How Much Does an Arthroscopic Rotator Cuff Repair Cost in North Carolina?
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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 North Carolina averages $915.
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- ✓The add-on codes that typically land on the bill
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North Carolina Medicare physician rate (2026)
-6.3% vs nationalSingle statewide locality.
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 North Carolina
Check your ZIP code for your region of North Carolina, whether Charlotte, Raleigh-Durham and the Triangle, the Triad, Asheville and the mountains, or Wilmington and the coastal east.
What arthroscopic rotator cuff repair costs at hospitals near you
Everything above is a national average. The hospital you pick in North Carolina 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 27006.
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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 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 North Carolina
Where North Carolina ranks for this CPT
Arthroscopic Rotator Cuff Repair and how North Carolina is priced
North Carolina's Medicare physician pricing comes from one statewide locality with indices just under the national average, so Charlotte, the Research Triangle, and the rural east and mountain west all share the same approved amounts. For a state with several fast-growing metros, the single-locality approach keeps the fee schedule simple even as local economies diverge. Nothing in the geographic adjustments distinguishes a Raleigh procedure from one in Boone or Greenville. As elsewhere, the office-versus-hospital setting decision moves prices more than geography within the state does.
North Carolina is unusually rich in academic medicine, with multiple nationally known university medical centers clustered in the Triangle and Winston-Salem, plus a major hospital system anchored in Charlotte that has grown across the Southeast. The rural east and the mountain counties are much thinner markets, and hospital consolidation has been reshaping who owns local care. Patients near the borders sometimes use Virginia or South Carolina providers.
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 North Carolina
Arthroscopic Rotator Cuff Repair in other states
Arthroscopic Rotator Cuff Repair in North Carolina: 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 North Carolina averages $915. North Carolina is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. North Carolina uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $183 for the office physician line or $183 for the hospital physician line in North Carolina. Medigap may cover that 20%. This is not the hospital facility fee.
No. $914.96 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. North Carolina ranks #13 of 51 states on the physician line (6% below the national office rate of $976.31).