CPT code 11042: Wound debridement, subcutaneous tissue, first 20 sq cm2026 Medicare rate & RVUs in Washington, DC area
Report this code when subcutaneous tissue is removed from a wound and the total area debrided to that depth is 20 square centimeters or less.
In Washington, DC area, Medicare pays $151.86 for 11042 in the office and $61.37 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 11042 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 11042 covers
Clinicians remove nonviable subcutaneous tissue from an open wound, sometimes taking overlying skin, using a scalpel, scissors, curette, or forceps. Podiatrists, wound care clinicians, surgeons, and qualified nonphysician practitioners perform this work in offices, outpatient wound centers, and hospitals. Typical wounds include diabetic foot ulcers, pressure injuries, venous leg ulcers, and dehisced surgical incisions. The code depends on subcutaneous tissue actually removed, not simply exposed by the wound.
Report 11042 for the first 20 sq cm or less debrided to subcutaneous depth; add 11045 for each additional 20 sq cm or part thereof. Sum debrided areas of separate wounds at this depth, but size wounds debrided to muscle or bone separately. Record each wound's location, debrided area, tissue removed, instrument, and deepest tissue level removed. The 0-day global period includes routine same-day preoperative and postoperative care. Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Washington, DC area compares for 11042
Across 109 of 109 payment localities, the office rate for 11042 runs from $117.03 in Arkansas to $176.41 in San Benito County, CA. Washington, DC area pays $151.86. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$151.86
- Los Angeles, CA · California$149.97−$1.89
- Miami, FL · Florida$143.16−$8.70
- Chicago, IL · Illinois$138.93−$12.93
- Manhattan, NY · New York$152.72+$0.86
- Alaska · Alaska$153.23+$1.37
- Alabama · Alabama$118.78−$33.08
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $117.03 | $51.04 |
| ArizonaArizona | $129.01 | $54.57 |
| Bakersfield, CACalifornia | $140.70 | $56.50 |
| Chico, CACalifornia | $140.31 | $56.12 |
| El Centro, CACalifornia | $140.34 | $56.14 |
| Fresno, CACalifornia | $140.31 | $56.12 |
| Hanford, CACalifornia | $140.31 | $56.12 |
| Madera, CACalifornia | $140.31 | $56.12 |
| Merced, CACalifornia | $140.31 | $56.12 |
| Modesto, CACalifornia | $140.31 | $56.12 |
| Napa, CACalifornia | $162.90 | $61.65 |
| Oxnard, CACalifornia | $149.27 | $58.46 |
| Redding, CACalifornia | $140.31 | $56.12 |
| Rest of CaliforniaCalifornia | $140.31 | $56.12 |
| Riverside, CACalifornia | $141.72 | $57.53 |
| Sacramento, CACalifornia | $147.34 | $57.99 |
| Salinas, CACalifornia | $146.79 | $57.75 |
| San Diego, CACalifornia | $150.32 | $58.44 |
| Marin County, CACalifornia | $172.53 | $64.21 |
| San Francisco, CACalifornia | $172.38 | $64.06 |
| San Benito County, CACalifornia | $176.41 | $65.63 |
| Santa Clara County, CACalifornia | $175.81 | $65.03 |
| San Luis Obispo, CACalifornia | $144.42 | $56.92 |
| Santa Cruz, CACalifornia | $151.81 | $58.47 |
| Santa Maria, CACalifornia | $147.36 | $57.79 |
| Santa Rosa, CACalifornia | $153.35 | $59.01 |
| Stockton, CACalifornia | $140.31 | $56.12 |
| Vallejo, CACalifornia | $162.69 | $61.44 |
| Visalia, CACalifornia | $140.31 | $56.12 |
| Yuba City, CACalifornia | $140.31 | $56.12 |
| ColoradoColorado | $138.16 | $56.42 |
| ConnecticutConnecticut | $141.52 | $58.79 |
| DelawareDelaware | $131.18 | $55.28 |
| Fort Lauderdale, FLFlorida | $137.35 | $59.53 |
| Rest of FloridaFlorida | $130.58 | $57.14 |
| Atlanta, GAGeorgia | $135.10 | $57.05 |
| Rest of GeorgiaGeorgia | $123.12 | $54.59 |
| Hawaii, Guam, HIHawaii | $143.86 | $56.51 |
| IowaIowa | $121.86 | $51.57 |
| IdahoIdaho | $122.67 | $51.99 |
| East St. Louis, ILIllinois | $129.36 | $58.69 |
| Rest of IllinoisIllinois | $126.74 | $56.60 |
| Suburban Chicago, ILIllinois | $138.76 | $59.87 |
| IndianaIndiana | $123.40 | $52.18 |
| KansasKansas | $121.28 | $51.83 |
| KentuckyKentucky | $121.63 | $53.33 |
| New Orleans, LALouisiana | $127.56 | $55.27 |
| Rest of LouisianaLouisiana | $121.43 | $53.45 |
| Metropolitan Boston, MAMassachusetts | $152.00 | $60.27 |
| Rest of MassachusettsMassachusetts | $137.31 | $56.41 |
| Baltimore area, MDMaryland | $141.13 | $58.70 |
| Rest of MarylandMaryland | $133.72 | $55.98 |
| Rest of MaineMaine | $123.32 | $52.64 |
| Southern Maine, MEMaine | $130.14 | $54.01 |
| Detroit, MIMichigan | $132.24 | $58.10 |
| Rest of MichiganMichigan | $124.85 | $54.71 |
| MinnesotaMinnesota | $132.31 | $53.27 |
| Metropolitan Kansas City, MOMissouri | $126.67 | $54.54 |
| Metropolitan St. Louis, MOMissouri | $128.02 | $54.89 |
| Rest of MissouriMissouri | $119.31 | $53.09 |
| MississippiMississippi | $118.19 | $52.05 |
| MontanaMontana | $132.59 | $55.77 |
| North CarolinaNorth Carolina | $124.63 | $52.96 |
| North DakotaNorth Dakota | $130.02 | $53.20 |
| NebraskaNebraska | $122.55 | $51.64 |
| New HampshireNew Hampshire | $135.98 | $56.00 |
| Northern New JerseyNew Jersey | $150.24 | $61.13 |
| Rest of New JerseyNew Jersey | $143.12 | $59.23 |
| New MexicoNew Mexico | $125.55 | $55.10 |
| NevadaNevada | $131.97 | $55.07 |
| NYC suburbs and Long Island, NYNew York | $156.47 | $65.13 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $144.06 | $59.94 |
| Queens, NYNew York | $154.00 | $63.20 |
| Rest of New YorkNew York | $126.54 | $53.55 |
| OhioOhio | $124.33 | $54.19 |
| OklahomaOklahoma | $121.41 | $52.81 |
| Portland, OROregon | $142.62 | $57.27 |
| Rest of OregonOregon | $130.93 | $54.42 |
| Metropolitan Philadelphia, PAPennsylvania | $137.95 | $57.97 |
| Rest of PennsylvaniaPennsylvania | $124.53 | $54.01 |
| Puerto RicoPuerto Rico | $133.59 | $55.92 |
| Rhode IslandRhode Island | $135.91 | $56.55 |
| South CarolinaSouth Carolina | $124.69 | $53.71 |
| South DakotaSouth Dakota | $129.72 | $52.90 |
| TennesseeTennessee | $121.90 | $52.07 |
| Austin, TXTexas | $137.71 | $56.43 |
| Beaumont, TXTexas | $123.70 | $53.79 |
| Brazoria, TXTexas | $131.05 | $54.92 |
| Dallas, TXTexas | $131.90 | $55.38 |
| Fort Worth, TXTexas | $131.00 | $55.25 |
| Galveston, TXTexas | $131.45 | $55.16 |
| Houston, TXTexas | $133.83 | $57.54 |
| Rest of TexasTexas | $127.31 | $54.40 |
| UtahUtah | $126.43 | $54.21 |
| VirginiaVirginia | $129.70 | $54.18 |
| Virgin Islands, VIUnited States Virgin Islands | $133.59 | $55.92 |
| VermontVermont | $129.50 | $53.45 |
| Rest of WashingtonWashington | $137.05 | $56.16 |
| King County, WAWashington | $155.13 | $60.87 |
| WisconsinWisconsin | $125.58 | $51.99 |
| West VirginiaWest Virginia | $121.96 | $55.20 |
| WyomingWyoming | $131.47 | $54.65 |
11042 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$117.03
$158.36
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $153.23 | 1 |
| AL | $118.78 | 1 |
| AR | $117.03 | 1 |
| AZ | $129.01 | 1 |
| CA | $140.31–$176.41 | 29 |
| CO | $138.16 | 1 |
| CT | $141.52 | 1 |
| DC | $151.86 | 1 |
| DE | $131.18 | 1 |
| FL | $130.58–$143.16 | 3 |
| GA | $123.12–$135.10 | 2 |
| GU | $143.86 | 1 |
| HI | $143.86 | 1 |
| IA | $121.86 | 1 |
| ID | $122.67 | 1 |
| IL | $126.74–$138.93 | 4 |
| IN | $123.40 | 1 |
| KS | $121.28 | 1 |
| KY | $121.63 | 1 |
| LA | $121.43–$127.56 | 2 |
| MA | $137.31–$152.00 | 2 |
| MD | $133.72–$151.86 | 3 |
| ME | $123.32–$130.14 | 2 |
| MI | $124.85–$132.24 | 2 |
| MN | $132.31 | 1 |
| MO | $119.31–$128.02 | 3 |
| MS | $118.19 | 1 |
| MT | $132.59 | 1 |
| NC | $124.63 | 1 |
| ND | $130.02 | 1 |
| NE | $122.55 | 1 |
| NH | $135.98 | 1 |
| NJ | $143.12–$150.24 | 2 |
| NM | $125.55 | 1 |
| NV | $131.97 | 1 |
| NY | $126.54–$156.47 | 5 |
| OH | $124.33 | 1 |
| OK | $121.41 | 1 |
| OR | $130.93–$142.62 | 2 |
| PA | $124.53–$137.95 | 2 |
| PR | $133.59 | 1 |
| RI | $135.91 | 1 |
| SC | $124.69 | 1 |
| SD | $129.72 | 1 |
| TN | $121.90 | 1 |
| TX | $123.70–$137.71 | 8 |
| UT | $126.43 | 1 |
| VA | $129.70–$151.86 | 2 |
| VI | $133.59 | 1 |
| VT | $129.50 | 1 |
| WA | $137.05–$155.13 | 2 |
| WI | $125.58 | 1 |
| WV | $121.96 | 1 |
| WY | $131.47 | 1 |
How the 11042 rate is calculated
Each of 11042’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 11042
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense2.86
2.86 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
3.9700
Conversion factor
$33.4009
Medicare rate
$132.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,255
- Code
- 11042
- Physician work
- 0.98
- Practice expense
- 2.86
- Malpractice
- 0.13
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.054 | 1.0329 |
| Practice expense | 2.86 | × 1.178 | 3.3691 |
| Malpractice | 0.13 | × 1.113 | 0.1447 |
| Total RVUs | 4.5467 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$151.86
Office: (0.98 × 1.054 + 2.86 × 1.178 + 0.13 × 1.113) × $33.4009 = $151.86
Facility: (0.98 × 1.054 + 0.56 × 1.178 + 0.13 × 1.113) × $33.4009 = $61.37
Payment rules and modifiers for 11042
The CMS indicators that decide how 11042 is paid alongside other services.
CMS payment indicators · 11042
Wound debridement, subcutaneous tissue, first 20 sq cm
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11042 without 51 · national office
$132.60
Wound debridement, subcutaneous tissue, first 20 sq cm
11042-51 · Second procedure: 50%
$66.30
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 11042 has changed in Washington, DC area
11042 · Office / nonfacility
$151.86
Effective 2026-10-01
The base rate is $7.16 higher than on 2025-10-01, moving from $144.70 to $151.86 (4.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$144.70changed to$151.86
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.01 changed to 0.98
- Practice expense RVU 2.73 changed to 2.86
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$150.10changed to$144.70
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.76 changed to 2.73
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$147.65changed to$150.10
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$153.46changed to$147.65
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.73 changed to 2.76
- Malpractice RVU 0.12 changed to 0.13
- Work GPCI 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$159.41changed to$153.46
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.74 changed to 2.73
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$158.60changed to$159.41
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.68 changed to 2.74
- Malpractice RVU 0.13 changed to 0.12
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$151.29changed to$158.60
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.44 changed to 2.68
- Malpractice RVU 0.12 changed to 0.13
- Work GPCI 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$144.68changed to$151.29
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.33 changed to 2.44
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$139.75changed to$144.68
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.22 changed to 2.33
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$137.30changed to$139.75
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.17 changed to 2.22
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$137.13changed to$137.30
- Conversion factor 35.8043 changed to 35.8887
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$138.06changed to$137.13
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.18 changed to 2.17
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$137.37changed to$138.06
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$135.32changed to$137.37
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.14 changed to 2.18
- Work GPCI 1.050 changed to 1.051
- Practice expense GPCI 1.202 changed to 1.205
- Malpractice GPCI 1.205 changed to 1.280
Held through RVU15B.
January 1, 2014
RVU14A
$138.46changed to$135.32
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.39 changed to 2.14
- Malpractice RVU 0.13 changed to 0.12
- Work GPCI 1.049 changed to 1.050
- Practice expense GPCI 1.198 changed to 1.202
- Malpractice GPCI 1.130 changed to 1.205
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $138.46
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $151.86 | $61.37 | RVU26D |
| 2026-07-01 | $151.86 | $61.37 | RVU26C |
| 2026-04-01 | $151.86 | $61.37 | RVU26B |
| 2026-01-01 | $151.86 | $61.37 | RVU26A |
| 2025-10-01 | $144.70 | $65.66 | RVU25D |
| 2025-07-01 | $144.70 | $65.66 | RVU25C |
| 2025-04-01 | $144.70 | $65.66 | RVU25B |
| 2025-01-01 | $144.70 | $65.66 | RVU25A |
| 2024-10-01 | $150.10 | $67.18 | RVU24D |
| 2024-07-01 | $150.10 | $67.18 | RVU24C |
| 2024-04-01 | $150.10 | $67.18 | RVU24B |
| 2024-03-09 | $150.10 | $67.18 | RVU24AR |
| 2024-01-01 | $147.65 | $66.08 | RVU24A |
| 2023-10-01 | $153.46 | $67.48 | RVU23D |
| 2023-07-01 | $153.46 | $67.48 | RVU23C |
| 2023-04-01 | $153.46 | $67.48 | RVU23B |
| 2023-01-01 | $153.46 | $67.48 | RVU23A |
| 2022-10-01 | $159.41 | $69.16 | RVU22D |
| 2022-07-01 | $159.41 | $69.16 | RVU22C |
| 2022-04-01 | $159.41 | $69.16 | RVU22B |
| 2022-01-01 | $159.41 | $69.16 | RVU22A |
| 2021-10-01 | $158.60 | $69.75 | RVU21D |
| 2021-07-01 | $158.60 | $69.75 | RVU21C |
| 2021-04-01 | $158.60 | $69.75 | RVU21B |
| 2021-01-01 | $158.60 | $69.75 | RVU21A |
| 2020-10-01 | $151.29 | $71.09 | RVU20D |
| 2020-07-01 | $151.29 | $71.09 | RVU20C |
| 2020-04-01 | $151.29 | $71.09 | RVU20B |
| 2020-01-01 | $151.29 | $71.09 | RVU20A |
| 2019-10-01 | $144.68 | $70.85 | RVU19D |
| 2019-07-01 | $144.68 | $70.85 | RVU19C |
| 2019-04-01 | $144.68 | $70.85 | RVU19B |
| 2019-01-01 | $144.68 | $70.85 | RVU19A |
| 2018-10-01 | $139.75 | $71.64 | RVU18D |
| 2018-07-01 | $139.75 | $71.64 | RVU18C |
| 2018-04-01 | $139.75 | $71.64 | RVU18B |
| 2018-01-01 | $139.75 | $71.64 | RVU18AR1 |
| 2017-10-01 | $137.30 | $71.14 | RVU17D |
| 2017-07-01 | $137.30 | $71.14 | RVU17C |
| 2017-04-01 | $137.30 | $71.14 | RVU17B |
| 2017-01-01 | $137.30 | $71.14 | RVU17A |
| 2016-10-01 | $137.13 | $71.12 | RVU16D |
| 2016-07-01 | $137.13 | $71.12 | RVU16C |
| 2016-04-01 | $137.13 | $71.12 | RVU16B |
| 2016-01-01 | $137.13 | $71.12 | RVU16A |
| 2015-10-01 | $138.06 | $71.38 | RVU15D |
| 2015-07-01 | $138.06 | $71.38 | RVU15C |
| 2015-04-01 | $137.37 | $71.02 | RVU15B |
| 2015-01-01 | $137.37 | $71.02 | RVU15A |
| 2014-10-01 | $135.32 | $70.30 | RVU14D |
| 2014-07-01 | $135.32 | $70.30 | RVU14C |
| 2014-04-01 | $135.32 | $70.30 | RVU14B |
| 2014-01-01 | $135.32 | $70.30 | RVU14A |
| 2013-10-01 | $138.46 | $69.17 | RVU13D |
| 2013-07-01 | $138.46 | $69.17 | RVU13C |
| 2013-04-01 | $138.46 | $69.17 | RVU13B |
| 2013-01-01 | $138.46 | $69.17 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
11042 billing questions
How do I code two ulcers debrided to subcutaneous tissue on the same day?
Add the areas actually debrided to subcutaneous depth. Report 11042 for the first 20 sq cm and 11045 for each additional 20 sq cm or portion of the combined area.
What if one wound is debrided to subcutaneous tissue and another to muscle?
Do not combine areas across depths. Report 11042 for the subcutaneous wound and 11043 for the wound with muscle or fascia removed, sizing each separately.
Can selective debridement codes 97597 or 97598 be billed for the same wound?
Do not report selective debridement for the same wound when subcutaneous tissue is excised and reported with 11042. Selective debridement may be appropriate when subcutaneous tissue is not removed.
Can an E/M visit be billed on the same day?
A significant, separately identifiable E/M service beyond routine care associated with the debridement may be reported with modifier 25. Routine same-day preoperative and postoperative care is included in the 0-day global period.
Should modifier 50 be used for wounds on both feet?
No. Total the areas debrided to subcutaneous depth on both feet; report 11042 for the first 20 sq cm and 11045 for additional area.
What documentation best supports this code?
Record the location and area actually debrided for each wound, the instrument used, and removal of subcutaneous tissue. A wound extending into fat, or documentation of slough or eschar removal alone, does not establish that subcutaneous tissue was removed.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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