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CPT 01638Medical Service

Anesthesia for Open or Endoscopic Total Shoulder Joint Replacement

Anesthesia for open or endoscopic total shoulder joint replacement. Clinical pricing breakdown and utilization metrics across 1,432 practicing doctors nationwide.

$2460.68
Peer Median Charge
Gross billed rate
$224.00
Standard Baseline
Customary allowable
11.0x
National Markup
Charge vs baseline
1,432
Active Physicians
Billing this code
Planning care or already received a bill for CPT 01638?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $2460.68. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $224.00 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:
  • "Does Dr. [Name] participate in my specific insurance plan network?"
  • "What is the total self-pay or cash rate for code 01638 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"