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Knee Intercondylar Fracture Treatment, Closed

Arizona rates for HCPCS 27538

This treatment addresses a fracture at the top of the shinbone where knee ligaments attach, sometimes called a tibial spine fracture. The break is treated without opening the knee, using a cast, brace, or gentle manipulation of the joint from outside the skin to allow the bone fragment to heal in position. It is most common after a twisting injury to the knee, especially in children and teenagers.

Rates data updated October 2026.

How much does Knee Intercondylar Fracture Treatment, Closed cost?

$831

Typical total for the visit. In Arizona, October 2026.

Insurers have agreed to pay about $831 for this procedure. That total is two separate charges: $468 to the doctor who performs it, and $363 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$468$427 to $676
Facility feeThe hospital or surgery center$363$200 to $977

How much rates vary

Facilitymedian $363 · 10th to 90th $117 to $2,344Professionalmedian $468 · 10th to 90th $398 to $3,388
$100$200$500$1K$2K$5K$10Kfacility $363professional $468

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$977.24
Median
$3,715.35
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
None
Typical Low
$426.58
Median
$457.09
Typical High
$457.09
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$199.53
Typical High
$524.81
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$645.65
Typical High
$977.24
Cigna
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$190.55
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
None
Typical Low
$380.19
Median
$467.74
Typical High
$691.83
Medica
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$501.19
Typical High
$2,041.74
Medica
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$3,388.44
Typical High
$3,630.78
United
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$524.81
Typical High
$2,238.72
United
Setting
Professional
Modifier
None
Typical Low
$371.54
Median
$426.58
Typical High
$660.69
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$208.93
Median
$223.87
Typical High
$229.09
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$85.11
Median
$91.20
Typical High
$91.20
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$316.23
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$63.10
Median
$67.61
Typical High
$67.61
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$42.66
Median
$45.71
Typical High
$45.71
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$295.12
Median
$316.23
Typical High
$316.23

Where Arizona sits

The same service costs 4.9 times more in Connecticut than in Florida. 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

Arizona· 46th of 51

$831

$468 physician + $363 facility

CT $3,107FL $640

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.