How Much Does Repair Rotator Cuff Chronic Cost?
Also known as: Repair rotator cuff chronic (CPT 23412)
Open rotator cuff repair surgery through a larger incision on the shoulder.
The total estimated cost of Repair Rotator Cuff Chronic (CPT 23412) is $2,660 to $4,987, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $792.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Repair Rotator Cuff Chronic
What you need to know before your appointment
What to Expect
Under general anesthesia, the surgeon makes an incision on the shoulder, reattaches the torn rotator cuff tendon to the bone using anchors and sutures. You will be in a sling for 4-6 weeks.
How Long Does It Take?
1-3 hours
Common Reasons Doctors Order This
Large or complex rotator cuff tear, rotator cuff tear not amenable to arthroscopic repair, revision rotator cuff repair
How to Prepare
Fast before surgery. Set up a sleeping area with pillows to sleep reclined. Arrange help for 4-6 weeks. Start pendulum exercises when directed.
Procedures Commonly Done Together
These procedures are frequently performed alongside Repair rotator cuff chronic
What Insurance Companies Actually Pay
Real negotiated rates from 16 hospitals across 6 states (from hospital price transparency filings)
| Insurance Company | Avg Rate | Range | Hospitals |
|---|---|---|---|
| Aetna | $5,359 | $2,643 - $14,327 | 10 |
| United | $6,719 | $2,574 - $11,924 | 10 |
| Cigna | $7,743 | $2,666 - $12,909 | 10 |
| Humana | $5,748 | $2,998 - $15,871 | 8 |
| BCBS | $10,858 | $2,518 - $16,331 | 5 |
| Superior Health Plan | $2,892 | $2,369 - $10,733 | 4 |
| KAISER FOUNDATION HEALTH PLAN, INC. | $14,912 | $8,633 - $27,033 | 5 |
| BCBS-TX | $8,313 | $4,486 - $11,485 | 3 |
| Wellpoint | $5,017 | $2,399 - $10,733 | 2 |
| Molina Healthcare | $2,638 | $2,638 | 2 |
| Community Health Choice MCD | $2,686 | $2,686 | 2 |
| Multiplan | $9,218 | $5,350 - $11,500 | 5 |
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
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.
Payment = Total RVU (23.70) x CF ($33.40) = $792
Related Procedures
Similar procedures in the same category or body system
Consider These Alternatives
Depending on your clinical situation, these alternatives may be appropriate and could save you money.
Note: Alternative procedures may not be clinically appropriate for all patients. Always consult your physician to determine the best option for your specific situation.
People Also Ask
Common questions people search for about this procedure
Will insurance pay for rotator cuff surgery?
Can you recover 100% from rotator cuff surgery?
If you can get that weak muscle stronger. So that it can take some of the load off of the rotator cuff muscles. And its tendons. Then you can take the tension off the tendon.
Is surgery for a torn rotator cuff worth it?
Is rotator cuff repair considered a major surgery?
Frequently Asked Questions
How much does Repair rotator cuff chronic cost?
The Medicare facility rate for Repair rotator cuff chronic is $792. 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.