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Toe amputation: what insurers pay

Amputation of a toe at the joint, most often for infection or poor circulation. Commercial negotiated rates by hospital and market, next to Medicare for the same code.

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CPT 28820: Amputation of Toe

104 hospitals in 37 markets. National Medicare rate $3,343, surgery center $1,645.

MarketHospitals25th pctMedian75th pctLow–high
Atlanta GA4———$4,346–$5,531
Austin TX2———$2,628–$5,926
Boston MA7$4,607$5,232$6,040$4,086–$6,622
California (statewide)1———$11,297–$11,297
Chicago IL5$4,628$4,837$5,326$4,109–$7,516
Cleveland OH5$3,484$3,502$6,238$2,890–$6,370
Columbus OH1———$11,769–$11,769
Dallas-Fort Worth TX4———$4,302–$10,017
Denver CO7$4,527$4,764$4,994$4,300–$5,980
Detroit MI6$2,795$2,795$3,042$2,654–$5,812
Georgia (statewide)1———$4,797–$4,797
Houston TX1———$3,849–$3,849
Indianapolis IN2———$3,857–$8,718
Kansas (statewide)1———$3,708–$3,708
Las Vegas NV1———$3,769–$3,769
Los Angeles CA2———$8,293–$14,342
Miami-Fort Lauderdale FL1———$6,022–$6,022
Minneapolis-St. Paul MN4———$4,022–$7,452
Nashville TN4———$1,637–$3,284
New York (statewide)1———$5,783–$5,783
New York City3———$6,861–$8,622
Ohio (statewide)1———$5,506–$5,506
Pennsylvania (statewide)1———$6,958–$6,958
Philadelphia PA5$3,640$6,648$6,993$3,453–$11,399
Phoenix AZ3———$2,968–$3,039
Pittsburgh PA1———$4,387–$4,387
Portland OR6$7,274$7,274$10,788$7,274–$11,960
Research Triangle NC2———$5,152–$5,152
Richmond VA2———$5,670–$5,839
San Antonio TX1———$3,695–$3,695
San Diego CA1———$4,208–$4,208
San Francisco Bay Area CA1———$19,507–$19,507
Seattle-Tacoma WA6$10,046$10,872$13,228$8,834–$14,460
St. Louis MO5$6,730$6,730$6,730$4,953–$9,261
Tampa FL2———$3,630–$6,038
Washington DC3———$4,798–$5,012
Wisconsin (statewide)1———$6,484–$6,484
HospitalMarketMedian across insurers× MedicareInsurersFile date
Ascension Saint Thomas RutherfordNashville TN$1,6370.5×12026-01-01
Ascension Seton Medical Center AustinAustin TX$2,6280.8×12026-01-01
Trinity Health Oakland HospitalDetroit MI$2,6540.8×162026-03-31
Corewell Health Beaumont Grosse Pointe HospitalDetroit MI$2,7950.9×12026-05-01
Corewell Health William Beaumont University HospitDetroit MI$2,7950.9×12026-05-01
Corewell Health Beaumont Troy HospitalDetroit MI$2,7950.9×12026-05-01
University Hospitals - Elyria Medical CenterCleveland OH$2,8900.9×42026-07-14
TriStar StoneCrest Medical CenterNashville TN$2,8950.9×52026-09-01
HonorHealth Scottsdale Thompson Peak Medical CenterPhoenix AZ$2,9680.8×42026-04-01
HonorHealth Scottsdale Osborn Medical CenterPhoenix AZ$3,0390.9×52026-04-01
HonorHealth Scottsdale Shea Medical CenterPhoenix AZ$3,0390.9×52026-04-01
Henry Ford Health Rochester HospitalDetroit MI$3,1251.0×12026-01-01
Vanderbilt University Medical CenterNashville TN$3,2451.0×72025-10-01
Ascension Saint Thomas Hospital (Midtown + West)Nashville TN$3,2841.1×12026-01-01
Riddle Memorial HospitalPhiladelphia PA$3,4531.0×22026-04-01
Cleveland Clinic Lutheran HospitalCleveland OH$3,4841.1×22026-06-15
Medina HospitalCleveland OH$3,5021.1×32026-06-15
Tampa General HospitalTampa FL$3,6301.1×32026-04-01
Bryn Mawr HospitalPhiladelphia PA$3,6401.1×22026-04-01
Methodist HospitalSan Antonio TX$3,6951.1×52026-09-01
Menorah Medical CenterKansas (statewide)$3,7081.2×52026-09-01
University Medical Center of Southern NevadaLas Vegas NV$3,7691.1×72026-07-01
Houston Methodist HospitalHouston TX$3,8491.2×62026-04-01
Ascension St Vincent AndersonIndianapolis IN$3,8571.1×12026-01-01
Park Nicollet Methodist HospitalMinneapolis-St. Paul MN$4,0221.2×22026-03-31
Beverly Hospital CorporationBoston MA$4,0861.0×42026-04-01
Endeavor Health Northwest Community HospitalChicago IL$4,1091.2×22026-04-01
New England Baptist HospitalBoston MA$4,1831.1×42026-04-01
Scripps Green HospitalSan Diego CA$4,2081.0×12026-03-30
Adventhealth PorterDenver CO$4,3001.3×22026-04-01
Adventhealth ParkerDenver CO$4,3001.3×22026-04-01
Baylor University Medical CenterDallas-Fort Worth TX$4,3021.3×32026-06-29
Emory University HospitalAtlanta GA$4,3461.3×62026-04-01
Upmc Presbyterian ShadysidePittsburgh PA$4,3871.4×12026-03-06
Endeavor Health Edward HospitalChicago IL$4,6281.3×22026-04-01
HCA HealthONE Presbyterian/St. Luke'sDenver CO$4,7541.4×42026-09-01
HCA HealthONE SwedishDenver CO$4,7641.4×42026-09-01
Emory Houston Hospital Warner RobinsGeorgia (statewide)$4,7971.7×32026-04-01
Inova Alexandria HospitalWashington DC$4,7981.4×62026-04-01
Endeavor Health Evanston HospitalChicago IL$4,8371.4×22026-04-01
Mercy Hospital SouthSt. Louis MO$4,9531.5×12026-06-10
HCA HealthONE Sky RidgeDenver CO$4,9841.4×42026-09-01
Reston Hospital CenterWashington DC$5,0001.5×42026-09-01
Hca Healthone RoseDenver CO$5,0041.4×42026-09-01
Stonesprings Hospital CenterWashington DC$5,0121.5×42026-09-01
Beth Israel Deaconess Hospital - PlymouthBoston MA$5,0311.3×12026-04-01
UNC Hospitals (Chapel Hill)Research Triangle NC$5,1521.6×12026-04-01
UNC Rex HospitalResearch Triangle NC$5,1521.6×32026-04-01
Anna Jaques HospitalBoston MA$5,2321.3×32026-04-01
Endeavor Health Elmhurst HospitalChicago IL$5,3261.5×22026-04-01
Medical City MckinneyDallas-Fort Worth TX$5,3811.6×52026-09-01
Bethesda NorthOhio (statewide)$5,5061.7×42026-04-01
Piedmont Atlanta HospitalAtlanta GA$5,5311.7×22026-07-01
Piedmont Fayette HospitalAtlanta GA$5,5311.7×22026-07-01
Piedmont Newnan HospitalAtlanta GA$5,5311.7×22026-07-01
Medical City PlanoDallas-Fort Worth TX$5,6401.7×52026-09-01
Henrico Doctors' HospitalRichmond VA$5,6701.8×42026-09-01
Stony Brook University HospitalNew York (statewide)$5,7831.4×52026-06-10
Lahey Hospital & Medical Center, BurlingtonBoston MA$5,7931.5×12026-04-01
Harper University HospitalDetroit MI$5,8121.8×12026-09-02
CJW Medical Center (Chippenham + Johnston-Willis)Richmond VA$5,8391.8×42026-09-01
St David's Medical CenterAustin TX$5,9261.8×52026-09-01
UCHealth University of Colorado HospitalDenver CO$5,9801.7×32025-11-01
Boca Raton Regional HospitalMiami-Fort Lauderdale FL$6,0221.8×22026-03-30
Morton Plant HospitalTampa FL$6,0381.8×22026-01-01
Mercy Hospital (Allina, Coon Rapids)Minneapolis-St. Paul MN$6,1341.8×22026-06-17
United Hospital (Allina)Minneapolis-St. Paul MN$6,2161.8×22026-06-16
Cleveland Clinic (main campus)Cleveland OH$6,2382.0×12026-06-16
Beth Israel Deaconess Medical CenterBoston MA$6,2881.6×22026-04-01
Cleveland Clinic Hillcrest HospitalCleveland OH$6,3702.1×22026-06-15
Orthopaedic Hospital Of WisconsinWisconsin (statewide)$6,4842.0×32026-01-01
Winchester HospitalBoston MA$6,6221.7×22026-04-01
Jefferson Stratford HospitalPhiladelphia PA$6,6481.8×32026-09-15
Missouri Baptist Medical CenterSt. Louis MO$6,7302.0×42025-12-15
Barnes-Jewish West County HospitalSt. Louis MO$6,7302.0×42025-12-15
Barnes-Jewish St Peters HospitalSt. Louis MO$6,7302.0×42025-12-15
Montefiore Medical CenterNew York City$6,8611.7×82026-04-01
Lehigh Valley HospitalPennsylvania (statewide)$6,9582.1×82026-07-01
Thomas Jefferson University HospitalPhiladelphia PA$6,9932.1×32026-09-15
Legacy Emanuel Medical CenterPortland OR$7,2742.0×52026-04-01
Legacy Good Samaritan Medical CenterPortland OR$7,2742.0×52026-04-01
Legacy Mount Hood Medical CenterPortland OR$7,2742.0×52026-04-01
Legacy Meridian Park Medical CenterPortland OR$7,2742.0×52026-04-01
Abbott Northwestern HospitalMinneapolis-St. Paul MN$7,4522.2×32026-06-16
University of Chicago Medical CenterChicago IL$7,5162.1×22026-04-01
Keck Hospital Of UscLos Angeles CA$8,2932.0×52026-04-01
NYU Langone Hospitals (Orthopedic Hospital + Tisch files)New York City$8,4422.1×72026-01-01
Hospital for Special SurgeryNew York City$8,6222.1×62026-04-01
Riverview HealthIndianapolis IN$8,7182.5×22026-04-01
Overlake Hospital Medical CenterSeattle-Tacoma WA$8,8342.3×52026-04-01
Barnes Jewish HospitalSt. Louis MO$9,2612.8×42025-12-15
St Clare HospitalSeattle-Tacoma WA$10,0022.6×62026-02-28
Texas Health Presbyterian Hospital DallasDallas-Fort Worth TX$10,0173.0×22026-04-21
St Anthony HospitalSeattle-Tacoma WA$10,1792.7×62026-02-28
Los Robles Hospital & Medical CenterCalifornia (statewide)$11,2972.7×52026-09-01
Inspira Medical Center Mullica HillPhiladelphia PA$11,3993.1×42026-03-24
Swedish Medical CenterSeattle-Tacoma WA$11,5653.0×52026-04-01
Mount Carmel New Albany Surgical HospitalColumbus OH$11,7693.7×202026-03-31
Providence St Vincent Medical CenterPortland OR$11,9603.3×32026-04-01
Providence Portland Medical CenterPortland OR$11,9603.3×32026-04-01
Tacoma General Allenmore HospitalSeattle-Tacoma WA$13,7823.6×52026-08-27
Cedars-Sinai Medical CenterLos Angeles CA$14,3423.4×32025-11-26
Multicare Good Samaritan HospitalSeattle-Tacoma WA$14,4603.8×42026-08-27
Stanford Health CareSan Francisco Bay Area CA$19,5074.0×42026-04-01

Questions

How much do commercial insurers pay hospitals for toe amputation?

Across 104 hospitals in 37 metro areas that post a usable dollar rate, the median commercial rate for CPT 28820, hospital outpatient is $5,519, 1.6× the same hospital's local Medicare base rate. The middle half of hospitals runs $4,103 to $6,967. Figures are each hospital's median across insurers, from its federal price-transparency file.

What does Medicare pay for toe amputation?

Medicare's national hospital outpatient rate for CPT 28820 is $3,343 and its surgery-center rate is $1,645, before local wage adjustment.

Which hospitals post the lowest and highest commercial rates for toe amputation?

Lowest medians: Ascension Saint Thomas Rutherford ($1,637), Ascension Seton Medical Center Austin ($2,628), Trinity Health Oakland Hospital ($2,654). Highest: Stanford Health Care ($19,507), Multicare Good Samaritan Hospital ($14,460), Cedars-Sinai Medical Center ($14,342). Coverage is limited to the markets listed on this page.