What Medicare actually pays for after bunion surgery

Reviewed by Erin Rose — healthcare price-transparency analyst. Last checked August 29, 2026. Part of the full bunion-surgery recovery checklist. No affiliate links on this page — every link below goes to a primary source or another page on this site.

The single device nearly every bunion-surgery patient wears — the post-op surgical shoe — is statutorily excluded from Medicare by federal law, not merely absent from the claims data. For the smaller subset of patients whose technique requires weeks of non-weight-bearing, Medicare pays $57.17-$88.73 toward crutches (E0114) with a prescription, but $0 toward a knee scooter (E0118) doing the identical job. Beyond those two contrasts, a bedside commode is covered "if needed," and seven more items on this checklist have no HCPCS code at all.

The post-op surgical shoe, the knee scooter, and the shower chair — all $0, for different legal reasons

Three items on this checklist pay nothing, but not for the same reason — the distinction matters, so we don't flatten it into one "not covered" label:

The surgical shoe (L3260) is the sharpest of the three: a specific statute names orthopedic shoes and excludes them, full stop. The knee scooter (E0118) is a narrower, ordinary absence — the code exists, Medicare just never gets billed under it (zero national claims in 2024). The shower chair (E0240) sits under the same general bath-safety exclusion this site has found on every other lower-extremity hub.

Which recovery items does Medicare actually cover?

Two, both requiring a doctor's prescription, and both relevant only to the non-weight-bearing subset of bunion patients — see which technique determines who that is. "Your share" is 20% of the fee, explained further down.

Policy citations: Canes and Crutches (A52459), Commodes (A52461) — both reused directly from the foot-ankle-surgery hub's own 2026-07-29 verification against all 68 rows of data/coverage_status.json; the underlying dataset hasn't changed since. Full DME MAC policy article links are in Sources below.

What about the wedge pillow, toe spacer, bunion splint, and the rest?

None of the following are billed as DME — there's no HCPCS code among the 68 this site tracks for any of them:

• Leg-elevation wedge pillow
• Ankle/foot-shaped ice wrap
• Toe spacer
• Bunion splint (post-op alignment maintenance)
• Waterproof leg/foot cast shower cover
• EVENup shoe leveler
• Reacher / grabber

This is a different situation from the shower chair or knee scooter above, which have codes that pay $0 by rule. These items were never assigned a billing code to begin with — an honest out-of-scope gap, not a covered-or-not-covered claim either way.

Do I need a prescription to get any of this paid?

Yes, and the order matters — for the two items that are covered at all. Federal DMEPOS rules require two things before a supplier delivers an item: a face-to-face visit with your doctor, and a Written Order Prior to Delivery (WOPD) — a signed order on file before the item goes out the door, not a receipt collected afterward.

None of this applies to the surgical shoe — no prescription, no WOPD, and no supplier enrollment changes its statutory exclusion under Sec. 1862(a)(8). A prescription only matters for the items that have a coverage pathway to begin with.

Does it matter where I buy it?

Yes, for the two covered items — it's the difference between a claim Medicare pays and a claim that doesn't exist. Medicare only pays a supplier holding a DMEPOS supplier number issued by CMS (42 CFR § 424.57(b)(2)). Buy identical crutches from a pharmacy shelf or Amazon instead, and there's no Medicare claim to submit at all — the seller was never set up to bill Medicare.

How much do I actually pay out of pocket?

Two numbers stack, for the two covered items: the annual Part B deductible, then 20% coinsurance on everything after that.

• The Part B deductible comes first. You pay 100% of your Part B costs — DME included — until you hit the annual deductible. For 2026, that's $283.
• Then 20% coinsurance applies. Medicare pays 80% of whichever is lower — the supplier's actual charge or the Medicare fee-schedule amount — and you owe the remaining 20% (42 CFR § 414.210(a)). That's the "your 20% share" column in the covered-items table above.

Both numbers assume a Medicare-enrolled supplier who accepts assignment. For the surgical shoe and every no-code item, none of this math applies at all — you're paying retail, full stop, regardless of a prescription.