How Much Does an Arthroscopic Rotator Cuff Repair Cost in Pennsylvania?
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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 Pennsylvania averages $980, from $941 to $1,020 across 2 Medicare localities.
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- ✓The add-on codes that typically land on the bill
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Pennsylvania Medicare physician rate (2026)
+0.4% vs nationalAverage of 2 localities. Office range $940.63–$1,020.14.
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 Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What arthroscopic rotator cuff repair costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania 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 15001.
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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 Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 29827 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $1,020.14 |
| rest of pennsylvania | $940.63 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Arthroscopic Rotator Cuff Repair and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
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 Pennsylvania
Arthroscopic Rotator Cuff Repair in other states
Arthroscopic Rotator Cuff Repair in Pennsylvania: 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 Pennsylvania averages $980, from $941 to $1,020 across 2 Medicare localities. Enter a ZIP for the exact Pennsylvania locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $79.51 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $196 for the office physician line or $196 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
No. $980.39 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. Pennsylvania ranks #36 of 51 states on the physician line (within 2% of the national office rate of $976.31).