11765

Removal of skin of fingernail or toenail

Medicare pricing data for 2,380 providers across 46 states

🤖AI Overview

Prices vary significantly by location — from $81 in Maine to $181 in New Jersey. 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

Removal of skin of fingernail or toenail (HCPCS code 11765) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $148.32, but hospitals typically charge $272.76 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.66

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $148.32, your out-of-pocket cost would be approximately $29.66. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$148.32
Average Hospital Charge
$272.76
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$272.76
Medicare Allowed$148.32
Medicare Payment$113.64

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $113.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$181$32554466+21.7%
Connecticut$177$2027196+19.6%
New York$175$2891695,494+17.7%
Hawaii$164$4521014+10.9%
Maryland$164$21634656+10.8%
Washington$164$36174278+10.6%
Pennsylvania$163$26049726+9.6%
Rhode Island$161$2728513+8.4%
Virginia$155$21150477+4.4%
Massachusetts$155$4022548+4.4%
California$153$26037813,521+3.3%
Illinois$153$28166563+3.1%
Nevada$152$26312175+2.8%
Florida$150$2921194,717+0.9%
Colorado$148$3363656-0.1%
Wyoming$148$3581213-0.3%
Arizona$146$3131141,668-1.9%
Oregon$145$4322286-2.5%
Wisconsin$143$4463597-3.6%
North Carolina$141$36161141-5.2%
South Carolina$140$38837336-5.6%
Idaho$140$3281786-5.7%
Kentucky$140$3571533-5.9%
Utah$139$3103261-6.0%
Mississippi$138$3271947-7.0%
New Hampshire$138$396789-7.1%
Indiana$138$242701,073-7.3%
Arkansas$138$28816240-7.3%
Kansas$137$2751520-7.4%
Missouri$137$3264674-7.8%
Michigan$136$18244612-8.3%
Texas$134$2651578,419-10.0%
Oklahoma$133$3233970-10.1%
Louisiana$133$4202895-10.2%
Minnesota$132$46351133-11.1%
Nebraska$132$3512128-11.2%
Ohio$131$20451610-11.4%
Georgia$129$26157720-13.3%
New Mexico$127$30917354-14.7%
Alabama$120$30830596-18.8%
South Dakota$110$2381425-25.7%
Tennessee$107$18458929-28.1%
North Dakota$104$4041699-29.9%
Iowa$103$3172277-30.3%
Alaska$88$509439-40.9%
Maine$81$1471056-45.1%

⚠️ 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