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See a sample rate comparisonCPT 11755 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.
Biopsy Of Nail Unit Any Metho, Biopsy Of Nail Unit Any Method (Eg Plate Bed Matrixhyponychium Proximal And Lateral Nail Folds) (Separate Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office None |
| Common Modifiers | None TA - Left foot, great toe T5 - Right foot, great toe |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 11755 |
| Medicaid Fee Schedule | View Medicaid rates for 11755 |
National average reimbursement for CPT 11755 by major payers:
$138.90
$158.73
$161.42
$200.48
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CPT 11755
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Richmond, LLC, Memorial Hermann Surgery Center Richmond
$2,666.00Published rateBergen Gastroenterology PC
Bergen Gastroenterology, P.C.
$804.00Published rateWellbrook Endoscopy Center, LLC
Wellbrook Endoscopy Center LLC
$437.00Published rateJohns Hopkins Surgery Centers Series, Lutherville Surgery Center
Johns Hopkins Surgery Center Series
$349.00Published rateOsaze Edo-Ohonba
Deaconess Hospital Inc
$99.30Published rate
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See a sample payer proposalCPT 11755 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11755 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 11755 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 |
| 11750-CPT | Low | Excision Of Nail And Nail Matr, Excision Of Nail And Nail Matrix Partial Or Complete (Eg Ingrown Or Deformed Nail) For Permanent Removal Excision Of Nail And Nail Matrix Partial Or Complete (Eg |
| 11755-CPT | Low | Biopsy Of Nail Unit Any Metho, Biopsy Of Nail Unit Any Method (Eg Plate Bed Matrixhyponychium Proximal And Lateral Nail Folds) (Separate Procedure) |
| 11760-CPT | Moderate | Nail Bed Repair, Reconstruction Or Repair Of The Nail Bed (Soft Tissue Under A Nail). The Procedure May Involve Use Of A Skin Graft. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11755. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11755 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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