Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 27443 Fee Schedule
Medicare rates as of October 2026
CPT 27443 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Knee Joint Replacement Surgery, Surgery To Replace The Damaged Cartilage Of The Knee And Repair Part Of The Knee That Connects To The Leg Bone (Femur) Or Tibial Plateau Joints With Artificial Parts.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft 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 | 0360 |
| Medicare Fee Schedule | $761.88 national non-facility rate (2026)View Medicare rates for 27443 |
| Medicaid Fee Schedule | $648.625 median of the 8 states in the free previewView Medicaid rates for 27443 |
National average reimbursement for CPT 27443 by major payers:
$1,109.15
BCBS / Anthem
$1,102.98
UnitedHealthcare
$1,114.02
Aetna
$1,342.86
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27443.
CPT 27443
5 of 25 sample ratesHigher to lower in this preview
Ridge View Endoscopy Center
$27,537.00Published rateMid Rivers Ambulatory Surgery Center Lp, Mid Rivers Surgery Center
Mid Rivers Ambulatory Surgery Center Lp
$5,966.00Published rateOhio Specialty Surgical Suites, LLC
Ohio Specialty Surgical Suites LLC
$3,700.00Published rateGriffiss Ec, LLC, Griffiss Eye Surgery Center
Griffiss Ec LLC
$1,661.00Published rateMid-Bronx Endoscopy Center LLC
Midbronx Endoscopy Center LLC
$400.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Looking for other data?
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 27443 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27443. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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. |
| 27443-CPT | Knee Joint Replacement Surgery, Surgery To Replace The Damaged Cartilage Of The Knee And Repair Part Of The Knee That Connects To The Leg Bone (Femur) Or Tibial Plateau Joints With Artificial Parts. |
| 27446-CPT | Surgical Service Bundle Includes All Surgery Related Health Services Which Are Incurred In Connection With An Approved Outpatient Surgical Procedure, Billed Via The Agreed Upon Cpt Codes And Reimbursed At A Single Payment Rate Including All Services Such |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27443. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27443 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 27443) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
What APC is CPT 27443 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27443 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 27443 in an ambulatory surgery center?
CMS lists CPT 27443 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 27443?
Hospital price transparency files list CPT 27443 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.