HCPCS G0289 at Legacy Salmon Creek Medical Center

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

Legacy Salmon Creek Medical Center, Vancouver

Description from CMS's HCPCS Level II code file.

What Legacy Salmon Creek Medical Center publishes for this code: as an outpatient

Legacy Salmon Creek Medical Center’s prices for HCPCS G0289, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$6,216 – $7,9202 plans	—
Cash pricePaying yourself, without insurance	$31.33	$125 – $157
List priceBefore any discount; few people pay it	$48.20	$193 – $241

Lowest and highest amounts Legacy Salmon Creek Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-04-01. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS G0289 at Legacy Salmon Creek Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS G0289 at every Washington hospital, with Medicare’s reference amounts.