Total knee replacement in the United States typically has a billed cost of $30,000 to $70,000 for the hospital and surgical team combined. What you actually pay depends on insurance: Medicare beneficiaries often owe a few hundred to a few thousand dollars out of pocket, privately insured patients with a moderate deductible typically pay $2,000 to $5,000, and uninsured cash-pay patients can find bundled rates of $18,000 to $30,000 at ambulatory surgical centers.
| Cost item | Typical 2026 US range | Insurance coverage |
|---|---|---|
| Total knee replacement, billed (hospital and surgical team) | $30,000 to $70,000 | Covered by Medicare and most private plans when medically necessary |
| Medicare beneficiary out-of-pocket | A few hundred to a few thousand dollars | Part A deductible (about $1,676 in 2026) plus 20% Part B coinsurance; Medigap covers most or all |
| Private insurance out-of-pocket, moderate deductible | $2,000 to $5,000 | After the deductible and coinsurance are met |
| High-deductible plan out-of-pocket | Up to $8,000 to $9,450 | Full 2026 individual out-of-pocket maximum |
| Uninsured cash-pay bundled (ASC) | $18,000 to $30,000 | Not covered; bundled self-pay rate |
| Outpatient / same-day vs inpatient | 20% to 40% lower than inpatient | Same coverage rules; lower facility fee |
Total knee replacement (also called total knee arthroplasty, or TKA) is one of the most common orthopedic surgeries in the United States. The financial side of the decision matters. Cost varies widely based on where the surgery is done, whether it is inpatient or outpatient, the implant chosen, and how insurance covers each piece of care. This 2026 US guide breaks down what total knee replacement typically costs, what Medicare and private insurance cover, what patients pay out of pocket, and how to get a personal estimate before your date is set.
The Short Answer on Total Knee Replacement Cost
In 2026 US dollars, a total knee replacement typically costs somewhere between $30,000 and $70,000 if you look at the sticker price billed by a hospital and surgical team combined. The number you actually pay depends heavily on your insurance:
- Medicare beneficiaries: Often pay a few hundred to a few thousand dollars out of pocket after Medicare Part A and Part B cover the bulk of the cost. Medigap or Medicare Advantage plans further reduce this.
- Private insurance with a moderate deductible: Out-of-pocket costs typically run in the $2,000 to $5,000 range after the deductible and coinsurance are met.
- High-deductible plans: Patients may pay closer to their full annual out-of-pocket maximum, which for 2026 individual plans is often $8,000 to $9,450.
- Uninsured cash-pay: Some ambulatory surgical centers offer bundled cash-pay rates for total knee replacement in the $18,000 to $30,000 range.
These are general ranges only. Your actual cost will depend on your specific plan, hospital, surgeon, and any complications.
What the Total Cost Actually Includes
Total knee replacement is not a single line item. The bundled cost usually includes:
- Pre-operative evaluation: Consultations, X-rays, MRI in some cases, medical clearance, blood work
- Surgeon’s fee: The professional fee for the orthopedic surgeon
- Anesthesia: Anesthesiologist fee and anesthesia drugs
- Facility fee: The largest single component; covers use of the operating room, staff, and post-op nursing
- Implant: The prosthesis itself; standard implants are less expensive than robotic-assisted or custom implants
- Hospital stay: If inpatient, typically 1 to 2 nights; costs less if done outpatient
- Post-op imaging: Follow-up X-rays
- Physical therapy: Usually 6 to 12 weeks of outpatient therapy after surgery
- Pain management: Prescriptions and any injections
Total Cost by Setting
Inpatient (Traditional Hospital)
Most total knee replacements were done in the hospital as inpatient procedures until Medicare rules changed in 2018. Inpatient stays include one to two nights of nursing care, IV medications, physical therapy in the hospital, and monitoring. Because facility fees are higher, total cost is typically at the upper end of the range.
Outpatient (Same-Day)
Outpatient total knee replacement is increasingly common for healthier patients under 65 and even for some Medicare patients. The patient goes home the same day. Costs are typically 20 to 40 percent lower than inpatient because facility fees at ambulatory surgical centers are lower.
Ambulatory Surgical Center (ASC)
ASCs offer bundled rates that are typically the lowest option for cash-pay patients and often for high-deductible plan patients. ASCs are best suited for lower-risk patients without significant heart, lung, or metabolic conditions.
Total Cost by Implant Type
- Standard cemented or uncemented implant: The most common option. Covered by Medicare and most private plans.
- Robotic-assisted total knee replacement: Uses a robotic system to guide implant placement. Facility fees may be slightly higher. Coverage varies by plan.
- Custom (patient-specific) implants: Made from your imaging. Typically costs a few thousand dollars more. Coverage is inconsistent.
- Partial (unicompartmental) knee replacement: Not the same as TKR, but if you qualify, it is typically less expensive.
Medicare Coverage for Total Knee Replacement
Medicare covers medically necessary total knee replacement for eligible beneficiaries. The coverage structure:
- Part A (Hospital Insurance): Covers inpatient hospital stays for total knee replacement. In 2026, the Part A deductible is around $1,676 per benefit period. After the deductible, Part A generally covers days 1 through 60 in full.
- Part B (Medical Insurance): Covers the surgeon’s fee, anesthesia, outpatient physical therapy, follow-up visits, and any outpatient portion of the surgery. Beneficiaries pay 20 percent of the Medicare-approved amount after meeting the Part B deductible (around $257 in 2026).
- Medigap: Supplemental plans can cover most or all of the 20 percent Part B coinsurance and the Part A deductible.
- Medicare Advantage: Costs and coverage depend on the specific plan; some have lower out-of-pocket exposure than Original Medicare plus Medigap.
Most Medicare beneficiaries with Medigap see very little out-of-pocket cost beyond the Part A deductible.
Private Insurance Coverage
Most commercial insurance plans cover medically necessary total knee replacement. Patient out-of-pocket cost depends on:
- Whether the deductible has been met for the year
- Coinsurance percentage (often 10 to 30 percent after deductible)
- The plan’s out-of-pocket maximum
- Whether the surgeon, hospital, and anesthesiologist are in-network
Timing matters. If your surgery is early in the calendar year, you may hit your full deductible and coinsurance. If it is late in the year and you have already met your out-of-pocket max, you may pay very little.
If You Don’t Have Insurance
Options for cash-pay patients:
- Ambulatory Surgical Centers: Many ASCs offer transparent bundled rates in the $18,000 to $30,000 range for a straightforward total knee replacement.
- Medical Tourism: Some patients travel abroad for lower-cost surgery. Quality varies; research surgeon credentials and hospital accreditation carefully. Post-op care coordination in the US is an important consideration.
- Hospital Financial Assistance: Nonprofit hospitals in the US must offer financial assistance policies for patients under certain income thresholds. Ask the billing office.
- Payment Plans: Most hospitals offer no-interest payment plans over 12 to 36 months.
Other Factors That Affect Your Total Knee Replacement Cost
- Geography: Costs are typically higher in major metropolitan areas and coastal states.
- Surgeon experience: High-volume surgeons may charge higher fees but tend to have shorter operative times and lower complication rates.
- Complications: Infection, blood clots, or manipulation under anesthesia for stiffness can significantly increase cost.
- Rehabilitation setting: Home physical therapy vs outpatient PT vs a short-term rehab facility all cost differently. Medicare and most plans cover outpatient PT for a defined number of sessions per year.
- Bilateral knee replacement: Doing both knees at once is not always cheaper (higher complication risk means it is used less often than staged surgery).
How to Get a Personal Cost Estimate
Before your surgery date is set:
- Ask the surgeon’s office for the CPT code(s) they will be billing (typically 27447 for a total knee replacement)
- Call your insurance to ask for the estimated allowed amount, your remaining deductible, and out-of-pocket maximum
- Request the facility’s “good faith estimate” (required under the No Surprises Act for uninsured or cash-pay patients, and often available for insured patients)
- Ask about in-network status for the surgeon, hospital, anesthesiologist, and radiologist
- If considering an ASC, request the bundled quote in writing
Frequently Asked Questions
Does Medicare pay for a knee replacement?
Yes. Medicare covers medically necessary total knee replacement for beneficiaries who meet the criteria. Coverage is split between Part A (hospital) and Part B (surgeon and outpatient). Most beneficiaries with Medigap pay very little out of pocket.
Is robotic knee surgery covered by insurance?
The robotic procedure itself is generally covered when the underlying surgery is covered. The facility may or may not bill the robotic component separately. Check with your insurer.
Can I negotiate the cost of a total knee replacement?
Cash-pay bundled prices at ASCs are often negotiable. Prices billed to insurance are not usually negotiable directly, but hospitals often offer prompt-pay discounts, financial assistance, or payment plans.
Related Reading on Know Your Surgery
- Total Knee Replacement: Overview, Types, and What to Expect
- Total Knee Replacement: Causes, Diagnosis, and When to Consider Surgery
- Total Knee Replacement: Procedure, Recovery, and Rehabilitation
- Total Knee Replacement: FAQs, Statistics, and Patient Stories
Sources
- Centers for Medicare and Medicaid Services (CMS): Total knee arthroplasty coverage guidelines and 2026 Part A/B deductibles
- American Academy of Orthopaedic Surgeons (AAOS): Total knee replacement patient guides
- American Joint Replacement Registry (AJRR): 2024 annual report cost data
- Healthcare Bluebook and FAIR Health cost transparency resources
- US No Surprises Act: patient rights to good faith estimates
Medical Disclaimer: This article is for informational purposes only and does not constitute medical, legal, or financial advice. Cost figures are general 2026 ranges and vary by hospital, insurer, region, and case complexity. Verify all cost information with your specific insurance plan and surgical facility before scheduling.
