CPT code 11762: Nail reconstruction, reconstructive procedure2026 Medicare rate & RVUs

Medicare pays $294.26 for 11762 nationally in the office and $175.02 in a hospital or facility. Local office rates run $262.38–$382.21.

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

What 11762 covers

This procedure rebuilds the nail bed when tissue loss or a substantial defect cannot be addressed by simply closing a laceration. It may be performed after traumatic injury or to address a damaged nail bed that no longer provides an adequate surface for nail growth. A podiatrist, hand surgeon, or plastic surgeon may perform the work in an office procedure room or operating room; the technique depends on the defect and may involve graft tissue.

Select this code for reconstruction, rather than straightforward repair of a nail-bed laceration. Document the affected digit, cause and extent of the defect, reconstructive work performed, and any grafting. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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.

Where 11762 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

11762 rates by state

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

How the 11762 rate is calculated

Each of 11762’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.

Payment rules and modifiers for 11762

11762 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

11762 compared with similar codes

How to choose

11760Nail bed repairTraumatic laceration

11760 addresses repair of a nail-bed injury; 11762 is for reconstructing a damaged or deficient nail bed.

11730Nail avulsionSingle nail plate

11730 removes a nail plate. It does not describe rebuilding the underlying nail bed.

11755Nail biopsyDiagnostic tissue sampling

11755 is used to biopsy the nail unit for diagnostic evaluation; 11762 describes reconstructive treatment.

11750Nail matrix excisionPermanent partial or complete removal

11750 removes the nail and matrix, commonly to prevent regrowth; 11762 rebuilds the nail bed rather than removing the growth unit.

Codes related to 11762

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates