28232

Incision to lengthen toe tendon

Medicare pricing data for 3,754 providers across 46 states

🤖AI Overview

This procedure has a 5.1x markup — hospitals charge $1,149 but Medicare allows only $224.97. Uninsured patients may face bills 5.1 times higher than what insurance negotiates. Prices vary significantly by location — from $127 in North Dakota to $351 in Rhode Island. Where you get this procedure matters more than almost any other factor. 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

Incision to lengthen toe tendon (HCPCS code 28232) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $224.97, but hospitals typically charge $1,149 — a 5.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$44.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $224.97, your out-of-pocket cost would be approximately $44.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$224.97
Average Hospital Charge
$1,149
Markup Ratio
5.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,148.87
Medicare Allowed$224.97
Medicare Payment$176.41

Hospitals charge 5.1x more than what Medicare allows for this procedure. Medicare actually pays $176.41 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Rhode Island$351$759717+55.8%
Maryland$281$1,11572403+24.8%
New Jersey$274$1,679122322+21.6%
Massachusetts$273$92581314+21.3%
Connecticut$272$1,10343143+20.9%
California$267$1,3062961,395+18.6%
New York$254$1,209178658+13.1%
Utah$253$1,10167471+12.6%
New Mexico$246$8922887+9.5%
Florida$245$9443021,695+9.0%
Louisiana$245$85347252+8.9%
Virginia$244$1,132108455+8.3%
Oregon$243$1,41249205+8.1%
Oklahoma$241$72750396+7.3%
Michigan$241$755202753+7.3%
Washington$234$1,19873371+3.9%
Montana$230$94022156+2.3%
Pennsylvania$229$878173634+1.6%
Ohio$227$995171612+1.0%
Colorado$223$1,82292320-0.8%
Nevada$222$1,11432129-1.4%
Texas$220$1,3022561,019-2.0%
Missouri$220$1,25262353-2.3%
Kentucky$219$86032133-2.7%
Wyoming$218$1,0637144-3.3%
South Carolina$217$83063329-3.5%
West Virginia$213$7631367-5.4%
North Carolina$207$1,17695420-8.1%
Georgia$205$1,19485348-8.8%
Illinois$202$1,407145639-10.2%
Indiana$200$1,633103475-11.1%
Kansas$199$1,22234290-11.4%
Delaware$197$87417181-12.3%
Wisconsin$197$2,26675287-12.3%
Tennessee$195$1,72483437-13.1%
South Dakota$193$4401575-14.0%
Idaho$193$87530144-14.2%
Minnesota$189$1,44952163-15.8%
Alabama$188$1,13945194-16.3%
Iowa$185$1,51776425-17.9%
Arizona$183$9211281,113-18.6%
Arkansas$181$60327565-19.7%
Mississippi$168$82316310-25.5%
Nebraska$156$1,66526125-30.8%
New Hampshire$128$2,3321058-42.9%
North Dakota$127$2,452739-43.6%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber