Debridement of skin and subcutaneous tissue, including removal of foreign material, at the site of an open fracture or open dislocation.

Verified May 8, 2026 · 7 sources ↓

Medicare: $469.28
Total RVUs: 14.05
Global, days: 10
Region: General

Drawn from CMSIcd10monitorAAPC

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Confirm open fracture or open dislocation diagnosis — closed fracture sites do not support 11010
Specify the technique used (e.g., excisional, pulse lavage, scrubbing) and instruments employed
Describe the depth of tissue debrided — skin and subcutaneous only; deeper layers require 11011 or 11012
Document the nature of tissue and foreign material removed (necrosis, devitalized tissue, debris, contamination)
Record wound size and appearance before and after debridement, including viable tissue margins
Note the companion fracture or dislocation treatment code billed on the same encounter

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 51 Multiple procedures 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 11010 covers excisional debridement of skin and subcutaneous tissue at an open fracture or open dislocation site — including removal of necrotic tissue, contamination, and foreign material. This is the shallowest code in the 11010–11012 series; the tier is determined by the deepest tissue layer debrided. If debridement extends into muscle fascia and muscle, bill 11011. If it reaches bone, bill 11012.

CMS NCCI policy explicitly carves out 11010–11012 from the general rule that debridement within a surgical field is not separately reportable. You can bill 11010 alongside the companion open fracture or dislocation treatment code. What you cannot do is stack a separate casting, splinting, or strapping code — those are bundled into the fracture treatment code when 11010 is also reported for the same anatomic area.

The 10-day global applies. Staged or planned repeat debridements during that global period require modifier 58. If a subsequent debridement is unplanned and related to the index procedure, use modifier 78. For debridements performed during the global period of a different, unrelated surgery, use modifier 79. Document the approach, instruments used, tissue layers debrided, nature of material removed, and wound appearance — vague operative notes like 'wound cleaned and irrigated' don't support this code.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	4.09
Practice expense RVU	9.21
Malpractice RVU	0.75
Total RVU	14.05
Medicare national rate	$469.28
Global period	10 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$469.28
HOPD (APC 5071) Hospital outpatient department	$723.47
ASC (PI A2) Ambulatory surgical center (freestanding)	$388.55

Common denial reasons

The recurring reasons claims for CPT 11010 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Billed at a closed fracture site — 11010 requires an open fracture or open dislocation diagnosis
Debridement documented as simple irrigation or wound cleansing only, which supports E/M, not 11010
Casting or splinting code billed on the same claim for the same anatomic area, triggering NCCI bundle denial
Tissue depth not documented — coder selected 11010 but op note describes fascia or muscle involvement warranting 11011 or 11012
Repeat debridement during the 10-day global submitted without modifier 58 or 78

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can I bill 11010 with the open fracture treatment code on the same claim?

Yes. CMS NCCI policy explicitly allows 11010–11012 to be reported separately alongside the companion open fracture or dislocation CPT code. This is the carved-out exception to the general rule that debridement within a musculoskeletal surgical field is not separately billable.

02What's the difference between 11010, 11011, and 11012?

The codes tier by depth of tissue debrided. 11010 covers skin and subcutaneous tissue only. 11011 adds muscle fascia and muscle. 11012 extends to bone. Bill the code matching the deepest layer actually debrided and documented — not the depth of the wound itself.

03Can I bill a casting or strapping code with 11010?

No. When 11010 is billed with a fracture treatment code, a separate cast, splint, or strapping code for the same anatomic area is not billable. NCCI bundles casting and splinting into the fracture treatment code in this scenario.

04What modifier applies when repeat debridement is needed during the 10-day global?

Use modifier 58 if the repeat debridement was planned or staged. Use modifier 78 if the patient returned to the OR for an unplanned, related complication. Submitting a repeat 11010 clean (no modifier) during the global period will deny.

05Does 11010 apply to debridement at a closed fracture site?

No. The code requires an open fracture or open dislocation. Debridement at a closed fracture site in the surgical field of a musculoskeletal procedure is not separately reportable under NCCI policy.

06Can an E/M be billed on the same day as 11010?

Only if the E/M represents a separately identifiable service distinct from the debridement itself — documented as such in the record. Use modifier 25 on the E/M. Non-surgical wound cleansing alone should be billed as E/M, not as 11010.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the fracture or dislocation type and anatomic site, tissue depth debrided, foreign material removed, technique and instruments used, and wound dimensions from the surgeon's dictation. That detail locks in the correct tier (11010 vs. 11011 vs. 11012) and prevents the most common audit flag — an operative note that reads 'wound irrigated and debrided' without specifying depth or tissue character.

See how Mira captures CPT 11010 documentation