$442.68–$489.19
Use 11010 when debridement at the open fracture or dislocation site is limited to skin and subcutaneous tissue; 11012 requires work through bone.
On this page
CMS RVU26D · Effective 2026-10-01
11012 Fracture-site debridement Medicare reimbursement rates in Pennsylvania
Reports debridement through bone at an open fracture or dislocation site when the surgeon removes devitalized tissue or foreign material. Compare 11012 office and facility rates across CMS payment localities in Pennsylvania.
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 11012 in Pennsylvania?
Pennsylvania 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
$649.95–$716.43
2 of 2 localities have a supported rate.
Facility setting
$352.22–$378.81
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 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 Pennsylvania, from the same CMS release.
$507.72–$560.92
Use 11011 when debridement at the injury site reaches muscle or fascia but not bone. Bone debridement supports 11012.
$305.89–$333.97
11044 describes bone-level wound debridement selected by area. 11012 is specific to debridement at an open fracture or dislocation site.
Compare 11012 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 Philadelphia →
Office / nonfacility
$716.43
Facility
$378.81
Rest Of Pennsylvania →
Office / nonfacility
$649.95
Facility
$352.22
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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.
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
1,2531102T,,Ntrop molec asmt lng tum tis,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00