CPT code 11720: Nail debridement, one to five nails2026 Medicare rate & RVUs in Rhode Island

Debridement of one to five dystrophic or mycotic fingernails or toenails, by any method, reported once per session, most often by podiatrists for onychomycosis.

CMS RVU26DEffective Oct 1, 2026One payment locality1.8M Medicare services in 2024

In Rhode Island, Medicare pays $33.53 for 11720 in the office and $12.82 when it’s performed in a hospital or facility.

$33.53Office (non-facility)
$12.82Hospital or facility
+2.4%vs the national office rate ($32.73)

Check a contract rate as a % of Medicare · 11720 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11720 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Rhode Island
  2. What 11720 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 11720 covers

This service reduces the thickness and bulk of diseased nails, often thick, discolored, crumbly nails affected by onychomycosis or other dystrophy. A clinician uses nippers, curettes, or a burr to remove thickened nail plate and subungual debris; debriding painful toenails may relieve pressure from footwear. Podiatrists commonly perform the service in offices, nursing facilities, and patients’ homes. Patients may have diabetes, peripheral vascular disease, or neuropathy that makes self-care difficult.

Count all fingernails and toenails debrided during the session. Report one unit of 11720 for one to five nails; use 11721 instead for six or more. Document each treated nail, its condition, and the reason debridement was needed. For Medicare coverage, document applicable findings, such as pain or secondary infection associated with mycotic nails, or qualifying systemic disease and class findings when required. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team surgery arrangements are not permitted.

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.

How Rhode Island compares for 11720

Across 109 of 109 payment localities, the office rate for 11720 runs from $29.23 in Arkansas to $42.86 in San Benito County, CA. Rhode Island pays $33.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

11720 in Rhode Island vs other payment areas
  1. Rhode Island · this page$33.53
  2. Los Angeles, CA · California$36.73+$3.20
  3. Washington, DC area · District of Columbia$37.21+$3.68
  4. Miami, FL · Florida$35.14+$1.61
  5. Chicago, IL · Illinois$34.21+$0.68
  6. Manhattan, NY · New York$37.45+$3.92
  7. Alaska · Alaska$38.85+$5.32

Other areas in Rhode Island first, then benchmark localities. Bars start at $0.

Every other payment area

11720 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$29.63$12.09
ArkansasArkansas$29.23$12.02
ArizonaArizona$31.93$12.51
Bakersfield, CACalifornia$34.59$12.63
Chico, CACalifornia$34.50$12.53
El Centro, CACalifornia$34.50$12.54
Fresno, CACalifornia$34.50$12.53
Hanford, CACalifornia$34.50$12.53

11720 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

$29.23

$38.85

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11720 office rate range by state
State / territoryOffice rate rangeLocalities
AK$38.851
AL$29.631
AR$29.231
AZ$31.931
CA$34.50–$42.8629
CO$34.011
CT$34.801
DC$37.211
DE$32.431
FL$32.30–$35.143
GA$30.62–$33.312
GU$35.241
HI$35.241
IA$30.311
ID$30.491
IL$31.44–$34.214
IN$30.661
KS$30.181
KY$30.271
LA$30.23–$31.612
MA$33.83–$37.192
MD$33.01–$37.213
ME$30.64–$32.172
MI$31.00–$32.672
MN$32.651
MO$29.76–$31.713
MS$29.501
MT$32.731
NC$30.941
ND$32.141
NE$30.461
NH$33.481
NJ$35.21–$36.872
NM$31.161
NV$32.591
NY$31.37–$38.295
OH$30.881
OK$30.221
OR$32.35–$35.012
PA$30.92–$33.992
PR$32.951
RI$33.531
SC$30.961
SD$32.071
TN$30.321
TX$30.74–$33.888
UT$31.351
VA$32.07–$37.212
VI$32.951
VT$32.021
WA$33.76–$37.922
WI$31.141
WV$30.361
WY$32.471

See 11720 in every payment locality

How the 11720 rate is calculated

Each of 11720’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 11720

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.31

0.31 RVUs× 1.000 GPCI

Practice expense0.64

0.64 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

0.9800

Conversion factor

$33.4009

Medicare rate

$32.73

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Rhode Island inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,361

Code
11720
Physician work
0.31
Practice expense
0.64
Malpractice
0.03

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for 11720 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work0.31× 1.0190.3159
Practice expense0.64× 1.0330.6611
Malpractice0.03× 0.8920.0268
Total RVUs1.0038
Conversion factor× 33.4009

Office rate, Rhode Island$33.53

Office: (0.31 × 1.019 + 0.64 × 1.033 + 0.03 × 0.892) × $33.4009 = $33.53

Facility: (0.31 × 1.019 + 0.04 × 1.033 + 0.03 × 0.892) × $33.4009 = $12.82

Open 11720 in the RVU calculator

Payment rules and modifiers for 11720

The CMS indicators that decide how 11720 is paid alongside other services.

CMS payment indicators · 11720

Nail debridement, one to five nails

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 11720 has changed in Rhode Island

11720 · Office / nonfacility

$33.53

Effective 2026-10-01

The base rate is $0.59 higher than on 2025-10-01, moving from $32.94 to $33.53 (1.8%).

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

    $32.94changed to$33.53

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.32 changed to 0.31
    • Work GPCI 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $33.90changed to$32.94

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $33.35changed to$33.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $34.27changed to$33.35

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.62 changed to 0.64
    • Malpractice RVU 0.04 changed to 0.03
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849
  5. January 1, 2023

    RVU23A

    $34.42changed to$34.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.60 changed to 0.62
    • Work GPCI 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $35.08changed to$34.42

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.61 changed to 0.60

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $34.86changed to$35.08

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.58 changed to 0.61
    • Malpractice RVU 0.03 changed to 0.04
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $35.27changed to$34.86

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.60 changed to 0.58
    • Malpractice RVU 0.02 changed to 0.03
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.050 changed to 1.049
    • Malpractice GPCI 0.999 changed to 0.990

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $35.23changed to$35.27

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $33.92changed to$35.23

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.57 changed to 0.60
    • Work GPCI 1.025 changed to 1.027
    • Practice expense GPCI 1.052 changed to 1.050
    • Malpractice GPCI 0.879 changed to 0.999

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $33.74changed to$33.92

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.022 changed to 1.025
    • Practice expense GPCI 1.053 changed to 1.052
    • Malpractice GPCI 0.759 changed to 0.879

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $33.86changed to$33.74

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $33.70changed to$33.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $33.86changed to$33.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.56 changed to 0.57
    • Malpractice RVU 0.03 changed to 0.02
    • Work GPCI 1.020 changed to 1.022
    • Malpractice GPCI 0.973 changed to 0.759

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$33.86

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$33.53$12.82RVU26D
2026-07-01$33.53$12.82RVU26C
2026-04-01$33.53$12.82RVU26B
2026-01-01$33.53$12.82RVU26A
2025-10-01$32.94$14.12RVU25D
2025-07-01$32.94$14.12RVU25C
2025-04-01$32.94$14.12RVU25B
2025-01-01$32.94$14.12RVU25A
2024-10-01$33.90$14.19RVU24D
2024-07-01$33.90$14.19RVU24C
2024-04-01$33.90$14.19RVU24B
2024-03-09$33.90$14.19RVU24AR
2024-01-01$33.35$13.96RVU24A
2023-10-01$34.27$14.81RVU23D
2023-07-01$34.27$14.81RVU23C
2023-04-01$34.27$14.81RVU23B
2023-01-01$34.27$14.81RVU23A
2022-10-01$34.42$15.20RVU22D
2022-07-01$34.42$15.20RVU22C
2022-04-01$34.42$15.20RVU22B
2022-01-01$34.42$15.20RVU22A
2021-10-01$35.08$15.33RVU21D
2021-07-01$35.08$15.33RVU21C
2021-04-01$35.08$15.33RVU21B
2021-01-01$35.08$15.33RVU21A
2020-10-01$34.86$15.55RVU20D
2020-07-01$34.86$15.55RVU20C
2020-04-01$34.86$15.55RVU20B
2020-01-01$34.86$15.55RVU20A
2019-10-01$35.27$15.59RVU19D
2019-07-01$35.27$15.59RVU19C
2019-04-01$35.27$15.59RVU19B
2019-01-01$35.27$15.59RVU19A
2018-10-01$35.23$15.57RVU18D
2018-07-01$35.23$15.57RVU18C
2018-04-01$35.23$15.57RVU18B
2018-01-01$35.23$15.57RVU18AR1
2017-10-01$33.92$15.42RVU17D
2017-07-01$33.92$15.42RVU17C
2017-04-01$33.92$15.42RVU17B
2017-01-01$33.92$15.42RVU17A
2016-10-01$33.74$15.27RVU16D
2016-07-01$33.74$15.27RVU16C
2016-04-01$33.74$15.27RVU16B
2016-01-01$33.74$15.27RVU16A
2015-10-01$33.86$15.32RVU15D
2015-07-01$33.86$15.32RVU15C
2015-04-01$33.70$15.25RVU15B
2015-01-01$33.70$15.25RVU15A
2014-10-01$33.86$15.76RVU14D
2014-07-01$33.86$15.76RVU14C
2014-04-01$33.86$15.76RVU14B
2014-01-01$33.86$15.76RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11720 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

11720 billing questions

How are units reported when nails on both feet are debrided?

Add up all nails treated at the session, including any fingernails, and report one unit. Use 11720 for one to five nails or 11721 alone for six or more. Do not append modifier 50.

Can 11720 be billed with 11721 on the same date?

No. Choose the code by the total number of nails debrided during the session, and report one code with one unit.

What is the difference between nail debridement and nail trimming?

Debridement reduces the thickness and bulk of a diseased nail plate; trimming only shortens the nail. Use 11719 for trimming nondystrophic nails or G0127 for trimming dystrophic nails rather than reporting trimming alone as debridement.

Which modifiers might a Medicare claim for 11720 need?

When coverage relies on class findings under the routine foot care exception, report the applicable Q7, Q8, or Q9 modifier as supported by the record. Modifier 50 is inappropriate; append modifier 25 to a separately reported, significant E/M service, not to 11720.

Is a same-day office visit separately payable?

The routine evaluation associated with debridement is included in the 0-day global period. A significant, separately identifiable E/M service beyond that routine care may be reported with modifier 25, even if it concerns the same condition.

Can callus paring be billed at the same visit?

Paring corns or calluses under 11055 through 11057 may be separately reported when it is performed in addition to nail debridement. Document the treated sites and medical necessity for each service, subject to applicable coverage and coding requirements.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 11720PPRRVU2026_Oct_nonQPP.csv, line 1,361 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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