A knee replacement without insurance typically costs between $30,000 and $112,000 in the United States. With insurance, most people pay somewhere between a few hundred dollars and several thousand, depending on their plan type, deductible status, and where the surgery is performed. The real number you’ll owe depends on a handful of specific factors, and understanding each one can save you thousands.
What the Full Procedure Costs Before Insurance
The total price tag for a knee replacement in the U.S. ranges from roughly $30,000 to $112,000, according to the American Association of Hip and Knee Surgeons. That wide range reflects enormous variation by geography, hospital system, and whether you’re at a major urban medical center or a smaller facility. The bill typically includes the surgeon’s fee, anesthesia, the operating room, the implant itself, and any inpatient stay. Each of these is often billed separately, which is why prices are so hard to pin down in advance.
Where you have the surgery matters more than most people realize. Ambulatory surgery centers (outpatient facilities designed for same-day procedures) charge 40% to 60% less than hospital outpatient departments for the same operation. Hospitals add facility fees on top of the procedure cost, and those fees alone can run from a few dollars to thousands of dollars. If your surgeon offers the option of an ambulatory center and you’re a good candidate for outpatient surgery, choosing that route is one of the most effective ways to lower your bill.
Out-of-Pocket Costs With Private Insurance
If you have employer-sponsored or marketplace insurance, your out-of-pocket cost hinges on three things: your annual deductible, your coinsurance rate, and your plan’s out-of-pocket maximum. The average coinsurance rate for a hospital admission on employer plans is 20%, meaning your insurer pays 80% of the allowed amount and you cover the rest. On a $50,000 procedure, 20% would be $10,000, but you’d never actually pay that much if your plan has a reasonable out-of-pocket maximum.
Most employer plans cap annual out-of-pocket spending. For 2025, the federal limit on out-of-pocket maximums for marketplace plans is $9,200 for an individual. Many employer plans set their cap lower. So even with a large surgery, your total exposure for the year is capped. If you’ve already spent money on medical care earlier in the year, some of your deductible or coinsurance may already be satisfied, which reduces what you owe for the knee replacement.
The best-case scenario: if you’ve already met your deductible and out-of-pocket maximum for the year, the surgery could be covered at 100%. The worst case on most plans is hitting that annual maximum, which for many people lands somewhere between $3,000 and $9,200.
What Medicare Beneficiaries Pay
Medicare covers knee replacement under both Part A (inpatient) and Part B (outpatient), and your cost depends on which route your surgeon takes. For 2025, the Part A inpatient hospital deductible is $1,676. If your surgery requires a hospital admission, that deductible covers the first 60 days of your stay, and you pay nothing beyond it for the hospitalization itself.
If the procedure is done on an outpatient basis, it falls under Part B. The 2025 Part B annual deductible is $257, and after that, you typically pay 20% of the Medicare-approved amount. However, Medicare caps outpatient copayments at $1,676 for procedures like knee replacement, so your hospital facility cost won’t exceed that ceiling.
Original Medicare beneficiaries without a supplemental (Medigap) policy can expect to pay roughly $1,700 to $2,000 for the surgery itself, combining the deductible and coinsurance. A Medigap plan can cover most or all of that remaining cost. Medicare Advantage plans have their own cost-sharing structures, so the number varies by plan.
Costs You Might Not Expect
The surgery bill isn’t the end of your spending. Physical therapy is the biggest ongoing cost after a knee replacement, and it’s not optional if you want a good outcome. Most surgeons recommend two to three sessions per week for about three months. Copays for PT visits typically run $10 to $45 per session, depending on your insurance. At three sessions a week for 12 weeks, that adds up to $360 to $1,620 in PT copays alone.
You’ll also need some equipment at home during recovery. A walker is standard for the first few weeks, and some patients use a cold therapy machine or knee brace. Medicare Part B covers walkers and other durable medical equipment at 80% of the approved amount after your deductible. Out of pocket, a basic walker costs $30 to $100 if you’re buying one yourself. Cold therapy machines, which circulate ice water around your knee to reduce swelling, typically run $150 to $300 and aren’t always covered by insurance.
Post-surgical medications, including blood thinners to prevent clots and pain management prescriptions, fall under your pharmacy benefit. Copays vary, but generic blood thinners and pain medications are usually inexpensive. Budget $20 to $75 for the first month of prescriptions on most insurance plans.
Paying Without Insurance
If you’re uninsured or self-pay, the sticker price of $30,000 to $112,000 is a starting point for negotiation, not a final number. Most hospitals and surgery centers offer significant discounts for cash-pay patients, sometimes 30% to 50% off the listed price, because they avoid the administrative cost of dealing with insurers. Always ask for the cash-pay or self-pay rate before assuming you’ll owe the full amount.
Nonprofit hospitals are required to offer financial assistance to patients who can’t afford their bills. This is sometimes called charity care, and eligibility is based on your income relative to the federal poverty level. Each hospital sets its own thresholds, so you’ll need to contact the billing department directly or search for the hospital’s financial assistance policy online. Even for-profit hospitals and surgery centers frequently offer payment plans that spread the cost over 12 to 24 months, often at zero interest.
How to Lower Your Out-of-Pocket Cost
Timing your surgery strategically can make a real difference. If you’ve already accumulated medical expenses earlier in the year, you may have met part or all of your deductible. Scheduling surgery later in a year when you’ve had other health costs means less out-of-pocket for the procedure. Conversely, if you schedule surgery early in January, you’ll hit your deductible and out-of-pocket maximum early, and any other medical care you need that year will be fully covered.
Ask your surgeon whether you’re a candidate for outpatient surgery at an ambulatory center. The 40% to 60% cost savings at these facilities translates directly into lower coinsurance for you. Not everyone qualifies (patients with significant heart or lung conditions, or those who live alone without a caregiver, may need the safety net of a hospital stay), but for otherwise healthy patients, it’s worth asking.
Get a cost estimate in writing before surgery. Call your insurance company with the procedure code for total knee replacement (CPT 27447) and ask what your expected cost share will be. Then call the facility and surgeon’s office to confirm they’re in-network. Out-of-network charges are the single fastest way to blow past your expected costs, sometimes by tens of thousands of dollars. Verify that the anesthesiologist assigned to your case is also in-network, since this is a common source of surprise bills.