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Knee Intercondylar Fracture Treatment, Closed

New Jersey 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?

$5,860

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $5,860 for this procedure. That total is two separate charges: $490 to the doctor who performs it, and $5,370 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$490$447 to $759
Facility feeThe hospital or surgery center$5,370$3,311 to $7,079

How much rates vary

Facilitymedian $5,370 · 10th to 90th $794 to $10,471Professionalmedian $490 · 10th to 90th $407 to $2,291
$500$1K$2K$5K$10Kfacility $5,370professional $490

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
$794.33
Median
$5,888.44
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$467.74
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$645.65
Typical High
$1,513.56
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$676.08
Typical High
$933.25
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$851.14
Typical High
$1,258.93
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$562.34
Typical High
$2,290.87
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$2,754.23
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$501.19
Typical High
$1,122.02

Where New Jersey sits

The same service costs 9.6 times more in New Jersey 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

New Jersey· 1st of 49

$5,860

$490 physician + $5,370 facility

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.