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See a sample rate comparisonCPT 10080 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Inc & Drain Pilonidal Cyst Simple
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 23 - Emergency Room 11 - Office |
| Common Modifiers | None AG - Primary physician UA |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 10080 |
| Medicaid Fee Schedule | View Medicaid rates for 10080 |
National average reimbursement for CPT 10080 by major payers:
$238.05
$245.16
$288.68
$355.23
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CPT 10080
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center, Memorial Hermann Surgery Center, The Woodlands
Memorial Hermann Surgery Center
$2,350.00Published rateSummit Ambulatory Surgical Center, LLC
$1,158.00Published rateBinghamton Asc LLC, Greater Binghamton Eye Surgery Center
Binghamton Asc LLC
$875.00Published rateEscondido Ca Endoscopy Asc Lp, Parkway Endoscopy Center
Escondido Ca Endoscopy Asc Lp
$464.00Published rateHendi Ambulatory Surgery Center, PC
Hendi Ambulatory Surgery Center PC
$147.00Published rate
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See a sample payer proposalCPT 10080 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 10080 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 10080 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 10080-CPT | Moderate | Inc & Drain Pilonidal Cyst Simple |
| 10081-CPT | Moderate | I&D Pilonidal Cyst Complicated |
| 10120-CPT | Low | Incision And Removal Of Forei, Incision And Removal Of Foreign Body Subcutaneous Tissuessimple Incision And Removal Of Foreignbody Subcutaneous Tissues |
| 10121-CPT | Moderate | Incision And Removal Of Foreig, Incision And Removal Of Foreign Body Subcutaneoustissues Complicated Incision And Removal Of For Eign Body Subcutaneous Tissues |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 10080. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10080 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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