Abscess drainage (CPT 10060): what Medicare pays
On a hospital bill, CPT 10060 is the code for: Simple or single drainage of skin abscess. Here is what Medicare pays for it, what is billed on average, and how to question the line on your bill.
CPT 10060 at a glance
| Medicare average allowed amount | $120.51 |
|---|---|
| Average amount billed to Medicare | $249.63 |
| Billed vs. allowed | 2.1 times |
| Services in the data | 234,031 |
| Setting and year | Office or clinic, national average, 2024 |
What this code is
This code is for a small procedure.
Why your hospital bill can show more
Medicare pays a national amount for each code. Hospitals set their own list prices, called the chargemaster, so a hospital bill can show a much higher amount for the same code. In a hospital or an emergency room, a separate facility charge is often added. Medicare's amount is not a price the hospital must accept, but it is a fair reference to negotiate.
Common billing problems with CPT 10060
A separate facility charge
In a hospital, the facility usually bills its own line for the room and staff, and the doctor can bill separately. Ask the hospital to list each part.
No code on the line
If your bill shows a total without codes, ask for a fully itemized bill. Without codes, nobody can check the charges.
How to question this charge
- Ask the hospital for a fully itemized bill, with the code, date, quantity and price of every line.
- Compare the line with the Medicare amount above.
- Ask in writing for a fair price, the lowest amount they will accept, and any discount for paying in full or for patients without insurance.
- Ask for the hospital's financial assistance policy.
BillCheck reads a photo of your bill on your phone, compares every line and writes the letter. Check my bill.
Related codes
- CPT 12001: Simple wound repair, small
- CPT 12002: Simple wound repair, medium
- CPT 12011: Simple wound repair of the face
- CPT 20610: Large joint injection or aspiration
- CPT 29125: Forearm and hand splint
Frequently asked questions
How much does CPT 10060 cost?
It depends on where it is done. In 2024, Medicare's average allowed amount for CPT 10060 in an office setting was $120.51, and providers billed Medicare $249.63 on average. Hospitals can bill more. If you have no insurance, ask for the self-pay price before you pay.
How do I question this charge?
Ask for an itemized bill, compare the line with the Medicare amount, then ask in writing for a fair price and for financial assistance. BillCheck writes the letter for you.