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CPT code 11770: Pilonidal excision, simple excision2026 Medicare rate & RVUs in Miami, FL

Reports surgical removal of a simple pilonidal cyst or sinus in the sacrococcygeal cleft, rather than drainage or more extensive excision.

CMS RVU26DEffective Oct 1, 2026One payment locality265 Medicare services in 2024

In Miami, FL, Medicare pays $432.89 for 11770 in the office and $215.23 when it’s performed in a hospital or facility.

$432.89Office (non-facility)
$215.23Hospital or facility
+11.0%vs the national office rate ($390.12)

Check a contract rate as a % of Medicare · 11770 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 11770 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Miami, FL
  2. What 11770 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 11770 covers

A surgeon excises a simple pilonidal cyst or sinus in the cleft near the tailbone, removing the lesion and involved tissue or tract. The procedure is commonly performed in an outpatient operating room, though a suitable simple case may be treated in an office setting. The operative report should show that excision was performed and describe the disease and extent of the work.

Choose this code for the simple-excision level, not for drainage alone or a more extensive or complicated excision. Document the operative findings and the basis for the selected level. CMS assigns 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 other procedures are subject to the standard multiple-procedure reduction. Bilateral adjustment is inappropriate. CMS does not pay an assistant at surgery for this code and does not permit co-surgeon or team-surgery billing.

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 Miami, FL compares for 11770

Across 109 of 109 payment localities, the office rate for 11770 runs from $340.30 in Arkansas to $515.38 in San Benito County, CA. Miami, FL pays $432.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

11770 in Miami, FL vs other payment areas
  1. Miami, FL · this page$432.89
  2. Fort Lauderdale, FL · Florida$410.27−$22.62
  3. Rest of Florida · Florida$387.91−$44.98
  4. Los Angeles, CA · California$438.66+$5.77
  5. Washington, DC area · District of Columbia$447.51+$14.62
  6. Chicago, IL · Illinois$418.53−$14.36
  7. Manhattan, NY · New York$453.48+$20.59

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

Every other payment area

11770 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$442.64$219.96
AlabamaAlabama$345.88$162.92
ArkansasArkansas$340.30$160.70
ArizonaArizona$378.41$175.80
Bakersfield, CACalifornia$410.99$181.83
Chico, CACalifornia$409.33$180.17
El Centro, CACalifornia$409.43$180.27
Fresno, CACalifornia$409.33$180.17

11770 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.

$340.30

$462.36

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

View every state and territory as a table
11770 office rate range by state
State / territoryOffice rate rangeLocalities
AK$442.641
AL$345.881
AR$340.301
AZ$378.411
CA$409.33–$515.3829
CO$404.831
CT$417.941
DC$447.511
DE$385.101
FL$387.91–$432.893
GA$363.44–$399.012
GU$420.351
HI$420.351
IA$353.761
ID$356.731
IL$376.95–$418.534
IN$358.971
KS$352.831
KY$356.951
LA$356.69–$376.182
MA$402.38–$446.382
MD$392.72–$447.513
ME$359.76–$380.062
MI$368.11–$394.192
MN$383.991
MO$350.51–$376.573
MS$345.431
MT$390.081
NC$363.791
ND$378.021
NE$355.641
NH$399.191
NJ$421.62–$442.282
NM$370.711
NV$387.001
NY$369.91–$466.655
OH$365.641
OK$355.271
OR$382.94–$417.732
PA$365.78–$407.222
PR$392.931
RI$398.911
SC$365.541
SD$376.591
TN$354.911
TX$363.18–$404.408
UT$371.051
VA$379.32–$447.512
VI$392.931
VT$377.231
WA$401.39–$455.012
WI$364.131
WV$361.801
WY$384.831

See 11770 in every payment locality

How the 11770 rate is calculated

Each of 11770’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 · 11770

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.59

2.59 RVUs× 1.000 GPCI

Practice expense8.48

8.48 RVUs× 1.000 GPCI

Malpractice0.61

0.61 RVUs× 1.000 GPCI

Adjusted RVUs

11.6800

Conversion factor

$33.4009

Medicare rate

$390.12

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

The exact Miami, FL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,372

Code
11770
Physician work
2.59
Practice expense
8.48
Malpractice
0.61

GPCI2026.csv

42

Locality
Miami, FL
Physician work
1.000
Practice expense
1.041
Malpractice
2.529
Office calculation for 11770 in Miami, FL
ComponentRVULocality factorAdjusted
Physician work2.59× 1.0002.5900
Practice expense8.48× 1.0418.8277
Malpractice0.61× 2.5291.5427
Total RVUs12.9604
Conversion factor× 33.4009

Office rate, Miami, FL$432.89

Office: (2.59 × 1 + 8.48 × 1.041 + 0.61 × 2.529) × $33.4009 = $432.89

Facility: (2.59 × 1 + 2.22 × 1.041 + 0.61 × 2.529) × $33.4009 = $215.23

Open 11770 in the RVU calculator

Payment rules and modifiers for 11770

11770 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11770

Pilonidal excision, simple excision

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 · 11770

Pilonidal excision, simple excision

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

11770 without 51 · national office

$390.12

Pilonidal excision, simple excision

11770-51 · Second procedure: 50%

$195.06

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 11770

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

Codes related to 11770
CodeHow it relatesOffice range, Miami, FL
Same family
11771Pilonidal excision, extensive diseaseSibling code for pilonidal excision at the extensive level.$783.73
11772Pilonidal excision, complicated diseaseSibling code for complicated pilonidal excision.$956.80
Used instead
10080Pilonidal drainage, simple incision and drainageFor simple pilonidal cyst drainage rather than excision.$288.91
10081Pilonidal drainage, complicated incision and drainageFor complicated pilonidal cyst drainage rather than excision.$416.20

How 11770 has changed in Miami, FL

11770 · Office / nonfacility

$432.89

Effective 2026-10-01

The base rate is $60.14 higher than on 2025-10-01, moving from $372.75 to $432.89 (16.1%).

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

    $372.75changed to$432.89

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.66 changed to 2.59
    • Practice expense RVU 7.17 changed to 8.48
    • Malpractice RVU 0.60 changed to 0.61
    • Practice expense GPCI 1.027 changed to 1.041
    • Malpractice GPCI 2.500 changed to 2.529

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $391.80changed to$372.75

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.41 changed to 7.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $385.40changed to$391.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $400.87changed to$385.40

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.47 changed to 7.41
    • Malpractice RVU 0.59 changed to 0.60
    • Practice expense GPCI 1.025 changed to 1.027
    • Malpractice GPCI 2.564 changed to 2.500

  5. January 1, 2023

    RVU23A

    $417.82changed to$400.87

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.66 changed to 7.47
    • Malpractice RVU 0.60 changed to 0.59
    • Practice expense GPCI 1.023 changed to 1.025
    • Malpractice GPCI 2.629 changed to 2.564

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $400.38changed to$417.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.10 changed to 7.66
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $359.56changed to$400.38

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.70 changed to 7.10
    • Malpractice RVU 0.56 changed to 0.59
    • Practice expense GPCI 1.026 changed to 1.023
    • Malpractice GPCI 2.598 changed to 2.629

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $328.62changed to$359.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.88 changed to 5.70
    • Practice expense GPCI 1.029 changed to 1.026
    • Malpractice GPCI 2.566 changed to 2.598

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $320.48changed to$328.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.67 changed to 4.88

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $318.86changed to$320.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.64 changed to 4.67
    • Malpractice RVU 0.57 changed to 0.56
    • Practice expense GPCI 1.031 changed to 1.029
    • Malpractice GPCI 2.528 changed to 2.566

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $318.41changed to$318.86

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.66 changed to 4.64
    • Practice expense GPCI 1.033 changed to 1.031
    • Malpractice GPCI 2.490 changed to 2.528

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $316.66changed to$318.41

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.63 changed to 4.66
    • Malpractice RVU 0.55 changed to 0.57

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $315.08changed to$316.66

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $315.96changed to$315.08

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.50 changed to 0.55
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 2.653 changed to 2.490

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $326.42changed to$315.96

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.19 changed to 4.63
    • Malpractice RVU 0.52 changed to 0.50
    • Practice expense GPCI 1.054 changed to 1.044
    • Malpractice GPCI 2.815 changed to 2.653

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $326.42

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$432.89$215.23RVU26D
2026-07-01$432.89$215.23RVU26C
2026-04-01$432.89$215.23RVU26B
2026-01-01$432.89$215.23RVU26A
2025-10-01$372.75$212.30RVU25D
2025-07-01$372.75$212.30RVU25C
2025-04-01$372.75$212.30RVU25B
2025-01-01$372.75$212.30RVU25A
2024-10-01$391.80$218.47RVU24D
2024-07-01$391.80$218.47RVU24C
2024-04-01$391.80$218.47RVU24B
2024-03-09$391.80$218.47RVU24AR
2024-01-01$385.40$214.91RVU24A
2023-10-01$400.87$221.29RVU23D
2023-07-01$400.87$221.29RVU23C
2023-04-01$400.87$221.29RVU23B
2023-01-01$400.87$221.29RVU23A
2022-10-01$417.82$227.00RVU22D
2022-07-01$417.82$227.00RVU22C
2022-04-01$417.82$227.00RVU22B
2022-01-01$417.82$227.00RVU22A
2021-10-01$400.38$226.90RVU21D
2021-07-01$400.38$226.90RVU21C
2021-04-01$400.38$226.90RVU21B
2021-01-01$400.38$226.90RVU21A
2020-10-01$359.56$227.00RVU20D
2020-07-01$359.56$227.00RVU20C
2020-04-01$359.56$227.00RVU20B
2020-01-01$359.56$227.00RVU20A
2019-10-01$328.62$225.16RVU19D
2019-07-01$328.62$225.16RVU19C
2019-04-01$328.62$225.16RVU19B
2019-01-01$328.62$225.16RVU19A
2018-10-01$320.48$224.91RVU18D
2018-07-01$320.48$224.91RVU18C
2018-04-01$320.48$224.91RVU18B
2018-01-01$320.48$224.91RVU18AR1
2017-10-01$318.86$224.14RVU17D
2017-07-01$318.86$224.14RVU17C
2017-04-01$318.86$224.14RVU17B
2017-01-01$318.86$224.14RVU17A
2016-10-01$318.41$223.36RVU16D
2016-07-01$318.41$223.36RVU16C
2016-04-01$318.41$223.36RVU16B
2016-01-01$318.41$223.36RVU16A
2015-10-01$316.66$222.37RVU15D
2015-07-01$316.66$222.37RVU15C
2015-04-01$315.08$221.27RVU15B
2015-01-01$315.08$221.27RVU15A
2014-10-01$315.96$220.22RVU14D
2014-07-01$315.96$220.22RVU14C
2014-04-01$315.96$220.22RVU14B
2014-01-01$315.96$220.22RVU14A
2013-10-01$326.42$223.14RVU13D
2013-07-01$326.42$223.14RVU13C
2013-04-01$326.42$223.14RVU13B
2013-01-01$326.42$223.14RVU13AR

Price 11770 for an earlier date of service

Where the Miami, FL rate applies

Miami, FL is a Medicare payment area, not a city. Our Census mapping connects it to 83 cities and communities in Florida. Some span more than one payment area; confirm with the service ZIP.

  • Miami
  • Aventura
  • Bal Harbour
  • Bay Harbor Islands
  • Big Coppitt Key
  • Big Pine Key
  • Biscayne Gardens
  • Biscayne Park

Browse all communities in Florida

11770 billing questions

How does 11770 differ from 11771 or 11772?

Use 11770 for simple excision. The higher family codes describe more extensive or complicated excision; the operative findings and work performed should support the selected level.

Can 11770 be reported for draining a pilonidal abscess?

No. When the service is incision and drainage rather than excision, consider the pilonidal drainage codes 10080 or 10081, as appropriate to the procedure.

Are related postoperative visits separately billable?

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

Can modifier 50 be used for pilonidal excision?

No. CMS identifies bilateral adjustment as inappropriate for this code and its anatomy.

Can an assistant or co-surgeon be billed with 11770?

CMS does not pay an assistant at surgery for this code and does not permit co-surgeon or team-surgery billing.

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

The highest-valued procedure is paid in full, while 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 11770PPRRVU2026_Oct_nonQPP.csv, line 1,372 (RVU26D)
Geographic factors for Miami, FLGPCI2026.csv, line 42 (RVU26D)

Open CMS sourceHow we calculate rates

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