Replacement Of Knee Joint, Both Sides Of Knee
What Medicare pays for 27447, what providers bill, and how the price varies across 54 states, drawn from CMS 2023 claims data.
27447 · the short answer
For replacement of knee joint, both sides of knee, Medicare pays about $1,092.80 while providers bill $7,873.64 on average, a 7.2× markup, a higher-than-typical markup. State-level Medicare rates range 299% from lowest to highest.
- Medicare pays
- $1,092.80
- Providers bill
- $7,873.64
- Markup
- 7.2×
- Markup percentile
- 75th
Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.
Price Range Across States
What You Might Pay
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
How we estimate these prices
These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Musculoskeletal Surgery procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.
Where this markup sits nationally
Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate
7 Among the most affordable more affordable than 75% of 8,901 procedures
Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Medicare Physician & Other Practitioners · 2023
Prices by State
| State | Medicare Payment | Billed Charge |
|---|---|---|
| U.S. Virgin Islands | $2,135.44 | $11,164.56 |
| Mississippi | $2,104.60 | $12,558.71 |
| Hawaii | $1,835.10 | $6,949.52 |
| Oregon | $1,505.04 | $8,758.34 |
| Maryland | $1,480.56 | $11,924.91 |
| Georgia | $1,458.35 | $9,887.47 |
| Nevada | $1,443.70 | $9,128.28 |
| Tennessee | $1,427.49 | $8,312.66 |
| Michigan | $1,411.61 | $9,051.03 |
| Alaska | $1,301.62 | $13,406.24 |
| New Hampshire | $1,289.33 | $12,566.93 |
| Minnesota | $1,275.13 | $8,237.55 |
| Arizona | $1,260.91 | $8,591.92 |
| Puerto Rico | $1,244.13 | $2,345.98 |
| Ohio | $1,239.91 | $8,276.10 |
| Connecticut | $1,229.03 | $8,613.28 |
| New Mexico | $1,227.12 | $5,391.90 |
| Florida | $1,212.04 | $9,381.12 |
| Washington | $1,168.40 | $5,578.51 |
| Rhode Island | $1,152.81 | $6,675.33 |
| Virginia | $1,142.28 | $6,785.13 |
| Missouri | $1,141.79 | $8,511.54 |
| California | $1,132.66 | $6,689.53 |
| Indiana | $1,125.74 | $10,210.71 |
| South Carolina | $1,075.53 | $7,312.58 |
| North Dakota | $1,064.12 | $6,172.00 |
| Montana | $1,061.02 | $5,068.57 |
| Utah | $1,054.97 | $5,603.31 |
| New York | $1,054.09 | $11,311.25 |
| Kentucky | $1,051.75 | $7,174.11 |
| Wyoming | $1,049.32 | $8,479.40 |
| New Jersey | $1,039.24 | $13,557.77 |
| Colorado | $1,034.37 | $6,631.11 |
| West Virginia | $1,033.07 | $5,646.35 |
| Guam | $1,025.85 | $3,574.97 |
| Illinois | $986.37 | $9,695.72 |
| North Carolina | $977.77 | $5,479.06 |
| Wisconsin | $952.88 | $12,887.89 |
| District of Columbia | $945.69 | $6,371.52 |
| Texas | $917.19 | $6,498.59 |
| Pennsylvania | $914.74 | $6,214.15 |
| Louisiana | $872.13 | $5,525.59 |
| Iowa | $869.49 | $5,146.27 |
| Massachusetts | $797.11 | $6,588.48 |
| Delaware | $796.87 | $6,007.46 |
| Maine | $746.03 | $3,228.00 |
| Arkansas | $736.68 | $3,945.51 |
| Oklahoma | $729.97 | $3,199.16 |
| Alabama | $714.49 | $5,172.83 |
| Idaho | $654.36 | $4,464.28 |
| Kansas | $635.62 | $4,177.67 |
| Nebraska | $608.56 | $5,116.28 |
| Vermont | $573.89 | $4,259.06 |
| South Dakota | $535.41 | $3,409.91 |
What the Data Says About Replacement Of Knee Joint, Both Sides Of Knee
Across 54 states with reporting providers, CPT code 27447 (Replacement Of Knee Joint, Both Sides Of Knee) shows a national average Medicare payment of $1,092.80 against an average billed charge of $7,873.64. That gap, a 7.2x markup, or 621% above the Medicare allowed amount, runs well above the median for tracked procedures, a sign the chargemaster rate here is more aspirational than transactional.
Musculoskeletal Surgery procedures like this one saw 564.9K services billed to Medicare in 2023 by 21.0K distinct providers, serving 299.0K unique beneficiaries. State-level variation is significant: South Dakota reports the lowest average payment at $535.41, while U.S. Virgin Islands reports the highest at $2,135.44. A 299% spread this wide is typically a GPCI story: practice-expense and malpractice-premium components of the fee formula diverge sharply by locality even though the procedure code never changes.
Applying RAND 2024 commercial-to-Medicare ratios specific to the Musculoskeletal Surgery category (2.24x), the estimated commercial insurance price lands near $3,077.83, with self-pay cash discounts commonly bringing the figure closer to $3,195.77. Within Musculoskeletal Surgery, Replacement Of Knee Joint, Both Sides Of Knee ranks #82 of 1411 tracked procedures by national average Medicare payment.
What to do with this
If you may have replacement of knee joint, both sides of knee done, these steps turn the numbers above into a real-world cost estimate.
- Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
- Compare replacement of knee joint, both sides of knee costs in your state, Medicare rates vary by locality. Browse states
- Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
- Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide
Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.
Frequently Asked Questions
How much does Replacement Of Knee Joint, Both Sides Of Knee cost?
Replacement Of Knee Joint, Both Sides Of Knee (CPT 27447) shows unusually wide state-to-state pricing: Medicare pays $1,092.80 on average nationally, but the $535.41-$2,135.44 range across states spans more than double from cheapest to priciest.
Why do providers charge more than Medicare pays?
Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.
How much does Replacement Of Knee Joint, Both Sides Of Knee cost with insurance?
With commercial insurance, replacement of knee joint, both sides of knee costs an estimated $3,077.83 on average (range: $2,154.48-$4,308.96), a moderate premium over Medicare's $1,092.80. Without insurance, the estimated cash price is $3,195.77.
Which state has the lowest cost for Replacement Of Knee Joint, Both Sides Of Knee?
South Dakota has by far the lowest average Medicare payment for Replacement Of Knee Joint, Both Sides Of Knee at $535.41, while U.S. Virgin Islands pays more than double at $2,135.44 - a $1,600.02 gap.
How many providers perform Replacement Of Knee Joint, Both Sides Of Knee?
Replacement Of Knee Joint, Both Sides Of Knee is a widely-performed procedure: 21.0K providers billed Medicare for it in 2023 across 54 states, together handling 564.9K services for 299.0K beneficiaries.
What is the billed-to-Medicare markup for Replacement Of Knee Joint, Both Sides Of Knee?
Providers bill 7.2x what Medicare pays for Replacement Of Knee Joint, Both Sides Of Knee - a higher-than-typical markup at 621% above the Medicare rate.
Related Guides
Tips to reduce out-of-pocket costs
Your right to upfront pricing
How Medicare payments work
Decode charges and codes
Why bills exceed actual costs
Geographic pricing factors
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology - how this data is sourced, computed, and verified.
Related
Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.