Billing code 11720: Nail debridementMedicare rate & RVUs in Delaware
Debridement of one to five dystrophic or mycotic fingernails or toenails, by any method, reported once per session, most often by podiatrists for onychomycosis.
Medicare pays $32.43 for 11720 in the office in Delaware (Delaware). 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.
On this page 9 sections
What 11720 covers
This service reduces the thickness and bulk of diseased nails, often thick, discolored, crumbly nails affected by onychomycosis or other dystrophy. A clinician uses nippers, curettes, or a burr to remove thickened nail plate and subungual debris; debriding painful toenails may relieve pressure from footwear. Podiatrists commonly perform the service in offices, nursing facilities, and patients’ homes. Patients may have diabetes, peripheral vascular disease, or neuropathy that makes self-care difficult.
Count all fingernails and toenails debrided during the session. Report one unit of 11720 for one to five nails; use 11721 instead for six or more. Document each treated nail, its condition, and the reason debridement was needed. For Medicare coverage, document applicable findings, such as pain or secondary infection associated with mycotic nails, or qualifying systemic disease and class findings when required. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team surgery arrangements 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.
11720 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $32.43 | $12.63 |
How the 11720 rate is calculated
Each of 11720’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 · 11720
RVUs × geographic indexes × conversion factor
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Work 0.31Practice expense 0.64Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11720
The CMS indicators that decide how 11720 is paid alongside other services.
CMS payment indicators · 11720
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. |
11720 compared with similar codes
Compare codes
11720 vs 11721 vs G0127 vs 11719 vs 11730: national Medicare rates
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How to choose
- 11721Nail debridement
- The choice depends on the total number of nails debrided at the session. One to five is 11720; six or more is 11721. Report one code with one unit.
- G0127Trim nail(s)
- G0127 is for trimming dystrophic nails. 11720 requires documented reduction of the nail plate’s thickness or bulk.
- 11719Trim nail(s) any number
- 11719 is for trimming nondystrophic nails, which is generally routine, noncovered care under Medicare. 11720 is for debriding diseased nails.
- 11730Nail avulsion
- 11730 removes all or part of a nail plate, such as when treating an ingrown or traumatized nail. 11720 reduces nail thickness while leaving the plate attached.
11720 billing questions
How are units reported when nails on both feet are debrided?
Add up all nails treated at the session, including any fingernails, and report one unit. Use 11720 for one to five nails or 11721 alone for six or more. Do not append modifier 50.
Can 11720 be billed with 11721 on the same date?
No. Choose the code by the total number of nails debrided during the session, and report one code with one unit.
What is the difference between nail debridement and nail trimming?
Debridement reduces the thickness and bulk of a diseased nail plate; trimming only shortens the nail. Use 11719 for trimming nondystrophic nails or G0127 for trimming dystrophic nails rather than reporting trimming alone as debridement.
Which modifiers might a Medicare claim for 11720 need?
When coverage relies on class findings under the routine foot care exception, report the applicable Q7, Q8, or Q9 modifier as supported by the record. Modifier 50 is inappropriate; append modifier 25 to a separately reported, significant E/M service, not to 11720.
Is a same-day office visit separately payable?
The routine evaluation associated with debridement is included in the 0-day global period. A significant, separately identifiable E/M service beyond that routine care may be reported with modifier 25, even if it concerns the same condition.
Can callus paring be billed at the same visit?
Paring corns or calluses under 11055 through 11057 may be separately reported when it is performed in addition to nail debridement. Document the treated sites and medical necessity for each service, subject to applicable coverage and coding requirements.
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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