27446

Replacement of knee joint on side of knee

Medicare pricing data for 5,247 providers across 50 states

🤖AI Overview

This procedure has a 5.3x markup — hospitals charge $10,504 but Medicare allows only $1,986. Uninsured patients may face bills 5.3 times higher than what insurance negotiates. Prices vary significantly by location — from $647 in South Dakota to $3,435 in Hawaii. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Replacement of knee joint on side of knee (HCPCS code 27446) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,986, but hospitals typically charge $10,504 — a 5.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$397.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,986, your out-of-pocket cost would be approximately $397.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,986
Average Hospital Charge
$10,504
Markup Ratio
5.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$10,503.93
Medicare Allowed$1,985.60
Medicare Payment$1,580.06

Hospitals charge 5.3x more than what Medicare allows for this procedure. Medicare actually pays $1,580 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$3,435$8,06820138+73.0%
Maryland$3,417$20,828134765+72.1%
Mississippi$3,138$21,14952736+58.0%
Indiana$2,894$19,4421711,131+45.7%
New Hampshire$2,800$19,83549322+41.0%
Michigan$2,606$11,193175974+31.3%
Missouri$2,475$9,85577602+24.6%
Oregon$2,471$8,99269189+24.4%
Connecticut$2,429$11,166105254+22.3%
New Mexico$2,341$6,7783988+17.9%
Arizona$2,299$13,594164978+15.8%
Florida$2,288$13,1713791,931+15.2%
Georgia$2,254$11,072116421+13.5%
North Dakota$2,240$6,66822110+12.8%
Ohio$2,144$13,443200900+8.0%
Washington$2,073$6,661181848+4.4%
North Carolina$1,979$7,665212846-0.4%
Wyoming$1,972$9,41532129-0.7%
Tennessee$1,969$7,465112665-0.9%
California$1,948$8,7784392,278-1.9%
Minnesota$1,937$8,405100321-2.5%
Utah$1,889$6,75054180-4.9%
New Jersey$1,872$11,881131491-5.7%
Kentucky$1,757$10,17259315-11.5%
Illinois$1,684$10,847205938-15.2%
Arkansas$1,636$7,10644192-17.6%
Wisconsin$1,530$10,18796195-22.9%
Louisiana$1,503$7,66555146-24.3%
Alabama$1,497$10,01651263-24.6%
New York$1,494$12,543236733-24.7%
Nevada$1,485$6,5872972-25.2%
Rhode Island$1,484$5,11327144-25.2%
Virginia$1,423$7,563153919-28.4%
Texas$1,362$7,3122861,256-31.4%
Delaware$1,342$4,81820133-32.4%
South Carolina$1,327$6,36173279-33.2%
Kansas$1,290$7,24054137-35.1%
Colorado$1,228$6,345104323-38.2%
District of Columbia$1,200$5,2981345-39.6%
Nebraska$1,175$4,8372668-40.8%
Pennsylvania$1,121$5,153202892-43.5%
Montana$1,096$4,18841229-44.8%
Massachusetts$1,069$5,337137505-46.2%
Maine$981$2,6113982-50.6%
West Virginia$818$3,0772994-58.8%
Iowa$791$3,69544135-60.2%
Vermont$771$3,8681647-61.2%
Idaho$757$3,57443110-61.9%
Oklahoma$739$2,93155239-62.8%
South Dakota$647$2,9572561-67.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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