Incision and drainage of a complicated skin or subcutaneous abscess, or of several abscesses at one session.
- Medicare
- $220.11
- Work RVU
- 2.39
- Global, days
- 10
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Size and location of each abscess
- Loculations broken and how
- Irrigation, packing, or drain placed
- Depth limited to skin and subcutaneous tissue
- Cultures obtained and antibiotic plan
- Number of separate abscesses if multiple
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
10061 is used when a skin or subcutaneous abscess takes real work to drain. That means loculations broken up, a large cavity packed, a wound left open, or more than one abscess handled in the same visit. Like 10060, it has a 10-day global.
Foot and ankle surgeons and podiatrists see this with diabetic patients who come in with a larger abscess on the foot that has to be opened widely and packed. Hand surgeons see it on the forearm or dorsum of the hand. Once the infection goes below the fascia or into a tendon sheath, the region-specific deep codes apply instead.
Payers look for proof of complexity. A note that says "I&D abscess, drained" will get downcoded or denied as 10060. Describe size, loculations, how they were broken up, irrigation, and packing. When multiple abscesses are drained, list each one. The code already covers multiple abscesses, so it normally goes on the claim once per session. Packing changes during the global are included. A planned return for more drainage takes modifier 58, and an unrelated new abscess takes 79.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (2.39) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (6.59) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 2.39 |
| Practice expense RVU | 3.87 |
| Malpractice RVU | 0.33 |
| Total RVU | 6.59 |
| Medicare national rate | $220.11 |
| Global period | 10 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $220.11 |
HOPD (APC 5052) Hospital outpatient department | $415.32 |
ASC (PI P3) Ambulatory surgical center (freestanding) | $129.91 |
Common denial reasons
The recurring reasons claims for CPT 10061 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Note does not support complexity and payer downcodes to 10060
- Billed once per abscess instead of once per session
- Deep subfascial infection that needed a deeper drainage code
- Packing changes billed separately during the global period
- E/M billed without modifier 25 or separate documentation
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can I bill 10061 for each abscess?
02What makes an I&D complicated?
03Are packing changes billable after 10061?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures loculations, packing, cavity size, and the number of abscesses, which is the detail that separates 10061 from 10060 on review.
See how Mira captures CPT 10061 documentation