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CMS RVU26D · Effective 2026-10-01

11012 in Redding

Office / nonfacility

$710.28

Base rate per service

Facility setting

$354.82

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Orthopedic surgery

About 11012: Open fracture site debridement to bone

Reports debridement through bone at an open fracture or dislocation site when the surgeon removes devitalized tissue or foreign material.

An orthopedic or trauma surgeon uses this service to remove contaminated or devitalized tissue, including bone, at the site of an open fracture or dislocation. It may be performed in the operating room during acute injury care. The defining feature is debridement through bone at that injury site; the code also encompasses the skin, subcutaneous tissue, and muscle or fascia addressed in the procedure.

Choose this level from the deepest tissue debrided at the open fracture or dislocation site, and document the injury site, tissues removed, and operative findings supporting bone debridement. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. CMS prices the code as bilateral; modifier 50 does not increase payment. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

CMS billing rules for 11012

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
The code is already priced as bilateral; modifier 50 does not increase payment.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU6.70 · 33%
  • Practice expense (office) RVU12.54 · 61%
  • Malpractice RVU1.32 · 6%

8.9K

Medicare services in 2024 · #1537 by national volume

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.

11012 compared with similar codes

Office rates for Redding, from the same CMS release.

11010

Fracture debridement

Skin and subcutaneous tissue

$489.51

Use 11010 when debridement at the open fracture or dislocation site is limited to skin and subcutaneous tissue; 11012 requires work through bone.

11011

Fracture-site debridement

Through muscle or fascia

$558.89

Use 11011 when debridement at the injury site reaches muscle or fascia but not bone. Bone debridement supports 11012.

11044

Wound debridement

Bone, first 20 sq cm

$328.91

11044 describes bone-level wound debridement selected by area. 11012 is specific to debridement at an open fracture or dislocation site.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 11012 is $713.94—$3.66 higher than the $710.28 rate in Redding. Both use the same code, release and participation basis.

11012 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $710.28

  2. $3.66 higher than Redding

  3. Chico

    $710.28

    The same base rate than Redding

  4. El Centro

    $710.50

    $0.22 higher than Redding

  5. Fresno

    $710.28

    The same base rate than Redding

  6. The same base rate than Redding

  7. $47.45 higher than Redding

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 11012 ranges from $606.28 in Arkansas to $876.01 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Madera

    California · 11012

    Office

    $710.28

    Facility

    $354.82

    The same base rate than Redding for the office setting.

  • Merced

    California · 11012

    Office

    $710.28

    Facility

    $354.82

    The same base rate than Redding for the office setting.

  • Modesto

    California · 11012

    Office

    $710.28

    Facility

    $354.82

    The same base rate than Redding for the office setting.

  • Napa

    California · 11012

    Office

    $812.32

    Facility

    $384.87

    $102.04 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 11012

    Office

    $752.60

    Facility

    $369.25

    $42.32 higher than Redding for the office setting.

  • Rest Of California

    California · 11012

    Office

    $710.28

    Facility

    $354.82

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 11012

    Office

    $724.48

    Facility

    $369.02

    $14.20 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 11012

    Office

    $742.59

    Facility

    $365.41

    $32.31 higher than Redding for the office setting.

  • Salinas

    California · 11012

    Office

    $739.80

    Facility

    $363.91

    $29.52 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 11012

    Office

    $755.34

    Facility

    $367.45

    $45.06 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 11012

    Office

    $855.86

    Facility

    $398.56

    $145.58 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 11012

    Office

    $854.36

    Facility

    $397.06

    $144.08 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 11012

    Office

    $876.01

    Facility

    $408.34

    $165.73 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 11012

    Office

    $869.88

    Facility

    $402.21

    $159.60 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 11012

    Office

    $728.29

    Facility

    $358.89

    $18.01 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 11012

    Office

    $761.02

    Facility

    $366.96

    $50.74 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 11012

    Office

    $742.06

    Facility

    $363.90

    $31.78 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 11012

    Office

    $768.48

    Facility

    $370.21

    $58.20 higher than Redding for the office setting.

  • Stockton

    California · 11012

    Office

    $710.28

    Facility

    $354.82

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 11012

    Office

    $810.16

    Facility

    $382.70

    $99.88 higher than Redding for the office setting.

  • Visalia

    California · 11012

    Office

    $710.28

    Facility

    $354.82

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 11012

    Office

    $710.28

    Facility

    $354.82

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 11012

    Office

    $778.34

    Facility

    $396.29

    $68.06 higher than Redding for the office setting.

  • Miami

    Florida · 11012

    Office

    $771.31

    Facility

    $433.69

    $61.03 higher than Redding for the office setting.

  • Chicago

    Illinois · 11012

    Office

    $747.48

    Facility

    $421.53

    $37.20 higher than Redding for the office setting.

  • Manhattan

    New York · 11012

    Office

    $794.73

    Facility

    $417.87

    $84.45 higher than Redding for the office setting.

  • Alaska*

    Alaska · 11012

    Office

    $806.04

    Facility

    $460.64

    $95.76 higher than Redding for the office setting.

  • Alabama

    Alabama · 11012

    Office

    $615.23

    Facility

    $331.45

    $95.05 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 11012

    Office

    $606.28

    Facility

    $327.69

    $104.00 lower than Redding for the office setting.

  • Arizona

    Arizona · 11012

    Office

    $667.39

    Facility

    $353.12

    $42.89 lower than Redding for the office setting.

  • Colorado

    Colorado · 11012

    Office

    $706.56

    Facility

    $361.48

    $3.72 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 11012

    Office

    $732.71

    Facility

    $383.41

    $22.43 higher than Redding for the office setting.

  • Delaware

    Delaware · 11012

    Office

    $678.36

    Facility

    $357.93

    $31.92 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 11012

    Office

    $727.79

    Facility

    $399.25

    $17.51 higher than Redding for the office setting.

  • Rest Of Florida

    Florida · 11012

    Office

    $690.47

    Facility

    $380.42

    $19.81 lower than Redding for the office setting.

  • Atlanta

    Georgia · 11012

    Office

    $702.96

    Facility

    $373.45

    $7.32 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 11012

    Office

    $649.95

    Facility

    $360.66

    $60.33 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 11012

    Office

    $725.54

    Facility

    $356.79

    $15.26 higher than Redding for the office setting.

  • Iowa

    Iowa · 11012

    Office

    $624.53

    Facility

    $327.78

    $85.75 lower than Redding for the office setting.

  • Idaho

    Idaho · 11012

    Office

    $629.98

    Facility

    $331.60

    $80.30 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 11012

    Office

    $697.92

    Facility

    $399.54

    $12.36 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 11012

    Office

    $675.11

    Facility

    $379.00

    $35.17 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 11012

    Office

    $733.63

    Facility

    $400.56

    $23.35 higher than Redding for the office setting.

  • Indiana

    Indiana · 11012

    Office

    $633.48

    Facility

    $332.84

    $76.80 lower than Redding for the office setting.

  • Kansas

    Kansas · 11012

    Office

    $624.64

    Facility

    $331.46

    $85.64 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 11012

    Office

    $636.48

    Facility

    $348.16

    $73.80 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 11012

    Office

    $668.01

    Facility

    $362.82

    $42.27 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 11012

    Office

    $636.70

    Facility

    $349.68

    $73.58 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 11012

    Office

    $772.30

    Facility

    $385.06

    $62.02 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 11012

    Office

    $703.55

    Facility

    $362.04

    $6.73 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 11012

    Office

    $731.33

    Facility

    $383.33

    $21.05 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 11012

    Office

    $690.37

    Facility

    $362.16

    $19.91 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 11012

    Office

    $636.55

    Facility

    $338.17

    $73.73 lower than Redding for the office setting.

  • Southern Maine

    Maine · 11012

    Office

    $666.68

    Facility

    $345.28

    $43.60 lower than Redding for the office setting.

  • Detroit

    Michigan · 11012

    Office

    $702.31

    Facility

    $389.34

    $7.97 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 11012

    Office

    $655.97

    Facility

    $359.86

    $54.31 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 11012

    Office

    $667.83

    Facility

    $334.10

    $42.45 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 11012

    Office

    $660.16

    Facility

    $355.62

    $50.12 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 11012

    Office

    $666.71

    Facility

    $357.95

    $43.57 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 11012

    Office

    $627.78

    Facility

    $348.21

    $82.50 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 11012

    Office

    $617.00

    Facility

    $337.75

    $93.28 lower than Redding for the office setting.

  • Montana**

    Montana · 11012

    Office

    $686.63

    Facility

    $362.31

    $23.65 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 11012

    Office

    $642.74

    Facility

    $340.15

    $67.54 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 11012

    Office

    $660.53

    Facility

    $336.21

    $49.75 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 11012

    Office

    $627.05

    Facility

    $327.70

    $83.23 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 11012

    Office

    $698.38

    Facility

    $360.76

    $11.90 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 11012

    Office

    $770.83

    Facility

    $394.62

    $60.55 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 11012

    Office

    $738.48

    Facility

    $384.32

    $28.20 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 11012

    Office

    $660.82

    Facility

    $363.42

    $49.46 lower than Redding for the office setting.

  • Nevada**

    Nevada · 11012

    Office

    $679.78

    Facility

    $355.13

    $30.50 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 11012

    Office

    $817.99

    Facility

    $432.37

    $107.71 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 11012

    Office

    $745.84

    Facility

    $390.71

    $35.56 higher than Redding for the office setting.

  • Queens

    New York · 11012

    Office

    $796.76

    Facility

    $413.41

    $86.48 higher than Redding for the office setting.

  • Rest Of New York

    New York · 11012

    Office

    $652.69

    Facility

    $344.58

    $57.59 lower than Redding for the office setting.

  • Ohio

    Ohio · 11012

    Office

    $650.64

    Facility

    $354.53

    $59.64 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 11012

    Office

    $632.07

    Facility

    $342.45

    $78.21 lower than Redding for the office setting.

  • Portland

    Oregon · 11012

    Office

    $725.51

    Facility

    $365.19

    $15.23 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 11012

    Office

    $671.95

    Facility

    $348.93

    $38.33 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 11012

    Office

    $716.43

    Facility

    $378.81

    $6.15 higher than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 11012

    Office

    $649.95

    Facility

    $352.22

    $60.33 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 11012

    Office

    $690.67

    Facility

    $362.78

    $19.61 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 11012

    Office

    $700.03

    Facility

    $365.01

    $10.25 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 11012

    Office

    $648.28

    Facility

    $348.60

    $62.00 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 11012

    Office

    $657.45

    Facility

    $333.12

    $52.83 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 11012

    Office

    $628.19

    Facility

    $333.38

    $82.09 lower than Redding for the office setting.

  • Austin

    Texas · 11012

    Office

    $706.44

    Facility

    $363.30

    $3.84 lower than Redding for the office setting.

  • Beaumont

    Texas · 11012

    Office

    $645.90

    Facility

    $350.76

    $64.38 lower than Redding for the office setting.

  • Brazoria

    Texas · 11012

    Office

    $675.04

    Facility

    $353.64

    $35.24 lower than Redding for the office setting.

  • Dallas

    Texas · 11012

    Office

    $680.80

    Facility

    $357.78

    $29.48 lower than Redding for the office setting.

  • Fort Worth

    Texas · 11012

    Office

    $677.19

    Facility

    $357.40

    $33.09 lower than Redding for the office setting.

  • Galveston

    Texas · 11012

    Office

    $678.00

    Facility

    $355.95

    $32.28 lower than Redding for the office setting.

  • Houston

    Texas · 11012

    Office

    $702.16

    Facility

    $380.11

    $8.12 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 11012

    Office

    $661.08

    Facility

    $353.30

    $49.20 lower than Redding for the office setting.

  • Utah

    Utah · 11012

    Office

    $657.09

    Facility

    $352.23

    $53.19 lower than Redding for the office setting.

  • Virginia

    Virginia · 11012

    Office

    $666.64

    Facility

    $347.83

    $43.64 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 11012

    Office

    $690.67

    Facility

    $362.78

    $19.61 lower than Redding for the office setting.

  • Vermont

    Vermont · 11012

    Office

    $660.75

    Facility

    $339.67

    $49.53 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 11012

    Office

    $701.29

    Facility

    $359.78

    $8.99 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 11012

    Office

    $784.92

    Facility

    $386.98

    $74.64 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 11012

    Office

    $638.62

    Facility

    $327.92

    $71.66 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 11012

    Office

    $650.86

    Facility

    $369.02

    $59.42 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 11012

    Office

    $675.26

    Facility

    $350.94

    $35.02 lower than Redding for the office setting.

See how rates vary across the country

11012 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$606.28

$806.04

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$806.041
AL$615.231
AR$606.281
AZ$667.391
CA$710.28–$876.0129
CO$706.561
CT$732.711
DC$778.341
DE$678.361
FL$690.47–$771.313
GA$649.95–$702.962
GU$725.541
HI$725.541
IA$624.531
ID$629.981
IL$675.11–$747.484
IN$633.481
KS$624.641
KY$636.481
LA$636.70–$668.012
MA$703.55–$772.302
MD$690.37–$778.343
ME$636.55–$666.682
MI$655.97–$702.312
MN$667.831
MO$627.78–$666.713
MS$617.001
MT$686.631
NC$642.741
ND$660.531
NE$627.051
NH$698.381
NJ$738.48–$770.832
NM$660.821
NV$679.781
NY$652.69–$817.995
OH$650.641
OK$632.071
OR$671.95–$725.512
PA$649.95–$716.432
PR$690.671
RI$700.031
SC$648.281
SD$657.451
TN$628.191
TX$645.90–$706.448
UT$657.091
VA$666.64–$778.342
VI$690.671
VT$660.751
WA$701.29–$784.922
WI$638.621
WV$650.861
WY$675.261

Explore 11012 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 11012 in Redding, the physician’s office rate is $710.28 and the facility-setting rate is $354.82: a difference of $355.46.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 11012 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$781.31

$710.28 × 110% = $781.31

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11012 in Redding.

PPRRVU2026_Oct_nonQPP.csv

1,250

Code
11012
Physician work
6.70
Practice expense
12.54
Malpractice
1.32

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 11012 in Redding
ComponentRVULocality factorAdjusted
Physician work6.70× 1.0176.8139
Practice expense12.54× 1.09613.7438
Malpractice1.32× 0.5360.7075
Total RVUs21.2653
Conversion factor× 33.4009

Office / nonfacility rate, Redding$710.28

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 11012 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work6.71.017
Practice expense12.541.096
Malpractice1.320.536

(6.7 × 1.017 + 12.54 × 1.096 + 1.32 × 0.536) × $33.4009 = $710.28

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work6.71.017
Practice expense2.831.096
Malpractice1.320.536

(6.7 × 1.017 + 2.83 × 1.096 + 1.32 × 0.536) × $33.4009 = $354.82

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

11012 · Office / nonfacility

$710.28

Effective 2026-10-01

The base rate is $65.60 higher than on 2025-10-01, moving from $644.68 to $710.28 (10.2%).

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

    $644.68changed to$710.28

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.87 changed to 6.70
    • Practice expense RVU 11.19 changed to 12.54
    • Malpractice RVU 1.31 changed to 1.32
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $644.68

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$710.28$354.82RVU26D
2026-07-01$710.28$354.82RVU26C
2026-04-01$710.28$354.82RVU26B
2026-01-01$710.28$354.82RVU26A
2025-10-01$644.68$400.73RVU25D
2025-07-01$644.68$400.73RVU25C
2025-04-01$644.68$400.73RVU25B
2025-01-01$644.68$400.73RVU25A

11012 billing questions

How does 11012 differ from 11010 and 11011?

11012 is selected when debridement at the open fracture or dislocation site reaches bone. 11010 covers skin and subcutaneous tissue, while 11011 includes muscle or fascia but not bone.

Can 11012 be used for routine wound debridement?

No. It describes debridement at an open fracture or dislocation site. For wound debridement outside that injury context, consider the wound-debridement code family selected by tissue depth and area.

What documentation supports reporting 11012?

Document the open fracture or dislocation site, operative findings, and the tissue actually debrided, including bone. The record should support that the work was performed at the injury site.

Does modifier 50 increase payment for bilateral services?

No. CMS prices 11012 as bilateral, and modifier 50 does not increase payment.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant surgeon or co-surgeon be paid for 11012?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 11012PPRRVU2026_Oct_nonQPP.csv, line 1,250 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)