No office rate
Use 11004 for necrotizing infection debridement of the external genitalia and perineum without abdominal-wall involvement; 11005 is for the abdominal wall.
On this page
CMS RVU26D · Effective 2026-10-01
11005 NSTI debridement Medicare reimbursement rates in Wyoming
Report this service when a surgeon removes infected or necrotic skin, subcutaneous tissue, muscle, and fascia for a necrotizing soft tissue infection of the abdominal wall. Compare 11005 office and facility rates across CMS payment localities in Wyoming.
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 11005 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$662.77
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
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.
Surgical debridement
About 11005: Abdominal wall necrotizing infection debridement
Report this service when a surgeon removes infected or necrotic skin, subcutaneous tissue, muscle, and fascia for a necrotizing soft tissue infection of the abdominal wall.
This code describes operative debridement for a necrotizing soft tissue infection involving the abdominal wall, such as necrotizing fasciitis. The surgeon removes infected or necrotic skin, subcutaneous tissue, muscle, and fascia. It is typically performed in a hospital operating room when urgent source control is needed; the operative report should identify the abdominal-wall involvement and the tissues actually debrided.
Select this code for the abdominal wall alone, not by measuring wound surface area or choosing the deepest tissue level as with routine wound-debridement codes. Document the infection, anatomic extent, and debridement performed. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this code. An assistant at surgery is payable only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 11005
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.88 · 67%
- Practice expense (office) RVU3.41 · 16%
- Malpractice RVU3.45 · 17%
1.3K
Medicare services in 2024 · #2774 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.
11005 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Use 11006 when debridement for the necrotizing infection involves the abdominal wall together with the external genitalia and perineum.
$131.47
Use 11042 for qualifying routine wound debridement through subcutaneous tissue, based on tissue depth and area; 11005 is specific to abdominal-wall necrotizing infection.
$235.84
Use 11043 for qualifying routine wound debridement involving muscle or fascia, based on tissue depth and area, rather than the NSTI-specific abdominal-wall service.
Compare 11005 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$662.77
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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 11005 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
1,243
- Code
- 11005
- Physician work
- 13.88
- Practice expense
- 3.41
- Malpractice
- 3.45
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.88 | × 1.000 | 13.8800 |
| Practice expense | 3.41 | × 1.000 | 3.4100 |
| Malpractice | 3.45 | × 0.740 | 2.5530 |
| Total RVUs | 19.8430 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$662.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.88 | 1 |
| Practice expense | 3.41 | 1 |
| Malpractice | 3.45 | 0.74 |
(13.88 × 1 + 3.41 × 1 + 3.45 × 0.74) × $33.4009 = $662.77
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.
11005 billing questions
When should I report 11005 rather than 11004 or 11006?
Use 11005 when the necrotizing soft tissue infection and debridement involve the abdominal wall alone. Code 11004 describes the external genitalia and perineum; 11006 covers those areas together with the abdominal wall.
Is code selection based on wound size or the deepest tissue removed?
No. This code is specific to necrotizing soft tissue infection of the abdominal wall and is not selected by surface area or a deepest-tissue level.
Can removal of infected abdominal-wall mesh be reported separately?
When infected prosthetic material or mesh is removed from the abdominal wall, 11008 is an add-on reported with the applicable primary debridement code, including 11005 when appropriate.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
What documentation supports reporting 11005?
The operative report should establish necrotizing soft tissue infection of the abdominal wall, identify the extent and tissues involved, and describe the debridement performed.
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.
1,24011000,,Dbrdmt ecz/infected skin<10%,A,,0.59,1.13,,0.09,,0.05,1.77,0.73,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,24111001,,Dbrdmt ecz/infct skn ea addl,A,,0.29,0.49,,0.06,,0.03,0.81,0.38,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,24211004,,Dbrdmt skin xtrnl gent&per,A,,10.53,2.46,NA,2.46,,2.12,15.11,15.11,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,24311005,,Dbrdmt skin abdominal wall,A,,13.88,3.41,NA,3.41,,3.45,20.74,20.74,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,24411006,,Dbrdmt skin xtrnl gent per,A,,12.77,3.09,NA,3.09,,2.82,18.68,18.68,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,24511008,,Rmv prstc mtrl/mesh abd wall,A,,4.88,1.19,NA,1.19,,1.25,7.32,7.32,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,