Total knee arthroplasty

What is CPT Code 27447?

Total knee replacement (total knee arthroplasty) — removal of the damaged knee joint surfaces and replacement with metal and plastic implants. One of the most common elective surgeries in the US with major cost variation.

The Medicare reimbursement rate shown above is the amount the federal government has determined is a reasonable payment for this service. Hospitals and providers that participate in Medicare have agreed to accept these rates from Medicare patients.

Who typically bills this:Orthopedic surgeon + hospital facility (two separate bills)

Common Billing Errors for CPT 27447

• !Implant costs (the knee hardware) billed at chargemaster rates 3–5x the actual acquisition cost
• !Surgeon fee and facility fee both billed at full rates without bundled payment negotiation
• !Assistant surgeon billed at full surgeon rate when they should be billed at a reduced rate

Red Flags on Your Bill

Negotiation Tips for CPT 27447

1. 1Total knee replacement is highly bundled — many insurers and hospitals offer bundled payment arrangements; ask about this
2. 2The implant is a negotiable line item — ask the hospital for their actual acquisition cost
3. 3Get a written good-faith estimate before surgery; the No Surprises Act requires it
4. 4Surgeon fees for 27447 are often negotiable 20–40% below the initial ask for self-pay patients

Codes That Often Appear With This One

These CPT codes commonly appear on the same bill. Review each one to spot potential bundling errors or duplicate charges.

Found CPT 27447 on Your Bill?

If you see CPT code 27447 on a hospital or medical bill, compare the charged amount to the Medicare rate above. If your bill shows a significantly higher charge, you may have grounds to negotiate.

1. Note the amount charged for CPT 27447 on your itemized bill
2. Compare it to the Medicare rate above — calculate the markup
3. Call the billing department and use the Medicare rate as your anchor:“I see CPT code 27447 billed at [amount]. The Medicare rate for this procedure is $1,286.89. I'd like to discuss a fair adjustment.”