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CPT 11760: Nail Bed Repair for Traumatic Injury
CPT code 11760 denotes surgical repair of the nail bed after trauma (laceration, crush, or avulsion). This code is used when clinicians perform primary repair of the nail bed to restore form and function. Nail bed injuries are common in emergency and ambulatory surgical settings; correct coding supports appropriate clinical documentation and payment for minor surgical services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure and review commonly associated diagnoses for which the code is billed. The publication summarizes typical sites of service and how the code relates to reconstructive variants such as nail bed reconstruction procedures.
The report provides operational benchmarks and coding context useful for clinicians, coding staff, and revenue cycle teams: how the service is classified, common clinical indications, and the relationship to related reconstructive codes. Policy updates and payer trends affecting coverage and payment are summarized to help operational planning. Where input data is missing, the content states "Data not available in the input."
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Billing Code Overview
CPT code 11760 describes repair of nail bed following injury such as laceration, crush, or avulsion. The procedure restores the anatomy and function of the nail bed, addressing soft-tissue damage beneath or adjacent to the nail plate.
Service Type: Minor surgical procedure — nail bed repair
Typical Site of Service: Ambulatory surgical center, hospital outpatient department, or emergency department
National Reimbursement Benchmarks
Across national payers, Medicare’s mean rate of $193.4 sits notably below BUCA’s average commercial mean of $312.5 for CPT 11760, indicating a substantial gap between public and average commercial reimbursement levels. Blue Cross Blue Shield’s mean of $385.2 and Aetna’s mean of $118.4 further illustrate commercial variance: some commercial plans reimburse well above Medicare while others cluster closer or below, with BUCA positioned between the higher and lower commercial averages. Dispersion measured by the interquartile range (P75–P25) highlights which payers show tighter versus wider spread. Blue Cross Blue Shield has the widest IQR at $260.40 (P75 $500.40 minus P25 $254.00), followed by BUCA at $206.30 and UnitedHealth Group at $155.00; Aetna (IQR $118.00) and Cigna (IQR $151.70) are comparatively tighter, and Medicare’s IQR is narrowest at $21.00, indicating the most consistent rates among these payers.