How Much Does a Knee Replacement Cost?

A total knee replacement bill is composed of five major components, each billed separately:

• —Surgeon fee — The orthopedic surgeon's professional fee averages $5,000 to $12,000 depending on geographic location and the surgeon's experience.
• —Hospital stay (3 days average) — At $3,000+ per day, the inpatient stay typically adds $9,000 to $15,000 to the total bill.
• —Implant (prosthesis) — The knee implant itself costs the hospital $4,000 to $8,000 but is often marked up to $12,000 to $20,000 on the patient's bill.
• —Anesthesia — Spinal or general anesthesia for the 1-2 hour procedure averages $2,500 to $5,000.
• —Physical therapy (12 weeks) — Post-surgical rehabilitation averages $4,000 to $8,000 total for 2-3 sessions per week over 12 weeks.

Additional costs include pre-operative testing ($500-$1,500), post-operative medications ($200-$600), and any complications that extend the hospital stay ¹.

The knee implant is one of the most aggressively marked-up items on the bill. Hospitals purchase implants from manufacturers for $4,000 to $8,000 but routinely bill patients $12,000 to $20,000 — a markup of 150% to 400%. Unlike medications, there is no regulation limiting implant markup.

The type of implant also affects cost. Standard cobalt-chromium implants are the least expensive and have decades of clinical data. Ceramic and oxidized zirconium (Oxinium) implants are marketed as longer-lasting and command a premium of $2,000 to $5,000 — though clinical evidence of superior longevity is limited for most patients. Ask your surgeon whether the standard implant is appropriate for your case before agreeing to a premium device.

Total knee replacement was historically performed exclusively in hospitals with multi-day stays. Increasingly, qualified patients can have the surgery at an ambulatory surgery center (ASC) and go home the same day or the next morning. ASC knee replacements cost $25,000 to $35,000 — roughly half the hospital price.

Not every patient is a candidate for outpatient knee replacement. You generally need to be in good overall health, have a BMI under 40, have reliable support at home, and live within 30 minutes of a hospital in case of complications. Discuss with your surgeon whether an ASC is appropriate for your situation. The cost savings are substantial, and outcomes for well-selected patients are comparable to inpatient surgery ².

Most insurance plans cover total knee replacement when deemed medically necessary, but prior authorization is always required. Your insurer will want documentation that conservative treatments — physical therapy, injections, medications — have been tried and failed before approving surgery.

With insurance, out-of-pocket costs typically range from $3,000 to $10,000 depending on your deductible, coinsurance, and out-of-pocket maximum. Many patients find that a knee replacement pushes them past their annual out-of-pocket maximum, especially if the surgery occurs early in the plan year. If possible, schedule the surgery to maximize your insurance benefit — having it early in the year means the rest of your medical care that year may be fully covered.

Because knee replacement is an elective, plannable surgery, you have more cost-saving opportunities than with emergency procedures:

• —Compare facilities — Get quotes from at least 2-3 facilities. Ask for all-inclusive estimates that include surgeon, anesthesia, implant, and hospital stay.
• —Consider an ASC — If you qualify, an ambulatory surgery center can save $15,000-$25,000 compared to a hospital.
• —Ask about the implant — Request the cost of the specific implant being used. If a premium implant is recommended, ask for the clinical evidence that it is superior to the standard option for your case.
• —Bundle physical therapy — Some facilities offer bundled pricing that includes 12 weeks of PT. This is often cheaper than paying per-session.
• —Travel for surgery — In some cases, traveling to a lower-cost market can save more than the travel expenses. Some insurers even offer incentives for choosing high-value facilities.
• —Upload your estimate to ORVO — Compare your facility's quote against regional and national pricing data before committing.