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CPT code 11046: Wound debridement, each additional 20 cm²2026 Medicare rate & RVUs in Puerto Rico

Reports additional wound surface area debrided through muscle or fascia after the initial area, when the total area exceeds 20 square centimeters.

CMS RVU26DEffective Oct 1, 2026One payment locality307K Medicare services in 2024

In Puerto Rico, Medicare pays $76.80 for 11046 in the office and $47.76 when it’s performed in a hospital or facility.

$76.80Office (non-facility)
$47.76Hospital or facility
+0.4%vs the national office rate ($76.49)

Check a contract rate as a % of Medicare · 11046 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 11046 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 11046 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 11046 covers

This add-on represents debridement of additional wound area when the clinician removes nonviable tissue through muscle or fascia. It commonly accompanies wound care for pressure injuries, diabetic foot ulcers, or traumatic wounds, in a wound clinic, office, or operating room. The code selection follows the deepest tissue actually removed, not simply the wound’s appearance or diagnosis.

Report 11046 with 11043, the primary code for the initial area at this tissue depth. Each unit covers another 20 square centimeters or part of that increment beyond the first 20; document the total area debrided at muscle or fascia depth and the tissue removed. When multiple wounds are treated at the same depth, their areas are combined for code selection; do not combine areas debrided to different depths. As an add-on, 11046 is billed only with a primary procedure and paid within that procedure’s global period.

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 Puerto Rico compares for 11046

Across 109 of 109 payment localities, the office rate for 11046 runs from $68.23 in Arkansas to $93.46 in San Benito County, CA. Puerto Rico pays $76.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

11046 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$76.80
  2. Los Angeles, CA · California$82.45+$5.65
  3. Washington, DC area · District of Columbia$85.55+$8.75
  4. Miami, FL · Florida$87.70+$10.90
  5. Chicago, IL · Illinois$85.12+$8.32
  6. Manhattan, NY · New York$88.30+$11.50
  7. Alaska · Alaska$92.73+$15.93

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

Every other payment area

11046 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$69.14$44.01
ArkansasArkansas$68.23$43.56
ArizonaArizona$74.44$46.60
Bakersfield, CACalifornia$78.17$46.69
Chico, CACalifornia$77.64$46.16
El Centro, CACalifornia$77.67$46.19
Fresno, CACalifornia$77.64$46.16
Hanford, CACalifornia$77.64$46.16

11046 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.

$68.23

$92.73

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

View every state and territory as a table
11046 office rate range by state
State / territoryOffice rate rangeLocalities
AK$92.731
AL$69.141
AR$68.231
AZ$74.441
CA$77.64–$93.4629
CO$77.851
CT$81.321
DC$85.551
DE$75.571
FL$78.06–$87.703
GA$73.74–$78.452
GU$78.851
HI$78.851
IA$69.541
ID$70.201
IL$76.86–$85.124
IN$70.541
KS$69.811
KY$71.871
LA$72.00–$75.182
MA$77.68–$84.292
MD$76.74–$85.553
ME$71.15–$73.822
MI$74.11–$79.562
MN$73.091
MO$71.25–$74.743
MS$69.721
MT$76.481
NC$71.741
ND$72.721
NE$69.711
NH$77.201
NJ$81.82–$84.902
NM$74.711
NV$75.461
NY$72.77–$91.015
OH$73.341
OK$71.141
OR$74.46–$79.482
PA$73.13–$79.822
PR$76.801
RI$77.651
SC$72.741
SD$72.271
TN$70.211
TX$72.73–$78.888
UT$73.641
VA$74.00–$85.552
VI$76.801
VT$72.991
WA$77.35–$85.342
WI$70.551
WV$74.411
WY$74.841

See 11046 in every payment locality

How the 11046 rate is calculated

Each of 11046’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 · 11046

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.00

1.00 RVUs× 1.000 GPCI

Practice expense1.10

1.10 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

2.2900

Conversion factor

$33.4009

Medicare rate

$76.49

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,259

Code
11046
Physician work
1.00
Practice expense
1.10
Malpractice
0.19

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 11046 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0001.0000
Practice expense1.10× 1.0111.1121
Malpractice0.19× 0.9850.1872
Total RVUs2.2992
Conversion factor× 33.4009

Office rate, Puerto Rico$76.80

Office: (1 × 1 + 1.1 × 1.011 + 0.19 × 0.985) × $33.4009 = $76.80

Facility: (1 × 1 + 0.24 × 1.011 + 0.19 × 0.985) × $33.4009 = $47.76

Open 11046 in the RVU calculator

Payment rules and modifiers for 11046

The CMS indicators that decide how 11046 is paid alongside other services.

CMS payment indicators · 11046

Wound debridement, each additional 20 cm²

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 11046

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

Codes related to 11046
CodeHow it relatesOffice range, Puerto Rico
Add-on codes
11043Wound debridement, muscle or fascia, initial areaPrimary code for the initial area debrided at muscle or fascia depth.$240.79
Same family
11045Wound debridement, subcutaneous, each additional 20 sq cmAdditional-area code for debridement to subcutaneous tissue.$41.97
Used instead
11047Bone debridement, each additional 20 sq cmAdditional-area code when debridement reaches bone rather than muscle or fascia.$129.06
11042Wound debridement, subcutaneous tissue, first 20 sq cmPrimary code for the initial area when debridement reaches subcutaneous tissue.$133.59
11044Wound debridement, bone, first 20 sq cmPrimary code for the initial area when debridement reaches bone.$322.15

How 11046 has changed in Puerto Rico

11046 · Office / nonfacility

$76.80

Effective 2026-10-01

The base rate is $6.17 higher than on 2025-10-01, moving from $70.63 to $76.80 (8.7%).

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

    $70.63changed to$76.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.03 changed to 1.00
    • Practice expense RVU 0.97 changed to 1.10
    • Malpractice RVU 0.18 changed to 0.19
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $73.01changed to$70.63

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $71.82changed to$73.01

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $73.69changed to$71.82

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.95 changed to 0.97
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $73.54changed to$73.69

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $75.61changed to$73.54

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $75.88changed to$75.61

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.94 changed to 0.95

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $76.69changed to$75.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.90 changed to 0.94
    • Malpractice RVU 0.19 changed to 0.20
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $75.48changed to$76.69

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.88 changed to 0.90
    • Malpractice RVU 0.18 changed to 0.19
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $75.40changed to$75.48

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $68.15changed to$75.40

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $60.98changed to$68.15

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $60.84changed to$60.98

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.87 changed to 0.88
    • Malpractice RVU 0.17 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $60.54changed to$60.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $60.36changed to$60.54

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.88 changed to 0.87
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $58.94changed to$60.36

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.97 changed to 0.88
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $58.94

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$76.80$47.76RVU26D
2026-07-01$76.80$47.76RVU26C
2026-04-01$76.80$47.76RVU26B
2026-01-01$76.80$47.76RVU26A
2025-10-01$70.63$52.39RVU25D
2025-07-01$70.63$52.39RVU25C
2025-04-01$70.63$52.39RVU25B
2025-01-01$70.63$52.39RVU25A
2024-10-01$73.01$54.24RVU24D
2024-07-01$73.01$54.24RVU24C
2024-04-01$73.01$54.24RVU24B
2024-03-09$73.01$54.24RVU24AR
2024-01-01$71.82$53.36RVU24A
2023-10-01$73.69$54.90RVU23D
2023-07-01$73.54$54.90RVU23C
2023-04-01$73.54$54.90RVU23B
2023-01-01$73.54$54.90RVU23A
2022-10-01$75.61$56.42RVU22D
2022-07-01$75.61$56.42RVU22C
2022-04-01$75.61$56.42RVU22B
2022-01-01$75.61$56.42RVU22A
2021-10-01$75.88$56.89RVU21D
2021-07-01$75.88$56.89RVU21C
2021-04-01$75.88$56.89RVU21B
2021-01-01$75.88$56.89RVU21A
2020-10-01$76.69$58.50RVU20D
2020-07-01$76.69$58.50RVU20C
2020-04-01$76.69$58.50RVU20B
2020-01-01$76.69$58.50RVU20A
2019-10-01$75.48$58.06RVU19D
2019-07-01$75.48$58.06RVU19C
2019-04-01$75.48$58.06RVU19B
2019-01-01$75.48$58.06RVU19A
2018-10-01$75.40$58.36RVU18D
2018-07-01$75.40$58.36RVU18C
2018-04-01$75.40$58.36RVU18B
2018-01-01$75.40$58.36RVU18AR1
2017-10-01$68.15$53.71RVU17D
2017-07-01$68.15$53.71RVU17C
2017-04-01$68.15$53.71RVU17B
2017-01-01$68.15$53.71RVU17A
2016-10-01$60.98$48.86RVU16D
2016-07-01$60.98$48.86RVU16C
2016-04-01$60.98$48.86RVU16B
2016-01-01$60.98$48.86RVU16A
2015-10-01$60.84$48.93RVU15D
2015-07-01$60.84$48.93RVU15C
2015-04-01$60.54$48.69RVU15B
2015-01-01$60.54$48.69RVU15A
2014-10-01$60.36$48.71RVU14D
2014-07-01$60.36$48.71RVU14C
2014-04-01$60.36$48.71RVU14B
2014-01-01$60.36$48.71RVU14A
2013-10-01$58.94$46.72RVU13D
2013-07-01$58.94$46.72RVU13C
2013-04-01$58.94$46.72RVU13B
2013-01-01$58.94$46.72RVU13AR

Price 11046 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

11046 billing questions

Which primary code must accompany 11046?

Report 11046 with 11043, which represents the initial area debrided at muscle or fascia depth. It is not a stand-alone code.

How many units should be reported?

Count each additional 20 square centimeters or part of that increment beyond the initial 20 square centimeters. For example, a total treated area of 41 square centimeters at this depth supports two units of 11046 with 11043.

How is the area determined when there are multiple wounds?

Combine the surface areas of wounds debrided to the same depth. Keep areas debrided to different tissue depths separate.

What documentation supports 11046?

Record the tissue actually removed, the depth reached, and the total surface area debrided at muscle or fascia depth. The note should support the additional area beyond the initial 20 square centimeters.

Does 11046 have its own global period?

CMS identifies it as an add-on paid within the primary procedure’s global period. It must be reported with the primary procedure.

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 11046PPRRVU2026_Oct_nonQPP.csv, line 1,259 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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