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#328 of 11K

11042

Debridement, subcutaneous tissue, first 20 sq cm

Debridement, subcutaneous tissue, first 20 sq cm is the #328 most-billed Medicaid procedure code, with $416.3M in payments across 5.9M claims from 2018–2024. The national median cost per claim is $36.13. Costs vary widely — the 90th percentile is $159.57 per claim, 4.4× the median.

Total Paid

$416.3M

0.04% of all spending

Total Claims

5.9M

Providers

4K

Avg Cost/Claim

$71

National Cost Distribution

How much do providers bill per claim for 11042? Based on 4K providers billing this code nationally.

Median

$36.13

Average

$71.48

Std Dev

$103.03

Max

$1,128.11

Percentile Distribution (Cost per Claim)

p10
$10.16
p25
$18.66
Median
$36.13
p75
$85.14
p90
$159.57
p95
$230.52
p99
$551.64

50% of providers bill between $18.66 and $85.14 per claim for this code.

90% bill between $10.16 and $159.57.

Top 1% bill above $551.64.

About This Procedure

HCPCS code 11042 (Debridement, subcutaneous tissue, first 20 sq cm) was billed by 4K providers across 5.9M claims, totaling $416.3M in Medicaid payments from 2018–2024. This code was used for 2.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$36.13

Providers Billing

4K

National Spending

$416.3M

Avg/Median Ratio

1.98×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 11042

#ProviderTotal Paid
1Community Health Network, Inc

Indianapolis, IN · General Acute Care Hospital

$7.5M
21619975331$6.6M
3Yuma Regional Medical Center

Yuma, AZ · General Acute Care Hospital

$5.3M
41225195340$5.0M
51063457380$4.7M
61467504555$4.0M
71326046467$3.8M
8Ahs Hospital Corp.

Summit, NJ · General Acute Care Hospital

$3.7M
91326043548$3.2M
101215151154$2.8M
11The Queens Medical Center

Honolulu, HI · Psychiatric Unit

$2.7M
121104998624$2.6M
13Samaritan Hospital Of Troy, New York

Troy, NY

$2.6M
141053361642$2.6M
151568413573$2.5M
161083883938$2.5M
17Southcoast Hospitals Group, Inc

New Bedford, MA · General Acute Care Hospital

$2.5M
181952309098$2.4M
19The Hospital Of Central Connecticut At New Britain General And Bradley

New Britain, CT · General Acute Care Hospital

$2.4M
20Saint Mary's Hospital, Inc.

Waterbury, CT · General Acute Care Hospital

$2.3M

Showing top 20 of 4K providers billing this code