Billing code 11771: Pilonidal excisionMedicare rate & RVUs
Reports surgical removal of extensive pilonidal disease in the sacrococcygeal cleft, with code selection based on the documented extent of the excision.
Medicare pays $692.40 for 11771 nationally in the office and $441.89 in a hospital or facility. Local office rates run $606.32–$889.30.
Medicare rate · 11771
Pilonidal excision
Swap in your local Medicare rate.
- Work RVUs
- 5.94
- Total RVUs
- 20.73
- Global days
- 090
National rate · 2026
$692.40
Office setting, before claim adjustments.
See every locality for 11771 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 11771 covers
A surgeon excises extensive pilonidal disease involving the skin and underlying tissue of the cleft between the buttocks near the tailbone. The condition may include a cyst or sinus tracts. General surgeons commonly perform the procedure in a facility operating room; it may also be performed in an office setting. The wound is managed according to the operative plan.
Choose this level when the operative findings and work support extensive disease, rather than a simple or complicated excision. Document the location and extent of the disease, sinus tracts or involved tissue, and what was removed. This major surgery has a 90-day global period: the day-before preoperative visit and related postoperative care 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 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons and team surgery 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 11771 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$606.32 to $889.30
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $615.89 | $396.70 |
| Alaska* | $799.16 | $532.37 |
| Arizona | $671.69 | $428.95 |
| Arkansas | $606.32 | $391.13 |
| Atlanta | $709.74 | $455.22 |
| Austin | $713.23 | $448.20 |
| Bakersfield | $720.33 | $445.78 |
| Baltimore/Surr. Cntys | $739.47 | $470.68 |
| Beaumont | $648.85 | $420.89 |
| Brazoria | $679.46 | $431.21 |
| Chicago | $757.87 | $506.11 |
| Chico | $716.45 | $441.89 |
| Colorado | $712.88 | $446.34 |
| Connecticut | $740.76 | $470.96 |
| Dallas | $685.62 | $436.11 |
| Dc + Md/Va Suburbs | $787.94 | $492.84 |
| Delaware | $683.21 | $435.71 |
| Detroit | $709.55 | $467.81 |
| East St. Louis | $705.13 | $474.67 |
| El Centro | $716.69 | $442.13 |
| Fort Lauderdale | $736.79 | $483.03 |
| Fort Worth | $681.78 | $434.78 |
| Fresno | $716.45 | $441.89 |
| Galveston | $682.65 | $433.90 |
| Hanford-Corcoran | $716.45 | $441.89 |
| Hawaii, Guam | $733.43 | $448.60 |
| Houston | $708.82 | $460.07 |
| Idaho | $631.53 | $401.06 |
| Indiana | $635.28 | $403.06 |
| Iowa | $625.67 | $396.46 |
| Kansas | $625.87 | $399.41 |
| Kentucky | $638.81 | $416.11 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $766.15 | $469.80 |
| Madera | $716.45 | $441.89 |
| Manhattan | $805.38 | $514.29 |
| Merced | $716.45 | $441.89 |
| Metropolitan Boston | $781.85 | $482.75 |
| Metropolitan Kansas City | $664.08 | $428.86 |
| Metropolitan Philadelphia | $723.49 | $462.71 |
| Metropolitan St. Louis | $671.08 | $432.59 |
| Miami | $783.73 | $522.95 |
| Minnesota | $671.72 | $413.94 |
| Mississippi | $617.91 | $402.22 |
| Modesto | $716.45 | $441.89 |
| Montana** | $692.31 | $441.80 |
| Napa | $823.30 | $493.14 |
| Nebraska | $628.33 | $397.11 |
| Nevada** | $684.87 | $434.11 |
| New Hampshire | $704.73 | $443.95 |
| New Mexico | $664.96 | $435.25 |
| New Orleans | $672.57 | $436.84 |
| North Carolina | $645.26 | $411.54 |
| North Dakota** | $664.03 | $413.52 |
| Northern Nj | $779.55 | $488.96 |
| Nyc Suburbs/Long Island | $830.37 | $532.52 |
| Ohio | $653.96 | $425.25 |
| Oklahoma | $634.00 | $410.30 |
| Oxnard-Thousand Oaks-Ventura | $761.16 | $465.07 |
| Portland | $732.88 | $454.57 |
| Poughkpsie/N Nyc Suburbs | $753.75 | $479.45 |
| Puerto Rico | $696.59 | $443.33 |
| Queens | $807.42 | $511.33 |
| Redding | $716.45 | $441.89 |
| Rest Of California | $716.45 | $441.89 |
| Rest Of Florida | $696.79 | $457.31 |
| Rest Of Georgia | $653.38 | $429.93 |
| Rest Of Illinois | $680.47 | $451.76 |
| Rest Of Louisiana | $639.08 | $417.38 |
| Rest Of Maine | $638.65 | $408.18 |
| Rest Of Maryland | $695.82 | $442.31 |
| Rest Of Massachusetts | $709.53 | $445.75 |
| Rest Of Michigan | $659.74 | $431.03 |
| Rest Of Missouri | $629.58 | $413.64 |
| Rest Of New Jersey | $746.02 | $472.47 |
| Rest Of New York | $655.90 | $417.92 |
| Rest Of Oregon | $676.43 | $426.93 |
| Rest Of Pennsylvania | $653.18 | $423.22 |
| Rest Of Texas | $665.01 | $427.28 |
| Rest Of Washington | $707.21 | $443.43 |
| Rhode Island | $705.74 | $446.96 |
| Riverside-San Bernardino-Ontario | $731.79 | $457.23 |
| Sacramento-Roseville-Folsom | $750.12 | $458.78 |
| Salinas | $747.34 | $457.00 |
| San Diego-Chula Vista-Carlsbad | $763.94 | $464.33 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $868.37 | $515.15 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $866.74 | $513.53 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $889.30 | $528.07 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $882.66 | $521.43 |
| San Luis Obispo-Paso Robles | $735.64 | $450.31 |
| Santa Cruz-Watsonville | $770.35 | $465.98 |
| Santa Maria-Santa Barbara | $749.87 | $457.78 |
| Santa Rosa-Petaluma | $777.93 | $470.31 |
| Seattle (King Cnty) | $794.88 | $487.50 |
| South Carolina | $651.32 | $419.85 |
| South Dakota** | $660.69 | $410.18 |
| Southern Maine | $670.76 | $422.51 |
| Stockton | $716.45 | $441.89 |
| Suburban Chicago | $742.71 | $485.44 |
| Tennessee | $629.68 | $401.97 |
| Utah | $660.75 | $425.28 |
| Vallejo | $820.96 | $490.80 |
| Vermont | $664.34 | $416.34 |
| Virgin Islands | $696.59 | $443.33 |
| Virginia | $670.77 | $424.52 |
| Visalia | $716.45 | $441.89 |
| West Virginia | $654.53 | $436.84 |
| Wisconsin | $640.61 | $400.62 |
| Wyoming** | $679.98 | $429.48 |
| Yuba City | $716.45 | $441.89 |
11771 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$606.32
$802.88
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $799.16 | 1 |
| AL | $615.89 | 1 |
| AR | $606.32 | 1 |
| AZ | $671.69 | 1 |
| CA | $716.45–$889.30 | 29 |
| CO | $712.88 | 1 |
| CT | $740.76 | 1 |
| DC | $787.94 | 1 |
| DE | $683.21 | 1 |
| FL | $696.79–$783.73 | 3 |
| GA | $653.38–$709.74 | 2 |
| GU | $733.43 | 1 |
| HI | $733.43 | 1 |
| IA | $625.67 | 1 |
| ID | $631.53 | 1 |
| IL | $680.47–$757.87 | 4 |
| IN | $635.28 | 1 |
| KS | $625.87 | 1 |
| KY | $638.81 | 1 |
| LA | $639.08–$672.57 | 2 |
| MA | $709.53–$781.85 | 2 |
| MD | $695.82–$787.94 | 3 |
| ME | $638.65–$670.76 | 2 |
| MI | $659.74–$709.55 | 2 |
| MN | $671.72 | 1 |
| MO | $629.58–$671.08 | 3 |
| MS | $617.91 | 1 |
| MT | $692.31 | 1 |
| NC | $645.26 | 1 |
| ND | $664.03 | 1 |
| NE | $628.33 | 1 |
| NH | $704.73 | 1 |
| NJ | $746.02–$779.55 | 2 |
| NM | $664.96 | 1 |
| NV | $684.87 | 1 |
| NY | $655.90–$830.37 | 5 |
| OH | $653.96 | 1 |
| OK | $634.00 | 1 |
| OR | $676.43–$732.88 | 2 |
| PA | $653.18–$723.49 | 2 |
| PR | $696.59 | 1 |
| RI | $705.74 | 1 |
| SC | $651.32 | 1 |
| SD | $660.69 | 1 |
| TN | $629.68 | 1 |
| TX | $648.85–$713.23 | 8 |
| UT | $660.75 | 1 |
| VA | $670.77–$787.94 | 2 |
| VI | $696.59 | 1 |
| VT | $664.34 | 1 |
| WA | $707.21–$794.88 | 2 |
| WI | $640.61 | 1 |
| WV | $654.53 | 1 |
| WY | $679.98 | 1 |
How the 11771 rate is calculated
Each of 11771’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 · 11771
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.94Practice expense 13.36Malpractice 1.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11771
11771 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11771
Pilonidal excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11771
Pilonidal excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11771 without 51 · national office
$692.40
Pilonidal excision
11771-51 · Second procedure: 50%
$346.20
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%).
11771 compared with similar codes
Compare codes
11771 vs 11770 vs 11772 vs 10081: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11770Pilonidal excision
- Use 11770 for simple pilonidal excision. Use 11771 when the documented extent supports an extensive excision.
- 11772Pilonidal excision
- 11772 is for complicated pilonidal excision; 11771 is the extensive level. The operative findings and work support the distinction.
- 10081Pilonidal drainage
- 10081 represents complicated incision and drainage, not excision. Select it when the service is drainage rather than removal of extensive pilonidal disease.
11771 billing questions
How does this code differ from 11770?
11771 is for extensive pilonidal disease excision; 11770 is for a simple excision. Base the choice on the documented disease and operative work, not on the diagnosis alone.
How does this code differ from 11772?
11772 describes complicated pilonidal disease excision. Use 11771 when the documented extent supports an extensive excision rather than a complicated one.
Can this be reported for incision and drainage?
No. This code represents excision of extensive pilonidal disease. Incision and drainage is represented by a different code family, such as 10080 or 10081, depending on the service.
Can modifier 50 be used for disease on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Is postoperative wound care separately reported during the global period?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
Fee sheets
Put 11771 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →