The True Cost of Knee Replacement Surgery: Breaking Down the Factors

Knee replacement surgery isn’t cheap, and if you don’t have health insurance, you may be in for an unpleasant surprise when you go to pay the bill after your procedure. What does knee replacement surgery cost? It depends on your health care provider, whether or not you have insurance coverage, the type of knee replacement surgery you need, and how much it costs in your area, among other factors. To get a better idea of what the total cost might be, let’s break down these different considerations.

How Much Does a Knee Replacement Cost?

The average cost of a knee replacement surgery is between $20,000 and $40,000. Knee replacement surgery isn’t cheap. The medical procedure for removing and replacing a damaged knee with an artificial joint costs about $15,100 on average, according to research from Truven Health Analytics. But you might pay less if you have health insurance that covers all or most of your expenses—or you might pay more if your coverage comes with high deductibles or copays.

How Much Does it Cost to Stay in Hospital for a Knee Replacement Procedure?

It’s important to understand that, in general, surgery is not cheap. You’ll probably have to pay for your surgery out-of-pocket; Medicare does not cover elective knee replacement procedures. Although there are a number of variables involved (location, medical care provider, and so on), typical costs for knee replacement can range from $20,000-$40,000 per procedure. A basic knee replacement without complications typically costs between $17,500 and $25,500. According to Healthline, you should expect an average hospital stay of five days if you undergo knee replacement surgery.

Typical Costs Associated with Knee Replacements

Knee Replacement Surgery
Knee Replacement Surgery

In 2016, patients could expect to pay $40,000–80,000 for a total knee replacement. The cost may vary according to your location and individual circumstances. The average costs associated with knee replacement surgery include (1) pre-surgery physical therapy, (2) hospital charges for an overnight stay, (3) fees for medications and IV fluids during recovery at home and (4) doctor fees for monitoring recovery. Let’s take a closer look at each category in turn. Pre-Surgery Physical Therapy:

One of the most important parts of preparing for knee replacement surgery is undergoing physical therapy beforehand. This is not only because it will improve your strength and mobility prior to surgery but also because it can help reduce your risk of complications after surgery. For example, a study published in JAMA found that postoperative complications were significantly reduced among participants who had undergone outpatient rehabilitation prior to their procedure compared with those who hadn’t—and all these improvements were free!

Potential Costs Associated with an Anterior Approach vs. Posterior Approach

Anterior Total Knee Replacement surgeries tend to cost more in general. A study that was published in 2017 found that it costs $18,500 on average for an anterior approach surgery and $16,500 for a posterior one, but because anterior knee replacement surgeries are relatively new, there aren’t many surgeons who perform them regularly. Anterior Total Knee Replacements can be three times as expensive as Posterior Total Knee Replacements.

Average Costs of the Total Procedure by State

Total costs vary dramatically by state, due to variations in labor and material prices. North Dakota and Maryland are tied for having some of the lowest average total costs ($23,404), while California has one of the highest ($50,092). In general, it appears that knee replacement surgery is more expensive on average in states where surgeons are not allowed to negotiate fees with hospitals. The average cost of a knee replacement surgery can range from $9,000 to $75,000 depending on many factors. However, it’s important to note that these numbers represent averages; many patients pay much less than these amounts and others may pay significantly more.

Average Insurance Rates for Total Procedures

A few different factors contribute to these rates, including health insurance provider and coverage limits. If your costs are higher than average, you may need to shop around for a new plan. More and more people are turning to high-deductible plans, which have lower monthly premiums but require consumers to pay more out-of-pocket when receiving medical services.

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