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Billing code 11005: NSTI debridementMedicare rate & RVUs

Report this service when a surgeon removes infected or necrotic skin, subcutaneous tissue, muscle, and fascia for a necrotizing soft tissue infection of the abdominal wall.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare pays $692.73 for 11005 nationally in a facility.

Medicare rate · 11005

NSTI debridement

Swap in your local Medicare rate.

Work RVUs
13.88
Total RVUs
20.74
Global days
000

National rate · 2026

$692.73

Facility setting, before claim adjustments.

See every locality for 11005 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 11005 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 11005 covers

This code describes operative debridement for a necrotizing soft tissue infection involving the abdominal wall, such as necrotizing fasciitis. The surgeon removes infected or necrotic skin, subcutaneous tissue, muscle, and fascia. It is typically performed in a hospital operating room when urgent source control is needed; the operative report should identify the abdominal-wall involvement and the tissues actually debrided.

Select this code for the abdominal wall alone, not by measuring wound surface area or choosing the deepest tissue level as with routine wound-debridement codes. Document the infection, anatomic extent, and debridement performed. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this code. An assistant at surgery is payable only when medical necessity is documented; 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 11005 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

11005 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$628.49
Alaska*Unavailable$880.20
ArizonaUnavailable$672.61
ArkansasUnavailable$620.79
AtlantaUnavailable$719.11
AustinUnavailable$687.13
BakersfieldUnavailable$667.42
Baltimore/Surr. CntysUnavailable$735.78
BeaumontUnavailable$674.30
BrazoriaUnavailable$670.07

11005 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
11005 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 11005 rate is calculated

Each of 11005’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 · 11005

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.88Practice expense 3.41Malpractice 3.45

20.7400 adjusted RVUs×$33.4009 conversion factor=$692.73

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 11005

The CMS indicators that decide how 11005 is paid alongside other services.

CMS payment indicators · 11005

NSTI debridement

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
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.

11005 compared with similar codes

Compare codes

11005 vs 11004 vs 11006 vs 11042 vs 11043: national Medicare rates

Swap in your local Medicare rate.

  • 11005
    NSTI debridement · 13.88 wRVU
    —
  • 11004
    Infection debridement · 10.53 wRVU
    —
  • 11006
    Infection debridement · 12.77 wRVU
    —
  • 11042
    Wound debridement · 0.98 wRVU
    $132.60
  • 11043
    Wound debridement · 2.63 wRVU
    $239.48

How to choose

11004Infection debridement
Use 11004 for necrotizing infection debridement of the external genitalia and perineum without abdominal-wall involvement; 11005 is for the abdominal wall.
11006Infection debridement
Use 11006 when debridement for the necrotizing infection involves the abdominal wall together with the external genitalia and perineum.
11042Wound debridement
Use 11042 for qualifying routine wound debridement through subcutaneous tissue, based on tissue depth and area; 11005 is specific to abdominal-wall necrotizing infection.
11043Wound debridement
Use 11043 for qualifying routine wound debridement involving muscle or fascia, based on tissue depth and area, rather than the NSTI-specific abdominal-wall service.

Codes related to 11005

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

Codes related to 11005
CodeHow it relatesNational office range
Same family
11004Infection debridementDebridement for necrotizing infection involving the external genitalia and perineum.No office rate
11006Infection debridementCovers combined abdominal-wall, external-genitalia, and perineal involvement.No office rate
Add-on codes
11008Mesh removalAdd-on for removal of infected abdominal-wall prosthetic material or mesh.No office rate
Used instead
11042Wound debridementRoutine wound debridement selected by subcutaneous tissue depth and wound area, rather than NSTI site.$117.03–$176.41
11043Wound debridementRoutine muscle or fascia wound debridement selected by depth and area, not NSTI anatomy.$213.28–$303.46

11005 billing questions

When should I report 11005 rather than 11004 or 11006?

Use 11005 when the necrotizing soft tissue infection and debridement involve the abdominal wall alone. Code 11004 describes the external genitalia and perineum; 11006 covers those areas together with the abdominal wall.

Is code selection based on wound size or the deepest tissue removed?

No. This code is specific to necrotizing soft tissue infection of the abdominal wall and is not selected by surface area or a deepest-tissue level.

Can removal of infected abdominal-wall mesh be reported separately?

When infected prosthetic material or mesh is removed from the abdominal wall, 11008 is an add-on reported with the applicable primary debridement code, including 11005 when appropriate.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

What documentation supports reporting 11005?

The operative report should establish necrotizing soft tissue infection of the abdominal wall, identify the extent and tissues involved, and describe the debridement performed.

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 11005PPRRVU2026_Oct_nonQPP.csv, line 1,243 (RVU26D)

Open CMS sourceHow we calculate rates

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