How much does Medicare pay for CPT 28124?

Medicare allowed an average of $323.10 per service and paid $248.82 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1820.04, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 28124?

Partial removal of toe bone. It was billed 1,111 times to 858 Medicare beneficiaries by 44 providers in 2024.

Does 28124 pay differently in an office than a hospital?

Yes. The allowed amount averaged $385.17 in an office setting and $193.08 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 28124 most?

Podiatry, with 916 services from 34 clinicians. Next are Ambulatory Surgical Center, Orthopedic Surgery.

CPT 28124

Partial removal of toe bone

$323.10Medicare-allowed amount per service, averaged across 1,111 services

Providers submitted

$1820.04

Asking price, not received

Medicare allowed

$323.10

The fee schedule figure

Medicare paid

$248.82

Balance is patient coinsurance

Providers submitted an average of $1820.04 for this code and Medicare allowed $323.10 — 5.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $248.82 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $385.17
Hospital / facility: $193.08

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 752 services were billed in an office setting and 359 in a facility.

Services: 1,111
Beneficiaries: 858
Providers billing it: 44
Total allowed: $358,964

What Medicare pays for CPT 28124

Across 1,111 services billed by 44 providers to 858 beneficiaries, Medicare allowed an average of $323.10 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 28124

Specialty	Services	Beneficiaries	Avg allowed	Providers
Podiatry	916	723	$351.72	34
Ambulatory Surgical Center	149	94	$189.56	7
Orthopedic Surgery	46	41	$185.73	3

28124 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Alabama	168	$402.85	$348.45	1
California	102	$389.33	$248.66	5
South Carolina	88	$422.20	$341.79	2
Mississippi	80	$234.15	$209.02	1
New Mexico	64	$165.38	$136.96	2
Arkansas	62	$344.48	$290.24	2
Utah	61	$185.46	$142.37	3
Florida	58	$324.16	$239.94	4
Illinois	54	$333.53	$270.72	2
Massachusetts	44	$400.01	$293.55	3
New York	43	$382.78	$273.02	3
Nebraska	40	$395.91	$358.82	1
Nevada	38	$169.64	$133.87	2
Washington	35	$343.43	$258.01	2
Maryland	24	$175.26	$131.77	1
Arizona	21	$191.71	$154.04	1
Virginia	18	$396.32	$302.79	1
North Dakota	17	$200.03	$166.15	1
Pennsylvania	15	$204.86	$143.49	1
Indiana	15	$380.89	$321.20	1
Tennessee	14	$200.05	$184.14	1
Texas	13	$419.75	$329.33	1
Missouri	13	$371.53	$336.95	1
Georgia	12	$181.97	$131.96	1
North Carolina	12	$369.62	$299.00	1

Related codes

28122Partial removal of foot or heel bone$383.33

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.