CPT 27427 Surgery - Musculoskeletal

How Much Does Ligamentous Reconstruction (acl), Knee Cost?

Also known as: Reconstruction knee (CPT 27427)

Surgery to reconstruct a torn knee ligament, such as the ACL (anterior cruciate ligament).

The total estimated cost of Ligamentous Reconstruction (acl), Knee (CPT 27427) is $2,227 to $4,176, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $663.

Total Estimated Cost of Care

$2,227 — $4,176

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$663
Hospital Facility Fee
$1,988
Anesthesia (est.)
$133
Important: The physician fee of $663 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$663
Physician component only — CMS PFS 2026

Patient Guide: Ligamentous Reconstruction (acl), Knee

What you need to know before your appointment

What to Expect

Under anesthesia, the surgeon rebuilds your torn knee ligament using tissue graft (from your own body or a donor). The surgery is often done arthroscopically through small incisions. Hospital stay is usually same-day or overnight.

How Long Does It Take?

1-2 hours of surgery

Common Reasons Doctors Order This

ACL tear from sports injury, knee instability, knee giving way during activities

How to Prepare

Pre-operative physical therapy (prehab) helps outcomes. Arrange for 1-2 weeks of help at home. Get crutches fitted. Plan for 6-9 months of rehabilitation.

Procedures Commonly Done Together

These procedures are frequently performed alongside Reconstruction knee

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What Insurance Companies Actually Pay

Real negotiated rates from 15 hospitals across 6 states (from hospital price transparency filings)

Lowest
$167
Highest
$27,033
Average
$6,714
Insurance Company Avg Rate Range Hospitals
Aetna $3,909 $1,488 - $11,019 9
United $7,460 $3,403 - $13,938 10
Cigna $5,366 $1,545 - $12,562 9
BCBS $10,945 $3,329 - $16,331 5
Humana $5,688 $2,519 - $15,871 8
Superior Health Plan $2,892 $2,369 - $10,733 4
KAISER FOUNDATION HEALTH PLAN, INC. $14,912 $8,633 - $27,033 5
BCBS-TX $8,280 $4,486 - $11,485 2
Wellpoint $5,600 $3,171 - $10,733 2
Multiplan $8,547 $2,819 - $11,500 5
Anthem $13,271 $9,701 - $16,686 2
UNITED $6,091 $3,234 - $10,207 2
Average by State
TN: $4,361 (21) GA: $5,735 (21) TX: $6,127 (225) KY: $6,678 (9) CO: $9,050 (34) CA: $14,912 (15)
Disclaimer: These rates are from hospital Machine-Readable Files (MRFs) required by federal price transparency law. They reflect specific hospital-payer contracts and may not represent your actual cost, which depends on your plan, deductible, and network status. Data sourced from CommonSpirit Health, HCA Healthcare, and Kaiser Permanente filings.

How to Reduce Your Cost for Reconstruction knee

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

9.55
Work RVU
8.42
Practice Expense RVU
1.87
Malpractice RVU
19.84
Total RVU

Payment = Total RVU (19.84) x CF ($33.40) = $663

Frequently Asked Questions

How much does Reconstruction knee cost?

The Medicare facility rate for Reconstruction knee is $663. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Reconstruction knee cost without insurance?

Without insurance, the cost of Reconstruction knee can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Reconstruction knee?

Most commercial health insurance plans and Medicare cover Reconstruction knee when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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