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

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 Tennessee, Medicare pays $220.47 for 11043 in the office and $128.47 when it’s performed in a hospital or facility.

$220.47Office (non-facility)
$128.47Hospital or facility
−7.9%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 Tennessee
  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 Tennessee 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. Tennessee pays $220.47. The RVUs are the same everywhere; the geographic indexes change the dollars.

11043 in Tennessee vs other payment areas
  1. Tennessee · this page$220.47
  2. Los Angeles, CA · California$263.56+$43.09
  3. Washington, DC area · District of Columbia$270.31+$49.84
  4. Miami, FL · Florida$266.58+$46.11
  5. Chicago, IL · Illinois$258.95+$38.48
  6. Manhattan, NY · New York$275.62+$55.15
  7. Alaska · Alaska$286.05+$65.58

Other areas in Tennessee first, then benchmark localities. Bars start at $0.

Every other payment area

11043 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$216.19$127.64
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

11043 rates by state

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

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 Tennessee 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

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 11043 in Tennessee
ComponentRVULocality factorAdjusted
Physician work2.63× 1.0002.6300
Practice expense4.12× 0.9093.7451
Malpractice0.42× 0.5370.2255
Total RVUs6.6006
Conversion factor× 33.4009

Office rate, Tennessee$220.47

Office: (2.63 × 1 + 4.12 × 0.909 + 0.42 × 0.537) × $33.4009 = $220.47

Facility: (2.63 × 1 + 1.09 × 0.909 + 0.42 × 0.537) × $33.4009 = $128.47

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

How 11043 has changed in Tennessee

11043 · Office / nonfacility

$220.47

Effective 2026-10-01

The base rate is $14.16 higher than on 2025-10-01, moving from $206.31 to $220.47 (6.9%).

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

    $206.31changed to$220.47

    • 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
    • Practice expense GPCI 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $213.14changed to$206.31

    • 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

    $209.66changed to$213.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $214.55changed to$209.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.83 changed to 3.89
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544
  5. January 1, 2023

    RVU23A

    $218.03changed to$214.55

    • 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
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $219.07changed to$218.03

    • 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

    $219.11changed to$219.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.52 changed to 3.78
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $217.70changed to$219.11

    • 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
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $216.30changed to$217.70

    • 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. April 1, 2018

    RVU18B

    No ratechanged to$216.30

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$220.47$128.47RVU26D
2026-07-01$220.47$128.47RVU26C
2026-04-01$220.47$128.47RVU26B
2026-01-01$220.47$128.47RVU26A
2025-10-01$206.31$138.20RVU25D
2025-07-01$206.31$138.20RVU25C
2025-04-01$206.31$138.20RVU25B
2025-01-01$206.31$138.20RVU25A
2024-10-01$213.14$141.26RVU24D
2024-07-01$213.14$141.26RVU24C
2024-04-01$213.14$141.26RVU24B
2024-03-09$213.14$141.26RVU24AR
2024-01-01$209.66$138.96RVU24A
2023-10-01$214.55$142.44RVU23D
2023-07-01$214.55$142.44RVU23C
2023-04-01$214.55$142.44RVU23B
2023-01-01$214.55$142.44RVU23A
2022-10-01$218.03$143.63RVU22D
2022-07-01$218.03$143.63RVU22C
2022-04-01$218.03$143.63RVU22B
2022-01-01$218.03$143.63RVU22A
2021-10-01$219.07$145.00RVU21D
2021-07-01$219.07$145.00RVU21C
2021-04-01$219.07$145.00RVU21B
2021-01-01$219.07$145.00RVU21A
2020-10-01$219.11$148.86RVU20D
2020-07-01$219.11$148.86RVU20C
2020-04-01$219.11$148.86RVU20B
2020-01-01$219.11$148.86RVU20A
2019-10-01$217.70$148.86RVU19D
2019-07-01$217.70$148.86RVU19C
2019-04-01$217.70$148.86RVU19B
2019-01-01$217.70$148.86RVU19A
2018-10-01$216.30$149.48RVU18D
2018-07-01$216.30$149.48RVU18C
2018-04-01$216.30$149.48RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11043 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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 TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 11043 pays in Tennessee?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 11043 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist