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

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 Virginia, Medicare pays $370.58 for 10081 in the office and $162.75 when it’s performed in a hospital or facility.

$370.58Office (non-facility)
$162.75Hospital or facility
−2.5%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 Virginia
  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 Virginia 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. Virginia pays $370.58. The RVUs are the same everywhere; the geographic indexes change the dollars.

10081 in Virginia vs other payment areas
  1. Virginia · this page$370.58
  2. Los Angeles, CA · California$429.77+$59.19
  3. Washington, DC area · District of Columbia$436.61+$66.03
  4. Miami, FL · Florida$416.20+$45.62
  5. Chicago, IL · Illinois$402.85+$32.27
  6. Manhattan, NY · New York$440.49+$69.91
  7. Alaska · Alaska$432.02+$61.44

Other areas in Virginia 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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 10081 in Virginia
ComponentRVULocality factorAdjusted
Physician work2.44× 1.0002.4400
Practice expense8.46× 0.9838.3162
Malpractice0.48× 0.7060.3389
Total RVUs11.0951
Conversion factor× 33.4009

Office rate, Virginia$370.58

Office: (2.44 × 1 + 8.46 × 0.983 + 0.48 × 0.706) × $33.4009 = $370.58

Facility: (2.44 × 1 + 2.13 × 0.983 + 0.48 × 0.706) × $33.4009 = $162.75

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, Virginia
Same family
10080Pilonidal drainage, simple incision and drainageSimple pilonidal cyst drainage; 10081 represents the complicated level.$263.79
Used instead
10060Abscess drainage, simple, single abscessFor simple or single abscess drainage when the abscess is not coded as pilonidal.$125.88
10061Abscess drainage, complex or multipleFor complicated or multiple abscess drainage outside the pilonidal-specific code family.$214.67
11770Pilonidal excision, simple excisionExcision of pilonidal disease is a different procedure from incision and drainage.$379.32

How 10081 has changed in Virginia

10081 · Office / nonfacility

$370.58

Effective 2026-10-01

The base rate is $49.45 higher than on 2025-10-01, moving from $321.13 to $370.58 (15.4%).

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

    $321.13changed to$370.58

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $336.93changed to$321.13

    • 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

    $331.43changed to$336.93

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $345.63changed to$331.43

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $359.56changed to$345.63

    • 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 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $346.22changed to$359.56

    • 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

    $309.65changed to$346.22

    • 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 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $278.90changed to$309.65

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $272.91changed to$278.90

    • 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

    $269.57changed to$272.91

    • 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 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $267.37changed to$269.57

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.76 changed to 4.78
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $268.33changed to$267.37

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $267.00changed to$268.33

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $265.84changed to$267.00

    • 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 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $272.09changed to$265.84

    • 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 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $272.09

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$370.58$162.75RVU26D
2026-07-01$370.58$162.75RVU26C
2026-04-01$370.58$162.75RVU26B
2026-01-01$370.58$162.75RVU26A
2025-10-01$321.13$162.63RVU25D
2025-07-01$321.13$162.63RVU25C
2025-04-01$321.13$162.63RVU25B
2025-01-01$321.13$162.63RVU25A
2024-10-01$336.93$166.60RVU24D
2024-07-01$336.93$166.60RVU24C
2024-04-01$336.93$166.60RVU24B
2024-03-09$336.93$166.60RVU24AR
2024-01-01$331.43$163.88RVU24A
2023-10-01$345.63$169.50RVU23D
2023-07-01$345.63$169.50RVU23C
2023-04-01$345.63$169.50RVU23B
2023-01-01$345.63$169.50RVU23A
2022-10-01$359.56$172.93RVU22D
2022-07-01$359.56$172.93RVU22C
2022-04-01$359.56$172.93RVU22B
2022-01-01$359.56$172.93RVU22A
2021-10-01$346.22$174.71RVU21D
2021-07-01$346.22$174.71RVU21C
2021-04-01$346.22$174.71RVU21B
2021-01-01$346.22$174.71RVU21A
2020-10-01$309.65$175.89RVU20D
2020-07-01$309.65$175.89RVU20C
2020-04-01$309.65$175.89RVU20B
2020-01-01$309.65$175.89RVU20A
2019-10-01$278.90$173.36RVU19D
2019-07-01$278.90$173.36RVU19C
2019-04-01$278.90$173.36RVU19B
2019-01-01$278.90$173.36RVU19A
2018-10-01$272.91$173.17RVU18D
2018-07-01$272.91$173.17RVU18C
2018-04-01$272.91$173.17RVU18B
2018-01-01$272.91$173.17RVU18AR1
2017-10-01$269.57$171.30RVU17D
2017-07-01$269.57$171.30RVU17C
2017-04-01$269.57$171.30RVU17B
2017-01-01$269.57$171.30RVU17A
2016-10-01$267.37$170.23RVU16D
2016-07-01$267.37$170.23RVU16C
2016-04-01$267.37$170.23RVU16B
2016-01-01$267.37$170.23RVU16A
2015-10-01$268.33$171.20RVU15D
2015-07-01$268.33$171.20RVU15C
2015-04-01$267.00$170.34RVU15B
2015-01-01$267.00$170.34RVU15A
2014-10-01$265.84$171.05RVU14D
2014-07-01$265.84$171.05RVU14C
2014-04-01$265.84$171.05RVU14B
2014-01-01$265.84$171.05RVU14A
2013-10-01$272.09$169.38RVU13D
2013-07-01$272.09$169.38RVU13C
2013-04-01$272.09$169.38RVU13B
2013-01-01$272.09$169.38RVU13AR

Price 10081 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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