10
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Object type, location, and depth
- Why the removal was complicated (dissection, fragments, nearby structures)
- Imaging used to localize it
- Incision length and tissue layers explored
- Confirmation all fragments were removed
- Closure and post-procedure plan
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
10121 is the complicated version of subcutaneous foreign body removal. It applies when the object is still under the skin but the provider has to dissect, explore, or work around it, often with imaging, to get it out. Global period is 10 days.
In ortho, a common case is a broken needle or glass fragment in the hand or forearm that has moved, or a retained piece of metal from an old injury that is now symptomatic. If the object is under the fascia, in muscle, or in tendon sheath, 20520 or 20525 is the better fit. Foot cases go to 28192 or 28193.
The word "complicated" is not defined in CPT, so the note has to show it: time spent, extent of dissection, multiple fragments, proximity to nerves or vessels, need for imaging to locate. Payers will downcode to 10120 when the note just says "FB removed." Removal of surgical hardware is not 10121 either. Hardware removal has its own codes.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (2.67) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8.24) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 2.67 |
| Practice expense RVU | 5.19 |
| Malpractice RVU | 0.38 |
| Total RVU | 8.24 |
| Medicare national rate | $275.22 |
| Global period | 10 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $275.22 |
HOPD (APC 5072) Hospital outpatient department | $1,687.37 |
ASC (PI A2) Ambulatory surgical center (freestanding) | $742.04 |
Common denial reasons
The recurring reasons claims for CPT 10121 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Complexity not documented, downcoded to 10120
- Hardware removal coded as foreign body removal
- Object in muscle or tendon sheath needed 20520 or 20525
- Foot location billed with 10121 instead of 28192 or 28193
- Repeat procedure in global without 58 or 79
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What counts as complicated for 10121?
02Can I use 10121 to remove a screw or plate?
03What is the global period for 10121?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures dissection, imaging, and the number of fragments, which is the evidence payers want before they pay the complicated removal code.
See how Mira captures CPT 10121 documentation