11732

Simple separation of fingernail or toenail from nail bed, each additional nail

Medicare pricing data for 4,114 providers across 47 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

Simple separation of fingernail or toenail from nail bed, each additional nail (HCPCS code 11732) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $32.39, but hospitals typically charge $82.44 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.48

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $32.39, your out-of-pocket cost would be approximately $6.48. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$32.39
Average Hospital Charge
$82.44
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$82.44
Medicare Allowed$32.39
Medicare Payment$24.93

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $24.93 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$40$1531030+24.9%
New York$38$1013191,508+18.8%
New Jersey$37$931491,282+13.4%
Connecticut$36$1083498+11.7%
Maryland$36$10568184+11.3%
District of Columbia$36$80711+10.9%
Massachusetts$35$9893284+7.9%
California$35$853794,531+6.6%
Rhode Island$34$1161019+6.1%
Delaware$34$1021432+4.4%
Colorado$34$8572225+4.0%
Illinois$33$891951,538+3.2%
Michigan$33$641901,411+2.7%
Pennsylvania$33$842411,703+2.3%
Florida$33$662981,786+1.5%
Montana$33$921931+0.4%
Washington$32$92100332+0.2%
Arizona$32$71108567+0.2%
New Mexico$32$993075-0.9%
Maine$32$1191126-0.9%
Virginia$32$8595271-1.3%
Nevada$32$7936187-2.6%
Texas$31$96217647-3.1%
Utah$31$7948150-3.2%
Oregon$31$863672-3.6%
North Carolina$31$86108390-5.0%
Ohio$31$86124442-5.1%
Oklahoma$31$8040189-5.7%
Arkansas$30$5128181-7.3%
Nebraska$30$7442331-7.3%
Louisiana$30$9241239-7.7%
Indiana$30$7684456-7.8%
Idaho$30$882278-8.0%
Mississippi$29$11620112-9.1%
Minnesota$29$10958114-10.4%
South Carolina$29$5863361-11.2%
Kentucky$28$6859125-12.1%
Georgia$28$109921,137-12.7%
Iowa$28$9457102-14.8%
Wisconsin$27$15474156-16.0%
Kansas$27$4051488-16.6%
Tennessee$27$4880643-17.4%
North Dakota$26$108712-18.7%
New Hampshire$26$103716-20.5%
West Virginia$25$842049-23.3%
Alabama$24$4350508-25.2%
Missouri$22$6365282-32.8%

⚠️ 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