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    OpenPayerBilling CodesIncision and Drainage Procedures on the Skin, Subcutaneous and Accessory StructuresCPT cpt-10060-incision-and-drainage-simple-abscess
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    CPT 10060: Incision and Drainage of Simple Skin Abscess

    Medicare pays $133 and commercial payers pay $237 on average nationally for this procedure.

    CPT code 10060 describes a simple incision and drainage procedure in which the provider uses surgical instruments to incise an abscess or similar lesion (e.g., furuncle, cyst, carbuncle, paronychia) and drain the collection of pus; service type: minor surgical procedure; typical site of service: office, urgent care, or emergency department for a superficial cutaneous abscess located just below the skin surface.

    For related coverage guidance, see recent payer policy updates: Mohs Micrographic Surgery, Mohs Micrographic Surgery, Mohs Micrographic Surgery.

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    National Reimbursement Benchmarks

    Nationally, Medicare's mean reimbursement for CPT 10060 sits at $133.10, while BUCA’s average commercial mean is substantially higher at $236.60, reflecting a spread of $103.50 between public and the BUCA commercial benchmark. This gap highlights the typical structural difference between Medicare and average commercial commercial rates for this code.

    Dispersion measured by the interquartile range (P75 minus P25) varies notably across payers: Blue Cross Blue Shield shows one of the widest spreads at $120.20 (P75 $353.70 minus P25 $233.50), while Aetna is much tighter with a spread of $95.00 (P75 $172.50 minus P25 $72.80). UnitedHealth Group and Cigna have similar dispersion at $119.70 and $116.60 respectively, and BUCA’s IQR is $115.90, indicating relatively broad commercial variability compared with Aetna’s tighter band; Medicare’s IQR is narrow at $14.00.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old patient presents to the emergency department with a 48-hour history of a painful, fluctuant swelling in the right axilla with localized erythema and fever. The clinician performs a focused history and targeted physical exam, documents review of systems and comorbidities (including diabetes screening), and confirms a superficial cutaneous abscess clinically consistent with L02.611. After informed consent, the procedure area is prepared with antiseptic, local anesthetic is infiltrated, and a single incision and drainage is performed using scalpel and blunt dissection to evacuate purulent material. Wound culture specimens are obtained as clinically indicated. The wound is irrigated, hemostasis achieved, and a sterile dressing and packing are placed when appropriate. Post-procedure instructions, wound care education, and prescriptions (e.g., oral antibiotics or analgesics) are provided. The visit is documented with procedure details (site, size, anesthesia, instruments, culture), estimated complexity, and follow-up plan. Typical sites of service include the emergency department, urgent care clinic, or outpatient procedure room. The service type is a minor surgical procedure: simple incision and drainage of a superficial cutaneous abscess (CPT 10060).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    10061Incision and drainage of abscess; complicated or multiple

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208600000X
    207Q00000X
    207P00000X
    2084B0002X
    344800000X
    224ZE0001X
    207ND0101X
    174V00000X

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    FilsuvezCigna2026-11-01
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Hyperhidrosispriority_health_medicare2026-09-01
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01

    Related Codes

    CPT-10040-LESION-EXTRACTION-DRAINAGE-REMOVAL

    CPT 10040: Extraction of Skin Lesion (Incision and Drainage)

    CPT-10061-COMPLICATED-INCISION-AND-DRAINAGE-ABSCESS

    CPT 10061: Incision and Drainage, Complicated Abscess

    CPT-10080-PILONIDAL-CYST-INCISION-AND-DRAINAGE

    CPT 10080: Incision and Drainage of Pilonidal Cyst

    CPT-10081-PILONIDAL-CYST-INCISION-DRAINAGE-PROCEDURE

    CPT 10081: Incision and Drainage of Pilonidal Cyst, Complex

    CPT-10120-FOREIGN-BODY-REMOVAL-SUBCUTANEOUS

    CPT 10120: Incision and Removal of Subcutaneous Foreign Body

    CPT-10121-DEEP-FOREIGN-BODY-REMOVAL-SOFT-TISSUE

    CPT 10121: Incision and Removal of Deep Foreign Body

    CPT-10140-INCISION-AND-DRAINAGE-HEMATOMA-SEROMA-FLUID-EVACUATION

    CPT 10140: Incision and Drainage of Hematoma/Seroma

    CPT-10160-PERCUTANEOUS-ASPIRATION-SKIN-FLUID-COLLECTION-CULTURE

    CPT 10160: Needle Aspiration of Skin Fluid or Pus

    CPT-10180-INCISION-DRAINAGE-INSTRUMENT-ASSISTED-INFECTION

    CPT 10180: Incision and Drainage of Complex Infected Area

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Used when the abscess is complex, multiloculated, or multiple incisions are required beyond a single simple I&D (CPT 10060).

    | 10160 | Puncture aspiration of abscess, hematoma, bulla, or cyst | Alternative to I&D when aspiration is appropriate rather than incision, or used for certain cystic lesions.

    | 99213 | Established patient office or other outpatient visit, level 3 | May be reported for an established patient visit when a separate E/M is provided and not bundled with the procedure (use 25 if same-day).

    | 99203 | New patient office or other outpatient visit, level 3 | May be reported for a new patient visit when a separate E/M is provided in addition to the procedure (use 25 if same-day).