localis

Type a CPT/HCPCS code, a place, a service in plain words, or a whole claim line like 90837 LCSW 94110.

Try

CPT 11720 Medicare rate and RVUs

Debridement of Nails

Participating physician · Before sequestration

CMS evidence · Q4 2026 release

Report a problem

The national PFS baseline is $32.73 for CPT 11720 in the Office (non-facility) setting and $12.69 in a facility under the Q4 2026 Physician Fee Schedule, effective October 2026. These are the national allowed amounts before locality (GPCI) adjustment; sequestration is excluded.

Why are the facility and non-facility amounts different?

Only the practice-expense RVU changes with the setting. For 11720 it's 0.64 RVUs in the Office (non-facility) setting versus 0.04 in a facility—the whole $20.04 gap between $32.73 and $12.69. In the Office (non-facility) setting the practice bears the overhead, so the allowed amount is higher; in a hospital or ASC the facility bills its own fee, so the professional amount is lower. See facility vs non-facility.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Practice Expense methodology (cms.gov).

What do commercial payers pay for 11720? Copy link

Negotiated medians run 76–133% of Medicare by specialty, in 4 payers' October 2026 and November 2026 files.

BCBSIL PPO · Cook County, IL · Oct 2026

100% = $34.21 · PFS Q4 2026 office (non-facility) amount, this county's locality

Podiatry 133% · $45.44 · 415 providers

92% paid exactly this

UnitedHealthcare Choice Plus · Cook County, IL · Oct 2026

100% = $34.21 · PFS Q4 2026 office (non-facility) amount, this county's locality

Podiatry 87% · $29.87 · 262 providers

Empire BCBS PPO/EPO · Kings County, NY · Nov 2026

100% = $38.29 · PFS Q4 2026 office (non-facility) amount, this county's locality

Podiatry 76% · $29.02 · 207 providers

79% paid exactly this

Median Middle half of providers Medicare (100%) Your contract

Payer-published negotiated rates. A negotiated rate describes the contract, not the payment.

Method, publication rule and your contract's locality

Commercial payers' negotiated rates for 11720 have medians of 76% to 133% of Medicare, depending on specialty. Insurers must publish the rates they negotiate with in-network clinicians (the Transparency in Coverage rule). We reduce each file to medians by county and specialty and set them against Medicare's amount for the same place. Specialties that rarely or never perform a service are left out: contracts list a rate for nearly every code, including ones the group never bills.

Networks and plan designs vary. We publish a benchmark only when at least 10 providers from at least 5 separately contracting groups stand behind it (tax IDs that contract together, like a health system's, count as one group), and no single group accounts for more than 25% of it.

A contract benchmarked to the fee schedule applies its percentage to your locality's allowed amount, not the $32.73 national baseline; the calculator finds that amount from your service ZIP. How to find your contract's percentage.

Browse all payer benchmarks →

Need rates from another insurer? Join the waitlist →

Allowed amount, Medicare's share, and patient share Copy link

A physician's $32.73 Office (non-facility) allowed amount: Medicare pays $25.66 after sequestration and the patient owes $6.55, once the Part B deductible is met.

Adjust for your locality →
11720: allowed amount and each party's share by who bills it, Office (non-facility), national baseline
Billed by Allowed amount Participating claim If not participating
What Medicare pays Patient coinsurance Non-participating amount Limiting charge
Physician (MD/DO) 100% Calculator $32.73 $25.66 $26.18 − $0.52 $6.55 $31.09 $35.75
NP, PA or CNS 85% Calculator $27.82 $21.81 $22.26 − $0.45 $5.56 Always takes assignment
NP or PA visit billed under the physician (incident-to) 100% Calculator $32.73 $25.66 $26.18 − $0.52 $6.55 $31.09 $35.75

Paid as if the physician did it, but only in the office and only when every incident-to requirement, including supervision, is met.

National Q4 2026, GPCI 1.000. Rows are provider types with at least 1% of 11720’s Medicare services in CMS’s CY2024 Physician & Other Practitioners data; each % applies before the 80/20 split and sequestration.

For the ZIP in the price card

Is $32.73 what a practice actually receives?

It's the national allowed amount—the starting point. Medicare pays 80% of it ($26.18) and the patient owes 20% coinsurance ($6.55). Sequestration trims Medicare's share by about 2%, your locality's GPCIs scale the total up or down, and the expected-payment calculator applies all three. That payment is practice revenue that covers staff, space, equipment, and billing. It isn't the clinician's take-home pay. The practice-expense RVU above is CMS's estimate of that overhead share.

Sources: Budget Control Act sequestration provisions; CMS Medicare Fee-for-Service payment guidance; CMS Geographic Practice Cost Index (GPCI) files; CMS Physician Fee Schedule overview (cms.gov).

What's the non-participating amount for 11720?

$31.09 in the Office (non-facility) setting—95% of the $32.73 participating fee schedule amount above. A participating provider takes the fee schedule amount as payment in full on every claim. A non-participating provider is paid this reduced amount, but chooses claim by claim whether to accept assignment. See participating vs non-participating.

Sources: CMS Physician Fee Schedule overview (cms.gov); CMS Medicare Fee-for-Service payment guidance.

What's the limiting charge for 11720?

$35.75 in the Office (non-facility) setting—the ceiling on what a non-participating provider can bill the patient on an unassigned claim. That's 109.25% of the $32.73 amount above. The non-participating amount is 95% of the fee schedule rate ($31.09), and the statutory cap is 115% of that. See limiting charge.

Sources: CMS Physician Fee Schedule overview (cms.gov); CMS Medicare Fee-for-Service payment guidance.

CMS RVU26DOctober 1 – December 31, 2026revision 2 See file rows

Which billing rules and modifiers apply? Copy link

CMS indicators that apply to 11720: GLOB DAYS 000 (same day only).

Global surgery period

Same day only

GLOB DAYS

000

The fee covers pre-operative and post-operative work on the day of the procedure only—there is no follow-up window afterward. A visit the next day is separately payable.

Not payable with 11720: -26/TC · -50 · -80/81/82 · -AS · -62 · -66.

Why would a Medicare claim for 11720 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • 67 codes form NCCI pairs with 11720 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
  • 235 codes pair with 11720 under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together
  • More than 1 unit per patient per date of service exceeds 11720's Medically Unlikely Edit (MUE) limit. See billing together
  • Bilateral surgery: no bilateral adjustment. See billing policy
  • Assistant at surgery: never separately payable. See billing policy
  • Co-surgeons: not permitted. See billing policy
  • Team surgery: not permitted. See billing policy

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

CMS RVU26DOctober 1 – December 31, 2026revision 2 See file rows

Can you bill it with another code? Copy link

11720 has 302 NCCI pairs (Q4 2026) and an MUE of 1 unit per patient per date of service.

This code

11720

Modifier indicator 0

67 pairs

No modifier bypasses the edit

  • 0213T
  • 0216T
  • 11721
  • +64 more

Modifier indicator 1

235 pairs

Only with an appropriate, documented modifier

Medically Unlikely Edit (MUE) limit

1 unit

Per patient per date of service

All 302 NCCI pairs for 11720 →

Payment review for 11720 Copy link

Checking a paid 11720 line?

Check an actual payment Model this code in a contract
What to check (4)

Three published payment rules can change what 11720 allows on a claim: the office/facility differential, the same-day global package and the assistant-at-surgery prohibition. Each is a legitimate reason for a paid amount to differ from the fee-schedule amount on this page.

  • Check the place-of-service code before attributing the gap to the payer: office and facility pricing differ by $20.04 nationally at GPCI 1.000, before any locality adjustment.
  • Check the visit date: this code carries no follow-up window, so a related visit the day after the procedure is separately payable and should not have bundled.
  • Expect an assistant-at-surgery denial here rather than appealing it—a -80 or -AS line on this procedure is never separately payable.
  • Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Practice Expense methodology (cms.gov); CMS Medicare Claims Processing Manual (Pub. 100-04); 42 USC 1395w-4(i)(2) (SSA §1848(i)(2))—Assistants-at-surgery.

How location and RVUs set the amount Copy link

Office (non-facility): 0.98 RVUs × $33.4009 = $32.73 national PFS baseline. Local GPCIs move it from $29.23 in Arkansas, AR to $42.86 in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.

Office (non-facility)

Office (non-facility): each RVU times its GPCI, summed, times the conversion factor
Component RVU × GPCI =
Work 0.31 1.000 0.31
Practice expense 0.64 1.000 0.64
Malpractice 0.03 1.000 0.03
Total RVUs 0.98
× Conversion factor $33.4009
= National PFS baseline $32.73

Facility

Facility: each RVU times its GPCI, summed, times the conversion factor
Component RVU × GPCI =
Work 0.31 1.000 0.31
Practice expense 0.04 1.000 0.04
Malpractice 0.03 1.000 0.03
Total RVUs 0.38
× Conversion factor $33.4009
= National PFS baseline $12.69

Rates by locality Copy link

Maine: $30.64–$32.17 across 2 localities ME Wisconsin: $31.14 WI Vermont: $32.02 VT New Hampshire: $33.48 NH Montana: $32.73 MT North Dakota: $32.14 ND Minnesota: $32.65 MN Michigan: $31.00–$32.67 across 2 localities MI New York: $31.37–$38.29 across 5 localities NY Massachusetts: $33.83–$37.19 across 2 localities MA Rhode Island: $33.53 RI Washington: $33.76–$37.92 across 2 localities WA Idaho: $30.49 ID Wyoming: $32.47 WY South Dakota: $32.07 SD Iowa: $30.31 IA Illinois: $31.44–$34.21 across 4 localities IL Indiana: $30.66 IN Ohio: $30.88 OH Pennsylvania: $30.92–$33.99 across 2 localities PA New Jersey: $35.21–$36.87 across 2 localities NJ Connecticut: $34.80 CT Oregon: $32.35–$35.01 across 2 localities OR Nevada: $32.59 NV Utah: $31.35 UT Colorado: $34.01 CO Nebraska: $30.46 NE Missouri: $29.76–$31.71 across 3 localities MO Kentucky: $30.27 KY West Virginia: $30.36 WV Virginia: $32.07 VA Maryland: $33.01–$34.70 across 2 localities MD Delaware: $32.43 DE California: $34.50–$42.86 across 29 localities CA Arizona: $31.93 AZ New Mexico: $31.16 NM Kansas: $30.18 KS Oklahoma: $30.22 OK Arkansas: $29.23 AR Tennessee: $30.32 TN North Carolina: $30.94 NC South Carolina: $30.96 SC District of Columbia: $37.21 DC Texas: $30.74–$33.88 across 8 localities TX Louisiana: $30.23–$31.61 across 2 localities LA Mississippi: $29.50 MS Alabama: $29.63 AL Georgia: $30.62–$33.31 across 2 localities GA Florida: $32.30–$35.14 across 3 localities FL Alaska: $38.85 AK Hawaii: $35.24 HI
$29–$31 $31–$32 $32–$34 $34–$36 $36–$37 $37–$39

11720 Office (non-facility) by metro, highest first

San Jose, CA $42.72 Locality 01112-09 San Francisco, CA $41.90 Locality 01112-05 Anchorage, AK $38.85 Locality 02102-01 Long Island, NY $38.29 Locality 13202-02 Seattle, WA $37.92 Locality 02402-02 Queens, NY $37.73 Locality 13292-04
Show 56 more metros
New York City, NY $37.45 Locality 13202-01 Washington, DC $37.21 Locality 12202-01 Boston, MA $37.19 Locality 14212-01 Northern New Jersey, NJ $36.87 Locality 12402-01 San Diego, CA $36.77 Locality 01182-72 Los Angeles, CA $36.73 Locality 01182-18 Ventura County, CA $36.54 Locality 01182-17 Sacramento, CA $36.13 Locality 01112-63 Honolulu, HI $35.24 Locality 01212-01 Miami, FL $35.14 Locality 09102-04 Portland, OR $35.01 Locality 02302-01 Riverside, CA $34.82 Locality 01112-62 Hartford, CT $34.80 Locality 13102-00 Baltimore, MD $34.70 Locality 12302-01 Bakersfield, CA $34.59 Locality 01112-54 Fresno, CA $34.50 Locality 01112-56 Chicago, IL $34.21 Locality 06102-16 Suburban Chicago, IL $34.16 Locality 06102-15 Denver, CO $34.01 Locality 04112-01 Philadelphia, PA $33.99 Locality 12502-01 Austin, TX $33.88 Locality 04412-31 Fort Lauderdale, FL $33.82 Locality 09102-03 Providence, RI $33.53 Locality 14412-01 Atlanta, GA $33.31 Locality 10212-01 Houston, TX $33.04 Locality 04412-18 Detroit, MI $32.67 Locality 08202-01 Minneapolis, MN $32.65 Locality 06202-00 Dallas, TX $32.60 Locality 04412-11 Las Vegas, NV $32.59 Locality 01312-00 Fort Worth, TX $32.40 Locality 04412-28 Tampa, FL $32.30 Locality 09102-99 Portland, ME $32.17 Locality 14112-03 Richmond, VA $32.07 Locality 11302-00 Metro East, IL $32.04 Locality 06102-12 Phoenix, AZ $31.93 Locality 03102-00 St. Louis, MO $31.71 Locality 05302-01 New Orleans, LA $31.61 Locality 07202-01 San Antonio, TX $31.55 Locality 04412-99 Kansas City, MO $31.41 Locality 05302-02 Buffalo, NY $31.37 Locality 13282-99 Salt Lake City, UT $31.35 Locality 03502-09 Albuquerque, NM $31.16 Locality 04212-05 Milwaukee, WI $31.14 Locality 06302-00 Charleston, SC $30.96 Locality 11202-01 Charlotte, NC $30.94 Locality 11502-00 Pittsburgh, PA $30.92 Locality 12502-99 Columbus, OH $30.88 Locality 15202-00 Indianapolis, IN $30.66 Locality 08102-00 Boise, ID $30.49 Locality 02202-00 Omaha, NE $30.46 Locality 05402-00 Nashville, TN $30.32 Locality 10312-35 Des Moines, IA $30.31 Locality 05102-00 Louisville, KY $30.27 Locality 15102-00 Oklahoma City, OK $30.22 Locality 04312-00 Wichita, KS $30.18 Locality 05202-00 Birmingham, AL $29.63 Locality 10112-00
Maine: $12.21–$12.31 across 2 localities ME Wisconsin: $11.94 WI Vermont: $12.18 VT New Hampshire: $12.62 NH Montana: $12.69 MT North Dakota: $12.10 ND Minnesota: $12.03 MN Michigan: $12.71–$13.33 across 2 localities MI New York: $12.33–$14.47 across 5 localities NY Massachusetts: $12.73–$13.27 across 2 localities MA Rhode Island: $12.82 RI Washington: $12.66–$13.33 across 2 localities WA Idaho: $12.06 ID Wyoming: $12.43 WY South Dakota: $12.03 SD Iowa: $11.97 IA Illinois: $13.14–$14.07 across 4 localities IL Indiana: $12.08 IN Ohio: $12.58 OH Pennsylvania: $12.53–$13.13 across 2 localities PA New Jersey: $13.33–$13.63 across 2 localities NJ Connecticut: $13.21 CT Oregon: $12.39–$12.75 across 2 localities OR Nevada: $12.53 NV Utah: $12.51 UT Colorado: $12.68 CO Nebraska: $11.97 NE Missouri: $12.48–$12.63 across 3 localities MO Kentucky: $12.46 KY West Virginia: $12.95 WV Virginia: $12.38 VA Maryland: $12.73–$13.19 across 2 localities MD Delaware: $12.63 DE California: $12.53–$13.96 across 29 localities CA Arizona: $12.51 AZ New Mexico: $12.78 NM Kansas: $12.07 KS Oklahoma: $12.33 OK Arkansas: $12.02 AR Tennessee: $12.11 TN North Carolina: $12.24 NC South Carolina: $12.44 SC District of Columbia: $13.60 DC Texas: $12.50–$13.14 across 8 localities TX Louisiana: $12.50–$12.75 across 2 localities LA Mississippi: $12.25 MS Alabama: $12.09 AL Georgia: $12.74–$12.95 across 2 localities GA Florida: $13.14–$14.28 across 3 localities FL Alaska: $17.51 AK Hawaii: $12.45 HI
$12–$13 $13–$14 $14–$15 $15–$16 $16–$17 $17–$18

11720 Facility by metro, highest first

Anchorage, AK $17.51 Locality 02102-01 Long Island, NY $14.47 Locality 13202-02 Miami, FL $14.28 Locality 09102-04 New York City, NY $14.16 Locality 13202-01 Chicago, IL $14.07 Locality 06102-16 Queens, NY $14.04 Locality 13292-04
Show 56 more metros
San Jose, CA $13.82 Locality 01112-09 San Francisco, CA $13.65 Locality 01112-05 Northern New Jersey, NJ $13.63 Locality 12402-01 Washington, DC $13.60 Locality 12202-01 Metro East, IL $13.60 Locality 06102-12 Suburban Chicago, IL $13.57 Locality 06102-15 Fort Lauderdale, FL $13.52 Locality 09102-03 Detroit, MI $13.33 Locality 08202-01 Seattle, WA $13.33 Locality 02402-02 Boston, MA $13.27 Locality 14212-01 Hartford, CT $13.21 Locality 13102-00 Baltimore, MD $13.19 Locality 12302-01 Tampa, FL $13.14 Locality 09102-99 Houston, TX $13.14 Locality 04412-18 Philadelphia, PA $13.13 Locality 12502-01 Los Angeles, CA $13.02 Locality 01182-18 Atlanta, GA $12.95 Locality 10212-01 Riverside, CA $12.86 Locality 01112-62 Ventura County, CA $12.85 Locality 01182-17 Sacramento, CA $12.82 Locality 01112-63 Providence, RI $12.82 Locality 14412-01 San Diego, CA $12.81 Locality 01182-72 Albuquerque, NM $12.78 Locality 04212-05 New Orleans, LA $12.75 Locality 07202-01 Portland, OR $12.75 Locality 02302-01 Denver, CO $12.68 Locality 04112-01 Austin, TX $12.68 Locality 04412-31 Dallas, TX $12.64 Locality 04412-11 Fort Worth, TX $12.64 Locality 04412-28 Bakersfield, CA $12.63 Locality 01112-54 St. Louis, MO $12.63 Locality 05302-01 Kansas City, MO $12.59 Locality 05302-02 Columbus, OH $12.58 Locality 15202-00 Fresno, CA $12.53 Locality 01112-56 Las Vegas, NV $12.53 Locality 01312-00 Pittsburgh, PA $12.53 Locality 12502-99 San Antonio, TX $12.53 Locality 04412-99 Phoenix, AZ $12.51 Locality 03102-00 Salt Lake City, UT $12.51 Locality 03502-09 Louisville, KY $12.46 Locality 15102-00 Honolulu, HI $12.45 Locality 01212-01 Charleston, SC $12.44 Locality 11202-01 Richmond, VA $12.38 Locality 11302-00 Buffalo, NY $12.33 Locality 13282-99 Oklahoma City, OK $12.33 Locality 04312-00 Portland, ME $12.31 Locality 14112-03 Charlotte, NC $12.24 Locality 11502-00 Nashville, TN $12.11 Locality 10312-35 Birmingham, AL $12.09 Locality 10112-00 Indianapolis, IN $12.08 Locality 08102-00 Wichita, KS $12.07 Locality 05202-00 Boise, ID $12.06 Locality 02202-00 Minneapolis, MN $12.03 Locality 06202-00 Des Moines, IA $11.97 Locality 05102-00 Omaha, NE $11.97 Locality 05402-00 Milwaukee, WI $11.94 Locality 06302-00

Q4 2026, each locality's GPCIs, before sequestration. Multi-locality states are shaded by their mean. Look up your exact locality →

CMS RVU26DOctober 1 – December 31, 2026revision 2 See file rows

Source & method Copy link

  1. 01 PPRRVU2026_Oct_nonQPP.csv · Q4 2026 (RVU26D) · row 1,361—status A, RVUs limits
    Source
    Physician relative value file (PPRRVU), Q4 2026 release
    Effective
    October 1 – December 31, 2026
    Locator
    PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip · row 1,361 of 19,453 · via CMS
    Fields read
    Status A (col 4) Work RVU 0.31 (col 6) Office (non-facility) PE RVU 0.64 (col 7) Facility PE RVU 0.04 (col 9) Malpractice RVU 0.03 (col 11)
    SHA-256 4d0d3f19bd954ffc…
    Doesn’t establish
    A locality-adjusted allowed amount, or the payment after sequestration. National baselines use GPCI 1.000 and exclude sequestration.
    Note
    Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero.
  2. 02 Conversion factor · same file · row 1,361 · column 26—$33.4009
    Source
    Conversion factor, read from the same file as the RVUs
  3. 03 NCCI · Q4 2026—the code-pair edits
    Source
    National Correct Coding Initiative (NCCI)
    Effective
    Same quarter as the Q4 2026 rate
  4. 04 Physician & Other Practitioners · CY2024—volume and who bills it limits
    Source
    CMS Physician & Other Practitioners dataset
    Effective
    Calendar-year snapshot, on a different cycle from the Q4 2026 fee schedule
    Doesn’t establish
    Medicare Advantage, Medicaid or commercial volume, or the exact place of service: CMS publishes only the facility vs non-facility split, so the Office (non-facility) share does not identify urgent care or any other specific setting.
    Note
    The dataset suppresses rows under 11 beneficiaries. Specialty groups with fewer than 30 observed clinicians are omitted, so the shares can fall short of 100%.
  5. 05 Payer files Transparency in Coverage · Oct 2026, Nov 2026—the commercial rates limits
    Source
    Transparency in Coverage files: BCBSIL PPO, UnitedHealthcare Choice Plus, Empire BCBS PPO/EPO, BCBSTX Blue Choice PPO
    Doesn’t establish
    What a claim paid. A negotiated rate describes the contract, not the payment.
    Note
    The only figures on this page that CMS did not publish.

Cite this rate

CPT 11720 National PFS baseline: Office (non-facility) $32.73; Facility $12.69 (Q4 2026; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU26D, PPRRVU2026_Oct_nonQPP.csv row 1,361. Localis. https://localishealth.com/cpt/11720/2026/D

Past releases are never edited, so the citation stays checkable after CMS publishes a newer one. Methodology · Plain-text summary · JSON

How has it changed? Copy link

$32.73 Office (non-facility) and $12.69 Facility since Jan 1, 2026, after a +2.2% increase in the Office (non-facility) amount. +0.2% increase since Q1 2013; peak $33.88 in Q1 2019.

  1. Jan 1, 2026 – present

    Q1 2026

    Still in effect · 4 releases at this rate
    Office
    $32.73 (+$0.71, +2.2% increase)
    Facility
    $12.69 (−$1.22, -8.8% decrease)

    Q1 2026 Jan 1, 2026 – Mar 31, 2026 · Q2 2026 Apr 1, 2026 – Jun 30, 2026 · Q3 2026 Jul 1, 2026 – Sep 30, 2026 · Q4 2026 Oct 1, 2026 – present

    • +$1.04 the conversion factor
    • −$0.33 work RVUs

  2. Jan 1, 2025 – Dec 31, 2025

    Q1 2025

    4 releases at this rate
    Office
    $32.02 (−$0.93, -2.8% decrease)
    Facility
    $13.91 (−$0.07, -0.5% decrease)

    Q1 2025 Jan 1, 2025 – Mar 31, 2025 · Q2 2025 Apr 1, 2025 – Jun 30, 2025 · Q3 2025 Jul 1, 2025 – Sep 30, 2025 · Q4 2025 Oct 1, 2025 – Dec 31, 2025

    • −$0.93 the conversion factor

  3. Mar 9, 2024 – Dec 31, 2024

    Q1 2024

    4 releases at this rate
    Office
    $32.95 (+$0.53, +1.6% increase)
    Facility
    $13.98 (+$0.23, +1.7% increase)

    Q1 2024 Mar 9, 2024 – Mar 31, 2024 · Q2 2024 Apr 1, 2024 – Jun 30, 2024 · Q3 2024 Jul 1, 2024 – Sep 30, 2024 · Q4 2024 Oct 1, 2024 – Dec 31, 2024

    • +$0.53 the conversion factor

  4. Jan 1, 2024 – Mar 8, 2024 · Superseded revision

    Q1 2024 rev 1

    Revision 1, later corrected by CMS
    Office
    $32.42
    Facility
    $13.75

  5. Jan 1, 2023 – Dec 31, 2023

    Q1 2023

    4 releases at this rate
    Office
    $33.21 (−$0.01, 0.0% no change)
    Facility
    $14.57 (−$0.31, -2.1% decrease)

    Q1 2023 Jan 1, 2023 – Mar 31, 2023 · Q2 2023 Apr 1, 2023 – Jun 30, 2023 · Q3 2023 Jul 1, 2023 – Sep 30, 2023 · Q4 2023 Oct 1, 2023 – Dec 31, 2023

    • −$0.69 the conversion factor
    • +$0.68 practice-expense RVUs

  6. Jan 1, 2022 – Dec 31, 2022

    Q1 2022

    4 releases at this rate
    Office
    $33.22 (−$0.63, -1.9% decrease)
    Facility
    $14.88 (−$0.12, -0.8% decrease)

    Q1 2022 Jan 1, 2022 – Mar 31, 2022 · Q2 2022 Apr 1, 2022 – Jun 30, 2022 · Q3 2022 Jul 1, 2022 – Sep 30, 2022 · Q4 2022 Oct 1, 2022 – Dec 31, 2022

    • −$0.35 practice-expense RVUs
    • −$0.28 the conversion factor

National baseline (GPCI 1.000), before sequestration.

How each change is split
The chips under each change split the Office (non-facility) move into the conversion factor's share, which CMS sets for every code, and 11720's own work, practice-expense and malpractice RVUs. CMS doesn't publish this split; we derive it from each release's RVUs and conversion factor. We apply the new conversion factor to the earlier RVUs first, then price each RVU change at the new conversion factor. Another order would move a few cents between columns, but every total stays the same.
When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

The 11720 rate last moved in Q1 2026. See its rate history.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Did this answer your question about CPT 11720?

Tell us what you were trying to work out and we'll answer you or build the page that does.

Did this page answer your question?

Usage and related codes Copy link

In CY2024, 11720 ranked #200 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Services
1.8M
Allowed
$58.2M
Beneficiaries
746,977

Who bills 11720 to Medicare

95% Office (non-facility) · 5% facility
  • Podiatry 98%
  • NP/PA 2%

CY2024 Medicare fee-for-service, from the CMS Physician & Other Practitioners dataset (limits). Localis groups related codes for payment research; the grouping isn't the AMA's code families.