CPT code 11765: Nail-fold excision, skin fold only2026 Medicare rate & RVUs in Connecticut

In Connecticut, Medicare pays $173.68 for 11765 in the office and $94.18 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 11765 nationwide

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

What 11765 covers

A clinician removes a wedge of skin from the nail fold, often to address an ingrown nail with painful or inflamed tissue along the nail edge. The service targets the surrounding skin fold; it is distinct from removing the nail plate or excising the nail matrix. It is commonly performed by a physician or other qualified practitioner in an office or outpatient procedure setting.

Select the code when the operative note supports excision of nail-fold skin, rather than nail trimming, nail avulsion alone, or nail-matrix removal. Document the affected nail, the fold tissue excised, and the reason for the procedure. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 Connecticut compares for 11765

Across 109 of 109 payment localities, the office rate for 11765 runs from $144.58 in Arkansas to $219.12 in San Benito County, CA. Connecticut pays $173.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

11765 rates by state

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

See 11765 in every payment locality

How the 11765 rate is calculated

Each of 11765’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 11765

11765 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

Codes related to 11765

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

How 11765 has changed in Connecticut

Price 11765 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

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