CPT code 11762: Nail reconstruction, reconstructive procedure2026 Medicare rate & RVUs in Missouri
Reconstructs a damaged or deficient nail bed, typically after tissue loss or injury when simple nail-bed repair is not sufficient.
Medicare pays $268.15–$285.31 for 11762 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$268.15 to $285.31
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $282.59 | $170.62 |
| Metropolitan St. Louis, MO | $285.31 | $171.79 |
| Rest of Missouri | $268.15 | $165.37 |
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.
How the rate is built · 11762
RVUs × geographic indexes × conversion factor
Work2.87
2.87 RVUs× 1.000 GPCI
Practice expense5.60
5.60 RVUs× 1.000 GPCI
Malpractice0.34
0.34 RVUs× 1.000 GPCI
Adjusted RVUs
8.8100
Conversion factor
$33.4009
Medicare rate
$294.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11762
11762 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11762
Nail reconstruction, reconstructive procedure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 11762
Nail reconstruction, reconstructive procedure
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11762 without 51 · national office
$294.26
Nail reconstruction, reconstructive procedure
11762-51 · Second procedure: 50%
$147.13
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
11762 compared with similar codes
Compare codes · National
5 codes, side by side
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.
11762 billing questions
How is reconstruction different from nail-bed repair?
11762 is for rebuilding a deficient or substantially damaged nail bed. Use 11760 for repair of a nail-bed injury that can be addressed by repair rather than reconstruction.
Does removing the nail plate support reporting 11762?
No. Nail-plate removal alone does not establish that nail-bed reconstruction was performed; the record should describe the defect and the reconstructive work.
Can modifier 50 be used for both hands or feet?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 11762. Co-surgeon and team-surgery billing are not permitted.
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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