Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 10081 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.
I&D Pilonidal Cyst Complicated
| 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 10081 |
| Medicaid Fee Schedule | View Medicaid rates for 10081 |
National average reimbursement for CPT 10081 by major payers:
$339.32
$363.56
$419.92
$499.90
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 10081.
CPT 10081
5 of 25 sample ratesHigher to lower in this preview
Physicians West Houston Surgical Center, LLC, Memorial Hermann Surgery Center Park Ten
$2,350.00Published rateLeonardtown Surgery Center LLC
Leonardtown Surgery Center, LLC
$953.00Published rateElmhurst Outpatient Surgery Center LLC
Elmhurst Outpatient Surgery Center, LLC
$572.00Published rateAcademy Orthopedics, LLC, Dba Academy Orthopedics, LLC, Ambulatory Surgical Center
Academy Orthopedics, LLC
$450.00Published rateJoseph Anthony
Deaconess Hospital Inc
$221.28Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 10081 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 10081 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 10081 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 10081. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10081 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 10081) and we'll show you how you compare in 15 minutes or less.