How Much Does an Arthroscopic Rotator Cuff Repair Cost in California?
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$8,390Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an arthroscopic rotator cuff repair costs about $8,390 in total at a hospital outpatient department or about $4,672 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in California averages $1,015, from $973 to $1,147 across 29 Medicare localities.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
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- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
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- ✓Printable PDF download
California Medicare physician rate (2026)
+4.0% vs nationalAverage of 29 localities. Office range $972.88–$1,146.99.
What the whole procedure costs
The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.
Choosing a surgery center over a hospital saves about $3,718 on the Medicare allowed amount for arthroscopic rotator cuff repair. Ask whether your procedure can be done at an ambulatory surgery center.
Medicare pays the hospital a single comprehensive amount for this procedure, covering the facility's share of the encounter including implants and supplies. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in California
A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.
What arthroscopic rotator cuff repair costs at hospitals near you
Everything above is a national average. The hospital you pick in California moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 90001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.
National vs California
Where California ranks for this CPT
CPT 29827 by California locality
| Locality | Office |
|---|---|
| san jose-sunnyvale-santa clara (san benito cnty) | $1,146.99 |
| san jose-sunnyvale-santa clara (santa clara cnty) | $1,132.83 |
| san francisco-oakland-berkeley (marin cnty) | $1,119.79 |
| san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty) | $1,116.33 |
| napa | $1,074.80 |
| vallejo | $1,069.80 |
| los angeles-long beach-anaheim (los angeles/orange cnty) | $1,030.01 |
| santa rosa-petaluma | $1,027.89 |
| oxnard-thousand oaks-ventura | $1,018.86 |
| santa cruz-watsonville | $1,018.55 |
| san diego-chula vista-carlsbad | $1,016.76 |
| sacramento-roseville-folsom | $1,007.10 |
| riverside-san bernardino-ontario | $1,005.68 |
| santa maria-santa barbara | $1,004.13 |
| salinas | $1,003.09 |
| san luis obispo-paso robles | $988.65 |
| bakersfield | $981.33 |
| el centro | $973.39 |
| chico | $972.88 |
| fresno | $972.88 |
| hanford-corcoran | $972.88 |
| madera | $972.88 |
| merced | $972.88 |
| modesto | $972.88 |
| redding | $972.88 |
| stockton | $972.88 |
| visalia | $972.88 |
| yuba city | $972.88 |
| rest of california | $972.88 |
PE GPCI ranges from 1.096 to 1.442 in California. That index is why the same CPT is not one price statewide.
Arthroscopic Rotator Cuff Repair and how California is priced
California is the most finely divided state in the Medicare fee schedule, with roughly thirty payment localities drawn around metropolitan statistical areas after CMS reformed the state's locality map. The San Francisco Bay Area carries some of the highest geographic adjustments in the nation, with San Francisco, San Jose, and the East Bay each priced separately, while Los Angeles, Orange County, San Diego, and Sacramento have their own localities at somewhat lower levels. Rural and inland counties fall into lower-cost localities, so the same procedure can carry meaningfully different Medicare-approved amounts within a single day's drive. No other state shows this much in-state variation on the fee schedule itself.
California's markets differ sharply: the Bay Area combines high wages with heavily consolidated hospital systems, Los Angeles offers enormous choice across a sprawling region, and the Central Valley and far north face genuine access shortages. Where you are treated within the state matters more here than almost anywhere else in the country. Academic medical centers in the Bay Area, Los Angeles, San Diego, and Sacramento handle much of the complex referral care.
This procedure: Arthroscopic rotator cuff repair reattaches torn rotator cuff tendons to the top of the upper arm bone, using a small camera and instruments passed through several small incisions around the shoulder. The surgeon usually places small anchors in the bone and uses stitches to pull the tendon back into position. It is normally an outpatient operation under general anesthesia, often with a nerve block for pain, followed by several weeks in a sling and months of physical therapy.
What Is Arthroscopic Rotator Cuff Repair?
Arthroscopic rotator cuff repair reattaches torn rotator cuff tendons to the top of the upper arm bone, using a small camera and instruments passed through several small incisions around the shoulder. The surgeon usually places small anchors in the bone and uses stitches to pull the tendon back into position. It is normally an outpatient operation under general anesthesia, often with a nerve block for pain, followed by several weeks in a sling and months of physical therapy.
What Affects the Cost
- –Extra work in the same operation, such as shaving a bone spur (subacromial decompression) or treating the biceps tendon, adds codes and cost.
- –Hospital outpatient departments usually charge a much higher facility fee than surgery centers for the same repair.
- –Anesthesia, including any nerve block, is billed separately by the anesthesia provider.
- –Suture anchors and other implants are included in the facility payment, but the number used can affect a facility's cash price.
- –Physical therapy afterward is billed per visit and often runs for several months.
Questions to Ask Before Booking
- 1.Does my tear need surgery, or is physical therapy worth trying first?
- 2.Will you also treat a bone spur or the biceps tendon, and how does that change the bill?
- 3.Can the operation be done at a surgery center instead of a hospital?
- 4.Will I get a nerve block, and is the anesthesia group in my network?
- 5.How many physical therapy visits should I expect, and does my plan cover them?
Other featured procedures in California
Arthroscopic Rotator Cuff Repair in other states
Arthroscopic Rotator Cuff Repair in California: questions
Under 2026 Medicare rates, an arthroscopic rotator cuff repair costs about $8,390 in total at a hospital outpatient department or about $4,672 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in California averages $1,015, from $973 to $1,147 across 29 Medicare localities. Enter a ZIP for the exact California locality.
Yes. CMS splits California into 29 payment localities. For this CPT the office physician fee spans $174.11 from the lowest to highest locality. A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $203 for the office physician line or $203 for the hospital physician line in California. Medigap may cover that 20%. This is not the hospital facility fee.
No. $1,015.09 is only the physician's share. Adding Medicare's facility payment brings the total to about $8,390 in a hospital outpatient department, or about $4,672 at an ambulatory surgery center. Anesthesia, pathology and other codes billed the same day are extra. California ranks #42 of 51 states on the physician line (4% above the national office rate of $976.31).