CPT
10060 — Incision and drainage of abscess, simple
If just one abscess and simple drainage, 10060 is the correct code.
Dermatology
11042 — Debridement, subcutaneous tissue; first 20 sq cm or less
This code covers the removal of dead, damaged, or infected tissue from a wound extending into the subcutaneous (fat) layer of skin, for areas up to 20 square centimeters.
- Typical setting: Dermatology clinic, hospital
- National avg charge (illustrative): $75-$160 Medicare allowed (approx. $80-$130 national Medicare average)
- Most-disputed reason: Depth misclassification: billing 11042 (subcutaneous tissue) when only the skin/epidermis was debrided — the correct code for skin-only debridement is 97597-97598
What it means
What 11042 actually means
This code covers the removal of dead, damaged, or infected tissue from a wound extending into the subcutaneous (fat) layer of skin, for areas up to 20 square centimeters. Debridement helps wounds heal by cleaning the wound bed. This code has a 10-day global period, so follow-up care within 10 days is included in the fee.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Depth misclassification: billing 11042 (subcutaneous tissue) when only the skin/epidermis was debrided — the correct code for skin-only debridement is 97597-97598
- Upcoding wound size: billing for more than 20 sq cm without measuring and documenting the wound surface area in the chart
- Unbundling with wound care E/M: separately billing an office visit E/M code on the same day as debridement without documenting a significant, separately identifiable service
If you see 11042 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 11042 often also see these adjacent codes on the same bill.
CPT
11102 — Skin biopsy, tangential (single lesion)
First biopsy at full price; additional biopsies use add-on codes (11103).
CPT
11104 — Punch biopsy of skin; single lesion
Verify the code matches the actual service and dose.
CPT
11106 — Incisional biopsy of skin; single lesion
Verify the code matches the actual service and dose.
CPT
11400 — Excision benign lesion, except skin tag, trunk/arms/legs; 0.5 cm or less
Verify the code matches the actual service and dose.
CPT
11600 — Excision malignant lesion, trunk/arms/legs; 0.5 cm or less excised diameter
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 11042 on a bill.
11042 FAQ
Plain-English answers.
What does 11042 usually cost?
$75-$160 Medicare allowed (approx. $80-$130 national Medicare average). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 11042?
Depth misclassification: billing 11042 (subcutaneous tissue) when only the skin/epidermis was debrided — the correct code for skin-only debridement is 97597-97598
What should I do if I see 11042 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 11042 before paying.
Don't pay 11042 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.