CPT code 11721: Nail debridement, six or more nails2026 Medicare rate & RVUs in East St. Louis, IL
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.
In East St. Louis, IL, Medicare pays $44.73 for 11721 in the office and $22.91 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 East St. Louis, IL 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. East St. Louis, IL pays $44.73. The RVUs are the same everywhere; the geographic indexes change the dollars.
- East St. Louis, IL · this page$44.73
- Chicago, IL · Illinois$47.51+$2.78
- Rest of Illinois · Illinois$43.79−$0.94
- Suburban Chicago, IL · Illinois$47.20+$2.47
- Los Angeles, CA · California$49.96+$5.23
- Washington, DC area · District of Columbia$50.81+$6.08
- Miami, FL · Florida$48.70+$3.97
Other areas in Illinois first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NYNew York | $51.37 | $23.81 |
| AlaskaAlaska | $54.86 | $29.61 |
| AlabamaAlabama | $41.15 | $20.40 |
| ArkansasArkansas | $40.65 | $20.28 |
| ArizonaArizona | $44.05 | $21.07 |
| Bakersfield, CACalifornia | $47.24 | $21.25 |
| Chico, CACalifornia | $47.09 | $21.10 |
| El Centro, CACalifornia | $47.09 | $21.10 |
| Fresno, CACalifornia | $47.09 | $21.10 |
| Hanford, CACalifornia | $47.09 | $21.10 |
| 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 |
| Sacramento, CACalifornia | $49.15 | $21.57 |
| Salinas, CACalifornia | $48.95 | $21.47 |
| San Diego, CACalifornia | $49.90 | $21.54 |
| Marin County, CACalifornia | $56.41 | $22.98 |
| San Francisco, CACalifornia | $56.36 | $22.92 |
| San Benito County, CACalifornia | $57.63 | $23.43 |
| Santa Clara County, CACalifornia | $57.40 | $23.20 |
| San Luis Obispo, CACalifornia | $48.19 | $21.18 |
| Santa Cruz, CACalifornia | $50.22 | $21.40 |
| Santa Maria, CACalifornia | $49.08 | $21.43 |
| Santa Rosa, CACalifornia | $50.71 | $21.59 |
| Stockton, CACalifornia | $47.09 | $21.10 |
| Vallejo, CACalifornia | $53.48 | $22.23 |
| Visalia, CACalifornia | $47.09 | $21.10 |
| Yuba City, CACalifornia | $47.09 | $21.10 |
| ColoradoColorado | $46.58 | $21.35 |
| ConnecticutConnecticut | $47.78 | $22.24 |
| DelawareDelaware | $44.70 | $21.27 |
| Fort Lauderdale, FLFlorida | $46.77 | $22.75 |
| Rest of FloridaFlorida | $44.80 | $22.13 |
| Atlanta, GAGeorgia | $45.89 | $21.80 |
| Rest of GeorgiaGeorgia | $42.63 | $21.48 |
| Hawaii, Guam, HIHawaii | $47.91 | $20.95 |
| IowaIowa | $41.90 | $20.20 |
| IdahoIdaho | $42.15 | $20.34 |
| IndianaIndiana | $42.36 | $20.37 |
| KansasKansas | $41.79 | $20.36 |
| KentuckyKentucky | $42.09 | $21.01 |
| New Orleans, LALouisiana | $43.80 | $21.49 |
| Rest of LouisianaLouisiana | $42.06 | $21.08 |
| Metropolitan Boston, MAMassachusetts | $50.62 | $22.31 |
| Rest of MassachusettsMassachusetts | $46.40 | $21.43 |
| Baltimore area, MDMaryland | $47.65 | $22.20 |
| Rest of MarylandMaryland | $45.44 | $21.44 |
| Rest of MaineMaine | $42.40 | $20.58 |
| Southern Maine, MEMaine | $44.24 | $20.74 |
| Detroit, MIMichigan | $45.34 | $22.45 |
| Rest of MichiganMichigan | $43.07 | $21.42 |
| MinnesotaMinnesota | $44.66 | $20.26 |
| Metropolitan Kansas City, MOMissouri | $43.48 | $21.22 |
| Metropolitan St. Louis, MOMissouri | $43.86 | $21.28 |
| Rest of MissouriMissouri | $41.50 | $21.06 |
| MississippiMississippi | $41.08 | $20.66 |
| MontanaMontana | $45.09 | $21.37 |
| North CarolinaNorth Carolina | $42.77 | $20.64 |
| North DakotaNorth Dakota | $44.10 | $20.38 |
| NebraskaNebraska | $42.07 | $20.18 |
| New HampshireNew Hampshire | $45.94 | $21.25 |
| Northern New JerseyNew Jersey | $50.44 | $22.93 |
| Rest of New JerseyNew Jersey | $48.33 | $22.43 |
| New MexicoNew Mexico | $43.29 | $21.55 |
| NevadaNevada | $44.84 | $21.10 |
| NYC suburbs and Long Island, NYNew York | $52.52 | $24.32 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $48.68 | $22.71 |
| Queens, NYNew York | $51.64 | $23.61 |
| Rest of New YorkNew York | $43.31 | $20.78 |
| OhioOhio | $42.87 | $21.22 |
| OklahomaOklahoma | $41.97 | $20.79 |
| Portland, OROregon | $47.80 | $21.45 |
| Rest of OregonOregon | $44.49 | $20.87 |
| Metropolitan Philadelphia, PAPennsylvania | $46.79 | $22.10 |
| Rest of PennsylvaniaPennsylvania | $42.89 | $21.12 |
| Puerto RicoPuerto Rico | $45.35 | $21.37 |
| Rhode IslandRhode Island | $46.10 | $21.60 |
| South CarolinaSouth Carolina | $42.89 | $20.97 |
| South DakotaSouth Dakota | $43.98 | $20.27 |
| TennesseeTennessee | $41.98 | $20.42 |
| Austin, TXTexas | $46.43 | $21.34 |
| Beaumont, TXTexas | $42.66 | $21.08 |
| Brazoria, TXTexas | $44.63 | $21.13 |
| Dallas, TXTexas | $44.91 | $21.29 |
| Fort Worth, TXTexas | $44.68 | $21.29 |
| Galveston, TXTexas | $44.77 | $21.22 |
| Houston, TXTexas | $45.68 | $22.13 |
| Rest of TexasTexas | $43.62 | $21.11 |
| UtahUtah | $43.38 | $21.09 |
| VirginiaVirginia | $44.16 | $20.85 |
| Virgin Islands, VIUnited States Virgin Islands | $45.35 | $21.37 |
| VermontVermont | $44.01 | $20.53 |
| Rest of WashingtonWashington | $46.29 | $21.31 |
| King County, WAWashington | $51.51 | $22.41 |
| WisconsinWisconsin | $42.86 | $20.14 |
| West VirginiaWest Virginia | $42.44 | $21.83 |
| WyomingWyoming | $44.66 | $20.94 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $54.86 | 1 |
| AL | $41.15 | 1 |
| AR | $40.65 | 1 |
| AZ | $44.05 | 1 |
| CA | $47.09–$57.63 | 29 |
| CO | $46.58 | 1 |
| CT | $47.78 | 1 |
| DC | $50.81 | 1 |
| DE | $44.70 | 1 |
| FL | $44.80–$48.70 | 3 |
| GA | $42.63–$45.89 | 2 |
| GU | $47.91 | 1 |
| HI | $47.91 | 1 |
| IA | $41.90 | 1 |
| ID | $42.15 | 1 |
| IL | $43.79–$47.51 | 4 |
| IN | $42.36 | 1 |
| KS | $41.79 | 1 |
| KY | $42.09 | 1 |
| LA | $42.06–$43.80 | 2 |
| MA | $46.40–$50.62 | 2 |
| MD | $45.44–$50.81 | 3 |
| ME | $42.40–$44.24 | 2 |
| MI | $43.07–$45.34 | 2 |
| MN | $44.66 | 1 |
| MO | $41.50–$43.86 | 3 |
| MS | $41.08 | 1 |
| MT | $45.09 | 1 |
| NC | $42.77 | 1 |
| ND | $44.10 | 1 |
| NE | $42.07 | 1 |
| NH | $45.94 | 1 |
| NJ | $48.33–$50.44 | 2 |
| NM | $43.29 | 1 |
| NV | $44.84 | 1 |
| NY | $43.31–$52.52 | 5 |
| OH | $42.87 | 1 |
| OK | $41.97 | 1 |
| OR | $44.49–$47.80 | 2 |
| PA | $42.89–$46.79 | 2 |
| PR | $45.35 | 1 |
| RI | $46.10 | 1 |
| SC | $42.89 | 1 |
| SD | $43.98 | 1 |
| TN | $41.98 | 1 |
| TX | $42.66–$46.43 | 8 |
| UT | $43.38 | 1 |
| VA | $44.16–$50.81 | 2 |
| VI | $45.35 | 1 |
| VT | $44.01 | 1 |
| WA | $46.29–$51.51 | 2 |
| WI | $42.86 | 1 |
| WV | $42.44 | 1 |
| WY | $44.66 | 1 |
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
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 East St. Louis, IL 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
49
- Locality
- East St. Louis, IL
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 2.014
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.53 | × 1.000 | 0.5300 |
| Practice expense | 0.77 | × 0.920 | 0.7084 |
| Malpractice | 0.05 | × 2.014 | 0.1007 |
| Total RVUs | 1.3391 | ||
| Conversion factor | × 33.4009 | ||
Office rate, East St. Louis, IL$44.73
Office: (0.53 × 1 + 0.77 × 0.92 + 0.05 × 2.014) × $33.4009 = $44.73
Facility: (0.53 × 1 + 0.06 × 0.92 + 0.05 × 2.014) × $33.4009 = $22.91
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 11721 has changed in East St. Louis, IL
11721 · Office / nonfacility
$44.73
Effective 2026-10-01
The base rate is $2.09 higher than on 2025-10-01, moving from $42.64 to $44.73 (4.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$42.64changed to$44.73
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.54 changed to 0.53
- Malpractice RVU 0.04 changed to 0.05
- Practice expense GPCI 0.918 changed to 0.920
- Malpractice GPCI 1.784 changed to 2.014
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$43.57changed to$42.64
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.76 changed to 0.77
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$42.86changed to$43.57
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$43.96changed to$42.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.74 changed to 0.76
- Practice expense GPCI 0.930 changed to 0.918
- Malpractice GPCI 1.723 changed to 1.784
January 1, 2023
RVU23A
$44.46changed to$43.96
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.72 changed to 0.74
- Practice expense GPCI 0.942 changed to 0.930
- Malpractice GPCI 1.661 changed to 1.723
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$44.83changed to$44.46
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$46.32changed to$44.83
- 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
- Practice expense GPCI 0.939 changed to 0.942
- Malpractice GPCI 1.723 changed to 1.661
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$45.98changed to$46.32
- 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
- Practice expense GPCI 0.936 changed to 0.939
- Malpractice GPCI 1.785 changed to 1.723
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$45.93changed to$45.98
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$45.17changed to$45.93
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.69 changed to 0.71
- Practice expense GPCI 0.935 changed to 0.936
- Malpractice GPCI 1.835 changed to 1.785
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$45.11changed to$45.17
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.934 changed to 0.935
- Malpractice GPCI 1.885 changed to 1.835
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$44.59changed to$45.11
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.03 changed to 0.04
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$44.37changed to$44.59
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$44.86changed to$44.37
- 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
- Practice expense GPCI 0.935 changed to 0.934
- Malpractice GPCI 1.910 changed to 1.885
Held through RVU15B.
January 1, 2014
RVU14A
$44.57changed to$44.86
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.74 changed to 0.68
- Practice expense GPCI 0.936 changed to 0.935
- Malpractice GPCI 1.934 changed to 1.910
Held through RVU14B, RVU14C, RVU14D.
October 1, 2013
RVU13D
No ratechanged to$44.57
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $44.73 | $22.91 | RVU26D |
| 2026-07-01 | $44.73 | $22.91 | RVU26C |
| 2026-04-01 | $44.73 | $22.91 | RVU26B |
| 2026-01-01 | $44.73 | $22.91 | RVU26A |
| 2025-10-01 | $42.64 | $23.64 | RVU25D |
| 2025-07-01 | $42.64 | $23.64 | RVU25C |
| 2025-04-01 | $42.64 | $23.64 | RVU25B |
| 2025-01-01 | $42.64 | $23.64 | RVU25A |
| 2024-10-01 | $43.57 | $24.02 | RVU24D |
| 2024-07-01 | $43.57 | $24.02 | RVU24C |
| 2024-04-01 | $43.57 | $24.02 | RVU24B |
| 2024-03-09 | $43.57 | $24.02 | RVU24AR |
| 2024-01-01 | $42.86 | $23.63 | RVU24A |
| 2023-10-01 | $43.96 | $24.42 | RVU23D |
| 2023-07-01 | $43.96 | $24.42 | RVU23C |
| 2023-04-01 | $43.96 | $24.42 | RVU23B |
| 2023-01-01 | $43.96 | $24.42 | RVU23A |
| 2022-10-01 | $44.46 | $24.90 | RVU22D |
| 2022-07-01 | $44.46 | $24.90 | RVU22C |
| 2022-04-01 | $44.46 | $24.90 | RVU22B |
| 2022-01-01 | $44.46 | $24.90 | RVU22A |
| 2021-10-01 | $44.83 | $25.10 | RVU21D |
| 2021-07-01 | $44.83 | $25.10 | RVU21C |
| 2021-04-01 | $44.83 | $25.10 | RVU21B |
| 2021-01-01 | $44.83 | $25.10 | RVU21A |
| 2020-10-01 | $46.32 | $27.00 | RVU20D |
| 2020-07-01 | $46.32 | $27.00 | RVU20C |
| 2020-04-01 | $46.32 | $27.00 | RVU20B |
| 2020-01-01 | $46.32 | $27.00 | RVU20A |
| 2019-10-01 | $45.98 | $26.42 | RVU19D |
| 2019-07-01 | $45.98 | $26.42 | RVU19C |
| 2019-04-01 | $45.98 | $26.42 | RVU19B |
| 2019-01-01 | $45.98 | $26.42 | RVU19A |
| 2018-10-01 | $45.93 | $26.39 | RVU18D |
| 2018-07-01 | $45.93 | $26.39 | RVU18C |
| 2018-04-01 | $45.93 | $26.39 | RVU18B |
| 2018-01-01 | $45.93 | $26.39 | RVU18AR1 |
| 2017-10-01 | $45.17 | $26.38 | RVU17D |
| 2017-07-01 | $45.17 | $26.38 | RVU17C |
| 2017-04-01 | $45.17 | $26.38 | RVU17B |
| 2017-01-01 | $45.17 | $26.38 | RVU17A |
| 2016-10-01 | $45.11 | $26.38 | RVU16D |
| 2016-07-01 | $45.11 | $26.38 | RVU16C |
| 2016-04-01 | $45.11 | $26.38 | RVU16B |
| 2016-01-01 | $45.11 | $26.38 | RVU16A |
| 2015-10-01 | $44.59 | $25.80 | RVU15D |
| 2015-07-01 | $44.59 | $25.80 | RVU15C |
| 2015-04-01 | $44.37 | $25.67 | RVU15B |
| 2015-01-01 | $44.37 | $25.67 | RVU15A |
| 2014-10-01 | $44.86 | $26.44 | RVU14D |
| 2014-07-01 | $44.86 | $26.44 | RVU14C |
| 2014-04-01 | $44.86 | $26.44 | RVU14B |
| 2014-01-01 | $44.86 | $26.44 | RVU14A |
| 2013-10-01 | $44.57 | $25.46 | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the East St. Louis, IL rate applies
East St. Louis, IL is a Medicare payment area, not a city. Our Census mapping connects it to 175 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.
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
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