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See a sample rate comparisonCPT 11005 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Dbrdmt Skin Abdominal Wall, Debridement Of Skin Subcutaneous Tissue Muscle And Fascia For Necrotizing Soft Tissue Infection Abdominal Wall With Or Without Fascial Closure
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11005 |
| Medicaid Fee Schedule | View Medicaid rates for 11005 |
National average reimbursement for CPT 11005 by major payers:
$939.45
$1,016.18
$1,004.13
$1,228.32
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CPT 11005
5 of 25 sample ratesHigher to lower in this preview
Union Health Services, LLC, Atrium Health Surgery Center Indian Trail
Union Health Services LLC
$6,500.00Published rateBsc Reid Park LLC
$1,146.00Published rateSurgery Center Of Lebanon, Lp, Physicians Surgical Center
Surgery Center Of Lebanon Lp
$650.00Published rateFallsgrove Endoscopy Center, LLC
$455.00Published rateNiagara Asc, LLC, Asc Of Niagara
Niagara Asc LLC
$240.00Published rate
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See a sample payer proposalCPT 11005 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11005 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 11005 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 11004-CPT | Moderate | Dbrdmt Skin Xtrnl Gent Per, Debridement Of Skin Subcutaneous Tissue Muscle And Fascia For Necrotizing Soft Tissue Infection External Genitalia And Perineum |
| 11005-CPT | Moderate | Dbrdmt Skin Abdominal Wall, Debridement Of Skin Subcutaneous Tissue Muscle And Fascia For Necrotizing Soft Tissue Infection Abdominal Wall With Or Without Fascial Closure |
| 11006-CPT | Moderate | Dbrdmt Skin Xtrnl Gent Per, Debridement Of Skin Subcutaneous Tissue Muscle And Fascia For Necrotizing Soft Tissue Infection External Genitalia Perineum And Abdominal Wall With Or Without Fascial Closure |
| 11042-CPT | Low | Debridement Subcutaneous Tiss, Debridement Subcutaneous Tissue (Includes Epidermis And Dermis If Performed) First 20 Sq Cm Or Less |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11005 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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