How much does Medicare pay for CPT 10061?

Medicare allowed an average of $210.58 per service and paid $160.01 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $336.03, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 10061?

Complicated or multiple drainage of skin abscess. It was billed 33,880 times to 24,113 Medicare beneficiaries by 742 providers in 2024.

Does 10061 pay differently in an office than a hospital?

Yes. The allowed amount averaged $211.90 in an office setting and $166.77 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 10061 most?

Podiatry, with 21,263 services from 428 clinicians. Next are Dermatology, General Surgery, Physician Assistant.

CPT 10061

Complicated or multiple drainage of skin abscess

$210.58Medicare-allowed amount per service, averaged across 33,880 services

Providers submitted

$336.03

Asking price, not received

Medicare allowed

$210.58

The fee schedule figure

Medicare paid

$160.01

Balance is patient coinsurance

Providers submitted an average of $336.03 for this code and Medicare allowed $210.58 — 1.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $160.01 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $211.90
Hospital / facility: $166.77

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 32,894 services were billed in an office setting and 986 in a facility.

Services: 33,880
Beneficiaries: 24,113
Providers billing it: 742
Total allowed: $7,134,450

What Medicare pays for CPT 10061

Across 33,880 services billed by 742 providers to 24,113 beneficiaries, Medicare allowed an average of $210.58 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 10061

Specialty	Services	Beneficiaries	Avg allowed	Providers
Podiatry	21,263	14,901	$213.61	428
Dermatology	9,830	7,159	$208.28	222
General Surgery	734	386	$199.95	17
Physician Assistant	576	497	$188.62	26
Internal Medicine	253	182	$218.88	5
Nurse Practitioner	247	208	$175.11	12
Otolaryngology	201	111	$192.97	2
Family Practice	195	164	$205.55	8
General Practice	161	137	$206.90	6
Plastic and Reconstructive Surgery	130	111	$191.10	4
Micrographic Dermatologic Surgery	110	101	$211.34	3
Emergency Medicine	68	59	$211.47	4
Ambulatory Surgical Center	42	32	$63.15	1
Undersea and Hyperbaric Medicine	23	22	$198.31	1
Thoracic Surgery	16	13	$235.11	1

10061 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	7,551	$206.03	$146.04	90
New York	5,323	$236.37	$160.68	102
Florida	4,140	$214.59	$158.92	125
Pennsylvania	2,466	$205.98	$160.12	37
New Jersey	2,446	$224.90	$157.52	57
Illinois	1,498	$206.33	$152.81	37
Texas	1,428	$196.37	$153.89	36
Michigan	806	$212.69	$158.68	16
Nevada	661	$186.74	$124.85	7
Maryland	577	$223.64	$156.33	22
Virginia	545	$203.57	$155.29	20
Georgia	487	$200.75	$153.02	11
Tennessee	466	$180.12	$158.81	10
Ohio	457	$199.04	$158.34	17
Alabama	446	$183.16	$153.40	10
Louisiana	438	$182.88	$150.97	17
South Dakota	432	$176.02	$130.23	3
Massachusetts	329	$218.97	$155.48	15
Connecticut	320	$215.09	$159.01	10
Arkansas	301	$180.55	$158.64	4
North Carolina	289	$196.97	$151.90	13
Indiana	275	$195.23	$158.86	11
South Carolina	246	$198.46	$160.92	7
Mississippi	240	$186.52	$160.23	7
Missouri	236	$187.75	$151.96	5
Wisconsin	209	$197.21	$154.67	3
Kentucky	187	$189.10	$154.42	7
Arizona	160	$184.93	$145.96	8
Delaware	144	$207.25	$159.96	6
Iowa	119	$187.59	$157.45	5
Hawaii	109	$221.61	$161.22	1
West Virginia	103	$193.14	$148.86	4
Oklahoma	100	$203.09	$157.35	5
Nebraska	62	$196.20	$159.67	2
District of Columbia	59	$219.02	$152.49	1
Washington	49	$239.63	$163.82	2
Utah	37	$200.71	$153.78	2
Kansas	36	$196.21	$156.31	2
Rhode Island	31	$215.83	$163.23	1
New Mexico	24	$201.85	$156.36	1
Puerto Rico	24	$211.66	$150.88	1
Alaska	13	$191.16	$140.57	1
Oregon	11	$230.53	$165.60	1

Related codes

10060Simple or single drainage of skin abscess$124.11
10005Fine needle aspiration biopsy$99.08
10040Acne surgery$109.41
10006Fine needle aspiration biopsy$56.90
10021Fine needle aspiration biopsy$74.12

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.