Billing code 10080: Pilonidal drainageMedicare rate & RVUs in Florida
Reports simple incision and drainage of a pilonidal cyst, typically to evacuate an abscess in the natal cleft without complex treatment.
Medicare pays $263.09–$288.91 for 10080 in the office in Florida, from Rest Of Florida to Miami. 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 10080 covers
This service is a limited incision and drainage of a pilonidal cyst or abscess in the cleft between the buttocks. A physician or other qualified practitioner typically performs it in an office, emergency department, or outpatient setting, often using local anesthesia. The aim is to release the collection rather than excise the pilonidal tract or cyst.
Select this code for a simple drainage; use the complex pilonidal code when the procedure is more involved. The note should identify the pilonidal site and describe the incision and drainage performed. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay for an assistant at surgery, and co-surgeon and team-surgery billing 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 10080 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$263.09 to $288.91
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $277.84 | $111.37 |
| Miami | $288.91 | $117.84 |
| Rest Of Florida | $263.09 | $105.99 |
How the 10080 rate is calculated
Each of 10080’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 · 10080
RVUs × geographic indexes × conversion factor
Work1.19
1.19 RVUs× 1.000 GPCI
Practice expense6.68
6.68 RVUs× 1.000 GPCI
Malpractice0.20
0.20 RVUs× 1.000 GPCI
Adjusted RVUs
8.0700
Conversion factor
$33.4009
Medicare rate
$269.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 10080
10080 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 10080
Pilonidal drainage
| 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 · 10080
Pilonidal drainage
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
10080 without 51 · national office
$269.55
Pilonidal drainage
10080-51 · Second procedure: 50%
$134.78
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%).
10080 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 10081Pilonidal drainage
- Both address pilonidal disease, but 10081 is for complex drainage; this code is for simple drainage.
- 10060Abscess drainage
- 10060 is for simple drainage of a single abscess not coded as pilonidal. Use this code when the drained lesion is pilonidal.
- 10061Abscess drainage
- 10061 covers complex or multiple abscess drainage outside the pilonidal-specific code pathway. For complex pilonidal drainage, compare 10081.
- 11770Pilonidal excision
- 11770 describes excision of a pilonidal cyst or sinus, while this code describes incision and drainage without excision.
10080 billing questions
How does this differ from the complex pilonidal drainage code?
Use this code for a simple drainage. The complex pilonidal code is for a more involved drainage procedure; document the work performed to support the selection.
Can this be reported for a routine skin abscess?
No. This code is specific to a pilonidal cyst or abscess. A simple or complex abscess elsewhere is reported with the applicable abscess drainage code.
Are related postoperative visits separately billable?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
Should modifier 50 be appended for bilateral disease?
No. The bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Can an assistant, co-surgeon, or surgical team be billed?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full; 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
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