$404.83
Use 11770 for simple pilonidal excision. Use 11771 when the documented extent supports an extensive excision.
On this page
CMS RVU26D · Effective 2026-10-01
11771 Pilonidal excision Medicare reimbursement rates in Colorado
Reports surgical removal of extensive pilonidal disease in the sacrococcygeal cleft, with code selection based on the documented extent of the excision. Compare 11771 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 11771 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$712.88
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$446.34
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Surgical procedure
About 11771: Extensive pilonidal disease excision
Reports surgical removal of extensive pilonidal disease in the sacrococcygeal cleft, with code selection based on the documented extent of the excision.
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.
CMS billing rules for 11771
- 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 RVU5.94 · 29%
- Practice expense (office) RVU13.36 · 64%
- Malpractice RVU1.43 · 7%
356
Medicare services in 2024 · #3831 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.
11771 compared with similar codes
Office rates for Colorado, from the same CMS release.
$873.09
11772 is for complicated pilonidal excision; 11771 is the extensive level. The operative findings and work support the distinction.
$395.65
10081 represents complicated incision and drainage, not excision. Select it when the service is drainage rather than removal of extensive pilonidal disease.
Compare 11771 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$712.88
Facility
$446.34
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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 11771 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
1,373
- Code
- 11771
- Physician work
- 5.94
- Practice expense
- 13.36
- Malpractice
- 1.43
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.94 | × 1.012 | 6.0113 |
| Practice expense | 13.36 | × 1.064 | 14.2150 |
| Malpractice | 1.43 | × 0.781 | 1.1168 |
| Total RVUs | 21.3432 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$712.88
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.94 | 1.012 |
| Practice expense | 13.36 | 1.064 |
| Malpractice | 1.43 | 0.781 |
(5.94 × 1.012 + 13.36 × 1.064 + 1.43 × 0.781) × $33.4009 = $712.88
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.94 | 1.012 |
| Practice expense | 5.86 | 1.064 |
| Malpractice | 1.43 | 0.781 |
(5.94 × 1.012 + 5.86 × 1.064 + 1.43 × 0.781) × $33.4009 = $446.34
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.
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 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.
1,37011762,,Reconstruction of nail bed,A,,2.87,5.60,,2.03,,0.34,8.81,5.24,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,37111765,,Wedge excision skn nail fold,A,,1.19,3.60,,1.39,,0.09,4.88,2.67,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,37211770,,Exc pilonidal cyst simple,A,,2.59,8.48,,2.22,,0.61,11.68,5.42,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,37311771,,Exc pilonidal cyst xtnsv,A,,5.94,13.36,,5.86,,1.43,20.73,13.23,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,37411772,,Exc pilonidal cyst comp,A,,7.17,16.50,,8.30,,1.70,25.37,17.17,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3751180F,,Thromboemb risk assessed,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,3761181F,,Neuropsychia sympts assessed,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899