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CMS RVU26D · Effective 2026-10-01

11772 in Delaware

Office / nonfacility

$836.23

Base rate per service

Facility setting

$565.63

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

General surgery

About 11772: Complicated pilonidal cyst excision

Report this code for surgical excision of complicated pilonidal disease in the sacrococcygeal cleft, supported by operative documentation of the case’s complexity.

A surgeon excises complicated pilonidal disease involving a cyst or sinus in the natal cleft near the coccyx. The procedure is generally performed in an operating room, often for disease with a complex course or extent that requires more involved excision than a simple case. The wound may be managed according to the operative plan; closure method alone does not establish the code level.

Select this code when the operative report supports complicated disease and the work performed, rather than choosing by diagnosis wording alone. Document the involved area, sinus or cyst extent, and the operative findings and technique that support the complexity. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

CMS billing rules for 11772

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU7.17 · 28%
  • Practice expense (office) RVU16.50 · 65%
  • Malpractice RVU1.70 · 7%

408

Medicare services in 2024 · #3722 by national volume

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.

11772 compared with similar codes

Office rates for Delaware, from the same CMS release.

11770

Pilonidal excision

Simple excision

$385.10

11770 describes excision of simple pilonidal disease. Use 11772 when the operative findings and work support a complicated case.

11771

Pilonidal excision

Extensive disease

$683.21

11771 describes extensive pilonidal disease, while 11772 describes complicated disease. The operative documentation should support the level selected.

10081

Pilonidal drainage

Complicated incision and drainage

$375.50

10081 is for incision and drainage of a complicated pilonidal abscess. Use 11772 when the performed service is excision of the cyst or sinus.

The same code, a different location

How does Delaware compare?

11772 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $836.23

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $938.98

    $102.75 higher than Delaware

  3. Dc + Md/Va Suburbs

    $964.83

    $128.60 higher than Delaware

  4. Miami

    $956.80

    $120.57 higher than Delaware

  5. Chicago

    $925.34

    $89.11 higher than Delaware

  6. Manhattan

    $985.26

    $149.03 higher than Delaware

  7. Alaska*

    $977.45

    $141.22 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 11772 ranges from $742.13 in Arkansas to $1090.97 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 11772

    Office

    $753.85

    Facility

    $514.20

    $82.38 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 11772

    Office

    $742.13

    Facility

    $506.87

    $94.10 lower than Delaware for the office setting.

  • Arizona

    Arizona · 11772

    Office

    $822.12

    Facility

    $556.72

    $14.11 lower than Delaware for the office setting.

  • Bakersfield

    California · 11772

    Office

    $882.64

    Facility

    $582.46

    $46.41 higher than Delaware for the office setting.

  • Chico

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • El Centro

    California · 11772

    Office

    $878.30

    Facility

    $578.12

    $42.07 higher than Delaware for the office setting.

  • Fresno

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Madera

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Merced

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Modesto

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Napa

    California · 11772

    Office

    $1009.79

    Facility

    $648.80

    $173.56 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 11772

    Office

    $932.98

    Facility

    $609.25

    $96.75 higher than Delaware for the office setting.

  • Redding

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Rest Of California

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 11772

    Office

    $896.25

    Facility

    $596.07

    $60.02 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 11772

    Office

    $919.49

    Facility

    $600.96

    $83.26 higher than Delaware for the office setting.

  • Salinas

    California · 11772

    Office

    $916.09

    Facility

    $598.65

    $79.86 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 11772

    Office

    $936.58

    Facility

    $609.01

    $100.35 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 11772

    Office

    $1065.37

    Facility

    $679.19

    $229.14 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 11772

    Office

    $1063.44

    Facility

    $677.26

    $227.21 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 11772

    Office

    $1090.97

    Facility

    $696.02

    $254.74 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 11772

    Office

    $1083.08

    Facility

    $688.13

    $246.85 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 11772

    Office

    $901.71

    Facility

    $589.75

    $65.48 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 11772

    Office

    $944.55

    Facility

    $611.78

    $108.32 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 11772

    Office

    $919.22

    Facility

    $599.87

    $82.99 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 11772

    Office

    $953.87

    Facility

    $617.54

    $117.64 higher than Delaware for the office setting.

  • Stockton

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Vallejo

    California · 11772

    Office

    $1007.00

    Facility

    $646.02

    $170.77 higher than Delaware for the office setting.

  • Visalia

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Yuba City

    California · 11772

    Office

    $878.01

    Facility

    $577.83

    $41.78 higher than Delaware for the office setting.

  • Colorado

    Colorado · 11772

    Office

    $873.09

    Facility

    $581.67

    $36.86 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 11772

    Office

    $906.53

    Facility

    $611.55

    $70.30 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 11772

    Office

    $900.42

    Facility

    $622.98

    $64.19 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 11772

    Office

    $851.69

    Facility

    $589.86

    $15.46 higher than Delaware for the office setting.

  • Atlanta

    Georgia · 11772

    Office

    $868.33

    Facility

    $590.06

    $32.10 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 11772

    Office

    $798.76

    Facility

    $554.45

    $37.47 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 11772

    Office

    $898.98

    Facility

    $587.57

    $62.75 higher than Delaware for the office setting.

  • Iowa

    Iowa · 11772

    Office

    $766.30

    Facility

    $515.69

    $69.93 lower than Delaware for the office setting.

  • Idaho

    Idaho · 11772

    Office

    $773.37

    Facility

    $521.39

    $62.86 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 11772

    Office

    $860.87

    Facility

    $608.89

    $24.64 higher than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 11772

    Office

    $831.40

    Facility

    $581.34

    $4.83 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 11772

    Office

    $907.77

    Facility

    $626.49

    $71.54 higher than Delaware for the office setting.

  • Indiana

    Indiana · 11772

    Office

    $777.96

    Facility

    $524.07

    $58.27 lower than Delaware for the office setting.

  • Kansas

    Kansas · 11772

    Office

    $766.31

    Facility

    $518.72

    $69.92 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 11772

    Office

    $781.38

    Facility

    $537.89

    $54.85 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 11772

    Office

    $822.59

    Facility

    $564.86

    $13.64 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 11772

    Office

    $781.62

    Facility

    $539.23

    $54.61 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 11772

    Office

    $957.87

    Facility

    $630.85

    $121.64 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 11772

    Office

    $868.90

    Facility

    $580.49

    $32.67 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 11772

    Office

    $904.90

    Facility

    $611.02

    $68.67 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 11772

    Office

    $851.73

    Facility

    $574.56

    $15.50 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 11772

    Office

    $781.83

    Facility

    $529.85

    $54.40 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 11772

    Office

    $821.47

    Facility

    $550.05

    $14.76 lower than Delaware for the office setting.

  • Detroit

    Michigan · 11772

    Office

    $867.04

    Facility

    $602.74

    $30.81 higher than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 11772

    Office

    $806.76

    Facility

    $556.70

    $29.47 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 11772

    Office

    $823.39

    Facility

    $541.56

    $12.84 lower than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 11772

    Office

    $812.46

    Facility

    $555.28

    $23.77 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 11772

    Office

    $821.04

    Facility

    $560.30

    $15.19 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 11772

    Office

    $769.85

    Facility

    $533.76

    $66.38 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 11772

    Office

    $755.96

    Facility

    $520.14

    $80.27 lower than Delaware for the office setting.

  • Montana**

    Montana · 11772

    Office

    $847.27

    Facility

    $573.38

    $11.04 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 11772

    Office

    $789.96

    Facility

    $534.42

    $46.27 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 11772

    Office

    $813.65

    Facility

    $539.77

    $22.58 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 11772

    Office

    $769.63

    Facility

    $516.83

    $66.60 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 11772

    Office

    $862.88

    Facility

    $577.76

    $26.65 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 11772

    Office

    $954.51

    Facility

    $636.80

    $118.28 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 11772

    Office

    $913.17

    Facility

    $614.09

    $76.94 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 11772

    Office

    $813.05

    Facility

    $561.90

    $23.18 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 11772

    Office

    $838.45

    Facility

    $564.29

    $2.22 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 11772

    Office

    $1015.53

    Facility

    $689.88

    $179.30 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 11772

    Office

    $922.44

    Facility

    $622.53

    $86.21 higher than Delaware for the office setting.

  • Queens

    New York · 11772

    Office

    $988.11

    Facility

    $664.37

    $151.88 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 11772

    Office

    $802.96

    Facility

    $542.77

    $33.27 lower than Delaware for the office setting.

  • Ohio

    Ohio · 11772

    Office

    $799.89

    Facility

    $549.83

    $36.34 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 11772

    Office

    $775.75

    Facility

    $531.17

    $60.48 lower than Delaware for the office setting.

  • Portland

    Oregon · 11772

    Office

    $897.85

    Facility

    $593.56

    $61.62 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 11772

    Office

    $828.31

    Facility

    $555.52

    $7.92 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 11772

    Office

    $885.25

    Facility

    $600.13

    $49.02 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 11772

    Office

    $799.07

    Facility

    $547.64

    $37.16 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 11772

    Office

    $852.59

    Facility

    $575.69

    $16.36 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 11772

    Office

    $863.99

    Facility

    $581.06

    $27.76 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 11772

    Office

    $796.98

    Facility

    $543.91

    $39.25 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 11772

    Office

    $809.68

    Facility

    $535.79

    $26.55 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 11772

    Office

    $770.94

    Facility

    $521.98

    $65.29 lower than Delaware for the office setting.

  • Austin

    Texas · 11772

    Office

    $873.35

    Facility

    $583.58

    $37.12 higher than Delaware for the office setting.

  • Beaumont

    Texas · 11772

    Office

    $793.75

    Facility

    $544.51

    $42.48 lower than Delaware for the office setting.

  • Brazoria

    Texas · 11772

    Office

    $831.84

    Facility

    $560.42

    $4.39 lower than Delaware for the office setting.

  • Dallas

    Texas · 11772

    Office

    $839.27

    Facility

    $566.48

    $3.04 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 11772

    Office

    $834.50

    Facility

    $564.44

    $1.73 lower than Delaware for the office setting.

  • Galveston

    Texas · 11772

    Office

    $835.67

    Facility

    $563.70

    $0.56 lower than Delaware for the office setting.

  • Houston

    Texas · 11772

    Office

    $866.79

    Facility

    $594.82

    $30.56 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 11772

    Office

    $813.77

    Facility

    $553.85

    $22.46 lower than Delaware for the office setting.

  • Utah

    Utah · 11772

    Office

    $808.52

    Facility

    $551.07

    $27.71 lower than Delaware for the office setting.

  • Virginia

    Virginia · 11772

    Office

    $821.32

    Facility

    $552.09

    $14.91 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 11772

    Office

    $852.59

    Facility

    $575.69

    $16.36 higher than Delaware for the office setting.

  • Vermont

    Vermont · 11772

    Office

    $813.82

    Facility

    $542.67

    $22.41 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 11772

    Office

    $866.13

    Facility

    $577.73

    $29.90 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 11772

    Office

    $974.07

    Facility

    $638.01

    $137.84 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 11772

    Office

    $784.94

    Facility

    $522.56

    $51.29 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 11772

    Office

    $799.66

    Facility

    $561.65

    $36.57 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 11772

    Office

    $832.62

    Facility

    $558.73

    $3.61 lower than Delaware for the office setting.

See how rates vary across the country

11772 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$742.13

$984.49

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$977.451
AL$753.851
AR$742.131
AZ$822.121
CA$878.01–$1,090.9729
CO$873.091
CT$906.531
DC$964.831
DE$836.231
FL$851.69–$956.803
GA$798.76–$868.332
GU$898.981
HI$898.981
IA$766.301
ID$773.371
IL$831.40–$925.344
IN$777.961
KS$766.311
KY$781.381
LA$781.62–$822.592
MA$868.90–$957.872
MD$851.73–$964.833
ME$781.83–$821.472
MI$806.76–$867.042
MN$823.391
MO$769.85–$821.043
MS$755.961
MT$847.271
NC$789.961
ND$813.651
NE$769.631
NH$862.881
NJ$913.17–$954.512
NM$813.051
NV$838.451
NY$802.96–$1,015.535
OH$799.891
OK$775.751
OR$828.31–$897.852
PA$799.07–$885.252
PR$852.591
RI$863.991
SC$796.981
SD$809.681
TN$770.941
TX$793.75–$873.358
UT$808.521
VA$821.32–$964.832
VI$852.591
VT$813.821
WA$866.13–$974.072
WI$784.941
WV$799.661
WY$832.621

Explore 11772 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 11772 in Delaware, the physician’s office rate is $836.23 and the facility-setting rate is $565.63: a difference of $270.60.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 11772 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$919.85

$836.23 × 110% = $919.85

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11772 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

1,374

Code
11772
Physician work
7.17
Practice expense
16.50
Malpractice
1.70

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 11772 in Delaware
ComponentRVULocality factorAdjusted
Physician work7.17× 1.0057.2058
Practice expense16.50× 0.98816.3020
Malpractice1.70× 0.8991.5283
Total RVUs25.0361
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$836.23

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 11772 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work7.171.005
Practice expense16.50.988
Malpractice1.70.899

(7.17 × 1.005 + 16.5 × 0.988 + 1.7 × 0.899) × $33.4009 = $836.23

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.171.005
Practice expense8.30.988
Malpractice1.70.899

(7.17 × 1.005 + 8.3 × 0.988 + 1.7 × 0.899) × $33.4009 = $565.63

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

11772 · Office / nonfacility

$836.23

Effective 2026-10-01

The base rate is $91.08 higher than on 2025-10-01, moving from $745.15 to $836.23 (12.2%).

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

    $745.15changed to$836.23

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.35 changed to 7.17
    • Practice expense RVU 14.12 changed to 16.50
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $745.15

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$836.23$565.63RVU26D
2026-07-01$836.23$565.63RVU26C
2026-04-01$836.23$565.63RVU26B
2026-01-01$836.23$565.63RVU26A
2025-10-01$745.15$566.42RVU25D
2025-07-01$745.15$566.42RVU25C
2025-04-01$745.15$566.42RVU25B
2025-01-01$745.15$566.42RVU25A

11772 billing questions

How does this code differ from 11771?

Both describe excision of pilonidal disease, but this code is for a complicated case, while 11771 is for an extensive case. The operative report should support the selected level through the disease findings and work performed.

Can an abscess drainage code be used instead?

Use an incision-and-drainage code when the service is drainage rather than excision of the pilonidal cyst or sinus. The choice depends on the procedure actually performed, not simply the presence of an abscess.

What documentation supports the complicated level?

Document the cyst or sinus findings, extent and course of disease, and the operative work that makes the case complicated. A diagnosis of pilonidal disease by itself does not establish this level.

Are related postoperative visits separately reported?

Related postoperative care during the 90-day global period is included. The global period also includes the preoperative visit on the day before surgery.

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.

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

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Co-surgeons and team surgery are not permitted for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 11772PPRRVU2026_Oct_nonQPP.csv, line 1,374 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet