Billing code 11750: Nail matrix excisionMedicare rate & RVUs in Delaware
Permanent nail-matrix removal treats recurrent ingrown or deformed nails when the clinician removes part or all of the nail and prevents regrowth.
Medicare pays $156.22 for 11750 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 11750 covers
billing code 11750 represents a nail procedure intended to stop regrowth: the clinician removes part or all of the nail plate and excises or destroys the corresponding matrix. It is commonly used for a recurrent ingrown toenail or persistently deformed nail when permanent removal of the involved portion is planned. Podiatrists, dermatologists, and other clinicians qualified to perform nail surgery typically do this in an office under local anesthesia; it may also be performed in an outpatient facility.
Document the specific nail, the extent of nail removal, treatment of the matrix, and the clinical reason for choosing a permanent approach. A simple nail-plate avulsion with the matrix left intact is a different service. The 10-day global period includes related postoperative visits. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, 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.
11750 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $156.22 | $93.52 |
How the 11750 rate is calculated
Each of 11750’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 · 11750
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.54Practice expense 3.04Malpractice 0.14
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11750
11750 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 11750
Nail matrix excision
| 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 · 11750
Nail matrix excision
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
11750 without 51 · national office
$157.65
Nail matrix excision
11750-51 · Second procedure: 50%
$78.83
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%).
11750 compared with similar codes
Compare codes
11750 vs 11730 vs 11755 vs 11765: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11730Nail avulsion
- 11730 removes a nail plate without the permanent matrix treatment included in 11750. Choose 11750 when part or all of the nail matrix is treated to prevent regrowth.
- 11755Nail biopsy
- 11755 is for diagnostic biopsy of the nail unit. It is distinct from 11750, which treats a nail condition through permanent nail-matrix removal.
- 11765Nail-fold excision
- 11765 removes a wedge of skin at the nail fold. It does not describe permanent removal of the nail and its matrix.
11750 billing questions
How is 11750 different from a simple nail avulsion?
11750 includes treatment of the nail matrix with the intent to prevent regrowth. Use 11730 for a simple nail-plate avulsion when permanent matrix treatment is not performed.
What documentation supports reporting 11750?
Record the affected nail, the ingrown or deformed nail condition, how much of the nail was removed, and the excision or destruction of the matrix.
Does 11750 have a postoperative global period?
Yes. Its 10-day global period includes related postoperative visits during that period.
Can modifier 50 be used for bilateral nail treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code. When multiple procedures are performed in the same session, the standard multiple-procedure reduction applies.
Can an assistant or co-surgeon be billed for 11750?
Medicare does not pay an assistant at surgery for this service. 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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