11004 Infection debridement Medicare reimbursement rates in Michigan

This code describes operative debridement of skin, subcutaneous tissue, muscle, and fascia in the external genitalia and perineum for a necrotizing soft-tissue infection. A surgeon, commonly a general surgeon or urologist depending on the involved anatomy, may perform it urgently in a hospital operating room. Fournier gangrene is a characteristic clinical situation. The code is distinguished by the infection and the treated anatomic region, not simply by the depth or surface area of an ordinary wound.

Select this code when the operative report supports necrotizing infection debridement in the genital-perineal region. Document the diagnosis, anatomic sites treated, and tissues removed; this helps distinguish the service from abdominal-wall debridement or wound debridement codes. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.