CPT29881

Knee Arthroscopy Cost in Illinois

Arthrs kne srg mnisectmy m/l

$3,859Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Illinois Medicare physician rate (2026)

+6.8% vs national

Average of 4 localities. Office range $521.14–$579.07.

Illinois (Hospital)
$551.01
Facility physician fee
Private plan est.
$716–$1,102
~130–200% of Medicare
Cash / self-pay est.
$441–$827
~80–150% of Medicare

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.

Surgery centre, total
$2,161
$516 physician + $1,645 facility
Physician fee alone
$516
Only 13% of the hospital total

Choosing a surgery centre over a hospital saves about $1,698 on the Medicare allowed amount for knee arthroscopy. Ask whether your procedure can be done at an ambulatory surgery centre.

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 knee arthroscopy 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.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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 centre 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

National office$515.71
National hospital (physician)$515.71
Illinois vs national7% above the national office rate of $515.71

Where Illinois ranks for this CPT

Rank (lowest physician fee first)#46 of 51
Lowest stateArkansas ($459.17)
Highest stateAlaska ($624.72)

CPT 29881 by Illinois locality

LocalityOffice
chicago$579.07
suburban chicago$559.90
east st. louis$543.91
rest of illinois$521.14

PE GPCI ranges from 0.913 to 1.027 in Illinois. That index is why the same CPT is not one price statewide.

Knee Arthroscopy 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: Knee arthroscopy with meniscectomy is keyhole surgery in which the surgeon inserts a small camera into the knee and trims away the torn portion of the meniscus, the cartilage shock absorber between the bones. It treats meniscal tears causing pain, catching, or locking. The procedure takes 30 to 60 minutes under general or regional anesthesia at an outpatient surgery center, and most patients walk the same day and return to desk work within days.

What Is Knee Arthroscopy?

Knee arthroscopy with meniscectomy is keyhole surgery in which the surgeon inserts a small camera into the knee and trims away the torn portion of the meniscus, the cartilage shock absorber between the bones. It treats meniscal tears causing pain, catching, or locking. The procedure takes 30 to 60 minutes under general or regional anesthesia at an outpatient surgery center, and most patients walk the same day and return to desk work within days.

What Affects the Cost

  • Ambulatory surgery centers typically charge far less for this procedure than hospital outpatient departments.
  • A meniscus repair with sutures, if the tear pattern allows one, is a different code with a longer recovery and different pricing than simple trimming.
  • The pre-operative MRI that diagnosed the tear is part of the true episode cost and may still be working through your deductible.
  • Post-operative physical therapy visits, often 4 to 12 of them, are billed per visit on top of the surgery.
  • Anesthesia bills separately, and a regional nerve block for pain control adds a line item.
  • Any additional work done through the scope at the same time, such as cartilage smoothing, can add or change surgical codes.

Questions to Ask Before Booking

  • 1.Is my tear traumatic or degenerative, and would a course of physical therapy first be a reasonable and cheaper option?
  • 2.Will this be a meniscectomy or a repair, and how do the costs and recovery differ?
  • 3.Can we book this at a freestanding surgery center rather than the hospital?
  • 4.What other procedures might you perform once you are inside the knee, and how would they change the bill?
  • 5.How many therapy visits will I need afterward and at what cost per visit?

Knee Arthroscopy in Illinois: questions

The 2026 Medicare physician office rate for CPT 29881 averages $551.01 across 4 Illinois localities, from $521.14 in REST OF ILLINOIS to $579.07 in CHICAGO. The hospital physician rate averages $551.01. Enter a ZIP for the exact locality.

Yes. CMS splits Illinois into 4 payment localities. For this CPT the office physician fee spans $57.93 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 $110 for the office physician line or $110 for the hospital physician line in Illinois. Medigap may cover that 20%. This is not the hospital facility fee.

No. $551.01 is only the physician's share. Adding Medicare's facility payment brings the total to about $3,859 in a hospital outpatient department, or about $2,161 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Illinois ranks #46 of 51 states on the physician line (7% above the national office rate of $515.71).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.