CPT code 11042: Wound debridement, subcutaneous tissue, first 20 sq cm2026 Medicare rate & RVUs in Iowa

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.

CMS RVU26DEffective Oct 1, 2026One payment locality2M Medicare services in 2024

In Iowa, Medicare pays $121.86 for 11042 in the office and $51.57 when it’s performed in a hospital or facility.

$121.86Office (non-facility)
$51.57Hospital or facility
−8.1%vs the national office rate ($132.60)

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.

We’ll open 11042 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 11042 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Iowa 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. Iowa pays $121.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

11042 in Iowa vs other payment areas
  1. Iowa · this page$121.86
  2. Los Angeles, CA · California$149.97+$28.11
  3. Washington, DC area · District of Columbia$151.86+$30.00
  4. Miami, FL · Florida$143.16+$21.30
  5. Chicago, IL · Illinois$138.93+$17.07
  6. Manhattan, NY · New York$152.72+$30.86
  7. Alaska · Alaska$153.23+$31.37

Other areas in Iowa first, then benchmark localities. Bars start at $0.

Every other payment area

11042 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$118.78$51.56
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

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
11042 office rate range by state
State / territoryOffice rate rangeLocalities
AK$153.231
AL$118.781
AR$117.031
AZ$129.011
CA$140.31–$176.4129
CO$138.161
CT$141.521
DC$151.861
DE$131.181
FL$130.58–$143.163
GA$123.12–$135.102
GU$143.861
HI$143.861
IA$121.861
ID$122.671
IL$126.74–$138.934
IN$123.401
KS$121.281
KY$121.631
LA$121.43–$127.562
MA$137.31–$152.002
MD$133.72–$151.863
ME$123.32–$130.142
MI$124.85–$132.242
MN$132.311
MO$119.31–$128.023
MS$118.191
MT$132.591
NC$124.631
ND$130.021
NE$122.551
NH$135.981
NJ$143.12–$150.242
NM$125.551
NV$131.971
NY$126.54–$156.475
OH$124.331
OK$121.411
OR$130.93–$142.622
PA$124.53–$137.952
PR$133.591
RI$135.911
SC$124.691
SD$129.721
TN$121.901
TX$123.70–$137.718
UT$126.431
VA$129.70–$151.862
VI$133.591
VT$129.501
WA$137.05–$155.132
WI$125.581
WV$121.961
WY$131.471

See 11042 in every payment locality

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

Office or facility?

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 Iowa 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

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 11042 in Iowa
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense2.86× 0.9152.6169
Malpractice0.13× 0.3970.0516
Total RVUs3.6485
Conversion factor× 33.4009

Office rate, Iowa$121.86

Office: (0.98 × 1 + 2.86 × 0.915 + 0.13 × 0.397) × $33.4009 = $121.86

Facility: (0.98 × 1 + 0.56 × 0.915 + 0.13 × 0.397) × $33.4009 = $51.57

Open 11042 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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%).

When to use modifier 51

How 11042 has changed in Iowa

11042 · Office / nonfacility

$121.86

Effective 2026-10-01

The base rate is $6.65 higher than on 2025-10-01, moving from $115.21 to $121.86 (5.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $115.21changed to$121.86

    • 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
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $119.48changed to$115.21

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.76 changed to 2.73

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $117.53changed to$119.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $120.21changed to$117.53

    • 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
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $122.72changed to$120.21

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.74 changed to 2.73
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $121.99changed to$122.72

    • 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.

  7. January 1, 2021

    RVU21A

    $118.16changed to$121.99

    • 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
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $114.39changed to$118.16

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.33 changed to 2.44
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $110.67changed to$114.39

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.22 changed to 2.33

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $108.47changed to$110.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.17 changed to 2.22
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $107.90changed to$108.47

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $108.61changed to$107.90

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.18 changed to 2.17

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $108.07changed to$108.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $106.60changed to$108.07

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.14 changed to 2.18
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $108.51changed to$106.60

    • 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
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $108.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$121.86$51.57RVU26D
2026-07-01$121.86$51.57RVU26C
2026-04-01$121.86$51.57RVU26B
2026-01-01$121.86$51.57RVU26A
2025-10-01$115.21$54.67RVU25D
2025-07-01$115.21$54.67RVU25C
2025-04-01$115.21$54.67RVU25B
2025-01-01$115.21$54.67RVU25A
2024-10-01$119.48$55.96RVU24D
2024-07-01$119.48$55.96RVU24C
2024-04-01$119.48$55.96RVU24B
2024-03-09$119.48$55.96RVU24AR
2024-01-01$117.53$55.05RVU24A
2023-10-01$120.21$55.76RVU23D
2023-07-01$120.21$55.76RVU23C
2023-04-01$120.21$55.76RVU23B
2023-01-01$120.21$55.76RVU23A
2022-10-01$122.72$56.49RVU22D
2022-07-01$122.72$56.49RVU22C
2022-04-01$122.72$56.49RVU22B
2022-01-01$122.72$56.49RVU22A
2021-10-01$121.99$56.79RVU21D
2021-07-01$121.99$56.79RVU21C
2021-04-01$121.99$56.79RVU21B
2021-01-01$121.99$56.79RVU21A
2020-10-01$118.16$58.58RVU20D
2020-07-01$118.16$58.58RVU20C
2020-04-01$118.16$58.58RVU20B
2020-01-01$118.16$58.58RVU20A
2019-10-01$114.39$58.82RVU19D
2019-07-01$114.39$58.82RVU19C
2019-04-01$114.39$58.82RVU19B
2019-01-01$114.39$58.82RVU19A
2018-10-01$110.67$59.41RVU18D
2018-07-01$110.67$59.41RVU18C
2018-04-01$110.67$59.41RVU18B
2018-01-01$110.67$59.41RVU18AR1
2017-10-01$108.47$58.94RVU17D
2017-07-01$108.47$58.94RVU17C
2017-04-01$108.47$58.94RVU17B
2017-01-01$108.47$58.94RVU17A
2016-10-01$107.90$58.81RVU16D
2016-07-01$107.90$58.81RVU16C
2016-04-01$107.90$58.81RVU16B
2016-01-01$107.90$58.81RVU16A
2015-10-01$108.61$59.02RVU15D
2015-07-01$108.61$59.02RVU15C
2015-04-01$108.07$58.73RVU15B
2015-01-01$108.07$58.73RVU15A
2014-10-01$106.60$58.35RVU14D
2014-07-01$106.60$58.35RVU14C
2014-04-01$106.60$58.35RVU14B
2014-01-01$106.60$58.35RVU14A
2013-10-01$108.51$57.20RVU13D
2013-07-01$108.51$57.20RVU13C
2013-04-01$108.51$57.20RVU13B
2013-01-01$108.51$57.20RVU13AR

Price 11042 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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
RVUs for 11042PPRRVU2026_Oct_nonQPP.csv, line 1,255 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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