28810

Amputation of toe and midfoot bone

Medicare pricing data for 5,590 providers across 52 states

🤖AI Overview

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

Amputation of toe and midfoot bone (HCPCS code 28810) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $362.03, but hospitals typically charge $1,389 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$72.41

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $362.03, your out-of-pocket cost would be approximately $72.41. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$362.03
Average Hospital Charge
$1,389
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,388.74
Medicare Allowed$362.03
Medicare Payment$287.62

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $287.62 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$513$3,8882145+41.6%
Delaware$487$1,2102337+34.6%
Wyoming$416$1,5771427+14.8%
Iowa$415$2,16266142+14.5%
New Mexico$409$9942560+12.9%
New Jersey$397$1,440154369+9.6%
New York$393$1,563308805+8.5%
Maryland$387$1,25788300+6.9%
Washington$381$1,152140291+5.3%
Puerto Rico$377$4481113+4.2%
Illinois$377$1,640231557+4.0%
Texas$374$1,346385871+3.2%
California$373$1,4014731,227+3.1%
Virginia$371$1,203146383+2.4%
Florida$371$1,240291640+2.4%
Massachusetts$368$1,626111333+1.6%
Oregon$367$1,33273148+1.3%
New Hampshire$365$2,51141145+0.8%
North Dakota$365$1,4962763+0.7%
North Carolina$362$1,317220521-0.0%
Michigan$362$1,199187360-0.1%
Colorado$362$1,34391174-0.1%
Montana$359$1,0654092-0.7%
Utah$358$1,4684173-1.1%
Oklahoma$358$1,06569170-1.2%
Mississippi$357$1,38595293-1.3%
Ohio$357$1,112208426-1.4%
Pennsylvania$355$1,097292720-2.1%
Connecticut$354$1,4943589-2.1%
Alabama$354$1,16992264-2.2%
Georgia$354$1,355167418-2.2%
Louisiana$351$1,17182204-3.1%
Indiana$351$1,542122284-3.1%
Minnesota$351$1,56583188-3.1%
Nevada$351$1,4163785-3.1%
Vermont$351$1,5151937-3.2%
Arizona$349$1,260114246-3.5%
Missouri$348$1,203117265-3.9%
Tennessee$348$1,183130301-4.0%
Maine$344$1,8063568-4.9%
Kentucky$344$1,09889251-4.9%
Rhode Island$342$1,3222136-5.5%
District of Columbia$335$1,239933-7.3%
South Carolina$334$1,402124344-7.8%
West Virginia$333$1,1753881-8.0%
Hawaii$328$1,0461444-9.3%
South Dakota$328$1,3031462-9.5%
Arkansas$323$1,10979214-10.8%
Wisconsin$321$3,025126324-11.3%
Idaho$309$1,18450103-14.6%
Nebraska$282$1,13560161-22.2%
Kansas$279$1,07557220-22.9%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber