Across five orthopedic procedures—including two that were added to the Covered Procedures List for 2026— ASCs consistently post lower total costs than hospital outpatient departments — in some cases by more than $6,000 per case — driven largely by lower facility fees.
However, the patient’s share of the bill doesn’t always follow the same pattern. While ASCs generally mean lower out-of-pocket costs for procedures like rotator cuff repairs, HOPDs carry lower copays for higher-acuity procedures such as total knee replacements.
Here’s what five orthopedics procedures cost at ASCs and hospital outpatient departments, using data from CMS’ procedure price lookup tool:
Total knee replacement (CPT code 27447)
ASCs:
- Patient pays: $2,109
- Total cost: $10,552
- Physician fee: $1,159
- Facility fee: $9,393
- Medicare pays: $8,441
HOPDs:
- Patient pays: $1,967
- Total cost: $14,275
- Physician fee: $1,159
- Facility fee: $13,116
- Medicare pays: $12,207
Rotator cuff repair (CPT code 23410)
ASCs:
- Patient pays: $891
- Total cost: $4,459
- Physician fee: $764
- Facility fee: $3,695
- Medicare pays: $3,567
HOPDs:
- Patient pays: $1,634
- Total cost: $8,177
- Physician fee: $764
- Facility fee: $7,413
- Medicare pays: $6,541
Posterior lumbar interbody fusion (CPT code 22630, added for 2026)
ASCs:
- Patient pays: $4,473
- Total cost: $22,368
- Physician fee: $1,510
- Facility fee: $20,858
- Medicare pays: $17,894
HOPDs:
- Patient pays: $2,038
- Total cost: $29,231
- Physician fee: $1,510
- Facility fee: $27,721
- Medicare pays: $27,193
Combined posterior lumbar and posterior lumbar interbody fusion (CPT code 22633, added for 2026)
ASCs:
- Patient pays: $4,508
- Total cost: $22,541
- Physician fee: $1,700
- Facility fee: $20,851
- Medicare pays: $18,033
HOPDs:
- Patient pays: $2,076
- Total cost: $29,421
- Physician fee: $1,700
- Facility fee: $27,721
- Medicare pays: $27,345
Total hip replacement (CPT code 27130)
ASCs:
- Patient pays: $2,154
- Total cost: $10,778
- Physician fee: $1,162
- Facility fee: $9,614
- Medicare pays: $8,620
HOPDs:
- Patient pays: $1,968
- Total cost: $14,278
- Physician fee: $1,162
- Facility fee: $13,116
- Medicare pays: $12,309
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