How Much Does an Arthroscopic Rotator Cuff Repair Cost in Illinois?
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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 Illinois averages $1,059, from $1,002 to $1,114 across 4 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
- ✓Bill-negotiation letter
- ✓Printable PDF download
Illinois Medicare physician rate (2026)
+8.4% vs nationalAverage of 4 localities. Office range $1,001.76–$1,113.62.
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 Illinois
Enter a ZIP code to see which Illinois locality applies to you, whether Chicago proper, the suburban collar counties, the Metro East near St. Louis, or downstate cities like Springfield, Peoria, and Champaign.
What arthroscopic rotator cuff repair costs at hospitals near you
Everything above is a national average. The hospital you pick in Illinois 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 60001.
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 Illinois
Where Illinois ranks for this CPT
CPT 29827 by Illinois locality
| Locality | Office |
|---|---|
| chicago | $1,113.62 |
| suburban chicago | $1,068.41 |
| east st. louis | $1,050.27 |
| rest of illinois | $1,001.76 |
PE GPCI ranges from 0.913 to 1.027 in Illinois. That index is why the same CPT is not one price statewide.
Arthroscopic Rotator Cuff Repair and how Illinois is priced
Illinois uses one of the more detailed locality maps in the Midwest: Chicago has its own locality, the suburban collar counties are priced separately, the East St. Louis area carries its own locality tied to the St. Louis market, and the rest of the state shares a fourth. Approved amounts step down noticeably from the city and suburbs to downstate, so the same procedure prices differently in Chicago, Naperville, Belleville, and Springfield. This four-way split makes Illinois one of the states where a ZIP-level check genuinely changes the answer. Downstate rates align more closely with neighboring rural states than with Chicagoland.
Chicago is one of the country's great medical hubs, with multiple academic medical centers and deep specialist supply, and its suburbs support large competing systems of their own. Downstate Illinois is a different market: smaller cities like Peoria, Springfield, and Champaign serve wide rural areas, and the Metro East suburbs orient toward St. Louis providers. Where you sit on that map shapes both price and choice.
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 Illinois
Arthroscopic Rotator Cuff Repair in other states
Arthroscopic Rotator Cuff Repair in Illinois: 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 Illinois averages $1,059, from $1,002 to $1,114 across 4 Medicare localities. Enter a ZIP for the exact Illinois locality.
Yes. CMS splits Illinois into 4 payment localities. For this CPT the office physician fee spans $111.86 from the lowest to highest locality. Enter a ZIP code to see which Illinois locality applies to you, whether Chicago proper, the suburban collar counties, the Metro East near St. Louis, or downstate cities like Springfield, Peoria, and Champaign.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $212 for the office physician line or $212 for the hospital physician line in Illinois. Medigap may cover that 20%. This is not the hospital facility fee.
No. $1,058.52 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. Illinois ranks #47 of 51 states on the physician line (8% above the national office rate of $976.31).