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See a sample rate comparisonCPT 11012 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.
Deb Skin Bone At Fx Site, Debridement Including Removal Of Foreign Material At The Site Of An Open Fracture And Or An Open Dislocation Eg Excisional Debridement Skin Subcutaneous Tissue Muscle Fascia Muscle And Bone
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11012 |
| Medicaid Fee Schedule | View Medicaid rates for 11012 |
National average reimbursement for CPT 11012 by major payers:
$765.57
$887.41
$912.34
$684.46
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CPT 11012
5 of 25 sample ratesHigher to lower in this preview
Lake Spivey Ambulatory Surgery Care, LLC, Spivey Station Surgery Center
Emory University
$2,026.00Published rateCapitol Surgical Center LLC
$967.00Published ratePort Orange Endoscopy & Surgery Center LLC, Adventhealth Surgery Center Port Orange
$694.00Published rateBienville Surgery Center, LLC
Bienville Surgery Center LLC
$408.00Published rateThibodaux Laser And Surgery Center, LLC
$294.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 11012 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11012 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 11012 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 |
|---|---|---|
| 11010-CPT | Moderate | Debridement Including Removal, Debridement Including Removal Of Foreign Material At The Site Of An Open Fracture Andor An Open Dislocation (Eg Excisional Debridement) Skin And Subcutaneous Tissues |
| 11011-CPT | Moderate | Debride Skin Musc At Fx Site, Debridement Including Removal Of Foreign Material At The Site Of An Open Fracture And Or An Open Dislocation Eg Excisional Debridement Skin Subcutaneous Tissue Muscle Fascia And Muscle |
| 11012-CPT | Moderate | Deb Skin Bone At Fx Site, Debridement Including Removal Of Foreign Material At The Site Of An Open Fracture And Or An Open Dislocation Eg Excisional Debridement Skin Subcutaneous Tissue Muscle Fascia Muscle And Bone |
| 11044-CPT | Moderate | Dbrdmt Bone 1st 20 Sq Cm, Debridement Bone Includes Epidermis Dermis Subcutaneous Tissue Muscle And Or Fascia 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 11012. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11012 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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