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CMS RVU26D · Effective 2026-10-01

11042 in Merced

Office / nonfacility

$140.31

Base rate per service

Facility setting

$56.12

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Wound care procedure

About 11042: Subcutaneous tissue debridement, first 20 sq cm

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.

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.

CMS billing rules for 11042

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU0.98 · 25%
  • Practice expense (office) RVU2.86 · 72%
  • Malpractice RVU0.13 · 3%

2M

Medicare services in 2024 · #80 by national volume

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.

11042 compared with similar codes

Office rates for Merced, from the same CMS release.

97597

Selective wound debridement

First 20 sq cm or less

$108.37

Choose 97597 for selective wound debridement when subcutaneous tissue is not removed. Report 11042 when subcutaneous tissue is actually excised, even if both wounds extend to that depth.

11043

Wound debridement

Muscle or fascia, initial area

$247.68

11043 requires documented removal of muscle and/or fascia. If tissue removal stops in the subcutaneous layer, even in a deeper wound, 11042 applies.

11045

Wound debridement

Subcutaneous, each additional 20 sq cm

$43.16

11045 is an add-on covering each additional 20 sq cm or part thereof debrided to subcutaneous depth; 11042 covers the first 20 sq cm.

11044

Wound debridement

Bone, first 20 sq cm

$328.91

Choose 11044 when bone is debrided. A wound that exposes bone still falls under 11042 if subcutaneous tissue is the deepest tissue actually removed.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 11042 is $140.70—$0.39 higher than the $140.31 rate in Merced. Both use the same code, release and participation basis.

11042 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $140.31

  2. Bakersfield

    $140.70

    $0.39 higher than Merced

  3. Chico

    $140.31

    The same base rate than Merced

  4. El Centro

    $140.34

    $0.03 higher than Merced

  5. Fresno

    $140.31

    The same base rate than Merced

  6. Hanford-Corcoran

    $140.31

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $149.97

    $9.66 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 11042 ranges from $117.03 in Arkansas to $176.41 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 11042

    Office

    $140.31

    Facility

    $56.12

    The same base rate than Merced for the office setting.

  • Modesto

    California · 11042

    Office

    $140.31

    Facility

    $56.12

    The same base rate than Merced for the office setting.

  • Napa

    California · 11042

    Office

    $162.90

    Facility

    $61.65

    $22.59 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 11042

    Office

    $149.27

    Facility

    $58.46

    $8.96 higher than Merced for the office setting.

  • Redding

    California · 11042

    Office

    $140.31

    Facility

    $56.12

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 11042

    Office

    $140.31

    Facility

    $56.12

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 11042

    Office

    $141.72

    Facility

    $57.53

    $1.41 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 11042

    Office

    $147.34

    Facility

    $57.99

    $7.03 higher than Merced for the office setting.

  • Salinas

    California · 11042

    Office

    $146.79

    Facility

    $57.75

    $6.48 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 11042

    Office

    $150.32

    Facility

    $58.44

    $10.01 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 11042

    Office

    $172.53

    Facility

    $64.21

    $32.22 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 11042

    Office

    $172.38

    Facility

    $64.06

    $32.07 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 11042

    Office

    $176.41

    Facility

    $65.63

    $36.10 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 11042

    Office

    $175.81

    Facility

    $65.03

    $35.50 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 11042

    Office

    $144.42

    Facility

    $56.92

    $4.11 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 11042

    Office

    $151.81

    Facility

    $58.47

    $11.50 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 11042

    Office

    $147.36

    Facility

    $57.79

    $7.05 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 11042

    Office

    $153.35

    Facility

    $59.01

    $13.04 higher than Merced for the office setting.

  • Stockton

    California · 11042

    Office

    $140.31

    Facility

    $56.12

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 11042

    Office

    $162.69

    Facility

    $61.44

    $22.38 higher than Merced for the office setting.

  • Visalia

    California · 11042

    Office

    $140.31

    Facility

    $56.12

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 11042

    Office

    $140.31

    Facility

    $56.12

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 11042

    Office

    $151.86

    Facility

    $61.37

    $11.55 higher than Merced for the office setting.

  • Miami

    Florida · 11042

    Office

    $143.16

    Facility

    $63.19

    $2.85 higher than Merced for the office setting.

  • Chicago

    Illinois · 11042

    Office

    $138.93

    Facility

    $61.73

    $1.38 lower than Merced for the office setting.

  • Manhattan

    New York · 11042

    Office

    $152.72

    Facility

    $63.45

    $12.41 higher than Merced for the office setting.

  • Alaska*

    Alaska · 11042

    Office

    $153.23

    Facility

    $71.41

    $12.92 higher than Merced for the office setting.

  • Alabama

    Alabama · 11042

    Office

    $118.78

    Facility

    $51.56

    $21.53 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 11042

    Office

    $117.03

    Facility

    $51.04

    $23.28 lower than Merced for the office setting.

  • Arizona

    Arizona · 11042

    Office

    $129.01

    Facility

    $54.57

    $11.30 lower than Merced for the office setting.

  • Colorado

    Colorado · 11042

    Office

    $138.16

    Facility

    $56.42

    $2.15 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 11042

    Office

    $141.52

    Facility

    $58.79

    $1.21 higher than Merced for the office setting.

  • Delaware

    Delaware · 11042

    Office

    $131.18

    Facility

    $55.28

    $9.13 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 11042

    Office

    $137.35

    Facility

    $59.53

    $2.96 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 11042

    Office

    $130.58

    Facility

    $57.14

    $9.73 lower than Merced for the office setting.

  • Atlanta

    Georgia · 11042

    Office

    $135.10

    Facility

    $57.05

    $5.21 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 11042

    Office

    $123.12

    Facility

    $54.59

    $17.19 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 11042

    Office

    $143.86

    Facility

    $56.51

    $3.55 higher than Merced for the office setting.

  • Iowa

    Iowa · 11042

    Office

    $121.86

    Facility

    $51.57

    $18.45 lower than Merced for the office setting.

  • Idaho

    Idaho · 11042

    Office

    $122.67

    Facility

    $51.99

    $17.64 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 11042

    Office

    $129.36

    Facility

    $58.69

    $10.95 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 11042

    Office

    $126.74

    Facility

    $56.60

    $13.57 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 11042

    Office

    $138.76

    Facility

    $59.87

    $1.55 lower than Merced for the office setting.

  • Indiana

    Indiana · 11042

    Office

    $123.40

    Facility

    $52.18

    $16.91 lower than Merced for the office setting.

  • Kansas

    Kansas · 11042

    Office

    $121.28

    Facility

    $51.83

    $19.03 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 11042

    Office

    $121.63

    Facility

    $53.33

    $18.68 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 11042

    Office

    $127.56

    Facility

    $55.27

    $12.75 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 11042

    Office

    $121.43

    Facility

    $53.45

    $18.88 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 11042

    Office

    $152.00

    Facility

    $60.27

    $11.69 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 11042

    Office

    $137.31

    Facility

    $56.41

    $3.00 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 11042

    Office

    $141.13

    Facility

    $58.70

    $0.82 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 11042

    Office

    $133.72

    Facility

    $55.98

    $6.59 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 11042

    Office

    $123.32

    Facility

    $52.64

    $16.99 lower than Merced for the office setting.

  • Southern Maine

    Maine · 11042

    Office

    $130.14

    Facility

    $54.01

    $10.17 lower than Merced for the office setting.

  • Detroit

    Michigan · 11042

    Office

    $132.24

    Facility

    $58.10

    $8.07 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 11042

    Office

    $124.85

    Facility

    $54.71

    $15.46 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 11042

    Office

    $132.31

    Facility

    $53.27

    $8.00 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 11042

    Office

    $126.67

    Facility

    $54.54

    $13.64 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 11042

    Office

    $128.02

    Facility

    $54.89

    $12.29 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 11042

    Office

    $119.31

    Facility

    $53.09

    $21.00 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 11042

    Office

    $118.19

    Facility

    $52.05

    $22.12 lower than Merced for the office setting.

  • Montana**

    Montana · 11042

    Office

    $132.59

    Facility

    $55.77

    $7.72 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 11042

    Office

    $124.63

    Facility

    $52.96

    $15.68 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 11042

    Office

    $130.02

    Facility

    $53.20

    $10.29 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 11042

    Office

    $122.55

    Facility

    $51.64

    $17.76 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 11042

    Office

    $135.98

    Facility

    $56.00

    $4.33 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 11042

    Office

    $150.24

    Facility

    $61.13

    $9.93 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 11042

    Office

    $143.12

    Facility

    $59.23

    $2.81 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 11042

    Office

    $125.55

    Facility

    $55.10

    $14.76 lower than Merced for the office setting.

  • Nevada**

    Nevada · 11042

    Office

    $131.97

    Facility

    $55.07

    $8.34 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 11042

    Office

    $156.47

    Facility

    $65.13

    $16.16 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 11042

    Office

    $144.06

    Facility

    $59.94

    $3.75 higher than Merced for the office setting.

  • Queens

    New York · 11042

    Office

    $154.00

    Facility

    $63.20

    $13.69 higher than Merced for the office setting.

  • Rest Of New York

    New York · 11042

    Office

    $126.54

    Facility

    $53.55

    $13.77 lower than Merced for the office setting.

  • Ohio

    Ohio · 11042

    Office

    $124.33

    Facility

    $54.19

    $15.98 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 11042

    Office

    $121.41

    Facility

    $52.81

    $18.90 lower than Merced for the office setting.

  • Portland

    Oregon · 11042

    Office

    $142.62

    Facility

    $57.27

    $2.31 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 11042

    Office

    $130.93

    Facility

    $54.42

    $9.38 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 11042

    Office

    $137.95

    Facility

    $57.97

    $2.36 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 11042

    Office

    $124.53

    Facility

    $54.01

    $15.78 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 11042

    Office

    $133.59

    Facility

    $55.92

    $6.72 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 11042

    Office

    $135.91

    Facility

    $56.55

    $4.40 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 11042

    Office

    $124.69

    Facility

    $53.71

    $15.62 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 11042

    Office

    $129.72

    Facility

    $52.90

    $10.59 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 11042

    Office

    $121.90

    Facility

    $52.07

    $18.41 lower than Merced for the office setting.

  • Austin

    Texas · 11042

    Office

    $137.71

    Facility

    $56.43

    $2.60 lower than Merced for the office setting.

  • Beaumont

    Texas · 11042

    Office

    $123.70

    Facility

    $53.79

    $16.61 lower than Merced for the office setting.

  • Brazoria

    Texas · 11042

    Office

    $131.05

    Facility

    $54.92

    $9.26 lower than Merced for the office setting.

  • Dallas

    Texas · 11042

    Office

    $131.90

    Facility

    $55.38

    $8.41 lower than Merced for the office setting.

  • Fort Worth

    Texas · 11042

    Office

    $131.00

    Facility

    $55.25

    $9.31 lower than Merced for the office setting.

  • Galveston

    Texas · 11042

    Office

    $131.45

    Facility

    $55.16

    $8.86 lower than Merced for the office setting.

  • Houston

    Texas · 11042

    Office

    $133.83

    Facility

    $57.54

    $6.48 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 11042

    Office

    $127.31

    Facility

    $54.40

    $13.00 lower than Merced for the office setting.

  • Utah

    Utah · 11042

    Office

    $126.43

    Facility

    $54.21

    $13.88 lower than Merced for the office setting.

  • Virginia

    Virginia · 11042

    Office

    $129.70

    Facility

    $54.18

    $10.61 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 11042

    Office

    $133.59

    Facility

    $55.92

    $6.72 lower than Merced for the office setting.

  • Vermont

    Vermont · 11042

    Office

    $129.50

    Facility

    $53.45

    $10.81 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 11042

    Office

    $137.05

    Facility

    $56.16

    $3.26 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 11042

    Office

    $155.13

    Facility

    $60.87

    $14.82 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 11042

    Office

    $125.58

    Facility

    $51.99

    $14.73 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 11042

    Office

    $121.96

    Facility

    $55.20

    $18.35 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 11042

    Office

    $131.47

    Facility

    $54.65

    $8.84 lower than Merced for the office setting.

See how rates vary across the country

11042 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 all state and territory rates as a table
State / territoryRate 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

Explore 11042 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 11042 in Merced, the physician’s office rate is $140.31 and the facility-setting rate is $56.12: a difference of $84.19.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 11042 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$154.34

$140.31 × 110% = $154.34

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11042 in Merced.

PPRRVU2026_Oct_nonQPP.csv

1,255

Code
11042
Physician work
0.98
Practice expense
2.86
Malpractice
0.13

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 11042 in Merced
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0170.9967
Practice expense2.86× 1.0963.1346
Malpractice0.13× 0.5360.0697
Total RVUs4.2009
Conversion factor× 33.4009

Office / nonfacility rate, Merced$140.31

Open 11042 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.981.017
Practice expense2.861.096
Malpractice0.130.536

(0.98 × 1.017 + 2.86 × 1.096 + 0.13 × 0.536) × $33.4009 = $140.31

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.981.017
Practice expense0.561.096
Malpractice0.130.536

(0.98 × 1.017 + 0.56 × 1.096 + 0.13 × 0.536) × $33.4009 = $56.12

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

11042 · Office / nonfacility

$140.31

Effective 2026-10-01

The base rate is $8.31 higher than on 2025-10-01, moving from $132.00 to $140.31 (6.3%).

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

    $132.00changed to$140.31

    • 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 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $132.00

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$140.31$56.12RVU26D
2026-07-01$140.31$56.12RVU26C
2026-04-01$140.31$56.12RVU26B
2026-01-01$140.31$56.12RVU26A
2025-10-01$132.00$59.52RVU25D
2025-07-01$132.00$59.52RVU25C
2025-04-01$132.00$59.52RVU25B
2025-01-01$132.00$59.52RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 11042PPRRVU2026_Oct_nonQPP.csv, line 1,255 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet