11721

Removal of fingernails or toenails, 6 or more nails

Medicare pricing data for 19,018 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 5.4 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Removal of fingernails or toenails, 6 or more nails (HCPCS code 11721) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $43.55, but hospitals typically charge $82.76 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.71

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $43.55, your out-of-pocket cost would be approximately $8.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$43.55
Average Hospital Charge
$82.76
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$82.76
Medicare Allowed$43.55
Medicare Payment$31.78

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $31.78 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$50$78375,344+14.6%
New York$48$891,787564,668+10.6%
New Jersey$48$841,069339,470+9.2%
California$47$881,840527,357+8.4%
Maryland$47$75376112,389+7.0%
Connecticut$46$8620448,735+5.7%
Massachusetts$46$96414159,467+5.4%
Rhode Island$45$1098118,747+3.0%
Hawaii$45$94385,476+2.8%
Delaware$44$766424,904+1.9%
Washington$44$8336576,722+1.4%
Wyoming$44$99157,881+0.9%
Nevada$44$8112923,012+0.5%
Virginia$43$7838792,171-0.2%
Alaska$43$135291,937-0.6%
Illinois$43$80940305,735-0.7%
Colorado$43$8424629,652-1.4%
Pennsylvania$43$741,277482,428-1.4%
Oregon$43$9118239,217-1.4%
Florida$43$781,383447,912-1.8%
Arizona$43$88419103,321-1.9%
Michigan$42$72786229,247-2.5%
Puerto Rico$42$46331,098-2.9%
New Hampshire$42$806415,231-3.9%
Texas$42$85978182,651-3.9%
Vermont$42$79245,107-4.1%
Utah$41$8919242,060-5.0%
Montana$41$887520,048-5.0%
North Carolina$41$8539383,743-5.0%
Georgia$41$97419111,696-5.2%
Minnesota$41$8729458,110-5.8%
New Mexico$41$8910116,616-5.8%
Ohio$41$741,023297,666-6.1%
South Carolina$41$7426188,040-6.1%
Maine$41$677620,346-6.3%
Indiana$41$7935191,185-7.0%
Alabama$40$7615641,223-7.1%
Oklahoma$40$6617735,710-8.2%
Wisconsin$40$12833171,142-8.4%
Kentucky$40$7424473,947-9.2%
Tennessee$39$8731870,358-9.4%
Iowa$39$97223102,067-9.6%
Arkansas$39$798015,385-10.1%
Idaho$39$848617,888-10.3%
Kansas$39$7312064,804-10.3%
Missouri$39$74332115,853-10.8%
Nebraska$38$7512433,509-11.9%
West Virginia$38$7610323,079-13.2%
Mississippi$37$907118,213-14.7%
Louisiana$37$8518936,363-14.8%
South Dakota$37$70518,068-15.9%
North Dakota$34$93547,966-22.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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