Knee arthroscopy costs $5,000–$25,000+ without insurance. At an ambulatory surgery center, the same procedure costs 40–60% less than at a hospital. With insurance, most patients pay $1,500–$6,000 out of pocket. Orthopedic billing has a 36% error rate—the highest of any specialty. Here’s the full breakdown.
1. Cost by procedure type
“Knee arthroscopy” is an umbrella term for several procedures of varying complexity and cost. What you pay depends primarily on what your surgeon does inside the joint:
| Procedure | CPT Code | Without Insurance | At ASC | Medicare Rate (surgeon) |
|---|---|---|---|---|
| Diagnostic arthroscopy only | 29870 | $5,000–$10,000 | $3,000–$6,000 | ~$500 |
| Synovectomy (partial) | 29875 | $6,000–$12,000 | $3,500–$7,000 | ~$580 |
| Partial meniscectomy | 29881 | $8,000–$16,000 | $5,000–$9,500 | ~$680 |
| Meniscus repair | 29882–29883 | $10,000–$20,000 | $6,000–$12,000 | ~$820–$950 |
| Chondroplasty (cartilage smoothing) | 29877 | $7,000–$15,000 | $4,000–$9,000 | ~$600 |
| ACL reconstruction (arthroscopic) | 29888 | $15,000–$25,000+ | $9,000–$16,000 | ~$1,400 |
| Loose body removal | 29874 | $6,000–$12,000 | $3,500–$7,000 | ~$560 |
2. Cost with vs. without insurance
| Scenario | Total Bill | What You Pay |
|---|---|---|
| Employer PPO (meniscectomy, deductible not met) | $12,000–$18,000 | Deductible ($1,500–$3,000) + 20% until OOP max |
| Employer PPO (deductible met) | $12,000–$18,000 | 20% coinsurance (~$1,200–$1,800) up to OOP max |
| Medicare (outpatient, Part B) | APC payment | 20% after Part B deductible ($257) |
| Medicaid | Medicaid rate | $0–$4 |
| Uninsured (hospital cash price) | $12,000–$25,000 | Full amount (negotiate 40–60% reduction) |
| Uninsured (ASC cash price) | $5,000–$12,000 | Full amount (often posted online by ASCs) |
Same surgery: $18,000 at hospital vs. $7,200 at ASC
A 34-year-old with a medial meniscus tear received a hospital quote of $18,400 for a partial meniscectomy. Her orthopedic surgeon also operated at an ASC two miles away, which quoted $7,200 for the same procedure. Both were in-network with her insurer. She chose the ASC and paid $1,440 (20% coinsurance) instead of an estimated $3,680 at the hospital—saving $2,240 in cost-sharing on a lower total bill.
3. Hospital vs. ambulatory surgery center
| Setting | Typical Total Cost | Your Insurance Copay | Recovery |
|---|---|---|---|
| Hospital inpatient (rare for arthroscopy) | $15,000–$30,000+ | Highest (inpatient deductible applies) | Overnight stay |
| Hospital outpatient department | $10,000–$25,000 | Moderate (facility + professional fee) | Same-day discharge |
| Ambulatory surgery center (ASC) | $4,000–$12,000 | Lowest (ASC facility rate) | Same-day discharge |
Knee arthroscopy is almost always performed on an outpatient basis. If your surgeon recommends an overnight hospital stay for a straightforward meniscectomy, ask why—it may not be medically necessary and will significantly increase your bill.
Find ASCs near you in our surgery center directory.
4. Medicare coverage
Medicare covers knee arthroscopy when medically necessary. Covered indications include:
- Meniscus tears (repair or meniscectomy)
- Loose bodies in the joint
- Plica syndrome
- ACL or PCL reconstruction
- Synovitis requiring synovectomy
Not covered: Knee arthroscopy for osteoarthritis. CMS does not cover arthroscopic lavage or debridement when the primary diagnosis is knee osteoarthritis (ICD-10: M17.x). A landmark 2002 New England Journal of Medicine trial (and subsequent evidence) found that arthroscopy for OA provides no benefit over sham surgery. If your diagnosis is primarily knee OA, Medicare will deny the claim and you will bear the full cost.
Arthroscopy is billed as a hospital outpatient procedure under the APC system. You pay 20% of the Medicare-approved amount after your Part B deductible. There is no separate global surgical period payment for arthroscopy under the outpatient system—follow-up visits are billed separately as office visits.
5. Insurance and prior authorization
Prior authorization is required by most commercial insurers for knee arthroscopy. Without it, your claim may be denied entirely. Here’s what to expect:
- What insurers require for prior auth: Documentation of conservative treatment failure (typically 4–6 weeks of physical therapy), MRI or imaging confirming the diagnosis, and a letter of medical necessity from your orthopedic surgeon.
- Timeline: Allow 5–10 business days for initial approval. Schedule surgery only after written confirmation.
- Scope matters: Your prior auth is for the procedure as planned. If the surgeon discovers additional pathology during arthroscopy (e.g., a second meniscus tear) and performs additional procedures, those may not be covered under the original authorization. Some insurers require retroactive authorization; others don’t cover unanticipated procedures at all.
- Hospital vs. ASC authorization: If you switch from a hospital to an ASC (or vice versa) after receiving auth, notify your insurer. The authorization may be facility-specific.
6. CPT codes for knee arthroscopy
| CPT Code | Description | Medicare Surgeon Fee (2026) |
|---|---|---|
| 29870 | Arthroscopy, knee, diagnostic, with or without synovial biopsy | ~$500 |
| 29871 | Arthroscopy, knee, surgical; for infection, lavage, and drainage | ~$550 |
| 29873 | Arthroscopy, knee, surgical; with lateral release | ~$560 |
| 29874 | Arthroscopy, knee, surgical; for removal of loose body or bodies | ~$560 |
| 29875 | Arthroscopy, knee, surgical; synovectomy, limited | ~$580 |
| 29877 | Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) | ~$600 |
| 29880 | Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) | ~$730 |
| 29881 | Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral) | ~$680 |
| 29882 | Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) | ~$820 |
| 29883 | Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) | ~$950 |
| 29888 | Arthroscopically aided ACL repair/augmentation or reconstruction | ~$1,400 |
7. Common billing errors
Orthopedic billing has a 36% error rate—among the highest of any medical specialty. For knee arthroscopy specifically:
- Upcoding the procedure: Billing a meniscus repair (29882, higher RVU) when a meniscectomy (29881) was actually performed. Repair pays more, but requires different surgical technique documented in the operative report.
- Unbundling arthroscopy components: Billing separately for the arthroscope insertion, irrigation, and wound closure when these are included in the base arthroscopy code.
- Billing diagnostic arthroscopy and surgical arthroscopy as separate procedures: When a diagnostic arthroscopy transitions to a surgical arthroscopy in the same session, only the surgical code is billable.
- Modifier 50 (bilateral) errors: Bilateral knee arthroscopy is extremely rare. If modifier 50 appears on your bill, verify that both knees were actually operated on.
- Facility fee on post-op visits: Follow-up visits within the 90-day global surgical period should not carry a facility fee if the global period is already paid.
- Anesthesia overbilling: Anesthesia for knee arthroscopy is short (typically 45–90 minutes). Anesthesia billing is in base units + time units (15-minute increments). Verify the total time matches operative records.
Think your knee arthroscopy bill has errors?
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Audit My Arthroscopy Bill →8. Recovery and PT costs after surgery
| Recovery Cost | Typical Range | Insurance Coverage |
|---|---|---|
| Physical therapy (meniscectomy, 8–16 sessions) | $800–$3,200 | Usually covered with $20–$75 copay |
| Physical therapy (ACL reconstruction, 30–40 sessions) | $3,000–$8,000 | Usually covered; watch annual visit cap |
| Crutches | $30–$150 | Covered as DME under most plans |
| Knee brace (functional, post-ACL) | $400–$1,200 | Often covered as DME; prior auth may be required |
| Ice/compression device (Game Ready, etc.) | $50–$400/week rental | Rarely covered; cash pay common |
| Follow-up surgeon visits (included in global) | Typically $0 | Included in surgical fee global period |
| MRI if complications arise | $500–$2,500 | Usually covered after deductible |
Frequently asked questions
How much does knee arthroscopy cost without insurance?
$5,000–$25,000+ depending on the procedure. Diagnostic arthroscopy costs $5,000–$10,000. Partial meniscectomy runs $8,000–$16,000. ACL reconstruction is $15,000–$25,000+. Choosing an ASC over a hospital saves 40–60%.
Does Medicare cover knee arthroscopy?
Yes, when medically necessary—for meniscus tears, loose bodies, ACL reconstruction, or plica syndrome. Medicare does not cover arthroscopy when the primary diagnosis is osteoarthritis. Arthroscopic debridement for OA is not covered under current CMS policy.
How much cheaper is an ASC than a hospital for knee arthroscopy?
40–60% cheaper. A meniscectomy costing $15,000 at a hospital typically runs $6,000–$9,000 at an ASC for the same procedure with the same surgeon. The lower overhead of an ASC is passed through as lower facility fees.
What is the most common billing error in knee arthroscopy?
Upcoding—billing for a meniscus repair (29882) when a meniscectomy (29881) was performed. Repairs pay more and require different documentation. Always request your operative report and compare it to the CPT codes on your bill.
Is prior authorization required for knee arthroscopy?
Almost always with commercial insurers. You typically need documentation of 4–6 weeks of failed conservative treatment and imaging confirming the diagnosis. Do not schedule surgery until you have written authorization. Medicare does not require prior auth for arthroscopy, but Medicare Advantage plans may.