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CPT code 11043: Wound debridement, muscle or fascia, initial area2026 Medicare rate & RVUs in Washington, DC area

Debridement extending into muscle or fascia is reported for the first 20 square centimeters or less of treated wound area.

CMS RVU26DEffective Oct 1, 2026One payment locality506.3K Medicare services in 2024

In Washington, DC area, Medicare pays $270.31 for 11043 in the office and $151.09 when it’s performed in a hospital or facility.

$270.31Office (non-facility)
$151.09Hospital or facility
+12.9%vs the national office rate ($239.48)

Check a contract rate as a % of Medicare · 11043 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11043 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 11043 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Washington, DC area compares for 11043

Across 109 of 109 payment localities, the office rate for 11043 runs from $213.28 in Arkansas to $303.46 in San Benito County, CA. Washington, DC area pays $270.31. The RVUs are the same everywhere; the geographic indexes change the dollars.

11043 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$270.31
  2. Los Angeles, CA · California$263.56−$6.75
  3. Miami, FL · Florida$266.58−$3.73
  4. Chicago, IL · Illinois$258.95−$11.36
  5. Manhattan, NY · New York$275.62+$5.31
  6. Alaska · Alaska$286.05+$15.74
  7. Alabama · Alabama$216.19−$54.12

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

11043 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$213.28$126.34
ArizonaArizona$233.20$135.13
Bakersfield, CACalifornia$248.88$137.96
Chico, CACalifornia$247.68$136.76
El Centro, CACalifornia$247.75$136.83
Fresno, CACalifornia$247.68$136.76
Hanford, CACalifornia$247.68$136.76
Madera, CACalifornia$247.68$136.76

11043 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$213.28

$286.05

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11043 office rate range by state
State / territoryOffice rate rangeLocalities
AK$286.051
AL$216.191
AR$213.281
AZ$233.201
CA$247.68–$303.4629
CO$246.271
CT$254.781
DC$270.311
DE$236.861
FL$240.49–$266.583
GA$227.32–$244.772
GU$252.431
HI$252.431
IA$219.331
ID$221.081
IL$235.41–$258.954
IN$222.231
KS$219.321
KY$223.021
LA$223.07–$233.272
MA$245.34–$268.242
MD$240.86–$270.313
ME$223.17–$233.072
MI$229.32–$244.292
MN$233.601
MO$220.13–$232.913
MS$216.701
MT$239.461
NC$225.201
ND$231.151
NE$220.161
NH$243.371
NJ$257.02–$267.992
NM$230.881
NV$237.281
NY$228.44–$283.145
OH$227.621
OK$221.631
OR$234.77–$252.572
PA$227.43–$249.422
PR$240.791
RI$244.181
SC$226.921
SD$230.171
TN$220.471
TX$226.10–$246.048
UT$229.801
VA$233.02–$270.312
VI$240.791
VT$231.181
WA$244.57–$272.552
WI$224.001
WV$227.501
WY$235.841

See 11043 in every payment locality

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

Office or facility?

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.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,256

Code
11043
Physician work
2.63
Practice expense
4.12
Malpractice
0.42

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 11043 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.63× 1.0542.7720
Practice expense4.12× 1.1784.8534
Malpractice0.42× 1.1130.4675
Total RVUs8.0928
Conversion factor× 33.4009

Office rate, Washington, DC area$270.31

Office: (2.63 × 1.054 + 4.12 × 1.178 + 0.42 × 1.113) × $33.4009 = $270.31

Facility: (2.63 × 1.054 + 1.09 × 1.178 + 0.42 × 1.113) × $33.4009 = $151.09

Open 11043 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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%).

When to use modifier 51

Codes related to 11043

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 11043
CodeHow it relatesOffice range, Washington, DC area
Add-on codes
11046Wound debridement, each additional 20 cm²Add-on for each additional 20 square centimeters or part debrided at the muscle or fascia level.$85.55
Same family
11042Wound debridement, subcutaneous tissue, first 20 sq cmDebridement at the subcutaneous tissue level rather than muscle or fascia.$151.86
11044Wound debridement, bone, first 20 sq cmDebridement extending to bone, a deeper tissue level than this code.$359.77
11047Bone debridement, each additional 20 sq cmAdditional-area code for debridement at the bone level.$143.43
Used instead
97597Selective wound debridement, first 20 sq cm or lessSelective wound debridement when the service does not extend into muscle or fascia.$116.40

How 11043 has changed in Washington, DC area

11043 · Office / nonfacility

$270.31

Effective 2026-10-01

The base rate is $13.68 higher than on 2025-10-01, moving from $256.63 to $270.31 (5.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $256.63changed to$270.31

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.70 changed to 2.63
    • Practice expense RVU 3.85 changed to 4.12
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $264.90changed to$256.63

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.89 changed to 3.85
    • Malpractice RVU 0.40 changed to 0.42

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $260.58changed to$264.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $270.87changed to$260.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.83 changed to 3.89
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $279.81changed to$270.87

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.81 changed to 3.83
    • Malpractice RVU 0.41 changed to 0.40
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $281.29changed to$279.81

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.78 changed to 3.81
    • Malpractice RVU 0.42 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $276.68changed to$281.29

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.52 changed to 3.78
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $270.53changed to$276.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.48 changed to 3.52
    • Malpractice RVU 0.39 changed to 0.42
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $268.48changed to$270.53

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.45 changed to 3.48
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $265.94changed to$268.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.39 changed to 3.45
    • Malpractice RVU 0.39 changed to 0.38
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $266.19changed to$265.94

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.40 changed to 0.39
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $266.72changed to$266.19

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.38 changed to 3.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $265.39changed to$266.72

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $264.80changed to$265.39

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.36 changed to 3.38
    • Malpractice RVU 0.43 changed to 0.40
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $266.10changed to$264.80

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.74 changed to 3.36
    • Malpractice RVU 0.45 changed to 0.43
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $266.10

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$270.31$151.09RVU26D
2026-07-01$270.31$151.09RVU26C
2026-04-01$270.31$151.09RVU26B
2026-01-01$270.31$151.09RVU26A
2025-10-01$256.63$166.02RVU25D
2025-07-01$256.63$166.02RVU25C
2025-04-01$256.63$166.02RVU25B
2025-01-01$256.63$166.02RVU25A
2024-10-01$264.90$169.28RVU24D
2024-07-01$264.90$169.28RVU24C
2024-04-01$264.90$169.28RVU24B
2024-03-09$264.90$169.28RVU24AR
2024-01-01$260.58$166.51RVU24A
2023-10-01$270.87$172.96RVU23D
2023-07-01$270.87$172.96RVU23C
2023-04-01$270.87$172.96RVU23B
2023-01-01$270.87$172.96RVU23A
2022-10-01$279.81$176.72RVU22D
2022-07-01$279.81$176.72RVU22C
2022-04-01$279.81$176.72RVU22B
2022-01-01$279.81$176.72RVU22A
2021-10-01$281.29$178.64RVU21D
2021-07-01$281.29$178.64RVU21C
2021-04-01$281.29$178.64RVU21B
2021-01-01$281.29$178.64RVU21A
2020-10-01$276.68$181.06RVU20D
2020-07-01$276.68$181.06RVU20C
2020-04-01$276.68$181.06RVU20B
2020-01-01$276.68$181.06RVU20A
2019-10-01$270.53$178.47RVU19D
2019-07-01$270.53$178.47RVU19C
2019-04-01$270.53$178.47RVU19B
2019-01-01$270.53$178.47RVU19A
2018-10-01$268.48$179.12RVU18D
2018-07-01$268.48$179.12RVU18C
2018-04-01$268.48$179.12RVU18B
2018-01-01$268.48$179.12RVU18AR1
2017-10-01$265.94$179.45RVU17D
2017-07-01$265.94$179.45RVU17C
2017-04-01$265.94$179.45RVU17B
2017-01-01$265.94$179.45RVU17A
2016-10-01$266.19$179.04RVU16D
2016-07-01$266.19$179.04RVU16C
2016-04-01$266.19$179.04RVU16B
2016-01-01$266.19$179.04RVU16A
2015-10-01$266.72$179.69RVU15D
2015-07-01$266.72$179.69RVU15C
2015-04-01$265.39$178.79RVU15B
2015-01-01$265.39$178.79RVU15A
2014-10-01$264.80$179.11RVU14D
2014-07-01$264.80$179.11RVU14C
2014-04-01$264.80$179.11RVU14B
2014-01-01$264.80$179.11RVU14A
2013-10-01$266.10$174.40RVU13D
2013-07-01$266.10$174.40RVU13C
2013-04-01$266.10$174.40RVU13B
2013-01-01$266.10$174.40RVU13AR

Price 11043 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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
RVUs for 11043PPRRVU2026_Oct_nonQPP.csv, line 1,256 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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