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See a sample rate comparisonCPT 11720 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Debridement Of Nail(S) By Any, Debridement Of Nail(S) By Any Method(S) One To Fivedebridement Of Nail(S) By Any Method(S) One To Five
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office None 99 - Other POS |
| Common Modifiers | None Q8 - Two Class B Findings 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 11720 |
| Medicaid Fee Schedule | View Medicaid rates for 11720 |
National average reimbursement for CPT 11720 by major payers:
$35.12
$40.77
$40.83
$51.21
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CPT 11720
5 of 25 sample ratesHigher to lower in this preview
Southeastern Surgical, LLC, Riverfront Surgery Center
Southeastern Surgical LLC
$131.00Published rateJustin Caramiciu
Albany Medical College
$52.81Published rateDimitri Koumanis
Capital Area Plastic Surgery, PLLC
$39.50Published rateMalcolm Roth
Albany Med Health System
$33.81Published rateBrooke Mcbride
Albany Med Health System
$28.65Published rate
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See a sample payer proposalCPT 11720 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11720 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 11720 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 11719-CPT | Low | Trimming Of Nondysrophic Nails, Any Number |
| 11720-CPT | Low | Debridement Of Nail(S) By Any, Debridement Of Nail(S) By Any Method(S) One To Fivedebridement Of Nail(S) By Any Method(S) One To Five |
| 11721-CPT | Low | Debridement Of Nail(S) By Any, Debridement Of Nail(S) By Any Method(S) Six Or Moredebridement Of Nail(S) By Any Method(S) Six Or More |
| 11730-CPT | Low | Avul Nail Plate Part/Comp Single |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11720 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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