CPT 11750
Global 010 ActiveExcision nail&nail matrix
CPT 11750 Billing & Documentation Guide
CPT code 11750 (Excision nail&nail matrix) is classified under Anesthesia with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.54, a non-facility practice expense RVU of 3.04, and a malpractice RVU of 0.14, a total non-facility RVU of 4.72 and facility RVU of 2.82. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $162.46, though rates vary from $141.07 to $206.02 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11750, 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 11750 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 6 units of 11750 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 11750
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.54 | 1.54 |
| Practice Expense RVU | 3.04 | 1.14 |
| Malpractice RVU | 0.14 | 0.14 |
| Total RVU | 4.72 | 2.82 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11750
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 | $175.96 | $100.87 | $166.1 - $206.02 | 29 |
| Florida | $162.42 | $98.74 | $155.54 - $168.97 | 3 |
| Georgia | $153.98 | $93.44 | $147.58 - $160.37 | 2 |
| Illinois | $158.67 | $97.35 | $151.45 - $164.58 | 4 |
| Michigan | $153.37 | $93.78 | $149.42 - $157.31 | 2 |
| North Carolina | $149.16 | $89.95 | $149.16 - $149.16 | 1 |
| New York | $173.51 | $102.71 | $151.19 - $184.14 | 5 |
| Ohio | $148.86 | $90.92 | $148.86 - $148.86 | 1 |
| Pennsylvania | $156.36 | $94.2 | $149.07 - $163.64 | 2 |
| Texas | $156.03 | $93.55 | $148.18 - $163.11 | 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 11750
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11750 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 0490T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 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 |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 11750
What does CPT code 11750 mean? +
CPT code 11750 represents: Excision nail&nail matrix. It's in the Anesthesia category with a global period of 010.
What is the Medicare reimbursement for CPT 11750? +
The 2026 Medicare national average non-facility payment for CPT 11750 is $162.46. Rates range from $141.07 to $206.02 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11750? +
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 11750? +
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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