{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:13:04Z","timestamp":1781845984095,"version":"3.54.5"},"reference-count":42,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Medicaid reimbursement to physicians is often perceived to be lower than Medicare, but little is known about orthopaedic foot and ankle reimbursement. This study sought to compare Medicare and Medicaid reimbursement for the 20 most common foot and ankle procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Medicare reimbursement rates for common foot and ankle codes were obtained from the online Centers for Medicare &amp; Medicaid fee schedule, while Medicaid rates were found from individual state fee schedule websites. Medicaid rates were compared by state and pooled to obtain national differences. The Medicare Wage Index was used to adjust Medicaid rates by state wages to ensure a more accurate comparison. Variability between states was measured using state percentages of Medicare and coefficient of variation values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Medicaid reimbursed physicians higher than Medicare in 31 states overall, with average reimbursement ranging from 37% to 324% of Medicare. Nationally, Medicaid reimbursed 8.8% higher than Medicare, but Medicare reimbursed 3.7% higher when adjusted for the Medicare Wage Index. The\n                      <jats:italic toggle=\"yes\">Current Procedural Terminology<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      ) codes with the highest ratio of Medicaid to Medicare reimbursement were\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      28002 for incision and drainage of the foot (176.6%) and\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      28820 for toe amputation (167.6%). Five codes had lower relative Medicaid reimbursement on average:\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      27687 for repair procedures on the leg and ankle joint,\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      28810 for amputation procedures on the foot and toes,\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      28010 for toe tenotomy,\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      28005 for incision procedures on the foot and toes, and\n                      <jats:italic toggle=\"yes\">CPT<\/jats:italic>\n                      28470 for closed treatment of a metatarsal fracture. The coefficient of variation values ranged from 0.34 to 0.84 in the Medicaid group and 0.40 to 0.78 in the adjusted group, indicating high variability between states and between procedures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Medicaid reimbursement is highly inconsistent between states, ranging from 37% to 324% of Medicare. Medicaid reimbursed more than Medicare overall, which is in contrast with most published findings that tend to show higher reimbursement for Medicare when compared to Medicaid. When adjusting for wage differences between states, Medicare reimbursed slightly higher than Medicaid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, economic analysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114251330302","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T04:39:26Z","timestamp":1744691966000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Medicaid Reimbursement for Common Orthopaedic Foot and Ankle Procedures Is Highly Inconsistent Among States, Ranging from 37% to 324% of Medicare Reimbursement"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4792-9338","authenticated-orcid":false,"given":"Adam P.","family":"Henderson","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3003-3316","authenticated-orcid":false,"given":"M. Lane","family":"Moore","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan C.","family":"Beckett","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Van Schuyver","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8190-7795","authenticated-orcid":false,"given":"Jack M.","family":"Haglin","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph C.","family":"Brinkman","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Orthopedic Surgery, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Alternative Payment Models in the Quality Payment Program as of December 2023. Centers for Medicare & Medicaid Services\u2014Quality Payment Program. 2023. Accessed June 19 2024. https:\/\/qpp-cm-prod-content.s3.amazonaws.com\/uploads\/2647\/2023and2024CompListofAPMs.pdf?linkId=277175263"},{"key":"e_1_3_3_3_2","unstructured":"American Hospital Association. Fact Sheet: Hospital Costs Explained. May 2021. Accessed June 19 2024. https:\/\/www.aha.org\/aha-search?search_api_fulltext=Fact+Sheet%3A+Hospital+Costs+Explained"},{"key":"e_1_3_3_4_2","unstructured":"American Medical Association. Relative value units. 2025. 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