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See a sample rate comparisonCPT 11043 Fee Schedule
Medicare rates as of October 2026
CPT 11043 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
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 | 99Other POS |
| Common Modifiers | 59Distinct Procedural Service GWCondition not related to the patient's terminal condition |
| Hospital Outpatient Group (APC) | APC 5053 - Level 3 Skin Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 1104620700Sign up to view all 3 |
| Common Revenue Codes | 07610450Sign up to view all 13 |
| Medicare Fee Schedule | $239.48 national non-facility rate (2026)View Medicare rates for 11043 |
| Medicaid Fee Schedule | $191.24 median of the 8 states in the free previewView Medicaid rates for 11043 |
National average reimbursement for CPT 11043 by major payers:
$275.92
BCBS / Anthem
$303.07
UnitedHealthcare
$304.49
Aetna
$377.54
Cigna
Compare published rates across providers.
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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 table lists codes related to 11043. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 11001-CPT | 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 | 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 | 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 | 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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Frequently Asked Questions
What APC is CPT 11043 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 11043 to APC 5053 (Level 3 Skin Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 11043 in an ambulatory surgery center?
CMS lists CPT 11043 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 11043?
CMS add-on code edits list CPT 11043 as a primary code for these add-on codes: 11046, 20700 and 20701.
Which revenue codes are billed with CPT 11043?
Hospital price transparency files list CPT 11043 under these revenue codes: including 0761, 0450, 0361, 0360 and 0510. A revenue code names the hospital department or charge category for the line; it does not change what the service is.