How Much Does Incision & Drainage of Abscess Cost in Pennsylvania?
I&d abscess simple/single
$127.52In-office total2026 Medicare, Pennsylvania averageUnder 2026 Medicare rates, incision & drainage of abscess in a doctor's office costs about $128 in Pennsylvania, from $121 in Rest of Pennsylvania to $134 in Metropolitan Philadelphia, with no separate facility fee. In a facility the national total is about $306 at a hospital outpatient department or about $185 at an ambulatory surgery center, because the facility is paid its own rate on top of the physician.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Pennsylvania Medicare physician rate (2026)
-0.8% vs nationalAverage of 2 localities. Office range $121.43–$133.61.
What it costs in a hospital or surgery center
In a doctor’s office, the office rate above is the whole Medicare payment. When the same procedure is done in a hospital or surgery center, the facility bills its own fee on top of the physician, which is what these totals show. They are 2026 national Medicare amounts.
Choosing a surgery center over a hospital saves about $120 on the Medicare allowed amount for incision & drainage of abscess. Ask whether your procedure can be done at an ambulatory surgery center.
This is Medicare's separate payment to the facility on top of the physician's fee. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What incision & drainage of abscess costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 15001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Pennsylvania the office and hospital physician lines for this CPT differ by $27.48.
National vs Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 10060 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $133.61 |
| rest of pennsylvania | $121.43 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Incision & Drainage of Abscess and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
This procedure: Incision and drainage of an abscess is a quick office or urgent care procedure for a painful, pus-filled pocket under the skin, often caused by an infected hair follicle or a staph infection. The clinician numbs the area with a local injection, makes a small cut so the abscess can drain, and may pack the cavity with gauze. Most patients are in and out in under 30 minutes and go home the same day with wound care instructions.
What Is Incision & Drainage of Abscess?
Incision and drainage of an abscess is a quick office or urgent care procedure for a painful, pus-filled pocket under the skin, often caused by an infected hair follicle or a staph infection. The clinician numbs the area with a local injection, makes a small cut so the abscess can drain, and may pack the cavity with gauze. Most patients are in and out in under 30 minutes and go home the same day with wound care instructions.
What Affects the Cost
- –Where you go matters enormously: the same drainage in an emergency department can cost several times what a primary care office or urgent care clinic charges.
- –If the drained material is sent for a wound culture to identify the bacteria, the lab bills that test separately.
- –A prescription antibiotic afterward, especially a brand-name drug for resistant staph, adds pharmacy cost on top of the procedure.
- –Packing changes or a recheck visit a few days later are usually billed as separate follow-up encounters.
- –A larger or deeper abscess may be coded as complicated (CPT 10061), which pays at a higher rate than this simple, single-abscess code.
Questions to Ask Before Booking
- 1.Can this be handled at urgent care or your office instead of the emergency department?
- 2.Will you send a culture to the lab, and what will that test cost me?
- 3.Is a follow-up packing change included, or is each recheck billed as a separate visit?
- 4.Will I be billed a facility fee on top of your fee at this location?
- 5.If the abscess is more complicated than expected, does the billing code and price change?
Other featured procedures in Pennsylvania
Incision & Drainage of Abscess in other states
Incision & Drainage of Abscess in Pennsylvania: questions
Under 2026 Medicare rates, incision & drainage of abscess in a doctor's office costs about $128 in Pennsylvania, from $121 in Rest of Pennsylvania to $134 in Metropolitan Philadelphia, with no separate facility fee. In a facility the national total is about $306 at a hospital outpatient department or about $185 at an ambulatory surgery center, because the facility is paid its own rate on top of the physician. Enter a ZIP for the exact Pennsylvania locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $12.18 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $26 for the office physician line or $20 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $127.52 is Medicare's whole payment in Pennsylvania: it covers the physician, the room and the supplies, with no separate facility fee. If it is done in a hospital outpatient department instead, the physician is paid about $100.04 and the hospital adds its own facility payment, bringing the national total to about $306. Services billed under other codes, such as lab work, are extra. Pennsylvania ranks #32 of 51 states on the office rate (within 2% of the national office rate of $128.59).