Billing code 11770: Pilonidal excisionMedicare rate & RVUs in Delaware
Reports surgical removal of a simple pilonidal cyst or sinus in the sacrococcygeal cleft, rather than drainage or more extensive excision.
Medicare pays $385.10 for 11770 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
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.
11770 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $385.10 | $178.52 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11770
Pilonidal 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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11770 without 51 · national office
$390.12
Pilonidal 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%).
11770 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11771Pilonidal excision
- 11770 describes simple excision; 11771 is for pilonidal excision at the extensive level.
- 11772Pilonidal excision
- Choose 11772 when the pilonidal excision is complicated, rather than a simple excision reported with 11770.
- 10080Pilonidal drainage
- 10080 represents simple incision and drainage of a pilonidal cyst. Use 11770 when the service is excision, not drainage.
- 10081Pilonidal drainage
- 10081 represents complicated pilonidal cyst drainage; 11770 is for simple excision of the lesion.
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
Fee sheets
Put 11770 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 →