How Much Does Orthopedic Hardware Removal Cost in Pennsylvania?
Removal of implant deep
$3,362Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, orthopedic hardware removal costs up to about $3,362 in total at a hospital outpatient department or about $1,643 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Pennsylvania averages $395, from $379 to $412 across 2 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
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Pennsylvania Medicare physician rate (2026)
-0.6% vs nationalAverage of 2 localities. Office range $596.99–$658.77.
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 $1,719 on the Medicare allowed amount for orthopedic hardware removal. Ask whether your procedure can be done at an ambulatory surgery center.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. 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 orthopedic hardware removal 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. In Pennsylvania the office and hospital physician lines for this CPT differ by $232.60.
National vs Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 20680 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $658.77 |
| rest of pennsylvania | $596.99 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Orthopedic Hardware Removal 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: CPT 20680 is the removal of deep orthopedic hardware, such as a rod, plate, screws or pins that were placed to fix a broken bone. Hardware is taken out when it causes pain or irritation, becomes infected, or limits movement, and sometimes after a fracture has fully healed in younger patients. It is usually an outpatient operation under anesthesia, and the size of the job depends on the implant: removing a long rod from the thigh bone is a bigger operation than taking out a few screws from the ankle.
What Is Orthopedic Hardware Removal?
CPT 20680 is the removal of deep orthopedic hardware, such as a rod, plate, screws or pins that were placed to fix a broken bone. Hardware is taken out when it causes pain or irritation, becomes infected, or limits movement, and sometimes after a fracture has fully healed in younger patients. It is usually an outpatient operation under anesthesia, and the size of the job depends on the implant: removing a long rod from the thigh bone is a bigger operation than taking out a few screws from the ankle.
What Affects the Cost
- –The size and location of the implant drive operating time: removing an intramedullary rod from the femur takes longer than removing a small ankle plate.
- –Hardware removed through separate incisions can be billed more than once in the same operation.
- –Anesthesia is billed separately by the anesthesia provider.
- –Surgery centers typically have lower facility fees than hospital outpatient departments.
- –If infection is found, cultures, antibiotics and sometimes a hospital stay add to the total.
Questions to Ask Before Booking
- 1.What is causing my symptoms, and is removal likely to help?
- 2.Is all of the hardware coming out, and through how many incisions?
- 3.Will this be done at a surgery center or a hospital?
- 4.Will I need crutches, a brace or physical therapy afterward?
- 5.Is the anesthesia group in my network?
Other featured procedures in Pennsylvania
Orthopedic Hardware Removal in other states
Orthopedic Hardware Removal in Pennsylvania: questions
Under 2026 Medicare rates, orthopedic hardware removal costs up to about $3,362 in total at a hospital outpatient department or about $1,643 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Pennsylvania averages $395, from $379 to $412 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 $61.78 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 $126 for the office physician line or $79 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
No. $395.28 is only the physician's share. Adding Medicare's facility payment brings the total to up to about $3,362 in a hospital outpatient department, or about $1,643 at an ambulatory surgery center. Anesthesia, pathology and other codes billed the same day are extra. Pennsylvania ranks #34 of 51 states on the physician line (within 2% of the national office rate of $631.95).