A total knee replacement costs $30,000–$50,000 at most hospitals before insurance. With insurance, you’ll typically pay $3,000–$8,000 out of pocket. But the price for the exact same surgery can vary by $30,000+ depending on where you have it done. Here’s the full cost breakdown, what Medicare pays, and how to avoid overpaying.
1. Full cost breakdown
A total knee replacement bill includes charges from multiple providers and departments. Here’s what each piece typically costs:
| Component | CPT/DRG Code | Typical Charge | Medicare Rate |
|---|---|---|---|
| Surgeon’s fee | CPT 27447 | $4,000–$8,000 | ~$1,500–$1,800 |
| Anesthesia | CPT 01402 | $2,000–$4,000 | ~$800–$1,200 |
| Facility/room (1–3 nights) | DRG 470/469 | $15,000–$25,000 | ~$10,000–$14,000 (total DRG) |
| Knee implant | Various | $5,000–$12,000 | Bundled in DRG |
| Pre-op imaging (MRI/X-ray) | CPT 73721/73565 | $500–$2,500 | ~$200–$500 |
| Lab work | Various | $200–$800 | ~$50–$150 |
| Physical therapy (in-hospital) | CPT 97110 | $300–$800 | ~$100–$200 |
| Post-op medications | Various | $200–$600 | Varies |
Look up what Medicare pays for knee replacement in your area:
2. Cost with vs. without insurance
| Scenario | Typical Total Bill | What You Pay |
|---|---|---|
| Employer insurance (PPO) | $35,000–$50,000 | $3,000–$8,000 (deductible + 20% coinsurance up to OOP max) |
| Medicare (Original) | $12,000–$14,000 (DRG rate) | $1,676 deductible + $0 for days 1–60 |
| Medicare Advantage | Varies by plan | $1,500–$5,000 (plan-specific copay) |
| Medicaid | $8,000–$12,000 (Medicaid rate) | $0–$4 |
| Uninsured (hospital chargemaster) | $35,000–$60,000 | Full amount (negotiate down 40–60%) |
| Uninsured (negotiated/cash pay) | $18,000–$28,000 | Full amount (ask for self-pay rate) |
Same surgery, $32,000 price difference
A 2025 RAND Corporation analysis found that the price of a total knee replacement ranged from $18,500 to $50,800 within the same metro area. The cheapest option was an ambulatory surgery center; the most expensive was a large academic medical center 12 miles away. The clinical outcomes were statistically identical.
3. Medicare coverage and rates
Medicare covers total knee replacement (CPT 27447) as medically necessary. Most knee replacements are billed under DRG 470 (major joint replacement without complications) or DRG 469 (with complications).
| DRG | Description | Medicare Payment (2026) |
|---|---|---|
| DRG 470 | Major joint replacement, no complications | ~$12,000–$13,500 |
| DRG 469 | Major joint replacement, with complications | ~$16,000–$20,000 |
Your cost on Original Medicare: You pay the Part A deductible ($1,676 in 2026) for the hospital stay. Days 1–60 are fully covered after the deductible. If you have a Medigap supplement, it may cover the deductible too.
Important: If your surgeon is “non-participating” with Medicare, they can charge up to 15% above the Medicare-approved amount. Always confirm your surgeon is Medicare-participating before scheduling. See our Medicare billing guide for more.
4. Partial vs. total knee replacement
| Factor | Partial (CPT 27446) | Total (CPT 27447) |
|---|---|---|
| Average cost | $22,000–$38,000 | $30,000–$50,000 |
| Medicare surgeon fee | ~$1,200–$1,500 | ~$1,500–$1,800 |
| Hospital stay | 0–1 night (often outpatient) | 1–3 nights |
| Recovery time | 4–6 weeks | 6–12 weeks |
| Implant lifespan | 15–20 years | 20–25 years |
| ASC eligible | Yes (common) | Yes (for healthy patients) |
| Best for | Damage in one compartment only | Widespread arthritis in multiple compartments |
5. Hospital vs. surgery center
Since CMS approved total knee replacements for ambulatory surgery centers in 2020, ASCs have become a major cost-saving option:
| Setting | Typical Total Cost | Savings vs. Hospital |
|---|---|---|
| Hospital inpatient (1–3 nights) | $35,000–$50,000 | — |
| Hospital outpatient | $25,000–$38,000 | 15–25% |
| Ambulatory surgery center | $18,000–$30,000 | 30–50% |
Find surgery centers near you in our surgery center directory.
6. Factors that affect your cost
- Geography: Knee replacement costs 40–60% more in high-cost areas (NYC, SF, Boston) than in lower-cost regions (Midwest, rural South). Medicare rates also vary by region.
- Hospital type: Academic medical centers charge the most. Community hospitals are mid-range. ASCs are cheapest. For-profit hospitals tend to charge more than nonprofits.
- Implant brand: Standard implants cost $5,000–$8,000. Custom/robotic-assisted implants can cost $10,000–$15,000. Clinical evidence shows comparable outcomes for most patients.
- Complications: Infection, blood clots, or revision surgery can add $10,000–$50,000+ to total costs. Choose a high-volume surgeon (100+ knee replacements/year) to minimize risk.
- Length of stay: Each extra hospital night adds $2,500–$5,000. Same-day discharge (common at ASCs) eliminates room charges entirely.
- Bilateral (both knees): Having both knees done in one surgery costs 40–50% less than two separate surgeries but requires longer recovery.
Compare hospital pricing in your area with our hospital directory.
7. 5 ways to lower your knee replacement bill
a) Get a Good Faith Estimate
Under the No Surprises Act, you have the right to a written cost estimate before any scheduled procedure. Request estimates from 2–3 facilities and compare. If the final bill exceeds the estimate by $400+, you can dispute it.
b) Choose an ASC over a hospital
If you’re a candidate for outpatient surgery, an ASC can save you $10,000–$20,000. Ask your surgeon if they operate at an ASC and whether you’re a good candidate.
c) Audit your itemized bill
Request an itemized statement with CPT codes after surgery. Common knee replacement billing errors include: duplicate charges for implant components, upcoding to DRG 469 (with complications) when there were none, and inflated supply charges. Upload your bill to BillKarma for an instant audit.
d) Ask about the implant
Ask your surgeon whether a standard implant will provide the same outcome as a premium/custom one. Many surgeons have implant preferences based on training rather than clinical evidence. A $6,000 implant may work just as well as a $12,000 one for your situation.
e) Apply for financial assistance
If you’re uninsured or underinsured, apply for the hospital’s financial assistance program before surgery. Nonprofit hospitals are required to have charity care policies. Many offer 50–100% discounts for patients below 300–400% of the federal poverty level. See our financial assistance guide.
$47,000 bill reduced to $14,200
A 58-year-old uninsured patient in Texas received a $47,000 bill for a total knee replacement. After requesting an itemized bill, she found: a duplicate charge for the implant ($6,200), a DRG 469 coding (with complications) despite an uneventful recovery, and a $3,800 “surgical tray” charge. After disputing the errors and applying for the hospital’s self-pay discount, the bill was reduced to $14,200—a 70% reduction.
8. Recovery costs people forget
The surgery bill is only part of the total cost. Budget for these post-op expenses:
| Recovery Cost | Typical Range | Insurance Coverage |
|---|---|---|
| Physical therapy (2–3x/week for 6–12 weeks) | $2,400–$7,200 | Usually covered with copay ($30–75/visit) |
| Walker/crutches | $50–$200 | Covered as DME under most plans |
| CPM machine rental (if prescribed) | $500–$1,500/month | Sometimes covered; check with insurer |
| Home modifications (grab bars, raised toilet seat) | $100–$500 | Not covered |
| Pain medications | $50–$300 | Covered under Part D / Rx benefit |
| Follow-up visits (surgeon, 3–4 visits) | Usually bundled in surgical fee | Included in global surgical period |
| Lost wages (4–12 weeks off work) | Varies | Short-term disability if available |
Frequently asked questions
How much does a total knee replacement cost without insurance?
$30,000–$50,000 at most hospitals, including surgeon, anesthesia, facility, and implant. At an ambulatory surgery center, costs drop to $18,000–$30,000. Uninsured patients should request the self-pay rate and apply for financial assistance before surgery.
How much does a knee replacement cost with insurance?
Most insured patients pay $3,000–$8,000 out of pocket (deductible + 20% coinsurance up to their out-of-pocket maximum). Many patients hit their annual OOP max with this surgery, capping costs at $8,050–$9,200 for most 2026 plans.
Does Medicare cover knee replacement surgery?
Yes. Medicare pays approximately $12,000–$14,000 via DRG 470. You owe the Part A deductible ($1,676), then days 1–60 are fully covered. Medigap plans may cover the deductible. Medicare also covers knee replacement at ASCs.
Is a partial knee replacement cheaper than a total?
Yes, typically 20–30% cheaper ($22,000–$38,000 vs. $30,000–$50,000). Partial replacements also have shorter hospital stays and faster recovery. However, not all patients are candidates—you need damage limited to one compartment of the knee.
Can I get a knee replacement at an ambulatory surgery center?
Yes. CMS approved total knee replacements for ASCs in 2020. ASCs save 30–50% compared to hospitals. You need to be generally healthy (no major cardiac, pulmonary, or obesity issues) to be a candidate. Ask your surgeon and find ASCs in our surgery center directory.