Incision of joint capsule of foot and toe
Medicare pricing data for 4,136 providers across 46 states
This procedure has a 5.9x markup — hospitals charge $1,938 but Medicare allows only $329.88. Uninsured patients may face bills 5.9 times higher than what insurance negotiates. Prices vary significantly by location — from $180 in South Dakota to $461 in Montana. 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 of joint capsule of foot and toe (HCPCS code 28270) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $329.88, but hospitals typically charge $1,938 — a 5.9x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $329.88, your out-of-pocket cost would be approximately $65.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.9x more than what Medicare allows for this procedure. Medicare actually pays $261.51 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Montana | $461 | $2,664 | 12 | 16 | +39.9% |
| New Jersey | $397 | $2,714 | 126 | 463 | +20.5% |
| Kansas | $397 | $3,166 | 33 | 147 | +20.2% |
| Maryland | $396 | $2,685 | 117 | 397 | +20.1% |
| Idaho | $382 | $1,309 | 38 | 246 | +15.8% |
| California | $379 | $2,331 | 335 | 1,572 | +14.7% |
| Illinois | $369 | $1,866 | 200 | 1,266 | +12.0% |
| Minnesota | $367 | $2,826 | 80 | 297 | +11.1% |
| Florida | $361 | $1,934 | 362 | 2,134 | +9.5% |
| Washington | $360 | $1,487 | 87 | 195 | +9.2% |
| New Hampshire | $353 | $3,147 | 18 | 108 | +7.0% |
| Arizona | $347 | $2,309 | 128 | 657 | +5.2% |
| Oregon | $346 | $1,764 | 61 | 141 | +4.8% |
| Nevada | $340 | $2,638 | 24 | 98 | +2.9% |
| Georgia | $338 | $2,402 | 137 | 541 | +2.4% |
| Connecticut | $335 | $1,531 | 35 | 100 | +1.7% |
| New York | $331 | $1,579 | 228 | 1,231 | +0.3% |
| North Carolina | $320 | $1,733 | 116 | 520 | -2.9% |
| Colorado | $319 | $2,499 | 89 | 393 | -3.2% |
| New Mexico | $314 | $2,262 | 26 | 181 | -4.8% |
| Iowa | $308 | $2,248 | 49 | 256 | -6.6% |
| Texas | $307 | $2,092 | 306 | 1,191 | -7.0% |
| Delaware | $304 | $2,388 | 25 | 168 | -7.7% |
| Virginia | $303 | $1,715 | 85 | 271 | -8.1% |
| South Carolina | $302 | $1,821 | 75 | 339 | -8.5% |
| Nebraska | $302 | $2,666 | 30 | 128 | -8.6% |
| Alabama | $302 | $772 | 49 | 353 | -8.6% |
| Indiana | $301 | $1,963 | 80 | 238 | -8.8% |
| Michigan | $299 | $1,478 | 143 | 475 | -9.4% |
| Mississippi | $298 | $1,486 | 26 | 433 | -9.6% |
| Ohio | $295 | $1,419 | 185 | 831 | -10.7% |
| Massachusetts | $294 | $1,631 | 65 | 201 | -11.0% |
| Utah | $289 | $2,511 | 45 | 158 | -12.4% |
| Missouri | $286 | $1,798 | 80 | 282 | -13.2% |
| Arkansas | $283 | $1,230 | 41 | 245 | -14.1% |
| Louisiana | $273 | $2,180 | 57 | 183 | -17.2% |
| Tennessee | $269 | $1,794 | 101 | 381 | -18.3% |
| North Dakota | $267 | $1,754 | 22 | 114 | -19.0% |
| Kentucky | $266 | $1,255 | 40 | 140 | -19.4% |
| Pennsylvania | $265 | $1,489 | 159 | 492 | -19.6% |
| Wisconsin | $264 | $2,869 | 63 | 158 | -20.1% |
| Oklahoma | $260 | $797 | 50 | 239 | -21.3% |
| Maine | $251 | $1,693 | 10 | 21 | -23.8% |
| Rhode Island | $221 | $1,728 | 15 | 55 | -32.9% |
| District of Columbia | $203 | $1,029 | 9 | 43 | -38.4% |
| South Dakota | $180 | $1,322 | 12 | 43 | -45.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber