Code Reality Check
11042 reimbursement rate: Debridement of skin, first 20 sq cm
Debridement of skin, first 20 sq cm (CPT 11042) pays a median $270.78 in North Carolina and $58.88 in Ohio, against a Medicare anchor of $82.39. 51 of 51 states clear the publication floor.
spread 4.6x top to bottom
Medicare anchor $82.39
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| North Carolina | $270.78 | 3.29x | $88–$464 · P90 $464 | 125,010 | Benchmark |
| Wisconsin | $224.80 | 2.73x | $118–$457 · P90 $730 | 130,240 | Benchmark |
| South Dakota | $219.37 | 2.66x | $110–$338 · P90 $353 | 2,159 | Benchmark |
| Alaska | $215.72 | 2.62x | $85–$312 · P90 $464 | 1,592 | Benchmark |
| Oregon | $201.86 | 2.45x | $109–$333 · P90 $428 | 10,670 | Benchmark |
| Minnesota | $191.42 | 2.32x | $107–$330 · P90 $464 | 32,441 | Benchmark |
| Hawaii | $170.61 | 2.07x | $112–$171 · P90 $210 | 3,818 | Benchmark |
| Colorado | $165.46 | 2.01x | $94–$278 · P90 $464 | 23,687 | Benchmark |
| District of Columbia | $163.72 | 1.99x | $104–$250 · P90 $318 | 6,634 | Benchmark |
| Iowa | $162.34 | 1.97x | $95–$238 · P90 $327 | 8,829 | Benchmark |
| Massachusetts | $158.00 | 1.92x | $88–$272 · P90 $448 | 34,742 | Benchmark |
| Utah | $157.95 | 1.92x | $83–$283 · P90 $283 | 6,437 | Benchmark |
| Nebraska | $157.53 | 1.91x | $118–$296 · P90 $319 | 5,351 | Benchmark |
| Washington | $156.29 | 1.90x | $90–$284 · P90 $373 | 26,630 | Benchmark |
| New York | $156.25 | 1.90x | $90–$230 · P90 $421 | 522,639 | Benchmark |
| North Dakota | $155.41 | 1.89x | $101–$244 · P90 $293 | 1,849 | Benchmark |
| Connecticut | $153.54 | 1.86x | $102–$255 · P90 $449 | 17,023 | Benchmark |
| New Mexico | $141.36 | 1.72x | $84–$251 · P90 $279 | 5,149 | Benchmark |
| Vermont | $132.77 | 1.61x | $84–$189 · P90 $346 | 4,481 | Benchmark |
| New Jersey | $127.73 | 1.55x | $84–$219 · P90 $347 | 41,179 | Benchmark |
| Pennsylvania | $126.75 | 1.54x | $86–$222 · P90 $276 | 45,761 | Benchmark |
| Delaware | $123.67 | 1.50x | $86–$208 · P90 $354 | 3,377 | Benchmark |
| New Hampshire | $121.77 | 1.48x | $83–$202 · P90 $306 | 28,007 | Benchmark |
| Wyoming | $121.60 | 1.48x | $83–$207 · P90 $273 | 1,423 | Benchmark |
| Maryland | $119.76 | 1.45x | $76–$209 · P90 $258 | 22,250 | Benchmark |
| Montana | $119.53 | 1.45x | $94–$204 · P90 $308 | 2,965 | Benchmark |
| South Carolina | $118.59 | 1.44x | $83–$214 · P90 $327 | 20,896 | Benchmark |
| Maine | $117.49 | 1.43x | $67–$175 · P90 $295 | 32,321 | Benchmark |
| Texas | $116.85 | 1.42x | $75–$180 · P90 $254 | 82,251 | Benchmark |
| Illinois | $116.37 | 1.41x | $77–$199 · P90 $350 | 58,058 | Benchmark |
| Georgia | $115.78 | 1.41x | $78–$181 · P90 $269 | 285,420 | Benchmark |
| Nevada | $115.27 | 1.40x | $70–$180 · P90 $283 | 6,616 | Benchmark |
| Mississippi | $114.10 | 1.38x | $82–$144 · P90 $270 | 6,579 | Benchmark |
| California | $113.82 | 1.38x | $57–$335 · P90 $640 | 181,117 | Benchmark |
| Louisiana | $112.46 | 1.36x | $80–$162 · P90 $319 | 11,314 | Benchmark |
| Arizona | $111.15 | 1.35x | $69–$180 · P90 $295 | 18,341 | Benchmark |
| Oklahoma | $111.09 | 1.35x | $82–$187 · P90 $253 | 8,453 | Benchmark |
| Virginia | $111.03 | 1.35x | $81–$173 · P90 $258 | 91,230 | Benchmark |
| Tennessee | $110.66 | 1.34x | $77–$170 · P90 $261 | 29,488 | Benchmark |
| Idaho | $110.41 | 1.34x | $85–$186 · P90 $264 | 4,433 | Benchmark |
| Arkansas | $108.77 | 1.32x | $73–$160 · P90 $228 | 7,652 | Benchmark |
| Florida | $108.44 | 1.32x | $74–$180 · P90 $270 | 69,189 | Benchmark |
| Kansas | $107.34 | 1.30x | $66–$158 · P90 $225 | 9,121 | Benchmark |
| Michigan | $101.45 | 1.23x | $68–$155 · P90 $252 | 30,315 | Benchmark |
| Alabama | $95.85 | 1.16x | $66–$129 · P90 $207 | 13,030 | Benchmark |
| Rhode Island | $92.65 | 1.12x | $63–$152 · P90 $250 | 7,900 | Benchmark |
| Missouri | $92.08 | 1.12x | $62–$144 · P90 $309 | 165,671 | Benchmark |
| Indiana | $87.89 | 1.07x | $62–$124 · P90 $199 | 169,848 | Benchmark |
| West Virginia | $86.53 | 1.05x | $50–$114 · P90 $195 | 9,004 | Benchmark |
| Kentucky | $69.49 | 0.84x | $45–$107 · P90 $156 | 72,154 | Benchmark |
| Ohio | $58.88 | 0.71x | $37–$116 · P90 $257 | 312,795 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 11042. Reddenda. https://reddenda.health/code/11042/
Derivation federally mandated TiC MRFs, verified to provider identity2,817,539 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0