CMS Price Transparency Data

Total knee replacement

Facility: M Health Fairview Ridges Hospital

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $4,066
Cash Discount Price: $2,138
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at M Health Fairview Ridges Hospital is $4,066. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,138. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.31x the Medicare baseline. Located in 201 East Nicollet Boulevard, Burnsville, MN.

Cash / Self-Pay

$2,138

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,066

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: $2,138 (16%)

Insurance Median: $4,066 (31%)

Cash: $2,138 (16% of Medicare)

Ins. Median: $4,066 (31% 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
Sanford Health Plan	$741 - $12,517	6%
Health Partners	$857 - $28,957	7%
Itasca Medical Care	$857 - $12,517	7%
Primewest	$857 - $12,517	7%
South Country Health Alliance	$857 - $12,517	7%
Ucare	$873 - $28,763	7%
Medica	$912 - $13,268	7%
Security Health Plan	$918 - $12,517	7%
America'S Ppo	$956 - $4,968	7%
Hennepin Health	$969 - $12,959	7%
Blue Cross Blue Shield	$976 - $13,017	7%
First Health	$1,031 - $5,157	8%
Multiplan	$1,069 - $5,345	8%
Private Healthcare Systems	$1,069 - $5,345	8%
Wisconsin Physician Services	$1,132 - $5,660	9%
UnitedHealthcare	$1,161 - $12,517	9%
Wellcare	$1,161 - $12,517	9%

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 $2,138.
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 M Health Fairview Ridges 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.