Revision of component of total knee joint prosthesis
Medicare pricing data for 7,456 providers across 51 states
This procedure has a 5.5x markup — hospitals charge $4,754 but Medicare allows only $861.78. Uninsured patients may face bills 5.5 times higher than what insurance negotiates. 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
Revision of component of total knee joint prosthesis (HCPCS code 27486) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $861.78, but hospitals typically charge $4,754 — a 5.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $861.78, your out-of-pocket cost would be approximately $172.36. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.5x more than what Medicare allows for this procedure. Medicare actually pays $685.89 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $1,407 | $5,122 | 12 | 31 | +63.3% |
| Hawaii | $1,186 | $3,412 | 7 | 12 | +37.6% |
| New York | $1,140 | $8,754 | 323 | 593 | +32.3% |
| California | $1,009 | $4,367 | 495 | 1,092 | +17.1% |
| Michigan | $998 | $3,324 | 197 | 364 | +15.8% |
| Alaska | $991 | $8,085 | 43 | 93 | +15.0% |
| Massachusetts | $985 | $5,896 | 173 | 380 | +14.3% |
| Maryland | $964 | $3,491 | 150 | 373 | +11.8% |
| Vermont | $963 | $5,138 | 14 | 31 | +11.7% |
| Illinois | $960 | $7,666 | 292 | 701 | +11.4% |
| Oregon | $933 | $3,848 | 75 | 137 | +8.2% |
| West Virginia | $923 | $3,452 | 33 | 57 | +7.1% |
| New Jersey | $921 | $11,747 | 168 | 375 | +6.9% |
| Missouri | $920 | $5,241 | 153 | 329 | +6.8% |
| Virginia | $916 | $4,257 | 178 | 430 | +6.3% |
| Wyoming | $914 | $5,457 | 34 | 62 | +6.1% |
| Connecticut | $886 | $5,216 | 101 | 167 | +2.8% |
| Texas | $876 | $4,302 | 476 | 1,097 | +1.6% |
| New Hampshire | $875 | $8,841 | 56 | 123 | +1.6% |
| Minnesota | $871 | $4,201 | 184 | 320 | +1.0% |
| Mississippi | $867 | $4,079 | 46 | 99 | +0.6% |
| North Dakota | $863 | $3,446 | 26 | 41 | +0.1% |
| Nevada | $855 | $4,254 | 56 | 129 | -0.8% |
| Arizona | $854 | $3,349 | 208 | 480 | -0.9% |
| New Mexico | $851 | $3,324 | 35 | 55 | -1.2% |
| Georgia | $843 | $5,397 | 179 | 400 | -2.1% |
| Louisiana | $837 | $4,300 | 95 | 229 | -2.9% |
| Montana | $837 | $3,523 | 54 | 131 | -2.9% |
| Pennsylvania | $830 | $3,932 | 343 | 665 | -3.7% |
| Florida | $820 | $4,307 | 515 | 1,187 | -4.9% |
| Oklahoma | $818 | $2,638 | 112 | 294 | -5.1% |
| Rhode Island | $816 | $4,458 | 28 | 58 | -5.3% |
| Washington | $806 | $2,987 | 207 | 378 | -6.4% |
| Delaware | $804 | $5,701 | 46 | 146 | -6.7% |
| Kentucky | $798 | $3,670 | 104 | 200 | -7.4% |
| Tennessee | $797 | $3,971 | 139 | 344 | -7.5% |
| Utah | $794 | $2,520 | 98 | 291 | -7.9% |
| Wisconsin | $791 | $10,255 | 208 | 375 | -8.2% |
| Kansas | $779 | $3,560 | 116 | 271 | -9.6% |
| Idaho | $779 | $3,546 | 71 | 126 | -9.6% |
| Iowa | $779 | $3,592 | 114 | 237 | -9.7% |
| South Carolina | $777 | $4,119 | 137 | 381 | -9.9% |
| Indiana | $770 | $4,078 | 213 | 470 | -10.7% |
| Maine | $764 | $2,449 | 33 | 61 | -11.4% |
| Nebraska | $748 | $4,156 | 74 | 160 | -13.2% |
| Colorado | $744 | $4,636 | 175 | 398 | -13.7% |
| Alabama | $742 | $5,160 | 117 | 244 | -13.9% |
| North Carolina | $737 | $3,548 | 269 | 668 | -14.5% |
| Ohio | $725 | $3,491 | 332 | 720 | -15.9% |
| Arkansas | $721 | $2,687 | 57 | 142 | -16.4% |
| South Dakota | $710 | $3,090 | 66 | 167 | -17.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber