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CPT code 10080: Pilonidal drainage, simple incision and drainage2026 Medicare rate & RVUs in New Mexico

Reports simple incision and drainage of a pilonidal cyst, typically to evacuate an abscess in the natal cleft without complex treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality868 Medicare services in 2024

In New Mexico, Medicare pays $252.37 for 10080 in the office and $101.68 when it’s performed in a hospital or facility.

$252.37Office (non-facility)
$101.68Hospital or facility
−6.4%vs the national office rate ($269.55)

Check a contract rate as a % of Medicare · 10080 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 10080 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 10080 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 10080 covers

This service is a limited incision and drainage of a pilonidal cyst or abscess in the cleft between the buttocks. A physician or other qualified practitioner typically performs it in an office, emergency department, or outpatient setting, often using local anesthesia. The aim is to release the collection rather than excise the pilonidal tract or cyst.

Select this code for a simple drainage; use the complex pilonidal code when the procedure is more involved. The note should identify the pilonidal site and describe the incision and drainage performed. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay for an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How New Mexico compares for 10080

Across 109 of 109 payment localities, the office rate for 10080 runs from $234.85 in Arkansas to $369.44 in San Benito County, CA. New Mexico pays $252.37. The RVUs are the same everywhere; the geographic indexes change the dollars.

10080 in New Mexico vs other payment areas
  1. New Mexico · this page$252.37
  2. Los Angeles, CA · California$309.76+$57.39
  3. Washington, DC area · District of Columbia$312.16+$59.79
  4. Miami, FL · Florida$288.91+$36.54
  5. Chicago, IL · Illinois$279.59+$27.22
  6. Manhattan, NY · New York$312.15+$59.78
  7. Alaska · Alaska$300.92+$48.55

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

10080 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$238.76$94.97
ArkansasArkansas$234.85$93.68
ArizonaArizona$261.67$102.43
Bakersfield, CACalifornia$289.11$109.00
Chico, CACalifornia$288.54$108.43
El Centro, CACalifornia$288.57$108.47
Fresno, CACalifornia$288.54$108.43
Hanford, CACalifornia$288.54$108.43

10080 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$234.85

$328.99

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
10080 office rate range by state
State / territoryOffice rate rangeLocalities
AK$300.921
AL$238.761
AR$234.851
AZ$261.671
CA$288.54–$369.4429
CO$282.841
CT$288.921
DC$312.161
DE$266.391
FL$263.09–$288.913
GA$246.73–$274.582
GU$297.301
HI$297.301
IA$246.551
ID$248.181
IL$253.89–$281.004
IN$249.821
KS$244.811
KY$244.211
LA$243.61–$257.292
MA$280.65–$313.722
MD$272.07–$312.163
ME$249.17–$265.072
MI$251.00–$266.322
MN$271.311
MO$238.58–$258.853
MS$236.791
MT$269.531
NC$252.181
ND$265.581
NE$248.211
NH$277.861
NJ$292.31–$308.202
NM$252.371
NV$268.651
NY$256.41–$319.985
OH$250.191
OK$244.181
OR$266.67–$293.242
PA$250.88–$280.702
PR$271.901
RI$276.941
SC$251.591
SD$265.111
TN$246.151
TX$248.99–$281.808
UT$255.481
VA$263.79–$312.162
VI$271.901
VT$264.011
WA$280.29–$320.962
WI$255.551
WV$243.201
WY$267.811

See 10080 in every payment locality

How the 10080 rate is calculated

Each of 10080’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 10080

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.19

1.19 RVUs× 1.000 GPCI

Practice expense6.68

6.68 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

8.0700

Conversion factor

$33.4009

Medicare rate

$269.55

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,093

Code
10080
Physician work
1.19
Practice expense
6.68
Malpractice
0.20

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 10080 in New Mexico
ComponentRVULocality factorAdjusted
Physician work1.19× 1.0001.1900
Practice expense6.68× 0.9176.1256
Malpractice0.20× 1.2010.2402
Total RVUs7.5558
Conversion factor× 33.4009

Office rate, New Mexico$252.37

Office: (1.19 × 1 + 6.68 × 0.917 + 0.2 × 1.201) × $33.4009 = $252.37

Facility: (1.19 × 1 + 1.76 × 0.917 + 0.2 × 1.201) × $33.4009 = $101.68

Open 10080 in the RVU calculator

Payment rules and modifiers for 10080

10080 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 10080

Pilonidal drainage, simple incision and drainage

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 10080

Pilonidal drainage, simple incision and drainage

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

10080 without 51 · national office

$269.55

Pilonidal drainage, simple incision and drainage

10080-51 · Second procedure: 50%

$134.78

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 10080

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 10080
CodeHow it relatesOffice range, New Mexico
Same family
10081Pilonidal drainage, complicated incision and drainageComplex pilonidal cyst drainage; distinguish by the extent and complexity of the procedure.$359.87
Used instead
11770Pilonidal excision, simple excisionSimple excision of pilonidal cyst or sinus rather than drainage.$370.71
11771Pilonidal excision, extensive diseaseMore extensive excision of pilonidal cyst or sinus.$664.96
11772Pilonidal excision, complicated diseaseExcision for complicated pilonidal disease rather than simple drainage.$813.05

How 10080 has changed in New Mexico

10080 · Office / nonfacility

$252.37

Effective 2026-10-01

The base rate is $30.57 higher than on 2025-10-01, moving from $221.80 to $252.37 (13.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $221.80changed to$252.37

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.22 changed to 1.19
    • Practice expense RVU 5.95 changed to 6.68
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $233.39changed to$221.80

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.12 changed to 5.95

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $229.58changed to$233.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $237.46changed to$229.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.17 changed to 6.12
    • Malpractice RVU 0.19 changed to 0.20
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172

  5. January 1, 2023

    RVU23A

    $245.32changed to$237.46

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.29 changed to 6.17
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $232.57changed to$245.32

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.83 changed to 6.29
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $202.39changed to$232.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.58 changed to 5.83
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $179.06changed to$202.39

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.84 changed to 4.58
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $175.34changed to$179.06

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.72 changed to 3.84
    • Malpractice RVU 0.18 changed to 0.17

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $173.07changed to$175.34

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.68 changed to 3.72
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $172.25changed to$173.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $172.87changed to$172.25

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $172.01changed to$172.87

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $169.76changed to$172.01

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.61 changed to 3.68
    • Malpractice RVU 0.19 changed to 0.18
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $173.89changed to$169.76

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.03 changed to 3.61
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $173.89

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$252.37$101.68RVU26D
2026-07-01$252.37$101.68RVU26C
2026-04-01$252.37$101.68RVU26B
2026-01-01$252.37$101.68RVU26A
2025-10-01$221.80$99.03RVU25D
2025-07-01$221.80$99.03RVU25C
2025-04-01$221.80$99.03RVU25B
2025-01-01$221.80$99.03RVU25A
2024-10-01$233.39$101.61RVU24D
2024-07-01$233.39$101.61RVU24C
2024-04-01$233.39$101.61RVU24B
2024-03-09$233.39$101.61RVU24AR
2024-01-01$229.58$99.95RVU24A
2023-10-01$237.46$101.14RVU23D
2023-07-01$237.46$101.14RVU23C
2023-04-01$237.46$101.14RVU23B
2023-01-01$237.46$101.14RVU23A
2022-10-01$245.32$102.07RVU22D
2022-07-01$245.32$102.07RVU22C
2022-04-01$245.32$102.07RVU22B
2022-01-01$245.32$102.07RVU22A
2021-10-01$232.57$101.89RVU21D
2021-07-01$232.57$101.89RVU21C
2021-04-01$232.57$101.89RVU21B
2021-01-01$232.57$101.89RVU21A
2020-10-01$202.39$102.77RVU20D
2020-07-01$202.39$102.77RVU20C
2020-04-01$202.39$102.77RVU20B
2020-01-01$202.39$102.77RVU20A
2019-10-01$179.06$102.72RVU19D
2019-07-01$179.06$102.72RVU19C
2019-04-01$179.06$102.72RVU19B
2019-01-01$179.06$102.72RVU19A
2018-10-01$175.34$103.06RVU18D
2018-07-01$175.34$103.06RVU18C
2018-04-01$175.34$103.06RVU18B
2018-01-01$175.34$103.06RVU18AR1
2017-10-01$173.07$102.41RVU17D
2017-07-01$173.07$102.41RVU17C
2017-04-01$173.07$102.41RVU17B
2017-01-01$173.07$102.41RVU17A
2016-10-01$172.25$101.51RVU16D
2016-07-01$172.25$101.51RVU16C
2016-04-01$172.25$101.51RVU16B
2016-01-01$172.25$101.51RVU16A
2015-10-01$172.87$102.53RVU15D
2015-07-01$172.87$102.53RVU15C
2015-04-01$172.01$102.02RVU15B
2015-01-01$172.01$102.02RVU15A
2014-10-01$169.76$101.03RVU14D
2014-07-01$169.76$101.03RVU14C
2014-04-01$169.76$101.03RVU14B
2014-01-01$169.76$101.03RVU14A
2013-10-01$173.89$100.65RVU13D
2013-07-01$173.89$100.65RVU13C
2013-04-01$173.89$100.65RVU13B
2013-01-01$173.89$100.65RVU13AR

Price 10080 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

10080 billing questions

How does this differ from the complex pilonidal drainage code?

Use this code for a simple drainage. The complex pilonidal code is for a more involved drainage procedure; document the work performed to support the selection.

Can this be reported for a routine skin abscess?

No. This code is specific to a pilonidal cyst or abscess. A simple or complex abscess elsewhere is reported with the applicable abscess drainage code.

Are related postoperative visits separately billable?

Related postoperative visits during the 10-day global period are included in this procedure's payment.

Should modifier 50 be appended for bilateral disease?

No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

Can an assistant, co-surgeon, or surgical team be billed?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What happens if another procedure is performed in the same session?

The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 10080PPRRVU2026_Oct_nonQPP.csv, line 1,093 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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