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CPT 27447: Knee Replacement of Medial and Lateral Compartments
CPT code 27447 denotes a knee joint replacement procedure that resurfaces the weight-bearing medial and lateral compartments using metal or other durable implants, with optional patellar replacement. This procedure is a central intervention for patients with end-stage degenerative or inflammatory knee disease that causes severe pain and functional limitation. Nationally, total knee arthroplasty represents a high-volume, high-cost surgical service with significant implications for hospital capacity, orthopedic practice patterns, and payer coverage policies.
This analysis covers major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for CPT code 27447, common sites of service, and typical use cases. The publication outlines benchmark considerations, coding relationships to related procedures, and areas of payer policy where coverage criteria and authorization processes frequently affect utilization. The content is intended to inform coding professionals, practice administrators, and policy analysts about the clinical scope of the code, its place in surgical care pathways, and the payer landscape relevant to national coverage and claims processing.
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Billing Code Overview
CPT code 27447 describes a surgical procedure in which the provider replaces the damaged weight-bearing surfaces of both the medial and lateral compartments of the knee joint with implants made of metal or other strong materials. The procedure may include replacement of the patella with an implant but does not always do so. The primary goal of this procedure is to relieve pain and restore function in a severely damaged knee.
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Service type: Joint replacement surgery of the knee involving both medial and lateral compartments (total knee arthroplasty with or without patellar component)
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Typical site of service: Inpatient hospital or ambulatory surgical center where orthopedic joint replacement procedures are performed
National Reimbursement Benchmarks
Nationwide, Medicare’s mean rate for CPT 27447 sits at $1,175.80, which is modestly below the average commercial benchmark represented by BUCA at $6,397.20. This gap of $5,221.40 highlights a substantial difference between Medicare and a composite commercial payer experience; Medicare’s central tendency (median $1,160 and interquartile span $88) indicates tightly clustered local rates across its 47 localities, while BUCA’s median is $7,627.20 with a wider commercial context implied by its quartiles.
Rate dispersion measured as the interquartile range (P75−P25) is narrowest for Medicare at $88.00 and also relatively tight for Aetna at $1,457.00 and Cigna at $1,482.40. The widest IQRs appear for Blue Cross Blue Shield at $8,338.50 and BUCA at $5,391.20, with UnitedHealth Group showing a substantial spread of $1,398.50. These differences indicate much greater variability among some commercial payers compared with Medicare’s concentrated locality pricing.