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See a sample rate comparisonCPT 27442 Fee Schedule
Medicare rates as of October 2026
CPT 27442 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Knee Joint Replacement Surgery, Surgery To Replace The Damaged Ends Of A Knee Joint (Cartilage) With Artificial Parts Where It Joins The Leg (Femur) Bone.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5115 - Level 5 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 03600960 |
| Medicare Fee Schedule | $804.96 national non-facility rate (2026)View Medicare rates for 27442 |
| Medicaid Fee Schedule | $651.785 median of the 8 states in the free previewView Medicaid rates for 27442 |
National average reimbursement for CPT 27442 by major payers:
$1,206.80
BCBS / Anthem
$1,179.81
UnitedHealthcare
$1,199.51
Aetna
$1,430.43
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27442.
CPT 27442
5 of 25 sample ratesHigher to lower in this preview
Comprehensive Digestive Surgicenter, LLC, Comprehensive Digestive Surgical Center
Comprehensive Digestive Surgicenter LLC
$23,322.00Published rateSurgcenter Tucson, LLC
$5,020.00Published rateClearway Surgery Center Of Easton, LLC
Clearway Surgery Center Of Easton LLC
$2,965.00Published rateAtlantic Gastro Surgicenter, LLC, T/A Access
Atlantic Gastro Surgicenter LLC
$2,200.00Published rateCommonwealth Eye Clinic Inc
$835.00Published rate
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See a sample payer proposalCPT 27442 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27442. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27438-CPT | Arthroplasty, Patella; W Prosthesis |
| 27440-CPT | Arthroplasty Knee Tibial Plateau |
| 27441-CPT | Arthroplst Knee Tibial Plateau; W/ Debrideme & Partial Synov, Arthroplasty Knee Tibial Plateau; With Debridement And Partial Synov |
| 27442-CPT | Knee Joint Replacement Surgery, Surgery To Replace The Damaged Ends Of A Knee Joint (Cartilage) With Artificial Parts Where It Joins The Leg (Femur) Bone. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27442. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27442 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is CPT 27442 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27442 to APC 5115 (Level 5 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27442 in an ambulatory surgery center?
CMS lists CPT 27442 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 27442?
Hospital price transparency files list CPT 27442 under these revenue codes: 0360 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.