How to Bill CPT Code 11730 for Toenail Removal – A Complete 2025 Guide
Toenail issues like ingrown nails are incredibly common in outpatient care, especially in podiatry and primary care. When conservative treatments fail, partial nail removal, known as nail avulsion, is often the next step. That’s where the 11730 CPT code comes in.
At Express Medical Billing Services, we’ve worked with countless providers across podiatry, dermatology, and family medicine. One of the most frequent questions we receive is: “How do I properly bill for nail avulsion using CPT code 11730?” Let’s break with real experience and supported insights.
What Is CPT Code 11730?
CPT Code 11730 is defined as:
“Avulsion of nail salver, partial or full, simple; single nail.”
In simpler terms, it refers to the removal of part or all of a toenail or fingernail, usually to treat an ingrown toenail, infection, or trauma. It’s important to note that 11730 applies only when no chemical or surgical destruction of the nail matrix is performed,  otherwise, you’d use 11750.
11730 CPT Code Description & Billing Tips
When documenting and billing 11730:
- Clearly document the reason for the avulsion (e.g., ingrown toenail, onychocryptosis)
- Specify which toe or finger was treated
- Confirm that only the nail plate was removed, without matrix destruction
- List relevant ICD-10 codes, like L60.0 (ingrowing nail)
Primary keyword usage: The 11730 CPT code should be supported by clear documentation to justify reimbursement.
What’s the Difference Between 11730 and 11750?
CPT Code | Description | Use When |
11730Â Â Â Â Â Â Â Â Â Â Â Â | Nail avulsion (simple removal) | No destruction of the nail matrix |
11750 | Excision of nail and matrix (permanent) | Matrix is destroyed chemically or surgically |
Many claim denials stem from choosing the wrong code, so always check the procedure note to confirm whether the matrix was treated.
Real Provider Insight - Why Claims Get Denied
We’ve seen firsthand how small mistakes can delay payment:
- Using 11730 when 11750 was appropriate
- Forgetting to append a modifier (more on that below)
- Not involving the right ICD-10 code (e.g., L60.0 for ingrown toenail)
That’s why Express Medical Billing Services reviews every note before claim submission helping clients avoid rejections and delays.
11730 CPT Code Reimbursements
Medicare Reimbursement (2025 Estimates):
- National Average: ~$38–$45
- Varies by region and place of service (office vs. facility)
Keep in mind:
- Reimbursement rates may change annually
- Use updated fee schedules or your MAC’s lookup tool
Does CPT Code 11730 Require a Modifier?
Yes, depending on the context. Use:
- Modifier 59 – At the time of billing 11730 with additional procedure on the same day (e.g., biopsy)
- Modifier RT/LT – To indicate right or left toe (or both with modifier 50)
- Modifier 79 – If done during a postoperative period of an unrelated procedure
Adding the right 11730 CPT code modifier is key to clean claims.
Does CPT 11730 Have a Global Period?
Related CPT and ICD-10 Codes
Yes. 11730 has a 10-day global period.
This means:
- Follow-up visits related to the procedure are bundled for 10 days
- Do not bill separately for routine post-op care during this window
- If a new issue arises during this time, add Modifier 24 for unrelated E/M services
Understanding the 11730 global period prevents unnecessary denials or overbilling.
Code | Description |
11732                  | Avulsion of additional nail plate(s) – use with 11730 |
11750 | Removal of nail including matrix |
L60.0 | Ingrown toenail (ICD-10) |
11055–11057 | Debridement of corns or calluses |
G0127 | Routine nail trimming for Medicare |
Each additional nail avulsed should be billed with 11732 CPT code description and linked to 11730 using appropriate modifiers.
Key Takeaways for Billing CPT 11730
- 11730 CPT code is for simple nail removal (no matrix destruction)
- Code bill with supporting ICD-10 codes like L60.0
- Watch for the 10-day global period
- Apply modifiers (59, RT, LT) when appropriate
- Avoid misunderstanding with 11750, which contains matrix removal
Why Work With Express Medical Billing Services?
At Express Medical Billing Services, we specialize in dermatology, podiatry, and outpatient procedures like nail avulsions. Our team:
- Reviews documentation to allocate the right CPT code
- Applies the appropriate modifiers
- Tracks global periods
- Follows up aggressively on denials
See the sights our Physician Billing Services and see how we help you get paid faster, and more accurately.
Frequently Asked Questions (FAQs)
CPT Code 11730 is used for the exclusion (avulsion) of a nail platter, either partially or completely. It typically applies to one nail, usually due to severe ingrown toenails, fungal infections, trauma, or pain that doesn't improve with conservative treatment. This code is for a simple, single nail removal, not multiple nails or complex cases.
Nail removal under CPT 11730 is medically necessary when a patient has infection, severe ingrown nails, hematomas under the nail, or chronic fungal infections that cause discomfort or impair walking. It’s regularly achieved in-office using a local anesthetic. The provider must document the condition clearly to justify billing for this procedure.
CPT 11730 is used per nail, so if more than one nail is removed, additional units may be billed. However, you typically need to use modifier 59 to indicate separate services (e.g., different anatomical sites). For example, removing both a toenail and fingernail would be billed with 11730 Ă— 2, one with a modifier.
Yes, CPT 11730 is generally covered by Medicare and most private insurers, especially when linked with an appropriate ICD-10 diagnosis such as L60.0 (ingrowing nail) or B35.1 (onychomycosis). Proper documentation of symptoms, failed prior treatments, and reason for removal is key for claim approval.
CPT 11730 is for temporary nail removal, the root matrix is not destroyed, so the nail may grow back. CPT code 11750, on the other point out, is used for permanent nail removal, regularly concerning obliteration of the nail medium (chemical or surgical). The two procedures serve different purposes and should not be billed interchangeably.
