CMS Price Transparency Data

Total knee replacement

Facility: Henry Ford Macomb Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,345
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at Henry Ford Macomb Hospital is $1,345. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.10x the Medicare baseline. Located in 15855 Nineteen Mile Rd, Clinton Township, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,345

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%)

Insurance Median: $1,345 (10%)

Ins. Median: $1,345 (10% 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	$721 - $13,867	5%
Blue Cross Blue Shield	$721 - $28,288	5%
Hap	$721 - $12,607	5%
Mclaren	$721	5%
Meridian Health Plan Of Mi	$721 - $17,019	5%
Priority Health	$721 - $30,277	5%
Amerihealth Michigan	$828 - $12,355	6%
Hap Caresource	$828 - $12,607	6%
Mclaren Health Plan Inc.	$828 - $1,345	6%
Meridian	$828 - $1,345	6%
Molina	$861 - $17,019	7%
Priority	$870 - $1,345	7%
Humana	$1,075 - $12,859	8%
Pace Se Mi	$1,278	10%
Bcn	$1,345 - $12,607	10%
Cca Health Mi	$1,345	10%
Health Alliance Plan Of Michigan	$1,345	10%
Mount Carmel Health Plan	$1,345 - $12,607	10%
United Behavioral Health, Inc.	$1,345	10%
UnitedHealthcare	$1,345 - $12,607	10%
Wellcare Ma	$1,345	10%
Vitalcore Physicians Group Of Mi	$1,749 - $28,995	13%
Cigna	$2,266	17%
Pace Of Se Mi	$11,976	91%
Cca Health Michigan	$12,607	96%
Mclaren Health	$12,607	96%
Molina Mi Health Link	$12,607	96%
Wellcare	$12,733	97%

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 $X.
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 Henry Ford Macomb 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.