Price AtlasInteractive atlas · All states · techysurgeon.comWhat the whole tibial plateau (knee) fracture fixation costs
Plates and screws for a break into the top of the shin bone at the knee. Every bill that usually comes with it, who sends it, and where each number comes from.
Price it for your ZIP, hospital or insurerRates by insurer
Medicare, national amounts, 2026
| Bill | Hospital stay |
|---|---|
| Facility | $18,455 |
| Surgeon | $815 |
| Assistant | $130 |
| Anesthesia | $232 |
| Before surgery (typical) | $251 |
| After surgery (typical) | $605 |
| Total | $20,489 |
National Medicare amounts (payment-area and wage adjustments at 1.0). Facility: OPPS Addendum B, July 2026 (national unadjusted rate); local = rate × (0.6 × wage index + 0.4); ASC Addendum AA, July 2026 (national rate); local = rate × (0.5 × wage index + 0.5); device-intensive (J8) codes keep the device portion unadjusted; FY 2026 IPPS final rule CMS-1833-F, Table 5; standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons. Surgeon: CMS Physician Fee Schedule CY2026 (RVU26D). Anesthesia: CMS base units × the CY2026 anesthesia conversion factor, with an assumed case time. An educational estimate, not a quote.
Line by line (hospital stay)
- Hospital stay, MS-DRG 493: $18,455. Billed by The hospital. CMS FY2026 IPPS: MS-DRG 493 weight 2.5361; FY 2026 IPPS final rule CMS-1833-F, Table 5; standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons.
- Surgeon, CPT 27535: $815. Billed by The surgeon's group. CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026 release), facility rate, PFS locality national (GPCI 1.0)
- Assistant surgeon (modifier 80): $130. Billed by The assistant surgeon. Medicare Claims Processing Manual, Ch. 12, §20.4.3: assistant-at-surgery (modifiers 80/81/82) = 16% of the surgeon's fee schedule amount; a PA, NP or CNS assisting (modifier AS) = 85% of that, 13.6%. Indicator from the RVU26D ASST SURG column (0 = only with documented medical necessity, 1 = not paid, 2 = paid).
- Anesthesia, ASA code 01392: $232. Billed by The anesthesia group. CMS anesthesia base units (CY2022 file, unchanged for CY2026) + CY2026 anesthesia conversion factor $20.49754 for the nation (ANES2026, RVU26D). Code mapping is ours, from the ASA code descriptors.
- Consultation visit (new patient): $177. Billed by The surgeon's group. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 99204
- X-rays before surgery: $42. Billed by Office or imaging center. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 73562
- Blood count (CBC): $8. Billed by The lab. CMS Clinical Laboratory Fee Schedule CY2026 Q4 (26CLABQ4), national limit
- Basic metabolic panel: $8. Billed by The lab. CMS Clinical Laboratory Fee Schedule CY2026 Q4 (26CLABQ4), national limit
- Pre-op ECG: $15. Billed by Office or hospital. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 93000
- Follow-up X-ray: $42. Billed by Office or imaging center. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 73562
- Physical therapy, 8 visits: $563. Billed by The therapy clinic. CMS PFS CY2026 (RVU26D), non-facility rates for 97161 and 97110
Questions
How much does a tibial plateau (knee) fracture fixation cost in total, with every bill?
At national Medicare rates for 2026, the whole tibial plateau (knee) fracture fixation comes to about $20,489 in a hospital stay, counting the facility, the surgeon, anesthesia and typical care before and after. Commercial plans usually pay more; local rates differ by area.
Why do I get separate bills for a tibial plateau (knee) fracture fixation?
The hospital bills for the facility; the surgeon's group bills for the operation (Surgeon, CPT 27535, about $815 from Medicare nationally); the anesthesia group bills by base units plus time (about $232 at our default time); labs, imaging, pathology and therapy each come from their own provider.
What does the surgeon's fee include?
90-day global: the fee covers the operation plus the visit the day before and routine follow-up visits for 90 days.