How much does Medicare pay for CPT 11719?

Medicare allowed an average of $10.40 per service and paid $7.57 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $37.11, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11719?

Trimming of fingernails or toenails. It was billed 505,782 times to 197,261 Medicare beneficiaries by 2,224 providers in 2024.

Does 11719 pay differently in an office than a hospital?

Yes. The allowed amount averaged $10.58 in an office setting and $5.82 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 11719 most?

Podiatry, with 491,709 services from 2,133 clinicians. Next are Nurse Practitioner, Physician Assistant, Geriatric Medicine.

CPT 11719

Trimming of fingernails or toenails

$10.40Medicare-allowed amount per service, averaged across 505,782 services

Providers submitted

$37.11

Asking price, not received

Medicare allowed

$10.40

The fee schedule figure

Medicare paid

$7.57

Balance is patient coinsurance

Providers submitted an average of $37.11 for this code and Medicare allowed $10.40 — 3.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $7.57 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $10.58
Hospital / facility: $5.82

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 486,333 services were billed in an office setting and 19,449 in a facility.

Services: 505,782
Beneficiaries: 197,261
Providers billing it: 2,224
Total allowed: $5,260,133

What Medicare pays for CPT 11719

Across 505,782 services billed by 2,224 providers to 197,261 beneficiaries, Medicare allowed an average of $10.40 per service. That is 2.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 11719

Specialty	Services	Beneficiaries	Avg allowed	Providers
Podiatry	491,709	188,060	$10.47	2,133
Nurse Practitioner	11,733	7,622	$7.79	63
Physician Assistant	1,850	1,221	$8.26	13
Geriatric Medicine	131	87	$12.79	2
Family Practice	107	71	$12.42	5
Internal Medicine	92	49	$11.39	3
General Surgery	79	74	$10.54	1
Endocrinology	47	43	$11.59	2
Cardiology	18	18	$12.15	1
Dermatology	16	16	$10.52	1

11719 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Pennsylvania	95,287	$10.41	$7.65	307
New Jersey	78,192	$10.52	$7.27	257
New York	60,229	$10.74	$7.40	299
Maryland	38,140	$10.90	$7.45	112
Massachusetts	25,255	$10.11	$6.79	113
California	22,512	$11.74	$7.81	54
Illinois	20,314	$8.72	$6.46	93
Florida	19,993	$9.89	$7.31	115
Ohio	15,892	$10.88	$8.21	81
Connecticut	12,853	$8.54	$5.93	67
Texas	11,675	$11.18	$8.51	82
North Carolina	9,272	$7.26	$5.84	47
Missouri	9,200	$10.61	$8.07	38
Rhode Island	7,219	$10.06	$6.93	27
Delaware	6,822	$10.77	$7.69	27
Virginia	6,319	$9.71	$7.09	42
South Carolina	5,908	$9.66	$7.18	36
Wisconsin	5,005	$12.19	$8.55	29
Michigan	4,734	$10.52	$7.65	59
Kentucky	4,313	$9.64	$7.58	28
Georgia	4,151	$11.73	$8.82	34
Arizona	3,463	$10.76	$8.29	17
Indiana	3,453	$8.82	$7.11	17
Washington	3,204	$11.54	$8.09	22
Kansas	2,829	$10.59	$7.95	11
Arkansas	2,592	$11.24	$9.07	12
Oklahoma	2,522	$11.09	$8.56	12
Utah	2,421	$8.68	$6.36	10
Iowa	2,292	$11.32	$8.57	19
Tennessee	2,291	$10.62	$8.44	21
West Virginia	1,961	$8.72	$6.62	12
New Hampshire	1,912	$10.19	$7.46	9
Oregon	1,719	$11.00	$7.94	11
Montana	1,523	$11.23	$7.72	5
Alabama	1,365	$10.91	$8.42	10
Colorado	1,239	$11.25	$7.94	15
Hawaii	998	$12.71	$10.14	3
Louisiana	953	$8.72	$6.94	18
Idaho	943	$11.31	$8.60	4
New Mexico	931	$10.63	$8.01	7
Minnesota	840	$11.16	$7.34	12
South Dakota	805	$7.75	$5.42	3
Vermont	540	$8.65	$6.04	5
Nebraska	475	$9.94	$7.31	4
District of Columbia	440	$11.95	$8.49	2
Maine	434	$11.34	$7.37	5
Mississippi	169	$11.27	$9.75	6
Nevada	126	$11.77	$8.40	3
Wyoming	38	$12.12	$8.19	1
North Dakota	19	$11.44	$7.95	1

Related codes

11721Removal of fingernails or toenails$42.83
11720Removal of fingernails or toenails$31.70
11730Simple separation of fingernail or toenail from nail bed$108.98
11750Permanent removal fingernail or toenail$140.90
11755Biopsy of fingernail or toenail$106.95
11765Removal of skin of fingernail or toenail$143.69
11732Simple separation of fingernail or toenail from nail bed$32.18
11740Removal of blood accumulation under fingernail or toenail$40.74
11760Repair of fingernail or toenail bed$122.75

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.