The tool shows national averages for the amount Medicare pays an ASC or hospital, as well as the national average copayment a patient without Medicare supplemental insurance owes in each setting. Here’s what 10 common orthopedic procedures cost at ASCs and hospital outpatient departments:
Editorial note: This is not an exhaustive list. Prices include facility and physician fees.
1. Repair of shoulder rotator cuff using an endoscope (29827)
ASC
Total cost: $3,918
Medicare pays: $3,134
Patient pays: $783
HOPD
Total cost: $7,096
Medicare pays: $5,677
Patient pays: $1,419
2. Removal of bone cyst or growth of hip or pelvic bone with patient-derived bone graft (27067)
ASC
Total cost: $3,881
Medicare pays: $3,104
Patient pays: $775
HOPD
Total cost: $7,059
Medicare pays: $5,647
Patient pays: $1,411
3. Removal or shaving of hip joint socket cartilage using an endoscope (29862)
ASC
Total cost: $3,649
Medicare pays: $2,919
Patient pays: $729
HOPD
Total cost: $6,827
Medicare pays: $5,462
Patient pays: $1,365
4. Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882)
ASC
Total cost: $2,007
Medicare pays: $1,605
Patient pays: $401
HOPD
Total cost: $3,458
Medicare pays: $2,765
Patient pays: $691
5. Incision to repair shoulder joint (23040)
ASC
Total cost: $2,033
Medicare pays: $1,626
Patient pays: $406
HOPD
Total cost: $3,484
Medicare pays: $2,786
Patient pays: $696
6. Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture (29879)
ASC
Total cost: $1,974
Medicare pays: $1,580
Patient pays: $394
HOPD
Total cost: $3,425
Medicare pays: $2,740
Patient pays: $684
7. Removal of tissue and/or bone at elbow with tendon repair, open procedure (24359)
ASC
Total cost: $1,974
Medicare pays: $1,580
Patient pays: $394
HOPD
Total cost: $3,425
Medicare pays: $2,740
Patient pays: $684
8. Removal of both knee cartilages using an endoscope (29880)
ASC
Total cost: $1,870
Medicare pays: $1,496
Patient pays: $373
HOPD
Total cost: $3,321
Medicare pays: $2,656
Patient pays: $663
9. Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial (29895)
ASC
Total cost: $1,769
Medicare pays: $1,415
Patient pays: $353
HOPD
Total cost: $3,220
Medicare pays: $2,575
Patient pays: $643
10. Release and/or relocation of median nerve of hand (64721)
ASC
Total cost: $1,242
Medicare pays: $994
Patient pays: $248
HOPD
Total cost: $2,165
Medicare pays: $1,732
Patient pays: $432
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