Billing code 10081: Pilonidal drainageMedicare rate & RVUs

Medicare pays $380.10 for 10081 nationally in the office and $168.67 in a hospital or facility. Local office rates run $332.48–$506.52.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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.

Where 10081 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

10081 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

Payment rules and modifiers for 10081

10081 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

10081 compared with similar codes

How to choose

10080Pilonidal drainage

Both address pilonidal disease, but 10080 is for simple drainage; report 10081 when the documented drainage is complicated.

10060Abscess drainage

10060 covers simple or single abscess drainage generally. Use 10081 for complicated drainage of a pilonidal cyst in the natal cleft.

10061Abscess drainage

10061 is for complicated or multiple abscess drainage generally; 10081 is the pilonidal-specific code when that condition is being drained.

11770Pilonidal excision

11770 describes excision of pilonidal disease, whereas 10081 reports incision and drainage of a complicated pilonidal cyst or abscess.

Codes related to 10081

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

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

Open CMS sourceHow we calculate rates