CPT 10060Surgery

I&d abscess simple/single

CPT code 10060 covers the incision and drainage (I&D) of a simple, single abscess—a procedure where a physician makes a small cut to drain pus from an infected pocket under the skin. This is one of the most common minor surgical procedures performed in outpatient settings.

Showing rates for

National Average

Base Medicare rate

$124.21

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.22

PE RVU (NF)

2.49

MP RVU

0.13

Total RVU

3.84

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Verify facility vs. non-facility status before billing—performing in your office yields $124.21 vs. $104.80 in hospital setting
Impact: $19.41 difference per procedure (18.5% higher reimbursement in non-facility setting)
Document size, depth, and complexity clearly to support 10060 vs. 10061 (complicated abscess) selection; 10061 reimburses at approximately $200+ vs. $124.21
Impact: Undercoding costs $75-100 per encounter when complicated abscess features are present but not documented
Always append modifier 25 to E/M when performed same day with proper documentation showing separate decision-making for the visit beyond the procedure
Impact: Recovers $50-150 in E/M reimbursement that would otherwise be bundled and denied
Bill multiple units or use modifier 59 only when draining truly separate abscesses in distinct anatomic locations with clear documentation
Impact: Each additional properly documented site adds $104.80-124.21, but improper use triggers audits and recoupment
Ensure documentation includes incision size, drainage amount/character, wound exploration, packing/drain placement, and patient instructions
Impact: Complete documentation reduces audit risk and supports medical necessity, preventing potential 100% claim denial
Check local coverage determinations (LCDs) and payer-specific policies regarding global periods (typically 10 days) to avoid billing follow-up visits separately during this window
Impact: Prevents automatic denials of follow-up E/M codes valued at $75-100 during the 10-day global period

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 10060?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 10060 in 2025?

The 2025 Medicare national average reimbursement for CPT 10060 is $124.21 in non-facility settings (such as physician offices) and $104.80 in facility settings (such as hospital outpatient departments). Actual reimbursement varies by geographic locality based on GPCI adjustments.

Can I bill an E/M visit with CPT 10060 on the same day?

Yes, you can bill an E/M service with CPT 10060 on the same day if you append modifier 25 to the E/M code and document a significant, separately identifiable evaluation beyond the decision to perform the I&D. The documentation must support that the E/M involved additional assessment, history, or decision-making separate from the procedure itself.

What is the difference between CPT 10060 and 10061?

CPT 10060 is for simple or single abscess drainage, while CPT 10061 is for complicated or multiple abscesses. Complicated features include: extensive dissection required, multiple interconnected abscesses, deep subcutaneous or subfascial location, or significant wound exploration. CPT 10061 reimburses at a higher rate (approximately $200+) due to increased complexity and work.

How many RVUs is CPT code 10060 worth?

CPT 10060 has a total RVU value of 3.84 for 2025, consisting of 1.22 work RVUs, 2.49 practice expense RVUs (non-facility), 1.89 practice expense RVUs (facility), and 0.13 malpractice RVUs. These RVUs multiplied by the 2025 conversion factor of 32.3465 determine Medicare reimbursement.

Can I bill CPT 10060 twice for draining two separate abscesses?

Yes, but only if the abscesses are in distinctly separate anatomic locations and you document each site clearly. Use modifier 59 or anatomic modifiers (LT/RT) to indicate separate sites. Billing multiple units for abscesses in the same general area or connected abscesses may be considered inappropriate and trigger denials or audits.

What documentation is required to bill CPT 10060?

Required documentation includes: medical necessity (clinical signs of abscess), anatomic location, consent, anesthesia type/amount, incision description, drainage characteristics and volume, wound exploration performed, irrigation, culture if sent, packing/drain placement, and wound care instructions. Incomplete documentation is a leading cause of claim denials and audit failures.

Does CPT 10060 have a global period?

Yes, CPT 10060 has a 10-day global period. This means routine follow-up care within 10 days post-procedure is included in the reimbursement and cannot be billed separately. If you see the patient during this period for unrelated problems, append modifier 24 to the E/M code; for complications requiring return to procedure, use modifier 78.