$482.69–$531.81
11010 applies when open fracture-site debridement is limited to skin and subcutaneous tissue. Choose 11011 when the debridement extends into muscle or fascia.
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CMS RVU26D · Effective 2026-10-01
11011 Fracture-site debridement Medicare reimbursement rates in Massachusetts
Reports debridement at an open fracture or dislocation site when removal of contaminated or devitalized tissue extends through muscle or fascia. Compare 11011 office and facility rates across CMS payment localities in Massachusetts.
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.
What does Medicare pay for 11011 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$552.18–$607.80
2 of 2 localities have a supported rate.
Facility setting
$264.83–$281.98
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic trauma
About 11011: Open fracture-site debridement through muscle or fascia
Reports debridement at an open fracture or dislocation site when removal of contaminated or devitalized tissue extends through muscle or fascia.
This code describes operative debridement at an open fracture or dislocation site, extending through skin and subcutaneous tissue into muscle or fascia, without debridement of bone. The work may include removing contaminated or foreign material from the wound. Orthopedic trauma surgeons commonly perform it during operative care of an open fracture or dislocation in a hospital or other surgical setting.
Choose the code according to the deepest tissue debrided at the fracture site: skin and subcutaneous tissue only points to 11010, while bone debridement points to 11012. The operative report should identify the open injury site, tissues removed, and extent of debridement. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 does not increase payment because CMS prices this code as bilateral. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 11011
- 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 RVU4.82 · 30%
- Practice expense (office) RVU10.33 · 64%
- Malpractice RVU0.95 · 6%
782
Medicare services in 2024 · #3173 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.
11011 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$703.55–$772.30
11012 is the open fracture-site level when bone is debrided. 11011 applies when debridement reaches muscle or fascia but not bone.
$245.34–$268.24
11043 describes qualifying muscle or fascia wound debridement outside the open-fracture-site family. Use 11011 for that depth at an open fracture or dislocation site.
Compare 11011 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$607.80
Facility
$281.98
Rest Of Massachusetts →
Office / nonfacility
$552.18
Facility
$264.83
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11011 billing questions
How does 11011 differ from 11010?
Use 11011 when debridement at the open fracture or dislocation site extends into muscle or fascia. Use 11010 when it is limited to skin and subcutaneous tissue.
When is 11012 the better choice?
Use 11012 when bone is debrided at the open fracture or dislocation site. The deepest tissue actually debrided determines the level.
Can this code be reported with fracture treatment?
The debridement code represents work at the open injury site, while a fracture-treatment code represents stabilization or repair. The operative note should support the debridement and the tissue depth reported.
Should modifier 50 be appended for bilateral sites?
CMS prices 11011 as bilateral, and modifier 50 does not increase payment.
What documentation supports 11011 rather than a shallower level?
Document the open fracture or dislocation site and the tissues actually debrided, including extension into muscle or fascia. Bone debridement supports consideration of 11012 instead.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.
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.
1,2461100F,,Ptfalls assess-docd ge2>/yr,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,2471100T,,Tc spi neuromd prgrmg ea 30,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,24811010,,Debride skin at fx site,A,,4.09,9.21,,2.63,,0.75,14.05,7.47,0,010,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,24911011,,Debride skin musc at fx site,A,,4.82,10.33,,2.16,,0.95,16.10,7.93,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,25011012,,Deb skin bone at fx site,A,,6.70,12.54,,2.83,,1.32,20.56,10.85,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,2511101F,,Pt falls assess-docd le1/yr,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,2521101T,,Tc spi neuromd appl each 15,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00