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Knee Arthroscopy, Body Removal or Chondroplasty

Pennsylvania rates for HCPCS G0289

Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee

Rates data updated July 2026.

Facilitymedian $5,495 · 10th–90th $537$10,2330%10%10th90th$5,495$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$6,606.93
Typical High
$10,232.93
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Cigna
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$10.23
Median
$10.23
Typical High
$10.23
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$5,370.32
Typical High
$10,232.93
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$3,801.89
Typical High
$6,606.93
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$630.96
Typical High
$4,466.84