How much does Medicare pay for CPT 27446?

Medicare allowed an average of $2647.88 per service and paid $2107.41 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $15,152, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 27446?

Replacement of knee joint on side of knee. It was billed 10,095 times to 9,703 Medicare beneficiaries by 423 providers in 2024.

Does 27446 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1235.47 in an office setting and $2651.25 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 27446 most?

Orthopedic Surgery, with 5,159 services from 223 clinicians. Next are Ambulatory Surgical Center, Physician Assistant, Nurse Practitioner.

CPT 27446

Replacement of knee joint on side of knee

$2647.88Medicare-allowed amount per service, averaged across 10,095 services

Providers submitted

$15,152

Asking price, not received

Medicare allowed

$2647.88

The fee schedule figure

Medicare paid

$2107.41

Balance is patient coinsurance

Providers submitted an average of $15,152 for this code and Medicare allowed $2647.88 — 5.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $2107.41 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1235.47
Hospital / facility: $2651.25

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 24 services were billed in an office setting and 10,071 in a facility.

Services: 10,095
Beneficiaries: 9,703
Providers billing it: 423
Total allowed: $26,730,349

What Medicare pays for CPT 27446

Across 10,095 services billed by 423 providers to 9,703 beneficiaries, Medicare allowed an average of $2647.88 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 27446

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	5,159	4,970	$1135.14	223
Ambulatory Surgical Center	2,431	2,310	$8413.62	87
Physician Assistant	2,177	2,107	$157.54	100
Nurse Practitioner	296	284	$147.08	11
Osteopathic Manipulative Medicine	21	21	$1075.06	1
Sports Medicine	11	11	$1055.94	1

27446 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	1,084	$2316.03	$1565.18	39
Florida	816	$2963.57	$2455.39	37
Mississippi	573	$3427.93	$3156.39	11
Virginia	551	$1476.31	$1231.90	20
Maryland	522	$4376.53	$3474.74	18
Tennessee	489	$2086.53	$1968.05	21
Michigan	489	$3154.46	$2648.17	20
Arizona	485	$2582.28	$2125.97	18
Texas	471	$1702.02	$1378.92	24
Missouri	463	$3016.68	$2600.85	11
Illinois	435	$2523.30	$1963.95	23
Washington	423	$2984.92	$2313.51	21
Indiana	419	$3764.57	$3201.74	13
Ohio	415	$2814.08	$2327.44	17
Pennsylvania	362	$1153.55	$922.52	18
North Carolina	294	$2302.74	$1931.46	18
New Hampshire	260	$3446.68	$2749.33	10
New York	223	$2055.91	$1541.48	14
Oklahoma	124	$699.38	$583.26	7
Kentucky	118	$3912.64	$3370.74	4
Massachusetts	111	$1188.29	$900.07	5
Georgia	100	$3454.79	$2804.53	7
North Dakota	82	$2698.39	$2383.19	4
Colorado	79	$1004.92	$792.24	4
Hawaii	76	$4034.47	$2868.20	3
Alabama	73	$2113.16	$1862.13	4
Montana	69	$1854.53	$1534.54	4
New Jersey	68	$4357.07	$3405.22	3
Louisiana	61	$2173.40	$1843.75	4
Delaware	49	$611.71	$486.52	2
Rhode Island	38	$4755.78	$3781.11	2
Minnesota	35	$3450.79	$2794.39	2
Kansas	32	$1089.69	$876.71	2
Utah	26	$618.55	$505.72	2
Connecticut	22	$9232.58	$6981.83	1
West Virginia	21	$1138.27	$878.34	1
District of Columbia	17	$1353.13	$900.98	1
Arkansas	17	$980.33	$935.60	1
Wyoming	17	$153.59	$122.65	1
Vermont	16	$1101.20	$906.92	1
Nevada	16	$1106.46	$889.11	1
Nebraska	16	$1008.93	$830.54	1
South Carolina	15	$1105.64	$929.41	1
New Mexico	12	$7952.33	$7127.39	1
South Dakota	11	$1062.90	$901.37	1

Related codes

27447Replacement of knee joint$1513.55
27487Revision of thigh and lower leg bone components of total knee joint pr$1314.21
27457Incision or partial removal of upper portion of lower leg bone to repa$286.11
27486Revision of component of total knee joint prosthesis$1025.80

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.