Tennessee · 27524

Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap in Tennessee

Tennessee Medicare Avg
$602.93
8% above national avg
National Medicare Avg
$555.97
All states combined
Billed Charge (TN)
$3,319.68
What providers submit
Est. Commercial (TN)
$1,640.47
National avg: $1,570.85
Est. Cash / Self-Pay (TN)
$1,485.17
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

178
Services in TN
129
Providers
N/A
Min Payment
N/A
Max Payment

Tennessee Pricing in Context

In Tennessee, CPT code 27524 (Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap) carries an average Medicare payment of $602.93 — 8% above the national benchmark of $555.97. 129 providers across the state submitted claims for this procedure in 2023, performing 178 total services. Individual payments in TN ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Tennessee is $3,319.68, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Tennessee sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Musculoskeletal Surgery procedures, the estimated commercial insurance price in Tennessee lands near $1,640.47, with self-pay cash prices typically around $1,485.17. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap cost in Tennessee?

The average Medicare payment for Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap in Tennessee is $602.93, which is 8% above the national average of $555.97. Providers in TN typically bill $3,319.68 for this procedure.

What does Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap cost with insurance in Tennessee?

With commercial insurance in Tennessee, Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap costs an estimated $1,640.47. Without insurance, the estimated cash price is $1,485.17. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap in Tennessee?

129 providers in Tennessee billed Medicare for Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap in 2023, performing 178 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap cheaper in Tennessee than the national average?

No — Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal Of Kneecap costs 8% above the national average in Tennessee. The state average Medicare payment is $602.93 compared to $555.97 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial