CPT 29806 Surgery - Musculoskeletal

How Much Does Shoulder Arthrs Srg Capsulorraphy Cost?

Also known as: Sho arthrs srg capsulorraphy (CPT 29806)

Shoulder Arthrs Srg Capsulorraphy (CPT 29806) costs $973 at Medicare rates. Hospital outpatient rate: $7.

Cost Comparison by Payer

How much Sho arthrs srg capsulorraphy costs across different settings and payers

Medicare
Facility rate
$973
Hospital Outpatient
OPPS rate
$7
Surgery Center
ASC rate
$3
Medicare (Facility)
$973
CMS PFS 2026 national rate
Hospital Outpatient
$7
OPPS rate
Surgery Center (ASC)
$3
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside Sho arthrs srg capsulorraphy

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Sho arthrs srg capsulorraphy Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $1,205 $1,566 — $2,410
AL — ALABAMA $886 $1,152 — $1,772
AR — ARKANSAS $875 $1,137 — $1,750
AZ — ARIZONA $951 $1,237 — $1,903
CA — BAKERSFIELD $984 $1,279 — $1,968
CA — CHICO $976 $1,269 — $1,952
CA — EL CENTRO $976 $1,269 — $1,953
CA — FRESNO $976 $1,269 — $1,952
CA — HANFORD-CORCORAN $976 $1,269 — $1,952
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $1,034 $1,344 — $2,068
CA — MADERA $976 $1,269 — $1,952
CA — MERCED $976 $1,269 — $1,952
CA — MODESTO $976 $1,269 — $1,952
CA — NAPA $1,080 $1,404 — $2,161
CA — OXNARD-THOUSAND OAKS-VENTURA $1,023 $1,330 — $2,046
CA — REDDING $976 $1,269 — $1,952
CA — REST OF CALIFORNIA $976 $1,269 — $1,952
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $1,008 $1,311 — $2,017
CA — SACRAMENTO-ROSEVILLE-FOLSOM $1,011 $1,314 — $2,021
CA — SALINAS $1,007 $1,309 — $2,013
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $1,021 $1,327 — $2,042
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $1,126 $1,464 — $2,253
CA — SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) $1,123 $1,460 — $2,246
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) $1,154 $1,500 — $2,307
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $1,140 $1,481 — $2,279

How to Reduce Your Cost for Sho arthrs srg capsulorraphy

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 $875 to $1,205 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.

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.

14.76
Work RVU
11.35
Practice Expense RVU
3.02
Malpractice RVU
29.13
Total RVU

Payment = Total RVU (29.13) x CF ($33.40) = $973

Frequently Asked Questions

How much does Sho arthrs srg capsulorraphy cost?

The Medicare facility rate for Sho arthrs srg capsulorraphy is $973. 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 Sho arthrs srg capsulorraphy cost without insurance?

Without insurance, the cost of Sho arthrs srg capsulorraphy 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 Sho arthrs srg capsulorraphy?

Most commercial health insurance plans and Medicare cover Sho arthrs srg capsulorraphy 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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