CPT 27425 Surgery - Musculoskeletal

How Much Does Lateral Retinacular Release Open Cost?

Also known as: Lat retinacular release open (CPT 27425)

The total estimated cost of Lateral Retinacular Release Open (CPT 27425) is $1,488 to $2,791, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $443.

Total Estimated Cost of Care

$1,488 — $2,791

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$443
Hospital Facility Fee
$1,329
Anesthesia (est.)
$89
Important: The physician fee of $443 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$443
Physician component only — CMS PFS 2026

Procedures Commonly Done Together

These procedures are frequently performed alongside Lat retinacular release open

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How to Reduce Your Cost for Lat retinacular release open

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

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

5.26
Work RVU
6.89
Practice Expense RVU
1.11
Malpractice RVU
13.26
Total RVU

Payment = Total RVU (13.26) x CF ($33.40) = $443

Frequently Asked Questions

How much does Lat retinacular release open cost?

The Medicare facility rate for Lat retinacular release open is $443. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Lat retinacular release open cost without insurance?

Without insurance, the cost of Lat retinacular release open 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 Lat retinacular release open?

Most commercial health insurance plans and Medicare cover Lat retinacular release open 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.

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