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CPT 27445 Fee Schedule

Last Verified: December 2025

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.

Arthroplasty Knee Total Prosthetic
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelHigh

National average reimbursement for CPT 27445 by major payers:

bcbs

$1,781.05

uhc

$1,703.32

aetna

$1,788.75

cigna

$2,101.38

Preview provider-level rates for...
For billing codeCPT 27445
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 27445

United
27445$3598.001083754352 - MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA, MERCY PHILADELPHIA HOSPITAL SHORT PROCEDURE UNIT231352191 - (PA) MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PAPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$2193.001992765986 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, WALDRON ENDOSCOPY CENTER200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$5750.001750553376 - SAN MATEO SURGERY CENTER LLC510655329CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$2115.001801073648 - ELITE ENDOSCOPY LLC202722461 - (NV) ELITE ENDOSCOPY LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$2367.001871644823 - PERLOW FACILITY, LLC251926011 - (GA) PERLOW FACILITY LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$4500.001700424322 - GEORGIA INTERVENTIONAL PAIN841727755 - (GA) GEORGIA INTERVENTIONAL PAINGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$5551.001881692036 - SAINT BARNABAS OUTPATIENT CENTERS, AMBULATORY SURGERY CENTER222458479 - (NJ) SAINT BARNABAS OUTPATIENT CENTERSNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$1222.001821459496 - GEM STATE ENDOSCOPY352553021 - (ID) GEM STATE ENDOSCOPYIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$2182.501649614462 - JAVED IQBAL350593390 - DEACONESS HOSPITAL INCINFamily Medicine Physician (207Q00000X)
United
27445$2277.001396012845 - PREMIER SURGERY CENTER OF PITTSBURGH, LLC453477201 - (PA) PREMIER SURGERY CENTER OF PITTSBURGH LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$2182.501124150685 - DAVID FISH350593390 - DEACONESS HOSPITAL INCINAnesthesiology Physician (207L00000X)
United
27445$7415.001194255372 - DECATUR UROLOGY SURGERY CENTER814721108 - (GA) DECATUR UROLOGY SURGERY CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$20777.001154454205 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLETXAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$26790.001295381572 - SOUTH SUBURBAN SURGICAL SUITES, LLC, SOUTH SUBURBAN SURGICAL SUITES842207819 - (IN) SOUTH SUBURBAN SURGICAL SUITES LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
27445$3700.001194959809 - BEVERLY HILLS REGIONAL SURGERY CENTER LP263718069 - (CA) BEVERLY HILLS REGIONAL SURGERY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 27445 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 27445 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 27445 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.

CodeComplexityDescription
27438-CPTHighArthroplasty, Patella; W Prosthesis
27440-CPTHighArthroplasty Knee Tibial Plateau
27442-CPTHighArthroplasty Knee Condyles/Plateaus
27445-CPTHighArthroplasty Knee Total Prosthetic

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27445. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 27445 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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