Cost of Surgery

Know Your Insurance: The Basics

Each insurance plan pays differently. Call your insurance company and verify your benefits with our facility to determine eligibility; based on those benefits, our office can anticipate your out-of-pocket cost.

• Dr. Moy is a non-contracted PPO provider (out of network).
• Medicare, Medi-Cal, and HMO plans are not accepted; patients under these plans are considered cash patients.
• The diagnosis code for a bunion is M20.11 (right foot) or M20.12 (left foot).
• The procedure code to correct the bunion is 28296.

An insurance deductible is the amount you must pay first, before your insurance begins applying payment to the surgical charges. Contact the office and speak with our office manager about your particular situation, whether insured or not.

Types of Surgery

Several types of surgery can be performed to correct a bunion, and more than one procedure may be done at the same time:

• Bunionectomy: removal of part of the metatarsal head (the prominent part of the bone).
• Osteotomy: making small cuts in the bone and realigning the joint into a more normal position.
• Resection arthroplasty: removing damaged parts of the joint.
• Arthrodesis: repairing and shortening the tendons and ligaments surrounding the misaligned bone to help keep it from moving back out of position.

Three Components to the Cost of Surgery

1. Surgical repair/physician's fee: the physician's fee, along with any post-operative care.
2. Facility services: the fee for the operating room, pre-operative testing, supplies, and medications needed before and during surgery at the outpatient surgery center.
3. Anesthesiologist: anesthesia services are billed separately, and include the anesthesiologist's fee, medications required for anesthesia, and related pre- and post-operative services.

What Determines Your Out-of-Pocket Cost

Because Dr. Moy is an out-of-network PPO provider, the exact amount you owe depends on your plan's specifics, not a fixed price set by the office:

• Whether you've already met your deductible for the year.
• Your plan's out-of-network reimbursement percentage (this varies widely between PPO plans, even from the same insurer).
• Whether the procedure involves only the bunion correction or additional work, such as revision surgery or a more involved reconstruction, which affects facility and anesthesia time.
• Whether you're a cash-pay patient (Medicare, Medi-Cal, HMO, or uninsured), in which case the office can provide a total price for the surgical fee directly.

Getting an Accurate Estimate

Because these variables differ from patient to patient, our office cannot publish a single price that applies to everyone. The most reliable way to get a number specific to your situation is to call the office: our staff will verify your benefits with your insurance company and walk you through anticipated out-of-pocket costs for the physician's fee, facility fee, and anesthesia before you schedule.

For more on the office location and what a consultation involves, see bunion surgery in Orange County.