CPT 11042 Surgery - Integumentary

How Much Does Wound Debridement (Skin and Tissue) Cost?

Also known as: Dbrdmt subq tis 1st 20sqcm/< (CPT 11042)

A procedure to clean a wound by removing dead, damaged, or infected tissue to promote healing.

Wound Debridement (Skin and Tissue) (CPT 11042) costs $56 at Medicare rates. Hospital outpatient rate: $415.

Cost Comparison by Payer

How much Dbrdmt subq tis 1st 20sqcm/< costs across different settings and payers

Medicare
Facility rate
$56
Hospital Outpatient
OPPS rate
$415
Surgery Center
ASC rate
$223
Medicare (Facility)
$56
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$133
Non-facility setting
Hospital Outpatient
$415
OPPS rate
Surgery Center (ASC)
$223
Ambulatory surgery center

Patient Guide: Wound Debridement (Skin and Tissue)

What you need to know before your appointment

What to Expect

The doctor removes unhealthy tissue from the wound using surgical tools. Local anesthesia is used to numb the area.

How Long Does It Take?

15-45 minutes

Common Reasons Doctors Order This

Chronic wound, diabetic ulcer, pressure sore, infected wound, burn wound care

How to Prepare

Take pain medication before if approved. The area will be numbed. Plan for follow-up wound care visits.

Procedures Commonly Done Together

These procedures are frequently performed alongside Dbrdmt subq tis 1st 20sqcm/<

Loading related procedures...

How to Reduce Your Cost for Dbrdmt subq tis 1st 20sqcm/<

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($133) differs from the facility rate ($56). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $223, compared to $415 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

0.98
Work RVU
0.56
Practice Expense RVU
0.13
Malpractice RVU
3.97
Total RVU

Payment = Total RVU (3.97) x CF ($33.40) = $133

Frequently Asked Questions

How much does Dbrdmt subq tis 1st 20sqcm/< cost?

The Medicare facility rate for Dbrdmt subq tis 1st 20sqcm/< is $56. In a hospital outpatient setting, the rate is $415. At an ambulatory surgery center, the rate is $223. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Dbrdmt subq tis 1st 20sqcm/< cost without insurance?

Without insurance, the cost of Dbrdmt subq tis 1st 20sqcm/< can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Dbrdmt subq tis 1st 20sqcm/<?

Most commercial health insurance plans and Medicare cover Dbrdmt subq tis 1st 20sqcm/< when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

Share This Cost Information

My Cost List

0 procedures

No procedures added yet

Click "Add to My List" on any procedure to start building your estimate.