Summary & Overview
CPT 11750: Excision of Nail and Nail Matrix, Partial or Complete
CPT 11750 denotes the surgical excision of the nail and nail matrix—partial or complete—for permanent nail removal, commonly performed to treat ingrown or deformed nails. Nationally, this code is relevant across outpatient settings and is frequently billed by dermatologists, podiatrists, and primary care clinicians who provide minor surgical procedures in the office. Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of the clinical context for CPT 11750, how it fits among related nail procedures, and practical billing considerations such as common modifiers and billing scenarios. The publication outlines typical site-of-service expectations and highlights related procedural codes for avulsion and nail-fold excision to aid correct code selection and claim differentiation. It also summarizes common ICD-10 diagnostic pairings used to support medical necessity. Where specific data elements are missing from the input, the text notes "Data not available in the input." This overview is intended to inform coding, billing oversight, and administrative review without offering clinical recommendations.
CPT Code Overview
CPT 11750 describes the excision of the nail and nail matrix, partial or complete, for permanent removal (for example, ingrown or deformed nails). This procedure is categorized under Surgical Procedures on the Nails and is commonly performed by specialists in dermatology or podiatry. The typical site of service for CPT 11750 is the office (POS 11).
Clinical & Coding Specifications
Clinical Context
A 35-year-old patient presents to a dermatology or podiatry office (POS 11) with a chronically ingrown right great toenail causing recurrent pain, inflammation, and localized infection despite conservative care. The clinician documents diagnosis, discusses permanent nail removal, obtains consent, prepares sterile field, administers local anesthesia, performs excision of the nail and nail matrix (partial or complete) to prevent regrowth, achieves hemostasis, and provides postoperative wound care instructions and follow-up.
Coding Specifications
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Common Modifiers:
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50— Bilateral procedure: Append when the excision of nail and nail matrix is performed on both corresponding nails (e.g., both great toes) during the same operative session. -
KX— Repeat nail excision on the same finger or toe when medically necessary: Use when documentation supports a medically necessary repeat excision on the same digit and payer requires KX for medical necessity attestation. -
51— Multiple procedures: Apply when multiple distinct procedures are reported on the same date of service to indicate multiple procedural services; sequencing and payer rules determine application and payment adjustments. -
59— : Use to indicate a separate and distinct surgical service on the same digit or toe when bundling edits might otherwise apply; ensure documentation supports distinctness.