CPT code 11721: Nail debridement, six or more nails2026 Medicare rate & RVUs in Santa Clara County, CA

Reduction of thickness and bulk of six or more diseased nails, typically mycotic toenails, reported once per session regardless of how many nails beyond five.

CMS RVU26DEffective Oct 1, 2026One payment locality5.4M Medicare services in 2024

In Santa Clara County, CA, Medicare pays $57.40 for 11721 in the office and $23.20 when it’s performed in a hospital or facility.

$57.40Office (non-facility)
$23.20Hospital or facility
+27.3%vs the national office rate ($45.09)

Check a contract rate as a % of Medicare · 11721 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 11721 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Santa Clara County, CA
  2. What 11721 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 11721 covers

This service involves reducing thickened, dystrophic, or fungal nails by manual or mechanical methods, such as nippers, curettes, or an electric burr, until the nail plates are thinner and more comfortable. Podiatrists commonly perform it in the office, nursing facility, or home for patients whose thickened toenails cause pain or interfere with walking. Unlike trimming, debridement removes nail thickness or bulk rather than simply shortening or shaping the nails.

Report one unit when six or more nails are debrided in a session; use the one-to-five-nail code when fewer are treated. Document the nails treated, their condition, symptoms, and findings supporting medical necessity. Medicare generally excludes routine foot care unless coverage criteria are met. For coverage based on a qualifying systemic condition, document the required findings, use Q7, Q8, or Q9 when the applicable class findings support one, and identify the managing physician when required. The 0-day global includes same-day preoperative and postoperative care; a separately reported E/M requires a significant, separately identifiable service and modifier 25. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery under the statutory restriction, and co-surgeons and team surgery 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 Santa Clara County, CA compares for 11721

Across 109 of 109 payment localities, the office rate for 11721 runs from $40.65 in Arkansas to $57.63 in San Benito County, CA. Santa Clara County, CA pays $57.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

11721 in Santa Clara County, CA vs other payment areas
  1. Santa Clara County, CA · this page$57.40
  2. Bakersfield, CA · California$47.24−$10.16
  3. Chico, CA · California$47.09−$10.31
  4. El Centro, CA · California$47.09−$10.31
  5. Fresno, CA · California$47.09−$10.31
  6. Hanford, CA · California$47.09−$10.31
  7. Los Angeles, CA · California$49.96−$7.44

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

Every other payment area

11721 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$47.09$21.10
Merced, CACalifornia$47.09$21.10
Modesto, CACalifornia$47.09$21.10
Napa, CACalifornia$53.56$22.31
Oxnard, CACalifornia$49.64$21.61
Redding, CACalifornia$47.09$21.10
Rest of CaliforniaCalifornia$47.09$21.10
Riverside, CACalifornia$47.63$21.64

11721 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.

$40.65

$54.86

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

View every state and territory as a table
11721 office rate range by state
State / territoryOffice rate rangeLocalities
AK$54.861
AL$41.151
AR$40.651
AZ$44.051
CA$47.09–$57.6329
CO$46.581
CT$47.781
DC$50.811
DE$44.701
FL$44.80–$48.703
GA$42.63–$45.892
GU$47.911
HI$47.911
IA$41.901
ID$42.151
IL$43.79–$47.514
IN$42.361
KS$41.791
KY$42.091
LA$42.06–$43.802
MA$46.40–$50.622
MD$45.44–$50.813
ME$42.40–$44.242
MI$43.07–$45.342
MN$44.661
MO$41.50–$43.863
MS$41.081
MT$45.091
NC$42.771
ND$44.101
NE$42.071
NH$45.941
NJ$48.33–$50.442
NM$43.291
NV$44.841
NY$43.31–$52.525
OH$42.871
OK$41.971
OR$44.49–$47.802
PA$42.89–$46.792
PR$45.351
RI$46.101
SC$42.891
SD$43.981
TN$41.981
TX$42.66–$46.438
UT$43.381
VA$44.16–$50.812
VI$45.351
VT$44.011
WA$46.29–$51.512
WI$42.861
WV$42.441
WY$44.661

See 11721 in every payment locality

How the 11721 rate is calculated

Each of 11721’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 · 11721

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.53

0.53 RVUs× 1.000 GPCI

Practice expense0.77

0.77 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

1.3500

Conversion factor

$33.4009

Medicare rate

$45.09

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

The exact Santa Clara County, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,362

Code
11721
Physician work
0.53
Practice expense
0.77
Malpractice
0.05

GPCI2026.csv

28

Locality
Santa Clara County, CA
Physician work
1.110
Practice expense
1.442
Malpractice
0.397
Office calculation for 11721 in Santa Clara County, CA
ComponentRVULocality factorAdjusted
Physician work0.53× 1.1100.5883
Practice expense0.77× 1.4421.1103
Malpractice0.05× 0.3970.0199
Total RVUs1.7185
Conversion factor× 33.4009

Office rate, Santa Clara County, CA$57.40

Office: (0.53 × 1.11 + 0.77 × 1.442 + 0.05 × 0.397) × $33.4009 = $57.40

Facility: (0.53 × 1.11 + 0.06 × 1.442 + 0.05 × 0.397) × $33.4009 = $23.20

Open 11721 in the RVU calculator

Payment rules and modifiers for 11721

The CMS indicators that decide how 11721 is paid alongside other services.

CMS payment indicators · 11721

Nail debridement, six or more 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 11721 has changed in Santa Clara County, CA

11721 · Office / nonfacility

$57.40

Effective 2026-10-01

The base rate is $1.90 higher than on 2025-10-01, moving from $55.50 to $57.40 (3.4%).

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

    $55.50changed to$57.40

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.54 changed to 0.53
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.100 changed to 1.110
    • Practice expense GPCI 1.435 changed to 1.442
    • Malpractice GPCI 0.420 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $56.64changed to$55.50

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.76 changed to 0.77

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $55.71changed to$56.64

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $55.99changed to$55.71

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.74 changed to 0.76
    • Work GPCI 1.098 changed to 1.100
    • Practice expense GPCI 1.409 changed to 1.435
    • Malpractice GPCI 0.417 changed to 0.420
  5. January 1, 2023

    RVU23A

    $55.51changed to$55.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.72 changed to 0.74
    • Work GPCI 1.096 changed to 1.098
    • Practice expense GPCI 1.383 changed to 1.409
    • Malpractice GPCI 0.414 changed to 0.417

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $55.97changed to$55.51

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $56.53changed to$55.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.70 changed to 0.72
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.089 changed to 1.096
    • Practice expense GPCI 1.369 changed to 1.383
    • Malpractice GPCI 0.401 changed to 0.414

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $56.28changed to$56.53

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.71 changed to 0.70
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.083 changed to 1.089
    • Practice expense GPCI 1.354 changed to 1.369
    • Malpractice GPCI 0.388 changed to 0.401

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $56.22changed to$56.28

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $55.08changed to$56.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.69 changed to 0.71
    • Work GPCI 1.086 changed to 1.083
    • Practice expense GPCI 1.351 changed to 1.354
    • Malpractice GPCI 0.402 changed to 0.388

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $54.91changed to$55.08

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.088 changed to 1.086
    • Practice expense GPCI 1.347 changed to 1.351
    • Malpractice GPCI 0.416 changed to 0.402

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $54.96changed to$54.91

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.03 changed to 0.04

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $54.68changed to$54.96

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $54.31changed to$54.68

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.68 changed to 0.69
    • Malpractice RVU 0.04 changed to 0.03
    • Work GPCI 1.083 changed to 1.088
    • Practice expense GPCI 1.342 changed to 1.347
    • Malpractice GPCI 0.466 changed to 0.416

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $54.15changed to$54.31

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.74 changed to 0.68
    • Work GPCI 1.077 changed to 1.083
    • Practice expense GPCI 1.337 changed to 1.342
    • Malpractice GPCI 0.516 changed to 0.466

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$54.15

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$57.40$23.20RVU26D
2026-07-01$57.40$23.20RVU26C
2026-04-01$57.40$23.20RVU26B
2026-01-01$57.40$23.20RVU26A
2025-10-01$55.50$25.79RVU25D
2025-07-01$55.50$25.79RVU25C
2025-04-01$55.50$25.79RVU25B
2025-01-01$55.50$25.79RVU25A
2024-10-01$56.64$26.06RVU24D
2024-07-01$56.64$26.06RVU24C
2024-04-01$56.64$26.06RVU24B
2024-03-09$56.64$26.06RVU24AR
2024-01-01$55.71$25.64RVU24A
2023-10-01$55.99$26.39RVU23D
2023-07-01$55.99$26.39RVU23C
2023-04-01$55.99$26.39RVU23B
2023-01-01$55.99$26.39RVU23A
2022-10-01$55.51$26.80RVU22D
2022-07-01$55.51$26.80RVU22C
2022-04-01$55.51$26.80RVU22B
2022-01-01$55.51$26.80RVU22A
2021-10-01$55.97$27.02RVU21D
2021-07-01$55.97$27.02RVU21C
2021-04-01$55.97$27.02RVU21B
2021-01-01$55.97$27.02RVU21A
2020-10-01$56.53$28.37RVU20D
2020-07-01$56.53$28.37RVU20C
2020-04-01$56.53$28.37RVU20B
2020-01-01$56.53$28.37RVU20A
2019-10-01$56.28$27.98RVU19D
2019-07-01$56.28$27.98RVU19C
2019-04-01$56.28$27.98RVU19B
2019-01-01$56.28$27.98RVU19A
2018-10-01$56.22$27.95RVU18D
2018-07-01$56.22$27.95RVU18C
2018-04-01$56.22$27.95RVU18B
2018-01-01$56.22$27.95RVU18AR1
2017-10-01$55.08$27.93RVU17D
2017-07-01$55.08$27.93RVU17C
2017-04-01$55.08$27.93RVU17B
2017-01-01$55.08$27.93RVU17A
2016-10-01$54.91$27.90RVU16D
2016-07-01$54.91$27.90RVU16C
2016-04-01$54.91$27.90RVU16B
2016-01-01$54.91$27.90RVU16A
2015-10-01$54.96$27.85RVU15D
2015-07-01$54.96$27.85RVU15C
2015-04-01$54.68$27.71RVU15B
2015-01-01$54.68$27.71RVU15A
2014-10-01$54.31$27.87RVU14D
2014-07-01$54.31$27.87RVU14C
2014-04-01$54.31$27.87RVU14B
2014-01-01$54.31$27.87RVU14A
2013-10-01$54.15$26.86RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11721 for an earlier date of service

Where the Santa Clara County, CA rate applies

Santa Clara County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • San Jose
  • Santa Clara
  • Sunnyvale
  • Alum Rock
  • Burbank
  • Cambrian Park
  • Campbell
  • Cupertino

Browse all communities in California

11721 billing questions

How many units are reported when all ten toenails are debrided?

One unit. The code covers six or more nails, so treating seven or ten nails still counts as a single service.

When should the one-to-five-nail code be used instead?

Use 11720 when one to five nails are debrided in the session. Count only nails actually reduced in thickness or bulk, not nails that were merely trimmed.

Can nail debridement be billed with paring of corns or calluses on the same date?

Yes, 11055–11057 may be reported for separately medically necessary hyperkeratotic lesions when the distinct work is documented. An applicable NCCI edit may require a modifier.

What modifiers may be needed for this code or a same-day visit?

When coverage is based on qualifying systemic disease and class findings, report the supported Q7, Q8, or Q9 modifier as required. Append modifier 25 to a same-day E/M only when it is significant and separately identifiable from the nail debridement.

Can modifier 50 be appended when nails on both feet are treated?

No. The count of nails already captures the work across both feet, so bilateral reporting is inappropriate.

What documentation supports medical necessity?

Record the specific nails treated, mycotic or dystrophic findings, relevant symptoms such as pain or walking difficulty, and any qualifying systemic condition and managing physician information when required.

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 11721PPRRVU2026_Oct_nonQPP.csv, line 1,362 (RVU26D)
Geographic factors for Santa Clara County, CAGPCI2026.csv, line 28 (RVU26D)

Open CMS sourceHow we calculate rates

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