Billing code 11012: Fracture-site debridementMedicare rate & RVUs in Delaware
Reports debridement through bone at an open fracture or dislocation site when the surgeon removes devitalized tissue or foreign material.
Medicare pays $678.36 for 11012 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
What 11012 covers
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.
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 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $678.36 | $357.93 |
How the 11012 rate is calculated
Each of 11012’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 · 11012
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.70Practice expense 12.54Malpractice 1.32
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11012
The CMS indicators that decide how 11012 is paid alongside other services.
CMS payment indicators · 11012
Fracture-site debridement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11012 without 51 · national office
$686.72
Fracture-site debridement
11012-51 · Second procedure: 50%
$343.36
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%).
11012 compared with similar codes
Compare codes
11012 vs 11010 vs 11011 vs 11044: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11010Fracture debridement
- Use 11010 when debridement at the open fracture or dislocation site is limited to skin and subcutaneous tissue; 11012 requires work through bone.
- 11011Fracture-site debridement
- Use 11011 when debridement at the injury site reaches muscle or fascia but not bone. Bone debridement supports 11012.
- 11044Wound debridement
- 11044 describes bone-level wound debridement selected by area. 11012 is specific to debridement at an open fracture or dislocation site.
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 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
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