Does Medicare Cover Bunion Surgery?
- Find out if Medicare covers bunion surgery and what procedures it covers and learn about the different types of bunion surgical procedures that are commonly performed.
Bunion surgery can cost a Medicare beneficiary an average of $404 or $717 out of pocket in 2024, depending on the type of facility where the surgery is performed. These average costs are according to the Medicare.gov Procedure Cost Lookup Tool.
A bunion or a hallux abducto valgus is a bony protrusion on the bone of the big toe that grows in size over time, causing significant pain and discomfort in certain individuals. Bunions develop due to the big toe leaning inward toward the second toe, which can occur following injuries that cause the bones in the front area of the foot to move out of position.
Another common cause of bunions is wearing ill-fitting footwear or shoes that cause the toes to bunch together, such as high heels. Arthritis can also factor into the development of bunions. Bunions are sometimes treatable with conservative methods such as medications and ice therapy; however, surgery may be required if the condition is severe.
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Does Medicare Cover Bunion Surgery?
The short answer is yes, medicare will cover bunion surgery. Medicare Part B will cover 80% of medically necessary bunion surgery procedures, along with medically necessary medical supplies and podiatrist visits. Recipients are required to pay for 20% of the procedure out-of-pocket, and you can get more details by looking up your specific plan.
Common Types of Bunion Surgery Procedures
There are several types of surgical procedures utilized to treat bunions, and the type of surgery performed depends on factors such as size and overall development of the bunion or bunions. Procedures include:
- Osteotomy and ligament or tendon repair
During this procedure, the surgeon creates an incision on the affected area. The bunion and surrounding ligaments and tendons are released, and the protrusion is removed with a bone saw. The big toe bone is then realigned, and the bones are held together with a plate or screw. - Exostectomy
During an exostectomy procedure, an incision is made and the bony growth is surgically removed. This procedure is not as common as an osteotomy since the toe bone is not realigned. - Arthrodesis
Arthrodesis procedures consist of complete removal of the damaged toe joint. Once the joint is removed, screws or metal plates are inserted in its place, which helps to improve the deformity. - Lapiplasty
Lapiplasty is a less invassive form of bunion procedure that relies on using advanced instruments to push the entire metatarsal bone back into place rather than shaving down the infected areas like in Osteotomy. Lapiplasty cost with medicare can be anywhere from $3,000 to $15,000+ but it all depends on your specific medicare plan.
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What to Expect Following Bunion Surgery
Patients who undergo surgery to correct bunions must follow aft
ercare instructions provided by their physicians to ensure the bones, joints and ligaments of the foot heal correctly. Patients may be required to wear a boot or a brace for up to a month or longer, and they may also be directed to use crutches. Additional aftercare instructions may include the following:
- Elevation of the affected foot for a set amount of time each day
- Taking prescription or over-the-counter pain medication as directed by a physician.
- Wrapping the foot in plastic during showers or baths to prevent moisture on the foot dressing or cast
- Monitoring surgical incisions for signs of infection
- Abstaining from exercise or strenuous physical activity until the foot is fully healed
Tips to Avoid Bunion Recurrence
While recurrence of bunions following surgery is fairly uncommon, it is possible. In most cases, recurrence doesn't happen for several years, but it's always a good idea for patients to take preventative measures to reduce the chances of regrowth. Failed bunion surgery syndrome is a condition in which previous bunion procedures failed to produce the desired results.
Failed bunion surgery can result from a doctor's error or misinterpretation of the severity of the condition, poor healing or for unknown reasons. In cases of failed surgery, patients can sometimes opt for a follow-up procedure called revision bunion surgery. Signs and symptoms of failed surgery include:
- Bunion recurrence or reappearance
- Big toe appearing shorter than the other toes
- Development of arthritis in the joint of the big toe
- Joint stiffness in the big toe
If a patient suspects failed bunion surgery, it's extremely important to contact a physician or the performing surgeon to remedy the situation and prevent future medical problems.
What Is the Average Cost of Bunion Surgery?
The cost of bunion surgery in the United States ranges between $3,500 and $12,000, with an average cost of $5,500. Prices can vary depending on the type of surgery and insurance coverage. For Medicare recipients, 80% of the cost is covered through Medicare, which equals $4,400 in the $5,500 average scenario.
How Often Does Medicare Pay for Podiatrist Services?
Medicare does not cover routine foot care services such as nail clipping, foot soaks or corn removals. However Medicare Part B provides coverage for podiatrist services every six months for recipients with nerve damage caused by diabetes and other foot issues that are considered medically necessary, such as deformities and injuries that include hammer toe and heel spurs.
