Billing code 11721: Nail debridementMedicare rate & RVUs
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.
Medicare pays $45.09 for 11721 nationally in the office and $21.38 in a hospital or facility. Local office rates run $40.65–$57.63.
Medicare rate · 11721
Nail debridement
- Work RVUs
- 0.53
- Total RVUs
- 1.35
- Global days
- 000
National rate · 2026
$45.09
Office setting, before claim adjustments.
See every locality for 11721 →Billed by an NP, PA or therapist? →
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 10 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.
Where 11721 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$40.65 to $57.63
109 of 109 payment localities
11721 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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.
Payment rules and modifiers for 11721
The CMS indicators that decide how 11721 is paid alongside other services.
CMS payment indicators · 11721
Nail debridement
| 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. |
11721 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11720Nail debridement
- 11720 covers one to five nails debrided; 11721 applies once six or more nails are reduced in the same session.
- G0127Trim nail(s)
- G0127 covers trimming dystrophic nails of any number; 11721 requires debriding thickness or bulk on six or more nails.
- 11719Trim nail(s) any number
- 11719 covers trimming nondystrophic nails of any number; 11721 covers debridement of six or more thickened nails.
- 11730Nail avulsion
- 11730 removes one nail plate partially or completely; 11721 leaves the nails in place and debrides six or more of them.
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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