How Much Does Repair rotator cuff chronic Cost?
Repair rotator cuff chronic (CPT 23412) costs vary by location and insurance at Medicare rates. Hospital outpatient rate: $7.
Cost Comparison by Payer
How much Repair rotator cuff chronic costs across different settings and payers
Repair rotator cuff chronic Cost by Location
Medicare-adjusted rates across CMS localities
| Location | Medicare Rate | Est. Commercial |
|---|---|---|
| US — Carrier 01112 Locality 05 | $919 | $1,379 — $2,298 |
| US — Carrier 01112 Locality 09 | $933 | $1,400 — $2,333 |
| US — Carrier 01112 Locality 51 | $883 | $1,325 — $2,209 |
| US — Carrier 01112 Locality 52 | $922 | $1,383 — $2,305 |
| US — Carrier 01112 Locality 53 | $879 | $1,319 — $2,199 |
| US — Carrier 01112 Locality 54 | $802 | $1,204 — $2,006 |
| US — Carrier 01112 Locality 55 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 56 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 57 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 58 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 59 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 60 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 61 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 62 | $822 | $1,233 — $2,055 |
| US — Carrier 01112 Locality 63 | $825 | $1,237 — $2,062 |
| US — Carrier 01112 Locality 64 | $822 | $1,233 — $2,054 |
| US — Carrier 01112 Locality 65 | $944 | $1,416 — $2,361 |
| US — Carrier 01112 Locality 66 | $836 | $1,254 — $2,090 |
| US — Carrier 01112 Locality 67 | $844 | $1,265 — $2,109 |
| US — Carrier 01112 Locality 68 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 69 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 70 | $796 | $1,194 — $1,989 |
| US — Carrier 01112 Locality 75 | $796 | $1,194 — $1,989 |
| US — Carrier 01182 Locality 17 | $835 | $1,253 — $2,088 |
| US — Carrier 01182 Locality 18 | $844 | $1,266 — $2,109 |
How to Reduce Your Cost for Repair rotator cuff chronic
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Medicare rates for this procedure range from $711 to $976 depending on location. Commercial rates vary even more.
- 4 Check ambulatory surgery centers (ASCs)
This procedure is available at ASCs for $3, compared to $7 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.
Frequently Asked Questions
How much does Repair rotator cuff chronic cost?
The Medicare facility rate for Repair rotator cuff chronic is variable. In a hospital outpatient setting, the rate is $7. At an ambulatory surgery center, the rate is $3. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Repair rotator cuff chronic cost without insurance?
Without insurance, the cost of Repair rotator cuff chronic can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Repair rotator cuff chronic?
Most commercial health insurance plans and Medicare cover Repair rotator cuff chronic when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.