CMS Price Transparency Data

Total knee replacement

Facility: United Memorial Medical Center

Billing Code: 27447 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 27447
Insurance Median: $1,359
Cash Discount Price: $2,642
vs. Medicare Baseline: 0.10x Medicare

The contracted insurance negotiated median rate for a Total knee replacement at United Memorial Medical Center is $1,359. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,642. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.10x the Medicare baseline. Located in 127 North Street, Batavia, NY.

Cash / Self-Pay

$2,642

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,359

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: $2,642 (20%)

Insurance Median: $1,359 (10%)

Cash: $2,642 (20% of Medicare)

Ins. Median: $1,359 (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
UnitedHealthcare	$409 - $1,675	3%
Mvp [109]	$953 - $1,894	7%
Excellus Hmo [104]	$1,022 - $1,284	8%
Aetna	$1,040 - $4,976	8%
Independent Health Association,In [138]	$1,077 - $1,831	8%
Medicare (plans)	$1,155 - $1,359	9%
Excellus Indemnity [127]	$1,356 - $1,596	10%
Fidelis Care New York [112]	$1,408	11%
Fidelis Exchange [157]	$1,408	11%
Molina Healthcare Of Ny [188]	$1,433 - $1,685	11%

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 $2,642.
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 United Memorial Medical Center 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.