Incision & Drainage of Abscess Cost in Wisconsin
I&d abscess simple/single
$306Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre 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
Wisconsin Medicare physician rate (2026)
-5.1% vs nationalSingle statewide locality.
What the whole procedure costs
The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.
Choosing a surgery centre 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 centre.
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 Wisconsin
Check your ZIP code for your part of Wisconsin, whether Milwaukee, Madison, Green Bay and the Fox Valley, La Crosse, Eau Claire, or the rural Northwoods.
What incision & drainage of abscess costs at hospitals near you
Everything above is a national average. The hospital you pick in Wisconsin 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.
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 centre 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 Wisconsin the office and hospital physician lines for this CPT differ by $26.88.
National vs Wisconsin
Where Wisconsin ranks for this CPT
Incision & Drainage of Abscess and how Wisconsin is priced
Wisconsin's Medicare pricing runs through a single statewide locality with indices near the national average, so Milwaukee, Madison, and the Northwoods share the same approved amounts. The unified locality sits atop one of the more regionally organized care systems in the country, with strong integrated groups serving defined territories. No metro premium exists in the fee schedule, so Milwaukee's higher practice costs are averaged into the statewide factors. The published rates here travel unchanged across all seventy-two counties.
Milwaukee and Madison hold the state's academic medicine and largest systems, while integrated clinics in Marshfield, La Crosse, and the Fox Valley have long histories of serving rural Wisconsin through hub-and-spoke networks. The far north is lake and forest country where specialty care means a long drive south, and some western residents use Twin Cities or Rochester, Minnesota providers. Wisconsin's tradition of clinic-based integrated care tends to keep billing relatively coordinated.
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 Wisconsin
Incision & Drainage of Abscess in other states
Incision & Drainage of Abscess in Wisconsin: questions
Wisconsin is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 10060 is $122.04 in an office and $95.16 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Wisconsin 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 Wisconsin. Medigap may cover that 20%. This is not the hospital facility fee.
No. $122.04 is only the physician's share. Adding Medicare's facility payment brings the total to about $306 in a hospital outpatient department, or about $185 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Wisconsin ranks #18 of 51 states on the physician line (5% below the national office rate of $128.59).