HCPCS G0289 at Seattle Children's Hospital

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

Seattle Children's Hospital, Seattle

Description from CMS's HCPCS Level II code file.

What Seattle Children's Hospital publishes for this code: as an outpatient

Seattle Children's Hospital’s prices for HCPCS G0289, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$84.35 – $211at least 54 plans	—
Other government programInsurer rates	$102at least 1 plan	—
UnknownInsurer rates	$84.35 – $200at least 15 plans	—
Cash pricePaying yourself, without insurance	—	—
List priceBefore any discount; few people pay it	$264	—

Lowest and highest amounts Seattle Children's Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.

What Seattle Children's Hospital publishes for this code: during a hospital stay

Seattle Children's Hospital’s prices for HCPCS G0289, during a hospital stay
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$16.87 – $211at least 54 plans	—
Other government programInsurer rates	$20.31 – $102at least 1 plan	—
UnknownInsurer rates	$16.87 – $200at least 15 plans	—
Cash pricePaying yourself, without insurance	—	—
List priceBefore any discount; few people pay it	$52.80 – $264	—

Lowest and highest amounts Seattle Children's Hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. 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 Seattle (King County) 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 Seattle Children's Hospital
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.