Removal of devitalized tissue down to and including muscle or fascia, for the first 20 square centimeters of wound surface or less.

3 sources ↓

Medicare: $239.48
Work RVU: 2.63
Global, days: 0
Region: Multi-region

Drawn from CMS

Documentation requirements

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

Source · Editorial brief grounded in 3 cited references ↓

Wound location, length, width, and depth after debridement
Deepest tissue removed (muscle or fascia) stated explicitly
Instrument used (scalpel, curette, scissors)
Condition of the wound before and after, including necrotic tissue
Total surface area at this depth across all wounds
Plan of care and why debridement is still needed

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

25 Significant separate E/M 58 Staged or related 79 Unrelated during global 59 Distinct service XS Separate structure LT Left side RT Right side T1 Modifier T2 Modifier T3 Modifier T4 Modifier T5 Modifier T6 Modifier T7 Modifier T8 Modifier T9 Modifier TA Modifier

What this code covers

Source · Editorial summary grounded in 3 cited references ↓

11043 is debridement where the deepest tissue removed is muscle or fascia, covering the first 20 sq cm. Each additional 20 sq cm at the same depth is reported with 11046. It has a 0-day global.

Orthopedic and podiatry practices use it for diabetic foot ulcers, pressure wounds over the heel, open fracture wounds, and dehisced surgical incisions. The code is chosen by the depth of tissue actually removed, not the depth of the wound. If you only remove slough from the surface of a deep wound, that is selective debridement or 11042, not 11043.

Surface area rules trip people up. Add up the area of all wounds debrided to the same depth, then code once. Wounds at different depths are coded separately. Modifier 59 or XS is not used to split wounds at the same depth. Measure after debridement, not before. Active wound care codes (97597, 97598) do not go with 11042 to 11047 on the same wound. Expect LCD review and frequency scrutiny for repeated debridements.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (2.63) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (7.17) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	2.63
Practice expense RVU	4.12
Malpractice RVU	0.42
Total RVU	7.17
Medicare national rate	$239.48
Global period	0 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	$239.48
HOPD (APC 5053) Hospital outpatient department	$755.08
ASC (PI A2) Ambulatory surgical center (freestanding)	$404.93