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CPT code 11770: Pilonidal excision, simple excision2026 Medicare rate & RVUs in North Carolina

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 North Carolina, Medicare pays $363.79 for 11770 in the office and $168.71 when it’s performed in a hospital or facility.

$363.79Office (non-facility)
$168.71Hospital or facility
−6.7%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 North Carolina
  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 North Carolina 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. North Carolina pays $363.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

11770 in North Carolina vs other payment areas
  1. North Carolina · this page$363.79
  2. Los Angeles, CA · California$438.66+$74.87
  3. Washington, DC area · District of Columbia$447.51+$83.72
  4. Miami, FL · Florida$432.89+$69.10
  5. Chicago, IL · Illinois$418.53+$54.74
  6. Manhattan, NY · New York$453.48+$89.69
  7. Alaska · Alaska$442.64+$78.85

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

Every other payment area

11770 in every other Medicare payment locality
Payment localityOfficeFacility
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
Hanford, 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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 11770 in North Carolina
ComponentRVULocality factorAdjusted
Physician work2.59× 1.0002.5900
Practice expense8.48× 0.9337.9118
Malpractice0.61× 0.6390.3898
Total RVUs10.8916
Conversion factor× 33.4009

Office rate, North Carolina$363.79

Office: (2.59 × 1 + 8.48 × 0.933 + 0.61 × 0.639) × $33.4009 = $363.79

Facility: (2.59 × 1 + 2.22 × 0.933 + 0.61 × 0.639) × $33.4009 = $168.71

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, North Carolina
Same family
11771Pilonidal excision, extensive diseaseSibling code for pilonidal excision at the extensive level.$645.26
11772Pilonidal excision, complicated diseaseSibling code for complicated pilonidal excision.$789.96
Used instead
10080Pilonidal drainage, simple incision and drainageFor simple pilonidal cyst drainage rather than excision.$252.18
10081Pilonidal drainage, complicated incision and drainageFor complicated pilonidal cyst drainage rather than excision.$355.38

How 11770 has changed in North Carolina

11770 · Office / nonfacility

$363.79

Effective 2026-10-01

The base rate is $50.08 higher than on 2025-10-01, moving from $313.71 to $363.79 (16.0%).

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

    $313.71changed to$363.79

    • 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 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $330.23changed to$313.71

    • 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

    $324.84changed to$330.23

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $339.63changed to$324.84

    • 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 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $355.06changed to$339.63

    • 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 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $339.58changed to$355.06

    • 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

    $302.61changed to$339.58

    • 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 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $273.63changed to$302.61

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.88 changed to 5.70
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $266.29changed to$273.63

    • 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

    $265.47changed to$266.29

    • 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
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $266.08changed to$265.47

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.66 changed to 4.64
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $265.49changed to$266.08

    • 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

    $264.17changed to$265.49

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $262.48changed to$264.17

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.50 changed to 0.55
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $266.49changed to$262.48

    • 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 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $266.49

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$363.79$168.71RVU26D
2026-07-01$363.79$168.71RVU26C
2026-04-01$363.79$168.71RVU26B
2026-01-01$363.79$168.71RVU26A
2025-10-01$313.71$169.04RVU25D
2025-07-01$313.71$169.04RVU25C
2025-04-01$313.71$169.04RVU25B
2025-01-01$313.71$169.04RVU25A
2024-10-01$330.23$173.96RVU24D
2024-07-01$330.23$173.96RVU24C
2024-04-01$330.23$173.96RVU24B
2024-03-09$330.23$173.96RVU24AR
2024-01-01$324.84$171.12RVU24A
2023-10-01$339.63$177.23RVU23D
2023-07-01$339.63$177.23RVU23C
2023-04-01$339.63$177.23RVU23B
2023-01-01$339.63$177.23RVU23A
2022-10-01$355.06$181.96RVU22D
2022-07-01$355.06$181.96RVU22C
2022-04-01$355.06$181.96RVU22B
2022-01-01$355.06$181.96RVU22A
2021-10-01$339.58$182.21RVU21D
2021-07-01$339.58$182.21RVU21C
2021-04-01$339.58$182.21RVU21B
2021-01-01$339.58$182.21RVU21A
2020-10-01$302.61$182.45RVU20D
2020-07-01$302.61$182.45RVU20C
2020-04-01$302.61$182.45RVU20B
2020-01-01$302.61$182.45RVU20A
2019-10-01$273.63$180.01RVU19D
2019-07-01$273.63$180.01RVU19C
2019-04-01$273.63$180.01RVU19B
2019-01-01$273.63$180.01RVU19A
2018-10-01$266.29$179.82RVU18D
2018-07-01$266.29$179.82RVU18C
2018-04-01$266.29$179.82RVU18B
2018-01-01$266.29$179.82RVU18AR1
2017-10-01$265.47$179.94RVU17D
2017-07-01$265.47$179.94RVU17C
2017-04-01$265.47$179.94RVU17B
2017-01-01$265.47$179.94RVU17A
2016-10-01$266.08$180.51RVU16D
2016-07-01$266.08$180.51RVU16C
2016-04-01$266.08$180.51RVU16B
2016-01-01$266.08$180.51RVU16A
2015-10-01$265.49$180.61RVU15D
2015-07-01$265.49$180.61RVU15C
2015-04-01$264.17$179.71RVU15B
2015-01-01$264.17$179.71RVU15A
2014-10-01$262.48$177.29RVU14D
2014-07-01$262.48$177.29RVU14C
2014-04-01$262.48$177.29RVU14B
2014-01-01$262.48$177.29RVU14A
2013-10-01$266.49$175.65RVU13D
2013-07-01$266.49$175.65RVU13C
2013-04-01$266.49$175.65RVU13B
2013-01-01$266.49$175.65RVU13AR

Price 11770 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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