Shoulder Replacement for a Broken Upper Arm Bone

Nationwide rates for HCPCS 23616

Treats a break at the top of the upper arm bone by replacing the broken ball of the shoulder with an artificial one through an open incision. It is chosen when the bone is in too many pieces, or its blood supply is too damaged, for a repair to be expected to heal. Tendons and bone fragments around the shoulder are reattached to the implant where possible.

Rates data updated July 2026.

How much does Shoulder Replacement for a Broken Upper Arm Bone cost?

$8,824

Typical total for the visit. Nationwide, July 2026.

Insurers have agreed to pay about $8,824 for this procedure. That total is two separate charges: $1,905 to the doctor who performs it, and $6,918 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

22% physician fee78% facility fee

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 54 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$1,905	$1,349 to $2,692
Facility feeThe hospital or surgery center	The hospital or surgery center	$6,918	$3,090 to $12,882

How much rates vary

Facilitymedian $6,918 · 10th to 90th $1,549 to $23,442Professionalmedian $1,905 · 10th to 90th $1,148 to $4,898

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $1,288.25 Median $4,677.35 Typical High $12,022.64	Facility	Global	$1,288.25	$4,677.35	$12,022.64
BCBS Setting Facility Modifier Global Typical Low $3,715.35 Median $11,220.18 Typical High $28,840.32	Facility	Global	$3,715.35	$11,220.18	$28,840.32
Cigna Setting Facility Modifier Global Typical Low $1,949.84 Median $3,715.35 Typical High $14,791.08	Facility	Global	$1,949.84	$3,715.35	$14,791.08
Cigna Setting Facility Modifier AS · PA/NP assist Typical Low $194.98 Median $194.98 Typical High $194.98	Facility	AS · PA/NP assist	$194.98	$194.98	$194.98
United Setting Facility Modifier Global Typical Low $2,951.21 Median $9,332.54 Typical High $24,547.09	Facility	Global	$2,951.21	$9,332.54	$24,547.09

What it costs in each state

The same service costs 8.0 times more in Colorado than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Touch or drag across the chart to see any state's rate.

CO $18,761MD $2,349

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.