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CPT code 10081: Pilonidal drainage, complicated incision and drainage2026 Medicare rate & RVUs in Connecticut

Reports surgical opening and drainage of a complicated pilonidal cyst or abscess in the natal cleft when the documented treatment is more involved than simple drainage.

CMS RVU26DEffective Oct 1, 2026One payment locality379 Medicare services in 2024

In Connecticut, Medicare pays $406.86 for 10081 in the office and $179.15 when it’s performed in a hospital or facility.

$406.86Office (non-facility)
$179.15Hospital or facility
+7.0%vs the national office rate ($380.10)

Check a contract rate as a % of Medicare · 10081 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 10081 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 10081 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 10081 covers

This service treats an infected pilonidal cavity in the cleft between the buttocks, typically near the tailbone. A surgeon or other qualified practitioner opens the affected area to release pus and may explore or irrigate the cavity and manage its wound as clinically indicated. It is commonly performed in an office, emergency department, or outpatient surgical setting for a painful, swollen, draining pilonidal abscess.

Choose this code when the record supports complicated rather than simple pilonidal drainage; document the site, infection findings, extent of the cavity, work performed, and why the procedure was complex. The service has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting 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 Connecticut compares for 10081

Across 109 of 109 payment localities, the office rate for 10081 runs from $332.48 in Arkansas to $506.52 in San Benito County, CA. Connecticut pays $406.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

10081 in Connecticut vs other payment areas
  1. Connecticut · this page$406.86
  2. Los Angeles, CA · California$429.77+$22.91
  3. Washington, DC area · District of Columbia$436.61+$29.75
  4. Miami, FL · Florida$416.20+$9.34
  5. Chicago, IL · Illinois$402.85−$4.01
  6. Manhattan, NY · New York$440.49+$33.63
  7. Alaska · Alaska$432.02+$25.16

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

Every other payment area

10081 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$337.82$152.82
ArkansasArkansas$332.48$150.87
ArizonaArizona$369.03$164.16
Bakersfield, CACalifornia$402.51$170.78
Chico, CACalifornia$401.18$169.45
El Centro, CACalifornia$401.26$169.53
Fresno, CACalifornia$401.18$169.45
Hanford, CACalifornia$401.18$169.45

10081 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.

$332.48

$453.85

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

View every state and territory as a table
10081 office rate range by state
State / territoryOffice rate rangeLocalities
AK$432.021
AL$337.821
AR$332.481
AZ$369.031
CA$401.18–$506.5229
CO$395.651
CT$406.861
DC$436.611
DE$375.501
FL$375.73–$416.203
GA$352.66–$388.092
GU$412.061
HI$412.061
IA$346.421
ID$349.051
IL$364.54–$402.854
IN$351.231
KS$345.021
KY$347.371
LA$346.93–$365.612
MA$393.13–$436.502
MD$382.99–$436.613
ME$351.44–$371.642
MI$357.59–$381.212
MN$377.011
MO$340.69–$366.573
MS$336.641
MT$380.071
NC$355.381
ND$370.581
NE$348.371
NH$389.681
NJ$410.91–$431.542
NM$359.871
NV$377.711
NY$361.21–$452.465
OH$355.651
OK$346.291
OR$374.21–$408.672
PA$356.05–$396.252
PR$382.971
RI$389.241
SC$356.221
SD$369.461
TN$346.971
TX$353.53–$394.838
UT$361.511
VA$370.58–$436.612
VI$382.971
VT$369.361
WA$392.31–$445.392
WI$357.141
WV$350.001
WY$375.931

See 10081 in every payment locality

How the 10081 rate is calculated

Each of 10081’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 · 10081

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.44

2.44 RVUs× 1.000 GPCI

Practice expense8.46

8.46 RVUs× 1.000 GPCI

Malpractice0.48

0.48 RVUs× 1.000 GPCI

Adjusted RVUs

11.3800

Conversion factor

$33.4009

Medicare rate

$380.10

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,094

Code
10081
Physician work
2.44
Practice expense
8.46
Malpractice
0.48

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 10081 in Connecticut
ComponentRVULocality factorAdjusted
Physician work2.44× 1.0202.4888
Practice expense8.46× 1.0779.1114
Malpractice0.48× 1.2100.5808
Total RVUs12.1810
Conversion factor× 33.4009

Office rate, Connecticut$406.86

Office: (2.44 × 1.02 + 8.46 × 1.077 + 0.48 × 1.21) × $33.4009 = $406.86

Facility: (2.44 × 1.02 + 2.13 × 1.077 + 0.48 × 1.21) × $33.4009 = $179.15

Open 10081 in the RVU calculator

Payment rules and modifiers for 10081

10081 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 10081

Pilonidal drainage, complicated 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 · 10081

Pilonidal drainage, complicated 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

10081 without 51 · national office

$380.10

Pilonidal drainage, complicated incision and drainage

10081-51 · Second procedure: 50%

$190.05

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 10081

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

Codes related to 10081
CodeHow it relatesOffice range, Connecticut
Same family
10080Pilonidal drainage, simple incision and drainageSimple pilonidal cyst drainage; 10081 represents the complicated level.$288.92
Used instead
10060Abscess drainage, simple, single abscessFor simple or single abscess drainage when the abscess is not coded as pilonidal.$136.81
10061Abscess drainage, complex or multipleFor complicated or multiple abscess drainage outside the pilonidal-specific code family.$233.98
11770Pilonidal excision, simple excisionExcision of pilonidal disease is a different procedure from incision and drainage.$417.94

How 10081 has changed in Connecticut

10081 · Office / nonfacility

$406.86

Effective 2026-10-01

The base rate is $52.02 higher than on 2025-10-01, moving from $354.84 to $406.86 (14.7%).

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

    $354.84changed to$406.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.50 changed to 2.44
    • Practice expense RVU 7.16 changed to 8.46
    • Malpractice RVU 0.50 changed to 0.48
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $371.95changed to$354.84

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.38 changed to 7.16
    • Malpractice RVU 0.47 changed to 0.50

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $365.88changed to$371.95

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $379.93changed to$365.88

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.41 changed to 7.38
    • Malpractice RVU 0.44 changed to 0.47
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $394.42changed to$379.93

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.56 changed to 7.41
    • Malpractice RVU 0.41 changed to 0.44
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $379.42changed to$394.42

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.09 changed to 7.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $340.41changed to$379.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.78 changed to 7.09
    • Malpractice RVU 0.39 changed to 0.41
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $307.75changed to$340.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.00 changed to 5.78
    • Malpractice RVU 0.34 changed to 0.39
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $301.00changed to$307.75

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.84 changed to 5.00

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $299.03changed to$301.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.78 changed to 4.84
    • Malpractice RVU 0.35 changed to 0.34
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $298.15changed to$299.03

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.76 changed to 4.78
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $299.22changed to$298.15

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $297.74changed to$299.22

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $297.81changed to$297.74

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.68 changed to 4.76
    • Malpractice RVU 0.43 changed to 0.35
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $305.79changed to$297.81

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.29 changed to 4.68
    • Malpractice RVU 0.45 changed to 0.43
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $305.79

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$406.86$179.15RVU26D
2026-07-01$406.86$179.15RVU26C
2026-04-01$406.86$179.15RVU26B
2026-01-01$406.86$179.15RVU26A
2025-10-01$354.84$179.10RVU25D
2025-07-01$354.84$179.10RVU25C
2025-04-01$354.84$179.10RVU25B
2025-01-01$354.84$179.10RVU25A
2024-10-01$371.95$183.10RVU24D
2024-07-01$371.95$183.10RVU24C
2024-04-01$371.95$183.10RVU24B
2024-03-09$371.95$183.10RVU24AR
2024-01-01$365.88$180.12RVU24A
2023-10-01$379.93$183.88RVU23D
2023-07-01$379.93$183.88RVU23C
2023-04-01$379.93$183.88RVU23B
2023-01-01$379.93$183.88RVU23A
2022-10-01$394.42$185.47RVU22D
2022-07-01$394.42$185.47RVU22C
2022-04-01$394.42$185.47RVU22B
2022-01-01$394.42$185.47RVU22A
2021-10-01$379.42$187.39RVU21D
2021-07-01$379.42$187.39RVU21C
2021-04-01$379.42$187.39RVU21B
2021-01-01$379.42$187.39RVU21A
2020-10-01$340.41$190.18RVU20D
2020-07-01$340.41$190.18RVU20C
2020-04-01$340.41$190.18RVU20B
2020-01-01$340.41$190.18RVU20A
2019-10-01$307.75$188.72RVU19D
2019-07-01$307.75$188.72RVU19C
2019-04-01$307.75$188.72RVU19B
2019-01-01$307.75$188.72RVU19A
2018-10-01$301.00$188.51RVU18D
2018-07-01$301.00$188.51RVU18C
2018-04-01$301.00$188.51RVU18B
2018-01-01$301.00$188.51RVU18AR1
2017-10-01$299.03$187.59RVU17D
2017-07-01$299.03$187.59RVU17C
2017-04-01$299.03$187.59RVU17B
2017-01-01$299.03$187.59RVU17A
2016-10-01$298.15$187.37RVU16D
2016-07-01$298.15$187.37RVU16C
2016-04-01$298.15$187.37RVU16B
2016-01-01$298.15$187.37RVU16A
2015-10-01$299.22$188.45RVU15D
2015-07-01$299.22$188.45RVU15C
2015-04-01$297.74$187.51RVU15B
2015-01-01$297.74$187.51RVU15A
2014-10-01$297.81$189.87RVU14D
2014-07-01$297.81$189.87RVU14C
2014-04-01$297.81$189.87RVU14B
2014-01-01$297.81$189.87RVU14A
2013-10-01$305.79$189.09RVU13D
2013-07-01$305.79$189.09RVU13C
2013-04-01$305.79$189.09RVU13B
2013-01-01$305.79$189.09RVU13AR

Price 10081 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

10081 billing questions

How do I choose between 10080 and 10081?

Use 10080 for simple pilonidal cyst drainage and 10081 when the operative note supports a complicated procedure. Document the extent and specific work that make the drainage more involved.

How is 10081 different from general abscess drainage?

10081 is specific to complicated drainage of a pilonidal cyst in the natal cleft. Codes 10060 and 10061 describe drainage of other abscesses rather than this pilonidal-specific service.

Are related postoperative visits separately reported?

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

Can modifier 50 be used for bilateral disease?

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

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for 10081. Co-surgeons and team surgery are not permitted.

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

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to the 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 10081PPRRVU2026_Oct_nonQPP.csv, line 1,094 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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