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

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 South Carolina, Medicare pays $124.69 for 11042 in the office and $53.71 when it’s performed in a hospital or facility.

$124.69Office (non-facility)
$53.71Hospital or facility
−6.0%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 South Carolina
  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 South Carolina 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. South Carolina pays $124.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

11042 in South Carolina vs other payment areas
  1. South Carolina · this page$124.69
  2. Los Angeles, CA · California$149.97+$25.28
  3. Washington, DC area · District of Columbia$151.86+$27.17
  4. Miami, FL · Florida$143.16+$18.47
  5. Chicago, IL · Illinois$138.93+$14.24
  6. Manhattan, NY · New York$152.72+$28.03
  7. Alaska · Alaska$153.23+$28.54

Other areas in South Carolina 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 South Carolina 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

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 11042 in South Carolina
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense2.86× 0.9242.6426
Malpractice0.13× 0.8500.1105
Total RVUs3.7331
Conversion factor× 33.4009

Office rate, South Carolina$124.69

Office: (0.98 × 1 + 2.86 × 0.924 + 0.13 × 0.85) × $33.4009 = $124.69

Facility: (0.98 × 1 + 0.56 × 0.924 + 0.13 × 0.85) × $33.4009 = $53.71

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 South Carolina

11042 · Office / nonfacility

$124.69

Effective 2026-10-01

The base rate is $7.96 higher than on 2025-10-01, moving from $116.73 to $124.69 (6.8%).

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

    $116.73changed to$124.69

    • 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 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $121.04changed to$116.73

    • 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

    $119.06changed to$121.04

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $121.30changed to$119.06

    • 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 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817
  5. January 1, 2023

    RVU23A

    $123.46changed to$121.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.74 changed to 2.73
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $122.84changed to$123.46

    • 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

    $119.02changed to$122.84

    • 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 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $115.37changed to$119.02

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.33 changed to 2.44
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $111.63changed to$115.37

    • 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

    $110.00changed to$111.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.17 changed to 2.22
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $110.09changed to$110.00

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $110.82changed to$110.09

    • 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

    $110.27changed to$110.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $108.68changed to$110.27

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.14 changed to 2.18
    • Practice expense GPCI 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $110.58changed to$108.68

    • 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 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $110.58

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$124.69$53.71RVU26D
2026-07-01$124.69$53.71RVU26C
2026-04-01$124.69$53.71RVU26B
2026-01-01$124.69$53.71RVU26A
2025-10-01$116.73$56.19RVU25D
2025-07-01$116.73$56.19RVU25C
2025-04-01$116.73$56.19RVU25B
2025-01-01$116.73$56.19RVU25A
2024-10-01$121.04$57.52RVU24D
2024-07-01$121.04$57.52RVU24C
2024-04-01$121.04$57.52RVU24B
2024-03-09$121.04$57.52RVU24AR
2024-01-01$119.06$56.58RVU24A
2023-10-01$121.30$56.99RVU23D
2023-07-01$121.30$56.99RVU23C
2023-04-01$121.30$56.99RVU23B
2023-01-01$121.30$56.99RVU23A
2022-10-01$123.46$57.53RVU22D
2022-07-01$123.46$57.53RVU22C
2022-04-01$123.46$57.53RVU22B
2022-01-01$123.46$57.53RVU22A
2021-10-01$122.84$57.93RVU21D
2021-07-01$122.84$57.93RVU21C
2021-04-01$122.84$57.93RVU21B
2021-01-01$122.84$57.93RVU21A
2020-10-01$119.02$59.45RVU20D
2020-07-01$119.02$59.45RVU20C
2020-04-01$119.02$59.45RVU20B
2020-01-01$119.02$59.45RVU20A
2019-10-01$115.37$59.50RVU19D
2019-07-01$115.37$59.50RVU19C
2019-04-01$115.37$59.50RVU19B
2019-01-01$115.37$59.50RVU19A
2018-10-01$111.63$60.09RVU18D
2018-07-01$111.63$60.09RVU18C
2018-04-01$111.63$60.09RVU18B
2018-01-01$111.63$60.09RVU18AR1
2017-10-01$110.00$59.93RVU17D
2017-07-01$110.00$59.93RVU17C
2017-04-01$110.00$59.93RVU17B
2017-01-01$110.00$59.93RVU17A
2016-10-01$110.09$60.13RVU16D
2016-07-01$110.09$60.13RVU16C
2016-04-01$110.09$60.13RVU16B
2016-01-01$110.09$60.13RVU16A
2015-10-01$110.82$60.35RVU15D
2015-07-01$110.82$60.35RVU15C
2015-04-01$110.27$60.05RVU15B
2015-01-01$110.27$60.05RVU15A
2014-10-01$108.68$59.40RVU14D
2014-07-01$108.68$59.40RVU14C
2014-04-01$108.68$59.40RVU14B
2014-01-01$108.68$59.40RVU14A
2013-10-01$110.58$58.00RVU13D
2013-07-01$110.58$58.00RVU13C
2013-04-01$110.58$58.00RVU13B
2013-01-01$110.58$58.00RVU13AR

Price 11042 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

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 South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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