CPT code 11043: Wound debridement, muscle or fascia, initial area2026 Medicare rate & RVUs in California
Debridement extending into muscle or fascia is reported for the first 20 square centimeters or less of treated wound area.
Medicare pays $247.68–$303.46 for 11043 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 11043 covers
This service involves removing devitalized tissue from a wound down into muscle and/or fascia; overlying skin, dermis, and subcutaneous tissue may also be removed. Surgeons, podiatrists, and wound-care physicians may perform it for complex chronic ulcers or traumatic and surgical wounds when muscle or fascia is actually debrided, rather than simply visible. Services may occur in an office wound clinic or a facility.
Select this code when the deepest tissue removed is muscle or fascia and the treated area is up to 20 square centimeters. Report 11046 for each additional 20 square centimeters or part. Document the wound site, tissue level removed, area treated, technique, and clinical need. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 11043 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$247.68 to $303.46
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $248.88 | $137.96 |
| Chico, CA | $247.68 | $136.76 |
| El Centro, CA | $247.75 | $136.83 |
| Fresno, CA | $247.68 | $136.76 |
| Hanford, CA | $247.68 | $136.76 |
| Los Angeles, CA | $263.56 | $143.83 |
| Madera, CA | $247.68 | $136.76 |
| Marin County, CA | $296.66 | $153.96 |
| Merced, CA | $247.68 | $136.76 |
| Modesto, CA | $247.68 | $136.76 |
| Napa, CA | $281.88 | $148.49 |
| Oxnard, CA | $261.70 | $142.08 |
| Redding, CA | $247.68 | $136.76 |
| Rest of California | $247.68 | $136.76 |
| Riverside, CA | $252.21 | $141.29 |
| Sacramento, CA | $258.57 | $140.87 |
| Salinas, CA | $257.58 | $140.28 |
| San Benito County, CA | $303.46 | $157.53 |
| San Diego, CA | $262.67 | $141.63 |
| San Francisco, CA | $296.18 | $153.49 |
| San Luis Obispo, CA | $253.60 | $138.32 |
| Santa Clara County, CA | $301.51 | $155.58 |
| Santa Cruz, CA | $264.41 | $141.44 |
| Santa Maria, CA | $258.28 | $140.27 |
| Santa Rosa, CA | $266.99 | $142.71 |
| Stockton, CA | $247.68 | $136.76 |
| Vallejo, CA | $281.19 | $147.80 |
| Visalia, CA | $247.68 | $136.76 |
| Yuba City, CA | $247.68 | $136.76 |
How the 11043 rate is calculated
Each of 11043’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 11043
RVUs × geographic indexes × conversion factor
Work2.63
2.63 RVUs× 1.000 GPCI
Practice expense4.12
4.12 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
7.1700
Conversion factor
$33.4009
Medicare rate
$239.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11043
The CMS indicators that decide how 11043 is paid alongside other services.
CMS payment indicators · 11043
Wound debridement, muscle or fascia, initial area
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11043 without 51 · national office
$239.48
Wound debridement, muscle or fascia, initial area
11043-51 · Second procedure: 50%
$119.74
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
11043 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 11042Wound debridementSubcutaneous tissue, first 20 sq cm
- 11042 is selected when subcutaneous tissue is the deepest layer debrided. Choose 11043 when muscle or fascia is actually reached and removed.
- 11044Wound debridementBone, first 20 sq cm
- 11044 is for debridement extending into bone. Use 11043 when the deepest tissue removed is muscle or fascia.
- 11046Wound debridementEach additional 20 cm²
- 11046 reports additional treated area beyond the initial 20 square centimeters at the muscle or fascia level; it is an add-on to 11043.
11043 billing questions
How does this differ from 11042?
Use 11043 when debridement reaches muscle or fascia. Use 11042 when the deepest tissue removed is subcutaneous tissue.
Does exposed muscle support reporting 11043?
Not by itself. Documentation should show that muscle or fascia was actually debrided, not merely exposed or visible in the wound.
When is 11046 reported with this code?
Report 11046 for each additional 20 square centimeters or part beyond the first 20 square centimeters treated at the muscle or fascia level.
What same-day care is included in the global period?
The 0-day global period includes preoperative and postoperative care on the procedure date.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 11043. Co-surgeons and team surgery are not permitted for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in that session are paid at 50% under the standard multiple procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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