Soft tissue repair · Foot & ankle
Add-on code for simple avulsion of each additional nail plate beyond the first, reported alongside the primary avulsion code 11730.
Verified May 8, 2026 · 4 sources ↓
- Medicare
- $32.40
- Work RVU
- 0.37
- Global, days
- Region
- Foot & ankle
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 4 cited references ↓
- Identify each specific digit treated using standard anatomical terminology (e.g., right great toe, left second toe)
- Document whether avulsion was partial or complete for each nail plate removed
- Record that local anesthesia was administered — avulsion without anesthesia does not support surgical nail codes
- For repeat avulsion within 16 weeks (finger) or 32 weeks (toe), document the specific clinical indication, such as ingrown nail of the opposite border or new significant pathology
- Confirm that lateral and medial border involvement of the same nail is captured in a single code entry, not reported separately
- Include the patient complaint, relevant medical history, and any pertinent prior treatment on the same digit
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 4 cited references ↓
CPT 11732 is an add-on code billed for every nail plate avulsion performed after the first on the same date of service. The primary procedure is always 11730; 11732 captures each subsequent nail. Report one unit of 11732 per additional nail, not one line per digit group — and append the appropriate identifying digit modifier (T-codes or F-codes) to each unit so payers can track which specific nail was treated.
CMS is explicit: a single code covers all work performed on that nail for that date, regardless of whether one or both borders were involved. Don't split lateral and medial border avulsions of the same nail into separate codes. Likewise, never report 11732 alongside 11750 (nail excision) or 11765 (wedge resection) for the same digit on the same DOS — those combinations constitute incorrect coding per CMS LCD L39258.
For repeat avulsions on the same digit within 16 weeks (finger) or 32 weeks (toe), append modifier KX and document the specific clinical indication — ingrown nail of the opposite border, new pathology on the same border, or another distinct medical necessity trigger. Claims missing the KX modifier or the supporting documentation in that window will deny. The MUE for 11732 is 9, so multiple additional nails on one claim are structurally supported — the add-on designation itself already accounts for quantity.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.37) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (0.97) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.37 |
| Practice expense RVU | 0.57 |
| Malpractice RVU | 0.03 |
| Total RVU | 0.97 |
| Medicare national rate | $32.40 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $32.40 |
Common denial reasons
The recurring reasons claims for CPT 11732 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed without primary code 11730 — 11732 is an add-on and cannot stand alone
- Repeat avulsion on the same digit within the CMS frequency window submitted without modifier KX
- 11732 reported on the same DOS as 11750 or 11765 for the same digit, which constitutes incorrect coding per CMS LCD L39258
- Missing or non-specific digit modifiers, preventing payers from confirming distinct nails were treated
- Medical record documents bilateral border involvement as two separate procedure units rather than one code per nail
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 4 cited references ↓
01Can I bill 11732 without 11730 on the same claim?
02How many units of 11732 can I report in a single encounter?
03Do I need modifier KX for every nail avulsion claim?
04A patient has an ingrown nail with both lateral and medial borders involved. Do I bill two units of 11730?
05Can I bill 11732 alongside 11750 or 11765 for the same toe on the same day?
06What digit modifiers should I use for toe nail avulsions?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
Mira Scribe
Mira's AI scribe captures the digit-level detail that makes or breaks an 11732 claim: which specific nail was avulsed (partial vs. complete), whether anesthesia was used, and — critically — whether this is a repeat avulsion within the CMS frequency window. If it is, the scribe flags the clinical indication from dictation so modifier KX can be appended with the required documentation already in the record. That prevents the most common denial on repeat nail avulsion claims: a missing or unsupported KX.
See how Mira captures CPT 11732 documentation