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See a sample rate comparisonCPT 27442 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
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 | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27442 |
| Medicaid Fee Schedule | View Medicaid rates for 27442 |
National average reimbursement for CPT 27442 by major payers:
$1,206.80
$1,179.81
$1,199.51
$1,430.43
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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 CPT 27442 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 27442 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 27438-CPT | High | Arthroplasty, Patella; W Prosthesis |
| 27440-CPT | High | Arthroplasty Knee Tibial Plateau |
| 27441-CPT | High | Arthroplst Knee Tibial Plateau; W/ Debrideme & Partial Synov, Arthroplasty Knee Tibial Plateau; With Debridement And Partial Synov |
| 27442-CPT | High | 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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