Correction of toe joint deformity
Medicare pricing data for 10,387 providers across 52 states
This procedure has a 6.8x markup — hospitals charge $2,948 but Medicare allows only $430.90. Uninsured patients may face bills 6.8 times higher than what insurance negotiates. Prices vary significantly by location — from $225 in South Dakota to $618 in Alaska. 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
Correction of toe joint deformity (HCPCS code 28285) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $430.90, but hospitals typically charge $2,948 — a 6.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $430.90, your out-of-pocket cost would be approximately $86.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.8x more than what Medicare allows for this procedure. Medicare actually pays $342.14 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $618 | $7,550 | 22 | 194 | +43.5% |
| Maryland | $578 | $3,064 | 265 | 1,895 | +34.0% |
| California | $537 | $3,829 | 930 | 6,264 | +24.6% |
| New Jersey | $508 | $4,400 | 423 | 2,017 | +17.8% |
| Wyoming | $503 | $3,222 | 26 | 147 | +16.7% |
| Delaware | $497 | $2,908 | 56 | 705 | +15.3% |
| Washington | $489 | $1,905 | 250 | 2,237 | +13.6% |
| Oregon | $482 | $2,417 | 156 | 1,028 | +11.8% |
| Illinois | $471 | $3,380 | 469 | 3,558 | +9.4% |
| Connecticut | $468 | $3,156 | 128 | 710 | +8.7% |
| Utah | $464 | $3,487 | 122 | 776 | +7.6% |
| New Hampshire | $459 | $4,624 | 39 | 356 | +6.4% |
| Kansas | $455 | $3,358 | 83 | 1,096 | +5.6% |
| Colorado | $452 | $3,989 | 211 | 1,663 | +4.8% |
| Nevada | $451 | $4,223 | 79 | 664 | +4.6% |
| Florida | $448 | $3,491 | 716 | 5,613 | +4.0% |
| Arizona | $448 | $3,370 | 268 | 2,641 | +4.0% |
| Minnesota | $448 | $2,829 | 170 | 1,341 | +4.0% |
| Idaho | $445 | $1,704 | 76 | 838 | +3.2% |
| Indiana | $435 | $3,216 | 237 | 2,042 | +0.9% |
| Virginia | $433 | $2,618 | 259 | 2,428 | +0.5% |
| Missouri | $425 | $2,968 | 202 | 1,504 | -1.4% |
| Mississippi | $418 | $2,897 | 52 | 518 | -3.0% |
| North Carolina | $413 | $2,266 | 290 | 2,446 | -4.1% |
| Nebraska | $411 | $2,611 | 78 | 759 | -4.7% |
| Georgia | $409 | $3,127 | 314 | 2,304 | -5.0% |
| New Mexico | $408 | $2,644 | 66 | 469 | -5.2% |
| Iowa | $406 | $2,513 | 132 | 1,512 | -5.8% |
| Texas | $405 | $3,324 | 748 | 5,912 | -6.0% |
| Louisiana | $401 | $2,517 | 113 | 1,065 | -6.8% |
| Alabama | $396 | $1,824 | 135 | 868 | -8.0% |
| Pennsylvania | $395 | $1,999 | 503 | 3,110 | -8.3% |
| Tennessee | $389 | $2,902 | 217 | 2,208 | -9.7% |
| South Carolina | $386 | $2,388 | 159 | 1,902 | -10.5% |
| Wisconsin | $379 | $4,287 | 203 | 1,373 | -12.0% |
| Michigan | $378 | $2,218 | 362 | 1,840 | -12.2% |
| Montana | $377 | $1,725 | 52 | 382 | -12.4% |
| New York | $375 | $2,853 | 604 | 3,606 | -13.0% |
| Massachusetts | $369 | $2,060 | 227 | 1,576 | -14.5% |
| Arkansas | $368 | $1,763 | 84 | 838 | -14.5% |
| Puerto Rico | $354 | $758 | 12 | 50 | -17.8% |
| Ohio | $349 | $1,980 | 391 | 2,251 | -19.1% |
| Maine | $344 | $1,635 | 25 | 102 | -20.1% |
| North Dakota | $343 | $1,943 | 27 | 412 | -20.5% |
| Hawaii | $342 | $1,413 | 15 | 58 | -20.7% |
| District of Columbia | $332 | $1,739 | 27 | 169 | -23.1% |
| Rhode Island | $322 | $1,649 | 59 | 329 | -25.3% |
| Oklahoma | $279 | $1,207 | 111 | 783 | -35.2% |
| West Virginia | $267 | $1,411 | 33 | 170 | -38.1% |
| Kentucky | $248 | $1,351 | 99 | 631 | -42.4% |
| Vermont | $238 | $1,513 | 11 | 59 | -44.7% |
| South Dakota | $225 | $1,392 | 24 | 259 | -47.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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