What does Aetna pay for a total knee replacement (27447) in Texas in 2026?
Aetna's published rate for 27447 across 513 confirmed orthopedic surgeons in Texas has a median of $684.63, 123.4 percent of locality-adjusted Medicare, as of the September 2026 file.
Data as of the September 2026 payer files.
CPT 27447 is a total knee arthroplasty. The rates below are what Aetna publishes in its Transparency in Coverage files for surgeons who the CMS Medicare utilization file confirms actually bill the code, so a rate a surgeon never bills cannot inflate the number. A metro appears only where at least five surgeons clear that filter.
Across 1 procedure code and 1 payer, the median published rate is 26 percent of locality-adjusted Medicare in the September 2026 payer files. Aetna is the only payer with enough confirmed NPIs to publish here, at 26 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 513 confirmed NPIs, and any combination under five is withheld rather than shown thin. These are contracted amounts the payer published, not what a practice was paid, and every row clears the ghost-rate filter, so each NPI counted here actually billed the code in the Medicare utilization file.
Texas statewide
Statewide, Aetna's median sits at 26 percent of Medicare across 513 confirmed surgeons.
| Payer | Code | Site | n | p25 | p50 | p75 | % of Medicare |
|---|---|---|---|---|---|---|---|
| Aetna | 27447 | professional | 513 | 124.67 | 684.63 | 1296.08 | 123.4% |
| Aetna | 27447 | professional | 43 | 189.79 | 648.05 | 1062.43 | 13.7% |
| Aetna | 27447 | professional | 35 | 245.4 | 864.06 | 1036.15 | 11.1% |
| Aetna | 27447 | facility | 29 | 1256.88 | 3596.5 | 4060 | 43% |
| Aetna | 27447 | facility | 17 | 743.7 | 1209.68 | 5684.5 | 43.4% |
| Aetna | 27447 | professional | 16 | 167.66 | 648.04 | 1046.77 | 14% |
| Aetna | 27447 | professional | 11 | 428.11 | 972.06 | 1307.99 | 13.8% |
| Aetna | 27447 | facility | 9 | 514.12 | 1136.06 | 3754.63 | 37.9% |
| Aetna | 27447 | professional | 5 | 204.03 | 651.14 | 1310.02 | 14% |
| Aetna | 27447 | facility | 5 | 371.86 | 796.82 | 3730.25 | 40.8% |
By Texas metro
No Texas metro clears the five-NPI floor for this code yet.
Nothing in this section clears the five-NPI floor in the published snapshot.
How this is measured
Rates come from each payer's published Transparency in Coverage machine-readable file, filtered to NPIs the CMS Medicare utilization file shows billing that code. Percentiles are computed per payer, code and site of service across those NPIs, then divided by the locality-adjusted Medicare amount for the same code and place. Full methodology.
- Payer files: 2026-09
Questions
Does this include the facility fee?
Only where the row says facility. A professional row is the surgeon side alone, and an episode total exists only when both sides are published.
Why does my contract say a different number?
Payers publish conflicting rates for the same line, and a published rate is not always the one your contract prices. Send us the contract page and we will correct the row.
Is this what the practice was paid?
No. These are contracted rates as published by the payer, not allowed or paid amounts.
Why are some cells blank?
Ghost rates are removed using Medicare utilization. A row appears only if that NPI billed the code.
What is an episode total?
Professional plus facility when both exist. We never average them or invent a total from one side.
Keep reading
Saran Siva
Co-founder & CTO, Insight Health · September 2026 files