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

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 New Mexico, Medicare pays $125.55 for 11042 in the office and $55.10 when it’s performed in a hospital or facility.

$125.55Office (non-facility)
$55.10Hospital or facility
−5.3%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 New Mexico
  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 New Mexico 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. New Mexico pays $125.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

11042 in New Mexico vs other payment areas
  1. New Mexico · this page$125.55
  2. Los Angeles, CA · California$149.97+$24.42
  3. Washington, DC area · District of Columbia$151.86+$26.31
  4. Miami, FL · Florida$143.16+$17.61
  5. Chicago, IL · Illinois$138.93+$13.38
  6. Manhattan, NY · New York$152.72+$27.17
  7. Alaska · Alaska$153.23+$27.68

Other areas in New Mexico 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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 11042 in New Mexico
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense2.86× 0.9172.6226
Malpractice0.13× 1.2010.1561
Total RVUs3.7588
Conversion factor× 33.4009

Office rate, New Mexico$125.55

Office: (0.98 × 1 + 2.86 × 0.917 + 0.13 × 1.201) × $33.4009 = $125.55

Facility: (0.98 × 1 + 0.56 × 0.917 + 0.13 × 1.201) × $33.4009 = $55.10

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 New Mexico

11042 · Office / nonfacility

$125.55

Effective 2026-10-01

The base rate is $7.77 higher than on 2025-10-01, moving from $117.78 to $125.55 (6.6%).

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

    $117.78changed to$125.55

    • 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 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $122.11changed to$117.78

    • 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

    $120.12changed to$122.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $122.43changed to$120.12

    • 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 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $124.75changed to$122.43

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.74 changed to 2.73
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $124.32changed to$124.75

    • 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

    $121.63changed to$124.32

    • 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
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $119.13changed to$121.63

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.33 changed to 2.44
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $115.35changed to$119.13

    • 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

    $113.08changed to$115.35

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.17 changed to 2.22
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $112.55changed to$113.08

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $113.29changed to$112.55

    • 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

    $112.73changed to$113.29

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $111.19changed to$112.73

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.14 changed to 2.18
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $113.26changed to$111.19

    • 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 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $113.26

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$125.55$55.10RVU26D
2026-07-01$125.55$55.10RVU26C
2026-04-01$125.55$55.10RVU26B
2026-01-01$125.55$55.10RVU26A
2025-10-01$117.78$57.57RVU25D
2025-07-01$117.78$57.57RVU25C
2025-04-01$117.78$57.57RVU25B
2025-01-01$117.78$57.57RVU25A
2024-10-01$122.11$58.94RVU24D
2024-07-01$122.11$58.94RVU24C
2024-04-01$122.11$58.94RVU24B
2024-03-09$122.11$58.94RVU24AR
2024-01-01$120.12$57.98RVU24A
2023-10-01$122.43$58.54RVU23D
2023-07-01$122.43$58.54RVU23C
2023-04-01$122.43$58.54RVU23B
2023-01-01$122.43$58.54RVU23A
2022-10-01$124.75$59.33RVU22D
2022-07-01$124.75$59.33RVU22C
2022-04-01$124.75$59.33RVU22B
2022-01-01$124.75$59.33RVU22A
2021-10-01$124.32$59.91RVU21D
2021-07-01$124.32$59.91RVU21C
2021-04-01$124.32$59.91RVU21B
2021-01-01$124.32$59.91RVU21A
2020-10-01$121.63$61.99RVU20D
2020-07-01$121.63$61.99RVU20C
2020-04-01$121.63$61.99RVU20B
2020-01-01$121.63$61.99RVU20A
2019-10-01$119.13$62.70RVU19D
2019-07-01$119.13$62.70RVU19C
2019-04-01$119.13$62.70RVU19B
2019-01-01$119.13$62.70RVU19A
2018-10-01$115.35$63.30RVU18D
2018-07-01$115.35$63.30RVU18C
2018-04-01$115.35$63.30RVU18B
2018-01-01$115.35$63.30RVU18AR1
2017-10-01$113.08$62.56RVU17D
2017-07-01$113.08$62.56RVU17C
2017-04-01$113.08$62.56RVU17B
2017-01-01$113.08$62.56RVU17A
2016-10-01$112.55$62.21RVU16D
2016-07-01$112.55$62.21RVU16C
2016-04-01$112.55$62.21RVU16B
2016-01-01$112.55$62.21RVU16A
2015-10-01$113.29$62.43RVU15D
2015-07-01$113.29$62.43RVU15C
2015-04-01$112.73$62.12RVU15B
2015-01-01$112.73$62.12RVU15A
2014-10-01$111.19$61.54RVU14D
2014-07-01$111.19$61.54RVU14C
2014-04-01$111.19$61.54RVU14B
2014-01-01$111.19$61.54RVU14A
2013-10-01$113.26$60.28RVU13D
2013-07-01$113.26$60.28RVU13C
2013-04-01$113.26$60.28RVU13B
2013-01-01$113.26$60.28RVU13AR

Price 11042 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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 New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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