Knee Replacement Cost

Typical costs:

• For patients without health insurance, a total knee replacement can cost $35,000 or more. However, some medical facilities offer uninsured discounts. At the Tulane University Hospital and Clinic, an uninsured patient would pay a discounted price between $29,335 and $34,050. And at the Kapiolani Medical Center[1] in Aiea, Hawaii, where the full price is about $33,000, an uninsured patient would pay a discounted rate of $20,212 to $23,581.
• Knee replacement surgery usually is covered by health insurance if ordered by a doctor. For example, according to Blue Cross Blue Shield of Kansas[2] , any necessary surgery would be covered, unless it is experimental or covered in a specific exclusion, which is most common for weight loss surgery. Medicare covers knee replacement surgery.
• For patients with insurance, out-of-pocket expenses can vary from hundreds to several thousand dollars, depending on deductible, and copay or coinsurance. For example, a Medicare patient undergoing a knee replacement at Dartmouth-Hitchcock Medical Center[3] in Lebanon, New Hampshire, could expect to pay $4,257 out of pocket, including deductibles and coinsurance. A patient with a $1,000 inpatient surgical deductible and 20 percent coinsurance, but an out-of-pocket maximum of $3,000 would pay $3,000. Actual costs could be lower because health insurance companies negotiate special rates with certain providers.

• The orthopedic surgeon performs an initial evaluation to evaluate the strength and range of motion in the knee and discuss whether a knee replacement is the best option.
• During surgery -- which usually requires general or epidural anesthesia -- the doctor removes damaged bone and cartilage, then inserts new joint surfaces made of plastic and metal.
• After surgery, a several-day hospital stay usually is required.
• The American Academy of Orthopaedic Surgeons[4] provides an overview of knee replacement.

• Some preparations to your living space will be necessary for optimal recovery. These include safety bars in the shower or bath, a stable shower bench, a toilet seat riser with arms and, if necessary, creating a temporary first-floor living area to avoid stairs.
• Implants usually need to be replaced in 10 to 15 years.

• A partial knee replacement can be an option for some patients, according to The American Academy of Orthopaedic Surgeons. A partial knee replacement costs about half the amount of a total knee replacement.

• Look for a surgeon who is certified by the American Board of Orthopaedic Surgery[5] and who has plenty of experience performing knee replacements.
• Possible candidates for knee replacement include people with pain so severe it limits everyday activities, and people with chronic knee inflammation not helped by medication.
• Complications can include knee joint infection, which occurs in less than 2 percent of surgeries and, even more rarely, heart attack or stroke.

1.  www.palimomi.org/my-hospital-bill/uninsured-calculator.aspx
2.  www.bcbsks.com/
3.  patients.dartmouth-hitchcock.org/billing_questions/charges_for_healthcare_services...
4.  orthoinfo.aaos.org/topic.cfm?topic=A00389
5.  www.abos.org/find-a-certified-orthopaedic-surgeon.aspx

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