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See a sample rate comparisonCPT 11043 Fee Schedule
Last Verified: September 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 Musc Fsca 1st 20, Debridement Muscle And Or Fascia Includes Epidermis Dermis And Subcutaneous Tissue If Performed First 20 Sq Cm Or Less
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | None 99 - Other POS |
| Common Modifiers | None 59 - Distinct Procedural Service GW - Condition not related to the patient's terminal condition |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 11043 |
| Medicaid Fee Schedule | View Medicaid rates for 11043 |
National average reimbursement for CPT 11043 by major payers:
$275.92
$303.07
$304.49
$377.54
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CPT 11043
5 of 25 sample ratesHigher to lower in this preview
Robert Dietz
University Physicians Incorporated
$992.35Published rateBharat Maraj
University Physicians Incorporated
$779.71Published rateRostislav Medvid
University Physicians Incorporated
$611.05Published rateRichard Ethridge
$258.58Published rateJames Trice Md PA, Digestive Disease Center
$118.00Published rate
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See a sample payer proposalCPT 11043 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11043 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 11043 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 |
|---|---|---|
| 11001-CPT | Low | Debridement Of Extensive Eczem, Debridement Of Extensive Eczematous Or Infected Skin Each Additional 10 Of The Body Surface Or Part Thereof (List Separately In Addition To Code For Primary Procedure) |
| 11043-CPT | Moderate | Dbrdmt Musc Fsca 1st 20, Debridement Muscle And Or Fascia Includes Epidermis Dermis And Subcutaneous Tissue If Performed First 20 Sq Cm Or Less |
| 11046-CPT | Low | Dbrdmt Musc Fsca Ea Addl, Debridement Muscle And Or Fascia Includes Epidermis Dermis And Subcutaneous Tissue If Performed Each Additional 20 Sq Cm Or Part Thereof List Separately In Addition To Code For Primary Procedure |
| 11047-CPT | Low | Dbrdmt Bone Each Addl, Debridement Bone Includes Epidermis Dermis Subcutaneous Tissue Muscle And Or Fascia If Performed Each Additional 20 Sq Cm Or Part Thereof List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11043. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11043 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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