How Much Does Incision & Drainage of Abscess Cost in West Virginia?
I&d abscess simple/single
$119.39In-office total2026 Medicare, West Virginia averageUnder 2026 Medicare rates, incision & drainage of abscess in a doctor's office costs about $119 in West Virginia, 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.
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West Virginia Medicare physician rate (2026)
-7.2% vs nationalSingle statewide locality.
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 West Virginia
Run a ZIP lookup for your part of West Virginia, whether Morgantown, Charleston, Huntington, Wheeling, the Eastern Panhandle near Martinsburg, or the southern coalfields.
What incision & drainage of abscess costs at hospitals near you
Everything above is a national average. The hospital you pick in West Virginia 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 24701.
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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 West Virginia the office and hospital physician lines for this CPT differ by $24.38.
National vs West Virginia
Where West Virginia ranks for this CPT
Incision & Drainage of Abscess and how West Virginia is priced
West Virginia is one statewide payment locality with geographic indices among the lowest in the eastern United States, so its published Medicare rates apply identically from the Eastern Panhandle to the southern coalfields. The uniform pricing spans a state whose mountainous terrain makes actual travel to care unusually difficult relative to straight-line distances. CMS's work index floor supports the state's low-cost profile. Morgantown, Charleston, and Huntington all bill against the same geographic factors.
The state's care concentrates around its academic medical centers in Morgantown and Huntington and the capital-region hospitals in Charleston, each serving long mountain catchments. West Virginia's population is among the oldest and highest-need in the country, and hospital finances have been fragile in many counties. Eastern Panhandle residents commonly use Maryland or Virginia providers, and northern residents look to Pittsburgh.
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 West Virginia
Incision & Drainage of Abscess in other states
Incision & Drainage of Abscess in West Virginia: questions
Under 2026 Medicare rates, incision & drainage of abscess in a doctor's office costs about $119 in West Virginia, 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. West Virginia is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. West Virginia uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $24 for the office physician line or $19 for the hospital physician line in West Virginia. Medigap may cover that 20%. This is not the hospital facility fee.
In a doctor's office, $119.39 is Medicare's whole payment in West Virginia: 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 $95.01 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. West Virginia ranks #10 of 51 states on the office rate (7% below the national office rate of $128.59).