CPT 11720
Global 000 ActiveDebride nail 1-5
CPT 11720 Billing & Documentation Guide
CPT code 11720 (Debride nail 1-5) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.31, a non-facility practice expense RVU of 0.64, and a malpractice RVU of 0.03, a total non-facility RVU of 0.98 and facility RVU of 0.38. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $33.73, though rates vary from $29.23 to $42.86 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11720, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 11720 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 11720 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 11720
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.31 | 0.31 |
| Practice Expense RVU | 0.64 | 0.04 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 0.98 | 0.38 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11720
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $36.56 | $12.85 | $34.5 - $42.86 | 29 |
| Florida | $33.75 | $13.65 | $32.3 - $35.14 | 3 |
| Georgia | $31.97 | $12.84 | $30.62 - $33.31 | 2 |
| Illinois | $32.96 | $13.6 | $31.44 - $34.21 | 4 |
| Michigan | $31.84 | $13.02 | $31 - $32.67 | 2 |
| North Carolina | $30.94 | $12.24 | $30.94 - $30.94 | 1 |
| New York | $36.06 | $13.7 | $31.37 - $38.29 | 5 |
| Ohio | $30.88 | $12.58 | $30.88 - $30.88 | 1 |
| Pennsylvania | $32.46 | $12.83 | $30.92 - $33.99 | 2 |
| Texas | $32.39 | $12.66 | $30.74 - $33.88 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 11720
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11720 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0183T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0552T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 11720
What does CPT code 11720 mean? +
CPT code 11720 represents: Debride nail 1-5. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11720? +
The 2026 Medicare national average non-facility payment for CPT 11720 is $33.73. Rates range from $29.23 to $42.86 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11720? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 11720? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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