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

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 South Dakota, Medicare pays $369.46 for 10081 in the office and $158.03 when it’s performed in a hospital or facility.

$369.46Office (non-facility)
$158.03Hospital or facility
−2.8%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 South Dakota
  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 South Dakota 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. South Dakota pays $369.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

10081 in South Dakota vs other payment areas
  1. South Dakota · this page$369.46
  2. Los Angeles, CA · California$429.77+$60.31
  3. Washington, DC area · District of Columbia$436.61+$67.15
  4. Miami, FL · Florida$416.20+$46.74
  5. Chicago, IL · Illinois$402.85+$33.39
  6. Manhattan, NY · New York$440.49+$71.03
  7. Alaska · Alaska$432.02+$62.56

Other areas in South Dakota 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.

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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 10081 in South Dakota
ComponentRVULocality factorAdjusted
Physician work2.44× 1.0002.4400
Practice expense8.46× 1.0008.4600
Malpractice0.48× 0.3360.1613
Total RVUs11.0613
Conversion factor× 33.4009

Office rate, South Dakota$369.46

Office: (2.44 × 1 + 8.46 × 1 + 0.48 × 0.336) × $33.4009 = $369.46

Facility: (2.44 × 1 + 2.13 × 1 + 0.48 × 0.336) × $33.4009 = $158.03

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

How 10081 has changed in South Dakota

10081 · Office / nonfacility

$369.46

Effective 2026-10-01

The base rate is $50.81 higher than on 2025-10-01, moving from $318.65 to $369.46 (15.9%).

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

    $318.65changed to$369.46

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $334.86changed to$318.65

    • 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

    $329.39changed to$334.86

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $341.25changed to$329.39

    • 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
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $353.06changed to$341.25

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $339.59changed to$353.06

    • 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

    $304.00changed to$339.59

    • 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
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $275.06changed to$304.00

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $269.00changed to$275.06

    • 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

    $266.23changed to$269.00

    • 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
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $264.95changed to$266.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.76 changed to 4.78
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $265.91changed to$264.95

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $264.58changed to$265.91

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $263.62changed to$264.58

    • 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
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $271.65changed to$263.62

    • 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
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $271.65

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$369.46$158.03RVU26D
2026-07-01$369.46$158.03RVU26C
2026-04-01$369.46$158.03RVU26B
2026-01-01$369.46$158.03RVU26A
2025-10-01$318.65$157.56RVU25D
2025-07-01$318.65$157.56RVU25C
2025-04-01$318.65$157.56RVU25B
2025-01-01$318.65$157.56RVU25A
2024-10-01$334.86$161.76RVU24D
2024-07-01$334.86$161.76RVU24C
2024-04-01$334.86$161.76RVU24B
2024-03-09$334.86$161.76RVU24AR
2024-01-01$329.39$159.12RVU24A
2023-10-01$341.25$163.34RVU23D
2023-07-01$341.25$163.34RVU23C
2023-04-01$341.25$163.34RVU23B
2023-01-01$341.25$163.34RVU23A
2022-10-01$353.06$165.50RVU22D
2022-07-01$353.06$165.50RVU22C
2022-04-01$353.06$165.50RVU22B
2022-01-01$353.06$165.50RVU22A
2021-10-01$339.59$167.22RVU21D
2021-07-01$339.59$167.22RVU21C
2021-04-01$339.59$167.22RVU21B
2021-01-01$339.59$167.22RVU21A
2020-10-01$304.00$169.03RVU20D
2020-07-01$304.00$169.03RVU20C
2020-04-01$304.00$169.03RVU20B
2020-01-01$304.00$169.03RVU20A
2019-10-01$275.06$168.02RVU19D
2019-07-01$275.06$168.02RVU19C
2019-04-01$275.06$168.02RVU19B
2019-01-01$275.06$168.02RVU19A
2018-10-01$269.00$167.84RVU18D
2018-07-01$269.00$167.84RVU18C
2018-04-01$269.00$167.84RVU18B
2018-01-01$269.00$167.84RVU18AR1
2017-10-01$266.23$166.46RVU17D
2017-07-01$266.23$166.46RVU17C
2017-04-01$266.23$166.46RVU17B
2017-01-01$266.23$166.46RVU17A
2016-10-01$264.95$166.13RVU16D
2016-07-01$264.95$166.13RVU16C
2016-04-01$264.95$166.13RVU16B
2016-01-01$264.95$166.13RVU16A
2015-10-01$265.91$167.09RVU15D
2015-07-01$265.91$167.09RVU15C
2015-04-01$264.58$166.26RVU15B
2015-01-01$264.58$166.26RVU15A
2014-10-01$263.62$166.89RVU14D
2014-07-01$263.62$166.89RVU14C
2014-04-01$263.62$166.89RVU14B
2014-01-01$263.62$166.89RVU14A
2013-10-01$271.65$166.52RVU13D
2013-07-01$271.65$166.52RVU13C
2013-04-01$271.65$166.52RVU13B
2013-01-01$271.65$166.52RVU13AR

Price 10081 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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