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Knee Intercondylar Fracture Treatment, Closed

North Carolina 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 July 2026.

How much does Knee Intercondylar Fracture Treatment, Closed cost?

$1,311

Typical total for the visit. In North Carolina, July 2026.

Insurers have agreed to pay about $1,311 for this procedure. That total is two separate charges: $603 to the doctor who performs it, and $708 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$603$479 to $871
Facility feeThe hospital or surgery center$708$513 to $1,622

How much rates vary

Facilitymedian $708 · 10th to 90th $447 to $5,248Professionalmedian $603 · 10th to 90th $447 to $1,288
$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0Kfacility $708professional $603

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$1,621.81
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$512.86
Typical High
$1,096.48
BCBS
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$117.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$676.08
Typical High
$1,445.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$398.11
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$630.96
Typical High
$1,047.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$1,122.02
Medcost
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$588.84
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$891.25
Typical High
$1,995.26
United
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$489.78
Typical High
$933.25
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$19,498.45
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,630.78
Median
$3,630.78
Typical High
$4,265.80

Where North Carolina sits

The same service costs 9.6 times more in New Jersey than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeNorth Carolina $1,311 · 41st of 49
NJ $5,860MD $613

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.