Anesthesia for open or endoscopic total shoulder joint replacement
Medicare pricing data for 36,835 providers across 52 states
This procedure has a 10.1x markup — hospitals charge $2,871 but Medicare allows only $283.80. Uninsured patients may face bills 10.1 times higher than what insurance negotiates. Prices vary significantly by location — from $209 in Alabama to $525 in Alaska. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Anesthesia for open or endoscopic total shoulder joint replacement (HCPCS code 01638) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $283.80, but hospitals typically charge $2,871 — a 10.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $283.80, your out-of-pocket cost would be approximately $56.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 10.1x more than what Medicare allows for this procedure. Medicare actually pays $224.83 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $525 | $3,012 | 55 | 203 | +84.9% |
| California | $410 | $3,020 | 1,931 | 5,497 | +44.4% |
| Puerto Rico | $399 | $2,922 | 27 | 58 | +40.5% |
| Montana | $384 | $2,158 | 149 | 482 | +35.1% |
| Hawaii | $378 | $2,788 | 53 | 119 | +33.1% |
| Utah | $378 | $2,373 | 335 | 1,092 | +33.1% |
| Idaho | $377 | $2,330 | 186 | 554 | +32.8% |
| Wyoming | $365 | $2,845 | 53 | 186 | +28.8% |
| Oregon | $362 | $2,247 | 363 | 1,118 | +27.6% |
| Washington | $358 | $2,482 | 802 | 2,299 | +26.1% |
| Arkansas | $357 | $2,106 | 326 | 920 | +25.8% |
| Nevada | $353 | $3,294 | 181 | 674 | +24.3% |
| New Mexico | $351 | $3,129 | 164 | 479 | +23.7% |
| Oklahoma | $349 | $2,602 | 426 | 1,333 | +23.0% |
| Iowa | $340 | $2,197 | 385 | 1,299 | +19.9% |
| Nebraska | $333 | $1,925 | 296 | 1,068 | +17.3% |
| Arizona | $321 | $3,560 | 732 | 2,695 | +13.1% |
| District of Columbia | $319 | $2,861 | 155 | 412 | +12.5% |
| Colorado | $314 | $2,936 | 632 | 2,272 | +10.8% |
| New York | $314 | $4,150 | 1,497 | 4,694 | +10.5% |
| Maryland | $313 | $2,741 | 531 | 2,054 | +10.3% |
| New Jersey | $311 | $3,414 | 643 | 2,028 | +9.6% |
| Kansas | $310 | $1,925 | 482 | 1,620 | +9.3% |
| Rhode Island | $309 | $2,407 | 90 | 216 | +9.1% |
| Vermont | $308 | $2,037 | 71 | 165 | +8.6% |
| Louisiana | $303 | $2,278 | 531 | 1,394 | +6.9% |
| Florida | $298 | $3,390 | 2,502 | 8,422 | +4.9% |
| Indiana | $296 | $2,554 | 770 | 2,458 | +4.4% |
| Illinois | $294 | $3,532 | 1,414 | 4,390 | +3.5% |
| Delaware | $294 | $2,656 | 131 | 448 | +3.4% |
| Missouri | $286 | $2,106 | 1,017 | 3,110 | +0.9% |
| New Hampshire | $286 | $3,869 | 245 | 686 | +0.9% |
| Texas | $280 | $3,687 | 2,640 | 7,929 | -1.3% |
| Kentucky | $274 | $2,746 | 574 | 2,006 | -3.6% |
| Massachusetts | $272 | $2,165 | 993 | 3,395 | -4.3% |
| Connecticut | $266 | $3,131 | 429 | 1,335 | -6.1% |
| Tennessee | $266 | $2,756 | 1,134 | 3,624 | -6.1% |
| Wisconsin | $265 | $3,905 | 887 | 2,340 | -6.5% |
| Ohio | $261 | $2,310 | 1,732 | 5,722 | -8.0% |
| North Dakota | $244 | $1,898 | 165 | 540 | -14.2% |
| Virginia | $241 | $2,865 | 1,122 | 4,212 | -15.0% |
| South Dakota | $241 | $2,265 | 219 | 863 | -15.0% |
| West Virginia | $238 | $2,382 | 228 | 647 | -16.2% |
| Maine | $236 | $2,340 | 280 | 713 | -17.0% |
| Michigan | $235 | $3,310 | 1,528 | 4,318 | -17.1% |
| Mississippi | $234 | $1,751 | 341 | 1,229 | -17.7% |
| Pennsylvania | $227 | $2,407 | 2,033 | 6,564 | -20.0% |
| South Carolina | $226 | $2,944 | 795 | 3,144 | -20.5% |
| Georgia | $225 | $2,438 | 1,342 | 3,576 | -20.8% |
| Minnesota | $224 | $2,082 | 965 | 2,944 | -21.1% |
| North Carolina | $220 | $2,798 | 1,471 | 4,752 | -22.4% |
| Alabama | $209 | $2,302 | 708 | 1,976 | -26.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber
🏥 See Medicare hospital data on OpenMedicare