The average arthroscopic shoulder surgery cost in the United States is $25,925, though prices can range from $6,900 to $31,650.
One factor that can greatly affect your arthroscopic shoulder surgery cost is whether you have the procedure performed in an inpatient facility, like a hospital, or an outpatient surgery center. Whether or not you can have outpatient surgery for your shoulder depends on your overall health.
Outpatient centers are just as safe as hospitals but could save you thousands on your medical bill.
Based on our data, the target fair price for arthroscopic shoulder surgery is $14,050, whether you have health insurance or not.
- National Average: $25,925
- National Range: $6,900 – $31,650+
- Outpatient Facility Average: $16,150
- Inpatient Facility Average: $26,875
- Target Fair Price: $14,050
Below, you’ll learn what factors into the cost of an arthroscopic shoulder surgery, as well as how to find a fair price for your surgery.
Arthroscopic Shoulder Surgery Cost Averages Around the Country
Specific Arthroscopic Shoulder Surgery Procedures and National Cost Averages
Which factors affect how much arthroscopic shoulder surgery costs?
Many things can affect the cost of healthcare, regardless of which type of procedure you’re getting. Generally, there are three factors that cause healthcare costs to vary:
- Facility setting — Where you have your medical procedure done affects the cost. Having arthroscopic shoulder surgery done in a hospital as an inpatient costs far more than having the same procedure done in an outpatient center. Since inpatient facilities tend to cost more to run, patients end up paying more for care.
- Insured or uninsured — The price of arthroscopic shoulder surgery can vary between insurance providers. The change in price largely depends on how much of the procedure your insurance plan will cover, if any at all. If you don’t have health insurance, you can expect to pay for the full cost of the procedure out-of-pocket.
- Location — The region, state, and even city you live in can affect your arthroscopic shoulder surgery cost. If you live in a rural area with fewer facilities to choose from, you can expect to pay more than you would if you lived in a city with many providers. Traveling for a medical procedure can be a great money-saving option.
Inpatient vs. outpatient facility cost differences
Your arthroscopic shoulder surgery cost will vary greatly between inpatient and outpatient facilities. The national average cost for a shoulder arthroscopy at inpatient facilities is $26,875, while the same procedure at outpatient facilities averaged $16,150.
Insured vs. uninsured cost differences
Insured patients have historically paid less than uninsured patients for arthroscopic shoulder surgery, especially when they stay in-network. When a patient has insurance, they share payment responsibility with their insurance company. For patients who don’t have health insurance, the cost of their arthroscopic shoulder surgery falls on them and, ultimately, costs more.
In-network vs. out-of-network cost differences
In-network refers to a healthcare provider or facility that has a contracted rate with a health insurance company. This rate is usually much lower than what someone would pay out-of-pocket; in-network providers are almost always cheaper than out-of-network providers. This does not apply to patients who are uninsured—without insurance, you shoulder the full cost of your medical procedure.
Payment responsibility
Nearly everyone who has arthroscopic shoulder surgery will have to pay some of the cost out-of-pocket. Uninsured patients will be responsible for the total cost of their surgery.
Patients who do have health insurance will be responsible for paying their deductible, copay, and coinsurance amounts. The amount of each of these costs depends on your health plan.
More factors that affect your arthroscopic shoulder surgery cost
- Prescriptions — A physician may prescribe painkillers or antibiotics post-procedure. To avoid high prescription prices, make sure the prescriptions you receive are covered by your insurance policy. You can also ask if there is a generic version of the same medicine, which can help lower the cost.
- Additional office visits — In some cases, you may be charged a separate fee for an initial consultation with the surgeon before the surgery. Your doctor will want to see you for follow-ups appointments throughout the first year after your surgery—usually at three, six, and nine months. Patients often see their doctor once a year after that, unless problems arise. Ask if these follow up visits are included in the total cost of your procedure.
- Physical therapy/rehabilitation — A physical therapy regimen, tailored to the surgical procedures performed, will play a critical role in regaining strength and mobility in the shoulder that was operated on. The length of time required will vary depending on the extent of the surgery, but your continued effort in rehabilitating your shoulder will contribute to the success of the surgery.
Your arthroscopic shoulder surgery checklist
1. Review your total arthroscopic shoulder surgery cost with your surgeon. Ask them to explain what each cost is for and keep a record. If you get a medical bill that’s higher than you expected, this information will come in handy.
2. Ask your surgeon if they can perform the procedure in an outpatient setting.
3. Check that all providers are in-network. Sometimes a provider who treats you will be out-of-network (this often happens with anesthesiologists). You can avoid this by asking your surgeon whether all of the providers who will treat you are in-network for your insurance.
4. Ask what the typical cost is if the surgeon finds other areas that need to be repaired during your procedure.
Finding a fair price for your arthroscopic shoulder surgery
The national average for an arthroscopic shoulder surgery is $25,925 but the fair price is $14,050. Still feel out of reach? New Choice Health’s Orthopedic Surgery Patient Assist program offers uninsured patients cash pay discounts and special financing options on shoulder surgery. You could pay as low as $10,500 for your shoulder surgery— significant savings! Learn more about Patient Assist today.
