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

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 Virginia, Medicare pays $233.02 for 11043 in the office and $133.54 when it’s performed in a hospital or facility.

$233.02Office (non-facility)
$133.54Hospital or facility
−2.7%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 Virginia
  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 Virginia 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. Virginia pays $233.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

11043 in Virginia vs other payment areas
  1. Virginia · this page$233.02
  2. Los Angeles, CA · California$263.56+$30.54
  3. Washington, DC area · District of Columbia$270.31+$37.29
  4. Miami, FL · Florida$266.58+$33.56
  5. Chicago, IL · Illinois$258.95+$25.93
  6. Manhattan, NY · New York$275.62+$42.60
  7. Alaska · Alaska$286.05+$53.03

Other areas in Virginia 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.

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 11043 in Virginia
ComponentRVULocality factorAdjusted
Physician work2.63× 1.0002.6300
Practice expense4.12× 0.9834.0500
Malpractice0.42× 0.7060.2965
Total RVUs6.9765
Conversion factor× 33.4009

Office rate, Virginia$233.02

Office: (2.63 × 1 + 4.12 × 0.983 + 0.42 × 0.706) × $33.4009 = $233.02

Facility: (2.63 × 1 + 1.09 × 0.983 + 0.42 × 0.706) × $33.4009 = $133.54

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, Virginia
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.$74.00
Same family
11042Wound debridement, subcutaneous tissue, first 20 sq cmDebridement at the subcutaneous tissue level rather than muscle or fascia.$129.70
11044Wound debridement, bone, first 20 sq cmDebridement extending to bone, a deeper tissue level than this code.$311.55
11047Bone debridement, each additional 20 sq cmAdditional-area code for debridement at the bone level.$124.17
Used instead
97597Selective wound debridement, first 20 sq cm or lessSelective wound debridement when the service does not extend into muscle or fascia.$99.78

How 11043 has changed in Virginia

11043 · Office / nonfacility

$233.02

Effective 2026-10-01

The base rate is $12.71 higher than on 2025-10-01, moving from $220.31 to $233.02 (5.8%).

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

    $220.31changed to$233.02

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $227.53changed to$220.31

    • 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

    $223.81changed to$227.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $231.18changed to$223.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.83 changed to 3.89
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $237.35changed to$231.18

    • 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 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $238.59changed to$237.35

    • 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

    $237.02changed to$238.59

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.52 changed to 3.78
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $233.73changed to$237.02

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $232.08changed to$233.73

    • 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

    $228.86changed to$232.08

    • 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
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $227.79changed to$228.86

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.40 changed to 0.39
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $228.25changed to$227.79

    • 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

    $227.12changed to$228.25

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $226.66changed to$227.12

    • 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
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $227.37changed to$226.66

    • 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
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $227.37

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$233.02$133.54RVU26D
2026-07-01$233.02$133.54RVU26C
2026-04-01$233.02$133.54RVU26B
2026-01-01$233.02$133.54RVU26A
2025-10-01$220.31$145.51RVU25D
2025-07-01$220.31$145.51RVU25C
2025-04-01$220.31$145.51RVU25B
2025-01-01$220.31$145.51RVU25A
2024-10-01$227.53$148.59RVU24D
2024-07-01$227.53$148.59RVU24C
2024-04-01$227.53$148.59RVU24B
2024-03-09$227.53$148.59RVU24AR
2024-01-01$223.81$146.16RVU24A
2023-10-01$231.18$151.34RVU23D
2023-07-01$231.18$151.34RVU23C
2023-04-01$231.18$151.34RVU23B
2023-01-01$231.18$151.34RVU23A
2022-10-01$237.35$154.37RVU22D
2022-07-01$237.35$154.37RVU22C
2022-04-01$237.35$154.37RVU22B
2022-01-01$237.35$154.37RVU22A
2021-10-01$238.59$155.96RVU21D
2021-07-01$238.59$155.96RVU21C
2021-04-01$238.59$155.96RVU21B
2021-01-01$238.59$155.96RVU21A
2020-10-01$237.02$159.41RVU20D
2020-07-01$237.02$159.41RVU20C
2020-04-01$237.02$159.41RVU20B
2020-01-01$237.02$159.41RVU20A
2019-10-01$233.73$158.39RVU19D
2019-07-01$233.73$158.39RVU19C
2019-04-01$233.73$158.39RVU19B
2019-01-01$233.73$158.39RVU19A
2018-10-01$232.08$158.96RVU18D
2018-07-01$232.08$158.96RVU18C
2018-04-01$232.08$158.96RVU18B
2018-01-01$232.08$158.96RVU18AR1
2017-10-01$228.86$158.16RVU17D
2017-07-01$228.86$158.16RVU17C
2017-04-01$228.86$158.16RVU17B
2017-01-01$228.86$158.16RVU17A
2016-10-01$227.79$156.69RVU16D
2016-07-01$227.79$156.69RVU16C
2016-04-01$227.79$156.69RVU16B
2016-01-01$227.79$156.69RVU16A
2015-10-01$228.25$157.26RVU15D
2015-07-01$228.25$157.26RVU15C
2015-04-01$227.12$156.47RVU15B
2015-01-01$227.12$156.47RVU15A
2014-10-01$226.66$156.80RVU14D
2014-07-01$226.66$156.80RVU14C
2014-04-01$226.66$156.80RVU14B
2014-01-01$226.66$156.80RVU14A
2013-10-01$227.37$152.58RVU13D
2013-07-01$227.37$152.58RVU13C
2013-04-01$227.37$152.58RVU13B
2013-01-01$227.37$152.58RVU13AR

Price 11043 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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