Orthopaedic Surgery reimbursement rates by service line
Compare payer-published orthopaedic surgery benchmarks for joint replacement; other surgery; imaging; therapy; office visits.
Compare national orthopaedic surgery rates by payer
Use the reference codes to compare payer benchmarks, then explore joint replacement; other surgery; imaging; therapy; office visits. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for 27447
National 27447 rate distribution
Each marker shows the national median published rate across billing entities for that payer.
National 27447 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jun–Jul 2026 | 50,274 | $1,681.17 | $1,900.59 | |||
| Cigna | Jun–Jul 2026 | 52,683 | $2,042.61 | $2,354.78 | |||
| United | Jun–Jul 2026 | 57,041 | $2,077.52 | $2,373.37 | |||
| Anthem | Jun–Jul 2026 | 45,259 | $2,417.16 | $2,904.68 |
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for total knee replacement (27447).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific orthopaedic surgery providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Orthopaedic Surgery provider benchmarks (CPT 27447)
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| EAST TENNESSEE CENTER FOR ORTHOPAEDIC EXCELLENCE PLLCNPI 1235545583 · Tax ID 471185716 | TN | 17 | $1,137.89 | -$543.28 | Below P25 |
| TAREEN DERMATOLOGY PANPI 1871118430 · Tax ID 454147351 | WI | 48 | $1,255.47 | -$425.70 | Below P25 |
| MCBRIDE ORTHOPEDIC HOSPITALNPI 1902026909 · Tax ID 200561474 | OK | 188 | $1,347.22 | -$333.95 | Below P25 |
| EAST ORANGE FOOT AND ANKLE CENTER LLCNPI 1447432679 · Tax ID 611542357 | NY | 2 | $1,499.27 | -$181.90 | P25 to median |
| STEVEN M MADEY MD PCNPI 1972631992 · Tax ID 931282634 | OR | 11 | Median to P75 | ||
| ADVANCED RADIOLOGY PARTNERS LLCNPI 1902855828 · Tax ID 851534946 | NY | 5,465 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.Explore orthopaedic surgery services
Compare codes within the same billing context. A reported billing unit may describe a timed service, supply quantity, daily service or procedure; it does not always mean one visit.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported billing unit · 4 codes | ||||
97110Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility | $28.88 | $38.03 | $35.38 | $64.75 |
97112Muscle Or Nerve Training | $31.86 | $42.05 | $39.58 | $68.96 |
97530Activity Therapy | $34.65 | $45.52 | $43.41 | $72.14 |
97140Manual Therapy 1 Regions | $28.56 | $35.16 | $32.68 | $63.37 |
$ per reported billing unit · 4 codes | ||||
73721MRI lower-extremity joint without contrast | $422.68 | $437.76 | $395.65 | $605.22 |
73221Mri Of An Arm Joint | $423.96 | $436.24 | $394.30 | $629.10 |
72148MRI lumbar spine without contrast | $417.49 | $424.79 | $381.11 | $628.30 |
73564Complete knee X-ray, four or more views | $56.61 | $67.99 | $61.64 | $85.13 |
$ per reported billing unit · 8 codes | ||||
23472Total shoulder replacement | $2,057.92 | $2,504.01 | $2,513.88 | $2,971.62 |
20611Large joint aspiration or injection with ultrasound guidance | $108.76 | $137.27 | $163.29 | $166.34 |
29823Sho Arthrs Srg Xtnsv Dbrdmt | $862.37 | $1,055.57 | $1,072.74 | $1,269.50 |
22551Cervical spinal fusion with disc removal and decompression | $2,413.27 | $3,019.48 | $3,011.15 | $3,510.29 |
63047Lam Facetec Foramot Lumbar | $1,612.81 | $1,993.12 | $1,949.80 | $2,380.36 |
27447Total knee replacement | $1,900.59 | $2,354.78 | $2,373.37 | $2,904.68 |
27130Total hip replacement | $1,875.95 | $2,316.13 | $2,352.43 | $2,812.81 |
20610Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance | $78.03 | $96.95 | $110.14 | $117.50 |
$ per reported billing unit · 4 codes | ||||
99214Established patient office visit, level 4 | $118.10 | $148.93 | $159.28 | $160.24 |
99213Established patient office visit, level 3 | $80.85 | $101.93 | $109.63 | $113.09 |
99204New patient office visit, level 4 | $170.57 | $216.21 | $237.61 | $239.94 |
99203New patient office visit, level 3 | $109.90 | $139.07 | $156.32 | $156.80 |
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Book a 20-min scoping call No trial or data preparation required.How to interpret these benchmarks
Payer-published rates provide market context. They do not establish a practice's contracted rate or the total cost of care.
- Source and periodRates come from the specialty's national report. The displayed period follows the processed data included in the latest published snapshot and updates when that snapshot is refreshed.
- Comparable ratesComparisons use positive professional fee-for-service negotiated and fee-schedule dollar amounts. Percentages, bundled arrangements and per-diem rate types are excluded. Modifier cohorts and code-specific amounts remain separate.
- CalculationRates are reduced to one modal value per NPI and TIN entity, averaging tied modes. Two percent per tail is targeted for trimming while keeping boundary ties. Benchmarks require at least 10 included entities and are not weighted by patient volume.
- CoverageNational report coverage does not guarantee every payer or state is available for every code. Anthem represents the displayed Anthem cohort, rather than all regional Blue plans. Missing benchmarks are not zero rates.
- Billing contextMatch the exact code, billing unit, modifier, setting and network. Equipment rentals and supplies require their own interval and quantity checks. Professional rates exclude facility charges; anesthesia conversion factors are outside these comparisons.
Get the orthopaedic surgery reimbursement data you're looking for
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We'll tell you what the data can support, where the gaps are, and the clearest way to structure the comparison.
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Explore orthopaedic surgery rates by state
Choose a state to compare payer reference averages for common services.
Questions about orthopaedic surgery benchmarks
How to interpret the selected market and payer-published rates.
What does the national benchmark compare?
The headline uses Total knee replacement (27447). The other reference codes and service lines provide separate comparisons rather than combining unlike services.
Why is a payer or state missing?
A benchmark appears only when the selected code and cohort meet the publication rules, including at least 10 entities after trimming. Report-wide coverage can be broader than an individual comparison.
Will the reporting period change?
Yes. The period displayed with the benchmark follows the processed source data when the publication snapshot is refreshed.