CMS Price Transparency Data

Total knee replacement

Facility: Decatur County Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $2,789
Cash Discount Price: $3,056
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Decatur County Hospital is $2,789. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,056. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.21x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.

Cash / Self-Pay

$3,056

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,789

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$13,116.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13,116.76 (100%)

Cash / Self-Pay: $3,056 (23%)

Insurance Median: $2,789 (21%)

Cash: $3,056 (23% of Medicare)

Ins. Median: $2,789 (21% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13,116.76 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$1,046	8%
Tricare	$1,046	8%
UnitedHealthcare	$1,046 - $3,247	8%
Amerigroup Mcaid-All Plans	$1,098	8%
Everystep Hospice-All Plans	$1,986	15%
Wellmark Hmo	$2,287	17%
Wellmark Ppo - All Other Plans	$2,287	17%
Misc Commercial-All Plans	$2,789	21%
Midlands Choice-All Plans	$2,827	22%
Rural Carrier Benefit Plan-All Plans	$2,941	22%
Christian Healthcare -All Plans	$3,056	23%
Ntca The Rural Broadband-All Plans	$3,247	25%
Farm Bureau Financial-All Other Plans	$3,438	26%
Farm Bureau Property And Ca	$3,438	26%
Priority Health-All Plans	$3,820	29%
Iowa Total Care Mcaid-All Plans	$3,896	30%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,056.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 27447.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Decatur County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 27447.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.