28122

Partial removal of foot or heel bone

Medicare pricing data for 5,997 providers across 51 states

🤖AI Overview

This procedure has a 5.3x markup — hospitals charge $2,118 but Medicare allows only $401.47. Uninsured patients may face bills 5.3 times higher than what insurance negotiates. 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

Partial removal of foot or heel bone (HCPCS code 28122) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $401.47, but hospitals typically charge $2,118 — a 5.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$80.29

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $401.47, your out-of-pocket cost would be approximately $80.29. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$401.47
Average Hospital Charge
$2,118
Markup Ratio
5.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,118.42
Medicare Allowed$401.47
Medicare Payment$319.00

Hospitals charge 5.3x more than what Medicare allows for this procedure. Medicare actually pays $319.00 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$590$6,3611530+47.0%
Delaware$560$2,3582880+39.5%
Wyoming$532$3,0551831+32.5%
Oregon$520$1,87786172+29.5%
Idaho$461$1,64653144+14.9%
California$461$2,4764621,237+14.8%
Washington$458$1,741160372+14.1%
Colorado$447$2,600129293+11.3%
New Jersey$440$2,650182401+9.7%
North Dakota$433$2,0792276+7.7%
Arizona$422$2,304180546+5.1%
Florida$421$2,2914121,189+5.0%
Indiana$421$2,404159456+4.9%
Texas$418$2,3774431,102+4.1%
Alabama$415$1,74370275+3.3%
Tennessee$414$1,974134386+3.2%
New Mexico$413$2,16749180+2.9%
Georgia$410$2,707154493+2.1%
Illinois$409$2,601288756+2.0%
Utah$402$2,01677240+0.0%
New York$400$2,620241528-0.3%
Montana$400$1,8162664-0.4%
Kansas$396$2,09366241-1.4%
Connecticut$393$1,99965237-2.1%
Massachusetts$391$1,816112279-2.6%
Minnesota$391$2,479116290-2.6%
Missouri$391$1,93798252-2.6%
Nevada$386$2,16556302-3.9%
Michigan$383$1,453209476-4.6%
Ohio$382$1,692222570-4.9%
Pennsylvania$382$1,665255663-4.9%
Virginia$379$1,605155513-5.5%
New Hampshire$373$2,68026109-7.1%
Arkansas$369$1,62444102-8.2%
North Carolina$360$1,784171534-10.3%
Maryland$360$1,560135724-10.4%
Vermont$350$1,944714-12.7%
Oklahoma$350$1,24164177-12.9%
District of Columbia$344$1,46921155-14.3%
Mississippi$341$2,23436136-15.0%
Nebraska$338$2,08860171-15.8%
Rhode Island$337$1,4062868-16.1%
Louisiana$337$1,61455129-16.2%
Maine$336$1,4222246-16.3%
Iowa$336$2,22588270-16.3%
South Carolina$334$1,717102225-16.9%
West Virginia$326$1,3932763-18.8%
Wisconsin$311$3,879131268-22.5%
Hawaii$302$1,6921025-24.7%
Kentucky$299$1,25462178-25.4%
South Dakota$296$1,2182885-26.3%

⚠️ 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