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CMS RVU26D · Effective 2026-10-01

10080 Pilonidal drainage Medicare reimbursement rates in Tennessee

Reports simple incision and drainage of a pilonidal cyst, typically to evacuate an abscess in the natal cleft without complex treatment. Compare 10080 office and facility rates across CMS payment localities in Tennessee.

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 10080 in Tennessee?

Tennessee 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

$246.15

1 of 1 localities have a supported rate.

Payment area: Tennessee

One mapped payment locality.

Facility setting

$96.77

1 of 1 localities have a supported rate.

Payment area: Tennessee

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.

Find 10080 in your payment locality →

Surgical procedure

About 10080: Simple pilonidal cyst drainage

Reports simple incision and drainage of a pilonidal cyst, typically to evacuate an abscess in the natal cleft without complex treatment.

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.

CMS billing rules for 10080

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 RVU1.19 · 15%
  • Practice expense (office) RVU6.68 · 83%
  • Malpractice RVU0.20 · 2%

868

Medicare services in 2024 · #3068 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.

10080 compared with similar codes

Office rates for Tennessee, from the same CMS release.

10081

Pilonidal drainage

Complicated incision and drainage

$346.97

Both address pilonidal disease, but 10081 is for complex drainage; this code is for simple drainage.

10060

Abscess drainage

Simple, single abscess

$118.89

10060 is for simple drainage of a single abscess not coded as pilonidal. Use this code when the drained lesion is pilonidal.

10061

Abscess drainage

Complex or multiple

$203.25

10061 covers complex or multiple abscess drainage outside the pilonidal-specific code pathway. For complex pilonidal drainage, compare 10081.

11770

Pilonidal excision

Simple excision

$354.91

11770 describes excision of a pilonidal cyst or sinus, while this code describes incision and drainage without excision.

Compare 10080 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

Office and facility base rates · shared scale starting at $0

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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 10080 in Tennessee.

PPRRVU2026_Oct_nonQPP.csv

1,093

Code
10080
Physician work
1.19
Practice expense
6.68
Malpractice
0.20

GPCI2026.csv

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office / nonfacility calculation for 10080 in Tennessee
ComponentRVULocality factorAdjusted
Physician work1.19× 1.0001.1900
Practice expense6.68× 0.9096.0721
Malpractice0.20× 0.5370.1074
Total RVUs7.3695
Conversion factor× 33.4009

Office / nonfacility rate, Tennessee$246.15

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.191
Practice expense6.680.909
Malpractice0.20.537

(1.19 × 1 + 6.68 × 0.909 + 0.2 × 0.537) × $33.4009 = $246.15

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.191
Practice expense1.760.909
Malpractice0.20.537

(1.19 × 1 + 1.76 × 0.909 + 0.2 × 0.537) × $33.4009 = $96.77

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.

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 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 10080PPRRVU2026_Oct_nonQPP.csv, line 1,093 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet