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Shoulder replacement in Virginia: what insurers pay

Posted commercial rates at 40 Virginia hospitals, each next to its own Medicare base rate.

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CPT 23472

HospitalMedian across insurers× MedicareInsurersFile date
Sentara Northern Virginia Medical Center Woodbridge$25,0721.4×22026-04-01
Fauquier Hospital Warrenton$25,1971.4×12026-07-14
CJW Medical Center (Chippenham + Johnston-Willis) Richmond$25,2801.5×72026-09-01
Henrico Doctors' Hospital Richmond$25,2801.5×72026-09-01
Inova Alexandria Hospital Alexandria$27,7181.5×32026-04-01
Inova Loudoun Hospital Leesburg$27,7181.5×32026-04-01
Inova Fair Oaks Hospital Fairfax$27,7181.5×32026-04-01
Inova Mount Vernon Hospital Alexandria$27,7181.5×32026-04-01
Inova Fairfax Hospital Falls Church$28,1551.6×32026-04-01
Tricities Hospital Hopewell$28,4221.7×62026-09-01
Spotsylvania Regional Medical Center Fredericksburg$28,5201.6×62026-09-01
Lewisgale Hospital Pulaski Pulaski$30,9021.8×42026-09-01
Lewisgale Hospital Alleghany Low Moor$31,2441.8×52026-09-01
Reston Hospital Center Reston$31,3281.7×62026-09-01
Stonesprings Hospital Center Dulles$31,3281.7×62026-09-01
Lewisgale Hospital Montgomery Blacksburg$31,4061.8×42026-09-01
Lewisgale Medical Center Salem$32,2611.9×32026-09-01
Sentara Leigh Hospital Norfolk$40,6802.4×22026-04-01
Sentara Virginia Beach General Hospital Virginia Beach$42,7502.5×22026-04-01
Sentara Martha Jefferson Hospital Charlottesville$43,9462.5×22026-04-01
Sentara Princess Anne Hospital Virginia Beach$44,2582.6×22026-04-01
Sentara Careplex Hospital Hampton$44,4622.6×22026-04-01
Sentara Norfolk General Hospital Norfolk$44,9822.6×22026-04-01
Augusta Health Fishersville$46,1382.7×32026-04-01
Sentara Williamsburg Regional Medical Center Williamsburg$46,8202.7×22026-04-01
Sentara Obici Hospital Suffolk$49,0082.9×22026-04-01
Sentara Rmh Medical Center Harrisonburg$53,9503.1×12026-04-01
Sentara Halifax Regional Hospital South Boston$59,4233.5×12026-04-01

MS-DRG 483

HospitalMedian across insurers× MedicareInsurersFile date
Spotsylvania Regional Medical Center Fredericksburg$21,9721.1×72026-09-01
Lewisgale Hospital Pulaski Pulaski$22,9091.2×62026-09-01
Lewisgale Hospital Alleghany Low Moor$25,6611.3×62026-09-01
Tricities Hospital Hopewell$25,9261.4×82026-09-01
Lewisgale Medical Center Salem$26,7081.4×42026-09-01
Reston Hospital Center Reston$27,4421.3×92026-09-01
Lewisgale Hospital Montgomery Blacksburg$27,6551.4×72026-09-01
Stonesprings Hospital Center Dulles$28,2521.4×82026-09-01
CJW Medical Center (Chippenham + Johnston-Willis) Richmond$28,9981.5×92026-09-01
Henrico Doctors' Hospital Richmond$28,9981.5×92026-09-01
Sentara Northern Virginia Medical Center Woodbridge$38,1971.9×52026-04-01
Bon Secours Southside Medical Center Petersburg$40,4572.1×42026-04-01
Sentara Martha Jefferson Hospital Charlottesville$45,7752.3×42026-04-01
Riverside Shore Memorial Hospital Onancock$48,4162.5×52026-01-02
Riverside Regional Medical Center Newport News$48,4162.5×52026-01-02
Riverside Doctors' Hospital Of Williamsburg Williamsburg$48,4162.5×52026-01-02
Bon Secours Maryview Medical Center Portsmouth$49,7582.6×52026-04-01
Bon Secours Mary Immaculate Hospital Newport News$49,8192.6×42026-04-01
Inova Alexandria Hospital Alexandria$49,9602.4×72026-04-01
Inova Mount Vernon Hospital Alexandria$49,9782.4×72026-04-01
Inova Loudoun Hospital Leesburg$51,2492.5×72026-04-01
Inova Fairfax Hospital Falls Church$51,7492.5×72026-04-01
Inova Fair Oaks Hospital Fairfax$52,2132.5×72026-04-01
Sentara Virginia Beach General Hospital Virginia Beach$52,4082.7×32026-04-01
Augusta Health Fishersville$53,9822.8×32026-04-01
Sentara Rmh Medical Center Harrisonburg$54,0602.7×12026-04-01
Sentara Obici Hospital Suffolk$54,6652.8×42026-04-01
Sentara Leigh Hospital Norfolk$54,9222.9×32026-04-01
Sentara Princess Anne Hospital Virginia Beach$55,1742.9×42026-04-01
Sentara Careplex Hospital Hampton$57,1403.0×32026-04-01
Sentara Williamsburg Regional Medical Center Williamsburg$57,6923.0×32026-04-01
Bon Secours St. Francis Medical Center Midlothian$59,4413.1×52026-04-01
Fauquier Hospital Warrenton$62,4873.1×12026-07-14
Bon Secours Memorial Regional Medical Center Mechanicsville$63,1113.3×52026-04-01
Bon Secours St. Mary's Hospital Richmond$66,6933.5×52026-04-01
Sentara Norfolk General Hospital Norfolk$66,9403.5×42026-04-01
VCU Medical Center Richmond$72,0043.8×32026-01-02
Carilion Roanoke Memorial Hospital Roanoke$87,8424.6×12025-12-15
Carilion New River Valley Medical Center Christiansburg$95,4315.0×12025-12-15

Questions

How much do insurers pay for shoulder replacement in Virginia?

40 Virginia hospitals post usable commercial rates for shoulder replacement in their federal price-transparency files. For CPT 23472, hospital outpatient, the median across 28 hospitals is $31,328, 1.8× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.