CPT landing page

CPT 11011 RVU Values & Medicare Payment 2026

Debride skin musc at fx site

Code-level payment context

review the code record, calculate payment with fixed assumptions, compare locality or setting effects, and route into benchmark review when needed.

Input
CPT 11011, setting, participant status, and locality
Source basis
CMS 2026 CPT/HCPCS RVU components, typical setting, 2026 conversion factor assumption, GPCI locality examples, and related-code mapping.
Result boundary
The page is not coding advice and does not validate code selection, payer-specific edits, modifier rules, or documentation support.
RVU payment profile

CPT 11011 is calculated with its CMS 2026 RVU components, the National Average GPCI locality, the non-facility practice expense setting, and the non-QPP conversion factor.

wRVU
4.82
Total RVU
16.10
Medicare payment
$537.75
CMS provenance
Source file and formula trace
Source file

2026/rvu26b

Release date

2026-03-10

Field mapping

CPT or HCPCS code, Work RVU, Practice expense RVU, Malpractice RVU, GPCI locality, Conversion factor

CPT 11011 landing page payment provenance. The calculation uses CMS April 2026 RVU records, GPCI localities, and conversion factors. Verify official CMS and payer rules before billing or contract decisions.

  • CPT or HCPCS code: CMS PFS Relative Value Files RVU record and descriptor fields
  • Work RVU: CMS PFS Relative Value Files work RVU component
  • Practice expense RVU: CMS PFS Relative Value Files facility and non-facility PE RVU fields
  • Malpractice RVU: CMS PFS Relative Value Files malpractice RVU component

CPT 11011 setting and related-code comparison

Compare the same CPT under both PE settings, then review adjacent codes using National Average GPCI and the selected 2026 conversion factor.

SettingWork RVUPE RVUMP RVUTotal RVUPayment
Non-facility4.8210.330.9516.10$537.75
Facility4.822.160.957.93$264.87
Setting note: CPT 11011 keeps the same work RVU across this comparison, while practice expense RVU changes from 10.33 non-facility PE RVU to 2.16 facility PE RVU. Use one setting consistently when comparing localities or adjacent CPT codes.
Related CPTDescriptorwRVUTypical settingNational payment
CPT 11008Rmv prstc mtrl/mesh abd wall4.88Non-facility$244.49
CPT 11010Debride skin at fx site4.09Non-facility$469.28
CPT 11012Deb skin bone at fx site6.70Non-facility$686.72
CPT 11042Dbrdmt subq tis 1st 20sqcm/<0.98Non-facility$132.60
CPT 99214Office o/p est mod 30 min1.92Non-facility$135.61

CPT RVU and Medicare payment calculator

Search a CPT code, choose geography and participation status, then review work RVU, PE RVU, MP RVU, total RVU, and estimated Medicare payment. Use work RVU for productivity context and total RVU for Medicare payment estimates.

Inputs
01
Setting
Conversion factor
Results
02
Estimated Medicare payment

16.10 total RVU in National Average, National.

$537.75
wRVU
4.82
PE RVU
10.33
MP RVU
0.95
Total RVU
16.10
Non-QPP
$537.75
QPP
$540.44
QPP delta
$2.69
How to use this result
  • Payment estimate: use total RVU and non-QPP $33.4009 for Medicare payment review.
  • Productivity review: use work RVU separately; total RVU is not a physician productivity target.
  • Before relying on it: confirm office / non-facility, National Average, and payer-specific billing rules.
Review
03
Calculation formula

Total RVU = work RVU x GPCI work + PE RVU x GPCI PE + MP RVU x GPCI MP. Payment = total RVU x selected 2026 conversion factor. Non-QPP uses $33.4009 and QPP uses $33.5675.

Selected calculation assumptions
CPT
11011
Setting
office / non-facility
Conversion factor
non-QPP $33.4009
Work GPCI
1.000
PE GPCI
1.000
MP GPCI
1.000
CMS provenance
Source file and formula trace
Source file

2026/rvu26b

Release date

2026-03-10

Field mapping

CPT or HCPCS code, Work RVU, Practice expense RVU, Malpractice RVU, GPCI locality, Conversion factor

CPT 11011 result provenance. The calculation uses CMS April 2026 RVU records, GPCI localities, and conversion factors. Verify official CMS and payer rules before billing or contract decisions.

  • CPT or HCPCS code: CMS PFS Relative Value Files RVU record and descriptor fields
  • Work RVU: CMS PFS Relative Value Files work RVU component
  • Practice expense RVU: CMS PFS Relative Value Files facility and non-facility PE RVU fields
  • Malpractice RVU: CMS PFS Relative Value Files malpractice RVU component
Professional use
Source-aware calculation path

Keep this CPT, setting, locality, and conversion factor fixed when moving into geography, contract, or benchmark review.

Next tool action
Next CPT checks
Related CPT codes
Same specialty checks
Try nearby specialty codes without leaving the calculator
CPT 11011: 16.10 total RVU, $537.75 Medicare payment (National Average, NON-QPP)

Payment by representative localities

LocalitywRVUTotal RVUMedicare Payment
National: National Average4.8216.10$537.75
California: San Francisco4.8219.19$640.88
California: Los Angeles4.8217.92$598.50
New York: Manhattan4.8218.64$622.55
New York: Rest of New York4.8217.09$570.69
Texas: Dallas4.8215.97$533.32
Texas: Houston4.8216.42$548.56
Florida: Miami4.8217.98$600.42

CPT 11011 code profile

CMS 2026 Physician Fee Schedule inputs for this CPT/HCPCS code, including the site-of-service assumption used for the payment examples on this page.

Descriptor

Debride skin musc at fx site

Work RVU
4.82
PE RVU
10.33
MP RVU
0.95
Typical setting
Office / non-facility
Specialty mapping
Anesthesiology
Related codes
11008, 11010, 11012, 11042, 99214
Interpretation notes

RVU components are payment inputs, not clinical coding guidance. Confirm code selection, modifiers, payer policy, and documentation requirements through the official CMS source files or billing review. Locality-adjusted estimates should be interpreted with the selected setting, GPCI locality, and QPP status held constant.

CPT FAQ

Common RVU and payment questions for CPT 11011.

What is the wRVU for CPT 11011?

The imported CMS 2026 Physician Fee Schedule source files list 4.82 work RVU for CPT 11011.

What is the national payment estimate for CPT 11011?

Using national GPCI and the 2026 non-QPP conversion factor, the estimate is $537.75.

Does locality change the payment?

Yes. GPCI values adjust work, practice expense, and malpractice components by geography.