$268.65
Both address pilonidal disease, but 10080 is for simple drainage; report 10081 when the documented drainage is complicated.
On this page
CMS RVU26D · Effective 2026-10-01
10081 Pilonidal drainage Medicare reimbursement rates in Nevada
Reports surgical opening and drainage of a complicated pilonidal cyst or abscess in the natal cleft when the documented treatment is more involved than simple drainage. Compare 10081 office and facility rates across CMS payment localities in Nevada.
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 10081 in Nevada?
Nevada 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
$377.71
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
Facility setting
$166.07
1 of 1 localities have a supported rate.
Payment area: Nevada**
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.
General surgery
About 10081: Complicated pilonidal abscess drainage
Reports surgical opening and drainage of a complicated pilonidal cyst or abscess in the natal cleft when the documented treatment is more involved than simple drainage.
This service treats an infected pilonidal cavity in the cleft between the buttocks, typically near the tailbone. A surgeon or other qualified practitioner opens the affected area to release pus and may explore or irrigate the cavity and manage its wound as clinically indicated. It is commonly performed in an office, emergency department, or outpatient surgical setting for a painful, swollen, draining pilonidal abscess.
Choose this code when the record supports complicated rather than simple pilonidal drainage; document the site, infection findings, extent of the cavity, work performed, and why the procedure was complex. The service has 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 the others are subject to the standard reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 10081
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU2.44 · 21%
- Practice expense (office) RVU8.46 · 74%
- Malpractice RVU0.48 · 4%
379
Medicare services in 2024 · #3780 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.
10081 compared with similar codes
Office rates for Nevada, from the same CMS release.
$127.95
10060 covers simple or single abscess drainage generally. Use 10081 for complicated drainage of a pilonidal cyst in the natal cleft.
$218.40
10061 is for complicated or multiple abscess drainage generally; 10081 is the pilonidal-specific code when that condition is being drained.
$387.00
11770 describes excision of pilonidal disease, whereas 10081 reports incision and drainage of a complicated pilonidal cyst or abscess.
Compare 10081 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
Nevada** →
Office / nonfacility
$377.71
Facility
$166.07
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 10081 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
1,094
- Code
- 10081
- Physician work
- 2.44
- Practice expense
- 8.46
- Malpractice
- 0.48
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.44 | × 1.000 | 2.4400 |
| Practice expense | 8.46 | × 1.001 | 8.4685 |
| Malpractice | 0.48 | × 0.833 | 0.3998 |
| Total RVUs | 11.3083 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nevada**$377.71
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.44 | 1 |
| Practice expense | 8.46 | 1.001 |
| Malpractice | 0.48 | 0.833 |
(2.44 × 1 + 8.46 × 1.001 + 0.48 × 0.833) × $33.4009 = $377.71
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.44 | 1 |
| Practice expense | 2.13 | 1.001 |
| Malpractice | 0.48 | 0.833 |
(2.44 × 1 + 2.13 × 1.001 + 0.48 × 0.833) × $33.4009 = $166.07
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.
10081 billing questions
How do I choose between 10080 and 10081?
Use 10080 for simple pilonidal cyst drainage and 10081 when the operative note supports a complicated procedure. Document the extent and specific work that make the drainage more involved.
How is 10081 different from general abscess drainage?
10081 is specific to complicated drainage of a pilonidal cyst in the natal cleft. Codes 10060 and 10061 describe drainage of other abscesses rather than this pilonidal-specific service.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can modifier 50 be used for bilateral disease?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 10081. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to the 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 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.
1,0911007F,,Anti-inflm/anlgsc otc assess,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
1,0921007T,,Eeg impl s-sclp eeg w/o vid,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,09310080,,I&d pilonidal cyst simple,A,,1.19,6.68,,1.76,,0.20,8.07,3.15,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,09410081,,I&d pilonidal cyst comp,A,,2.44,8.46,,2.13,,0.48,11.38,5.05,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,0951008F,,Gi/renal risk assess,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
1,0961008T,,Rem mntr s-scl eeg sys setup,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,0971009T,,Rem mntr s-sclp cont eeg sys,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097