How Much Does an Arthroscopic Rotator Cuff Repair Cost in Wisconsin?
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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 Wisconsin averages $890.
- ✓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
Wisconsin Medicare physician rate (2026)
-8.8% 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 Wisconsin
Check your ZIP code for your part of Wisconsin, whether Milwaukee, Madison, Green Bay and the Fox Valley, La Crosse, Eau Claire, or the rural Northwoods.
What arthroscopic rotator cuff repair costs at hospitals near you
Everything above is a national average. The hospital you pick in Wisconsin 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 53001.
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 Wisconsin
Where Wisconsin ranks for this CPT
Arthroscopic Rotator Cuff Repair and how Wisconsin is priced
Wisconsin's Medicare pricing runs through a single statewide locality with indices near the national average, so Milwaukee, Madison, and the Northwoods share the same approved amounts. The unified locality sits atop one of the more regionally organized care systems in the country, with strong integrated groups serving defined territories. No metro premium exists in the fee schedule, so Milwaukee's higher practice costs are averaged into the statewide factors. The published rates here travel unchanged across all seventy-two counties.
Milwaukee and Madison hold the state's academic medicine and largest systems, while integrated clinics in Marshfield, La Crosse, and the Fox Valley have long histories of serving rural Wisconsin through hub-and-spoke networks. The far north is lake and forest country where specialty care means a long drive south, and some western residents use Twin Cities or Rochester, Minnesota providers. Wisconsin's tradition of clinic-based integrated care tends to keep billing relatively coordinated.
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 Wisconsin
Arthroscopic Rotator Cuff Repair in other states
Arthroscopic Rotator Cuff Repair in Wisconsin: 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 Wisconsin averages $890. Wisconsin is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Wisconsin 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 $178 for the office physician line or $178 for the hospital physician line in Wisconsin. Medigap may cover that 20%. This is not the hospital facility fee.
No. $890.41 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. Wisconsin ranks #5 of 51 states on the physician line (9% below the national office rate of $976.31).