Bunion surgery is priced like several different operations, because it is several different operations. Shaving the bump and moving the toe back into line is a short outpatient case. Cutting and fusing the joint at the base of the first metatarsal, the Lapidus procedure that Lapiplasty is the branded version of, uses a plate, screws, and a much longer operating room booking. Those two sit under different CPT codes and they are not close in price.
This guide separates them using figures verified in September 2026: published cash price lists from three surgery centers, the July 2026 CMS facility payment addenda, and 2024 Medicare claims data released in May 2026. The number that surprises most people is not the surgeon’s fee. It is the facility fee, and it swings by a factor of six depending on which correction you get.
What Does Bunion Surgery Cost Without Insurance?
A standard bunionectomy is a $4,790 to $6,405 cash procedure per foot at a surgery center that publishes its rates. A midfoot fusion correction is roughly double that.
| Price you might be quoted | Low | Typical | High |
|---|---|---|---|
| Bundled ASC cash price, standard bunionectomy (per foot) | $4,790 | $5,239 | $6,405 |
| Bundled ASC cash price, minimally invasive (MICA) bunionectomy | n/a | $5,637 | n/a |
| Bundled ASC cash price, bilateral bunionectomy (both feet) | $6,950 | n/a | $7,623 |
| Bundled ASC cash price, foot bone fusion (Lapidus type) | n/a | $9,870 | n/a |
| Medicare 2026 all-in, CPT 28292 simple bunionectomy, surgery center | n/a | $2,105 | n/a |
| Medicare 2026 all-in, CPT 28292, hospital outpatient | n/a | $3,803 | n/a |
| Medicare 2026 all-in, CPT 28296 osteotomy, surgery center | n/a | $2,129 | n/a |
| Medicare 2026 all-in, CPT 28297 midfoot fusion, surgery center | n/a | $10,564 | n/a |
| Medicare 2026 all-in, CPT 28297 midfoot fusion, hospital outpatient | n/a | $13,679 | n/a |
| Average submitted surgeon charge, CPT 28296 (2024 claims) | n/a | $4,351 | n/a |
| Medicare allowed surgeon amount, CPT 28296 (2024 claims) | n/a | $698 | n/a |
| MDsave prepaid, bunion removal, national | $4,408 | $6,841 | $11,550 |
| MDsave prepaid, bunion correction, national | $5,842 | $11,627 | $17,221 |
The bundled prices come from centers that publish them. Surgery Center of Oklahoma lists $4,790 for a bunionectomy under CPT 28292, covering facility, surgeon, anesthesia, and uncomplicated follow-up, and $6,950 for a bilateral bunionectomy. The Orthopaedic Surgery Center lists $5,239 for a bunionectomy and $7,623 bilateral. Newport Orthopedic Institute, whose rates apply at the Hoag Orthopedic Institute Surgery Center in Newport Beach, lists $6,405 for a bunion correction with standard implants and $9,870 for a fusion of foot bones.
The Medicare rows are not what a self-pay patient pays. They are the cleanest apples-to-apples measure of what each version of the operation is actually worth, and they are the reason the cash prices land where they do.
What Drives the Price
Which correction you get
This is the whole ballgame. CPT 28292 removes the bony prominence and rebalances the joint. CPT 28296 adds an osteotomy, cutting and shifting the first metatarsal. CPT 28297 fuses the first metatarsal to the midfoot, which is the Lapidus procedure and the code Lapiplasty is billed under.
Under the July 2026 CMS ASC addenda, the ambulatory surgery center facility payment is $1,644.87 for both 28292 and 28296, and $10,002.69 for 28297. CMS flags 28297 as device-intensive, which is why the hardware is priced inside the facility rate rather than billed separately. Add the 2026 physician fee schedule amounts ($459.93, $484.31 and $561.80 respectively, calculated as total RVUs times the $33.4009 conversion factor) and Medicare’s all-in surgery center total goes from $2,105 for a simple bunionectomy to $10,564 for the fusion.
Surgery center versus hospital outpatient versus the office
The same code costs different money in different buildings. July 2026 OPPS Addendum B pays a hospital outpatient department $3,342.87 for 28292 and 28296 (APC 5113) and $13,116.76 for 28297 (APC 5115). That is roughly double the surgery center rate for the simple procedures and about $3,100 more for the fusion. If your surgeon operates at both, asking which one your case is booked at is the single highest-value question you can ask.
There is a third setting. A minority of these are done in a podiatrist’s own procedure room, and Medicare pays a higher professional fee there because the physician is absorbing the overhead: $703.09 for 28292 and $883.45 for 28296 in 2026, versus the facility-setting fees above. In the 2024 national claims data, only 412 of the 7,648 billed instances of CPT 28296 happened in an office. It is a real option for simple cases and a rare one.
Hardware, and whether the quote includes it
Screws and plates are the line item that turns a quoted price into a final price. Surgery Center of Oklahoma states that implants are not in its $4,790 and are billed at invoice cost with no markup. Its minimally invasive MICA bunionectomy at $5,637 also excludes implants. Newport Orthopedic Institute includes implants and intraoperative radiology in its $6,405. Those two prices are not comparable until you know that.
One foot or two
Bilateral pricing is genuinely cheaper per foot. Surgery Center of Oklahoma’s $6,950 bilateral price against its $4,790 single price means the second foot adds about $2,160. The Orthopaedic Surgery Center’s $7,623 against $5,239 means the second foot adds about $2,384. Both are roughly 45 percent of a first foot, because you pay the anesthesia and facility setup once.
Everything around the operation
The surgery is one line. You will also pay for the consultation (Surgery Center of Oklahoma charges $250 separately), weight-bearing X-rays before and after, a post-op boot, and follow-up visits. Aetna’s policy requires weight-bearing anterior/posterior and lateral views for radiographic confirmation, so imaging is not optional if you plan to bill anyone. Our guide to X-ray cost without insurance covers how to price those separately, and anesthesia cost explains the one bill that most often arrives uninvited when a quote was not truly all-inclusive.
Cash Price vs. Insurance
Bunion surgery is one of the procedures where insurance is least automatic, which changes the math. Aetna’s Clinical Policy Bulletin 0629, last reviewed December 11 2025, treats both simple and bony correction bunionectomy as medically necessary only when there is documented persistent pain and difficulty walking despite at least six months of conservative treatment, radiographic confirmation of a hallux valgus angle of 15 degrees or more, and skeletal maturity. The same bulletin lists surgery done “to improve the appearance of the foot” as not medically necessary, and notes that a bilateral bunionectomy done at the same time is generally not deemed medically necessary unless extenuating circumstances are present.
Read practically, that means a covered bunionectomy requires half a year of documented orthotics, injections, and shoe changes first. Plenty of people who want the operation now are effectively cash payers whether they have a card in their wallet or not.
The gap between billed and paid is also unusually wide here. In 2024 national Medicare claims released in May 2026, the average submitted charge for CPT 28296 was $4,351.33 against a Medicare allowed amount of $698.19, a six-fold gap. That submitted charge is the surgeon’s fee alone, with no facility and no anesthesia, which tells you how much room exists between a chargemaster number and a real one. Our guide to hospital price transparency explains how to pull a facility’s own posted cash rate for a CPT code before you call.
The trade-off with paying cash is the usual one: the money does not count toward a deductible or out-of-pocket maximum, so if you expect other large claims this year, price both routes.
How to Pay Less
Ask which CPT code your surgeon plans to bill. 28292, 28296 and 28297 are three different price tiers, and the difference between them at a surgery center is roughly $8,400 in Medicare terms. If a Lapidus fusion is being recommended, ask what makes your case unsuitable for an osteotomy. That is a clinical conversation, not a billing one, but you should have it before you sign a financial agreement.
Get bundled quotes from at least three surgery centers. The published prices in this guide came from Oklahoma, and from centers in California and elsewhere, and all landed between $4,790 and $6,405 for a standard correction. That tells you a fair bundled price for a simple bunionectomy is roughly $4,800 to $6,500 per foot. Run any quote you receive through our fair price checker before agreeing to it.
Ask whether the quote includes implants, the consult, and the boot. Two of the three price lists in this guide exclude hardware. One includes it. On a fusion, that single question can move the total by several thousand dollars.
Ask for the self-pay discount before scheduling, not after the bill. Hospitals almost always have a posted uninsured discount that is applied on request rather than automatically. If a bill has already arrived, our medical bill negotiation guide and the negotiation script tool have the exact language, and requesting an itemized hospital bill first is what makes the negotiation possible.
Check charity care before assuming you do not qualify. Nonprofit hospitals must have financial assistance policies, and income thresholds are often well above the poverty line. Our hospital charity care guide and the charity care checker show how to find and apply to a specific hospital’s program.
If both feet need work, price the bilateral option honestly. It is cheaper per foot on every published list, but it also means you cannot bear weight on either side for a while, and it is the version Aetna’s policy singles out as usually not medically necessary. Cost is only one input.
The Bottom Line
Budget $4,790 to $6,405 per foot for a standard bunionectomy as a bundled cash price at an ambulatory surgery center as of September 2026, and roughly $9,870 if the correction is a Lapidus or Lapiplasty style midfoot fusion. Add the consultation, the weight-bearing X-rays, the boot, and any hardware that sits outside the quote.
The figure to hold onto is the facility spread. July 2026 Medicare rates put the surgery center facility fee at $1,644.87 for a simple bunionectomy and $3,342.87 at a hospital outpatient department, and $10,002.69 versus $13,116.76 for the fusion version. Where the case is booked, and which correction is booked, decide the bill. Other orthopedic operations behave the same way, which is why our meniscus surgery and carpal tunnel surgery guides start with the same question, and why the post-op line item worth pricing separately is almost always physical therapy.