CPT 11044Surgery

Dbrdmt bone 1st 20 sq cm/<

CPT code 11044 covers the surgical removal of dead, damaged, or infected bone tissue down to healthy bone, treating the first 20 square centimeters or less. This deep-level debridement is performed when infection or tissue death has reached the bone layer.

Showing rates for

National Average

Base Medicare rate

$301.15

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

4.1

PE RVU (NF)

4.57

MP RVU

0.64

Total RVU

9.31

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document exact surface area measurement in square centimeters and confirm bone-level debridement with explicit mention of bone visualization and/or bone removal
Impact: Prevents downcoding to 11043 (muscle/fascia level, pays $217.69 non-facility vs $301.15 for 11044) - potential $83.46 loss per case
Use add-on code 11045 for each additional 20 sq cm beyond the first when total area exceeds 20 sq cm; measure and document total surface area accurately
Impact: 11045 adds $99.75 per additional 20 sq cm in non-facility settings; undermeasurement costs significant revenue on large wounds
Bill facility rate ($217.69) for hospital or ASC settings and non-facility rate ($301.15) only when performed in office-based surgical suite with practice overhead
Impact: Incorrect place of service coding results in $83.46 overpayment subject to recoupment or automatic adjustment by payer
Separate debridement codes from excisional debridement codes (11000-11006); use 11044 series for excisional debridement by depth, not simple paring codes
Impact: Using 11042-11047 series instead of 97597-97598 (active wound care) can increase reimbursement by $200+ per session when surgical debridement is documented
Document medical necessity with evidence of infection (osteomyelitis), necrotic bone, or wound healing failure; include culture results, imaging findings, or bone biopsy when available
Impact: Reduces denial rate from 15-20% to under 5% based on payer audits; well-documented medical necessity is primary defense against utilization review denials
Do not report 11044 in addition to flap or graft procedures (15000-15278) when debridement is performed as preparation in the same anatomical site

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 11044 in 2025?

Medicare pays $301.15 for CPT 11044 in non-facility settings and $217.69 in facility settings (hospital or ASC) based on the 2025 Physician Fee Schedule national average. Actual payment may vary by geographic location based on GPCI adjustments.

What is the difference between CPT 11044 and 11043?

CPT 11044 represents debridement to the bone level (including all superficial layers plus bone removal), while 11043 represents debridement to the muscle and/or fascia level without reaching bone. The depth of debridement determines the code, with 11044 reimbursing approximately $80-100 more than 11043 due to the additional complexity and deeper tissue involvement.

Can CPT 11044 be billed with modifier 25 on the same day as an E/M service?

No, modifier 25 is not typically appropriate with 11044 because bone debridement is a surgical procedure with a 90-day global period, not a minor procedure with 0 or 10-day global. If an E/M service is performed the same day, it would usually be included in the surgical decision-making unless performed for a completely separate condition, in which case modifier 25 with separate diagnosis might apply to the E/M only.

How many RVUs is CPT code 11044 worth?

CPT 11044 has a total of 9.31 RVUs in 2025, consisting of 4.1 work RVUs, 4.57 practice expense RVUs (non-facility), 1.99 practice expense RVUs (facility), and 0.64 malpractice RVUs. This makes it a moderately high-value procedure in terms of relative value units.

Can you bill CPT 11044 and 11045 together?

Yes, 11045 is an add-on code specifically designed to be reported with 11044 when bone debridement exceeds 20 square centimeters. Report 11044 for the first 20 sq cm or less, then add 11045 for each additional 20 sq cm. Documentation must support the total surface area measurement to justify multiple units.

What diagnosis codes support medical necessity for CPT 11044?

Common supporting ICD-10 codes include M86.x (osteomyelitis), L89.x (pressure ulcer Stage 3 or 4 with bone involvement), E11.621-E11.622 (diabetic foot ulcer), T81.31xA (disruption of wound with bone exposure), and S91.x (open wound of ankle/foot with bone involvement). The diagnosis must justify the depth and extent of debridement performed.

Is CPT 11044 a global surgery code and what is the global period?

Yes, CPT 11044 carries a 90-day global surgical period. This means the reimbursement includes preoperative evaluation (usually 1 day before), the procedure itself, and all routine postoperative care for 90 days after surgery. Separate E/M services during this period require modifier 24 (unrelated) or modifier 25 (significant separately identifiable service on same day as procedure decision) to be reimbursed separately.