11719

Trimming of fingernails or toenails

Medicare pricing data for 5,886 providers across 51 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

Trimming of fingernails or toenails (HCPCS code 11719) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $10.58, but hospitals typically charge $36.49 — a 3.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $10.58, your out-of-pocket cost would be approximately $2.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$10.58
Average Hospital Charge
$36.49
Markup Ratio
3.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$36.49
Medicare Allowed$10.58
Medicare Payment$7.74

Hospitals charge 3.4x more than what Medicare allows for this procedure. Medicare actually pays $7.74 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
North Dakota$13$44433+26.6%
District of Columbia$13$46695+22.1%
Hawaii$12$4241,285+17.3%
Nevada$12$4114424+14.0%
Wyoming$12$75320+12.9%
California$12$4017923,590+12.9%
Texas$12$362549,916+12.4%
Wisconsin$12$561075,338+11.8%
Georgia$12$381124,594+11.1%
Minnesota$12$461041,839+9.7%
Washington$12$36934,489+9.5%
Arkansas$12$35262,491+9.5%
Iowa$12$35593,658+9.3%
Oregon$11$36462,143+7.5%
Ohio$11$3028616,860+6.1%
Idaho$11$4417802+6.0%
Alabama$11$39431,689+5.9%
Maryland$11$3419442,154+5.6%
New York$11$3567371,660+3.9%
Arizona$11$45554,027+3.7%
Montana$11$3171,211+2.4%
Colorado$11$42731,082+2.2%
Delaware$11$34396,995+2.0%
Oklahoma$11$42622,887+1.9%
Nebraska$11$4329791+1.8%
Maine$11$4124667+1.5%
Kansas$11$34393,080+1.3%
New Jersey$11$3747780,035+0.9%
Tennessee$11$40942,927+0.4%
Pennsylvania$11$35582103,940+0.1%
Alaska$10$338303-1.0%
Michigan$10$341695,782-1.1%
Missouri$10$3611811,500-1.2%
South Carolina$10$401105,777-2.3%
Virginia$10$371557,315-2.6%
Mississippi$10$3331296-3.1%
New Hampshire$10$48321,850-3.3%
Rhode Island$10$38397,876-3.4%
Massachusetts$10$4724230,266-5.6%
Louisiana$10$37691,952-5.9%
Florida$10$3228624,597-7.0%
Kentucky$10$281094,086-7.4%
New Mexico$10$2325795-8.3%
Indiana$10$33644,616-8.6%
West Virginia$9$26512,553-12.1%
Illinois$9$3828322,003-15.6%
Utah$9$31322,218-17.2%
Connecticut$9$4313315,169-17.4%
Vermont$9$2810631-18.1%
North Carolina$8$2517610,994-21.3%
South Dakota$8$36141,013-21.9%

⚠️ 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