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

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 Utah, Medicare pays $361.51 for 10081 in the office and $162.77 when it’s performed in a hospital or facility.

$361.51Office (non-facility)
$162.77Hospital or facility
−4.9%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 Utah
  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 Utah 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. Utah pays $361.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

10081 in Utah vs other payment areas
  1. Utah · this page$361.51
  2. Los Angeles, CA · California$429.77+$68.26
  3. Washington, DC area · District of Columbia$436.61+$75.10
  4. Miami, FL · Florida$416.20+$54.69
  5. Chicago, IL · Illinois$402.85+$41.34
  6. Manhattan, NY · New York$440.49+$78.98
  7. Alaska · Alaska$432.02+$70.51

Other areas in Utah 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 Utah 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

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 10081 in Utah
ComponentRVULocality factorAdjusted
Physician work2.44× 1.0002.4400
Practice expense8.46× 0.9407.9524
Malpractice0.48× 0.8980.4310
Total RVUs10.8234
Conversion factor× 33.4009

Office rate, Utah$361.51

Office: (2.44 × 1 + 8.46 × 0.94 + 0.48 × 0.898) × $33.4009 = $361.51

Facility: (2.44 × 1 + 2.13 × 0.94 + 0.48 × 0.898) × $33.4009 = $162.77

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, Utah
Same family
10080Pilonidal drainage, simple incision and drainageSimple pilonidal cyst drainage; 10081 represents the complicated level.$255.48
Used instead
10060Abscess drainage, simple, single abscessFor simple or single abscess drainage when the abscess is not coded as pilonidal.$123.08
10061Abscess drainage, complex or multipleFor complicated or multiple abscess drainage outside the pilonidal-specific code family.$211.23
11770Pilonidal excision, simple excisionExcision of pilonidal disease is a different procedure from incision and drainage.$371.05

How 10081 has changed in Utah

10081 · Office / nonfacility

$361.51

Effective 2026-10-01

The base rate is $49.52 higher than on 2025-10-01, moving from $311.99 to $361.51 (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

    $311.99changed to$361.51

    • 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
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $326.97changed to$311.99

    • 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

    $321.63changed to$326.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $330.14changed to$321.63

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $338.28changed to$330.14

    • 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
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $326.02changed to$338.28

    • 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

    $296.58changed to$326.02

    • 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
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $271.41changed to$296.58

    • 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
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $265.78changed to$271.41

    • 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

    $263.06changed to$265.78

    • 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
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $261.30changed to$263.06

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.76 changed to 4.78
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $262.24changed to$261.30

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $260.93changed to$262.24

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $261.13changed to$260.93

    • 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 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $266.79changed to$261.13

    • 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 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $266.79

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$361.51$162.77RVU26D
2026-07-01$361.51$162.77RVU26C
2026-04-01$361.51$162.77RVU26B
2026-01-01$361.51$162.77RVU26A
2025-10-01$311.99$161.70RVU25D
2025-07-01$311.99$161.70RVU25C
2025-04-01$311.99$161.70RVU25B
2025-01-01$311.99$161.70RVU25A
2024-10-01$326.97$165.47RVU24D
2024-07-01$326.97$165.47RVU24C
2024-04-01$326.97$165.47RVU24B
2024-03-09$326.97$165.47RVU24AR
2024-01-01$321.63$162.77RVU24A
2023-10-01$330.14$165.40RVU23D
2023-07-01$330.14$165.40RVU23C
2023-04-01$330.14$165.40RVU23B
2023-01-01$330.14$165.40RVU23A
2022-10-01$338.28$165.91RVU22D
2022-07-01$338.28$165.91RVU22C
2022-04-01$338.28$165.91RVU22B
2022-01-01$338.28$165.91RVU22A
2021-10-01$326.02$167.61RVU21D
2021-07-01$326.02$167.61RVU21C
2021-04-01$326.02$167.61RVU21B
2021-01-01$326.02$167.61RVU21A
2020-10-01$296.58$172.00RVU20D
2020-07-01$296.58$172.00RVU20C
2020-04-01$296.58$172.00RVU20B
2020-01-01$296.58$172.00RVU20A
2019-10-01$271.41$172.19RVU19D
2019-07-01$271.41$172.19RVU19C
2019-04-01$271.41$172.19RVU19B
2019-01-01$271.41$172.19RVU19A
2018-10-01$265.78$172.00RVU18D
2018-07-01$265.78$172.00RVU18C
2018-04-01$265.78$172.00RVU18B
2018-01-01$265.78$172.00RVU18AR1
2017-10-01$263.06$170.77RVU17D
2017-07-01$263.06$170.77RVU17C
2017-04-01$263.06$170.77RVU17B
2017-01-01$263.06$170.77RVU17A
2016-10-01$261.30$170.18RVU16D
2016-07-01$261.30$170.18RVU16C
2016-04-01$261.30$170.18RVU16B
2016-01-01$261.30$170.18RVU16A
2015-10-01$262.24$171.13RVU15D
2015-07-01$262.24$171.13RVU15C
2015-04-01$260.93$170.28RVU15B
2015-01-01$260.93$170.28RVU15A
2014-10-01$261.13$172.24RVU14D
2014-07-01$261.13$172.24RVU14C
2014-04-01$261.13$172.24RVU14B
2014-01-01$261.13$172.24RVU14A
2013-10-01$266.79$170.49RVU13D
2013-07-01$266.79$170.49RVU13C
2013-04-01$266.79$170.49RVU13B
2013-01-01$266.79$170.49RVU13AR

Price 10081 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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 UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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