How Much Does a Hip Replacement Cost?
Key takeaways:
The out-of-pocket costs of a hip replacement vary based on where you live, the device type, length of stay in the hospital, insurance coverage, and after-care needs.
Without insurance, the cost typically ranges from $31,000 to $45,000 for the surgery alone. Even if you have insurance and have paid your deductibles, you may have out-of-pocket expenses.
You may pay less if you are eligible for a hospital stay of under 24 hours. The average outpatient hip replacement cost $22,000 in 2019, a study found.
Table of contents
Hip replacement surgery is a popular procedure that can restore mobility and reduce pain.
It is considered to be an elective surgery because it is typically done on a non-emergency basis. Your healthcare provider will tell you if you’re a candidate for total hip replacement, or if hip resurfacing or partial hip replacement are better options.
In the U.S., healthcare providers perform more than 450,000 total hip replacement surgeries annually. As the population ages, that number is expected to increase to more than 650,000 by 2025. And, as the number of hip replacements increase, so will the costs.
What’s the average cost of a hip replacement?
While the costs of hip replacement surgery vary depending on numerous factors, the average price tag for the procedure has been on the rise for years.
From 2003 to 2010, the average cost for hip replacement surgery increased from around $13,000 to $16,500. As of 2019, the cost of a hip replacement came in at nearly $40,400, slightly higher than a knee replacement, at $35,000. Although, according to recent estimates, the final figure falls within a wide range, with the average total cost landing anywhere from $23,200 to $74,000.
The nonprofit FAIR Health helps you compare prices for free so that you can estimate the costs based on where you live.
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What factors affect how much you’ll pay for a hip replacement?
As mentioned before, the costs of hip surgery vary greatly — even within the same regions. It is often cheaper to have the surgery outside of the U.S., though there can be compromises in quality when doing so.
A 2021 Centers for Medicare and Medicaid Services rule mandated price transparency at hospitals. But clear information about how much a procedure will cost can still be hard to come by.
And the issue is further complicated by the number of factors that affect the price. Below we outline some of those factors.
Location
The prices for hip surgery vary significantly both between and within metropolitan areas. Within Dallas, the highest cost for hip replacement is almost four times as much as the lowest-priced option. And Dallas and Fort Worth are already the most expensive American cities to have the surgery in.
Below is an example of how much the price of the procedure can vary between metropolitan areas. Prices include doctor, facility, and anesthesia fees.
Average Hip Replacement Costs
|
City |
Average price for procedure |
|
El Paso |
$23,260 |
|
Chicago |
$24,302 |
|
Washington, D.C. |
$29,680 |
|
New York City |
$34,231 |
|
San Francisco |
$37,473 |
|
Dallas |
$50,580 |
|
Fort Worth |
$50,580 |
Sources: Becker’s Spine Review, Healthcare Bluebook
Implant preference
Some orthopedic surgeons only use (and are trained on) specific manufacturers’ devices, which can impact costs.
How long you’re hospitalized (inpatient vs. outpatient)
The prices of an inpatient and an outpatient hip replacement (and knee replacement) can differ by 30% to 40%. An outpatient procedure means that you are discharged 12 to 23 hours after surgery, versus requiring at least one night in the hospital, or an inpatient stay.
The average price for an inpatient hip replacement is almost $30,700, compared to around $22,078 for an outpatient surgery, according to a 2019 Blue Cross Blue Shield report.
While the outcomes are comparable between the procedures, your doctor would have to determine that you are a candidate for a quick discharge in order for you to have outpatient surgery. Even so, you may be held overnight or longer if needed. Typically, people stay in the hospital for a few after a hip surgery.
The surgeon’s status
Whether your surgeon is independent or employed by the hospital can also lead to varying costs. Some orthopedic surgeons only practice at certain hospitals, which can affect the price of the procedure.
Post-surgical needs
The recovery time for a hip replacement depends on the person. But the process comes with additional costs, including for medications, devices, supplies, and physical therapy or rehabilitation.
Insurance coverage
Depending on your plan, you may need to meet a deductible before insurance covers the rest (or part) of the fees. And there are certain fees that your plan may not cover at all.
Kimberly A. Bartosiak, MD, an assistant professor of orthopedic surgery at Washington University School of Medicine, talked to GoodRx Health about some of the unexpected fees that insurance may not cover. According to Dr. Bartosiak, these include:
The preoperative ointment mupirocin
Anti-inflammatories like Celebrex
Brand-name Eliquis, which is sometimes prescribed to high-risk patients for anticoagulation in place of aspirin
Dressings, which can cost anywhere from $15 to $75
Medical and adaptive equipment, such as a bedside commode, which can cost about $35 to $60
A hip kit — which includes items like a grabber/reacher, shoehorn, long-handled sponge, dressing stick, sock aid, and elastic shoe laces — that costs about $25 to $65
You may be able to rent a walker, wheelchair, commode, hip kit, or other items through a local medical equipment loan program for free.
Is hip replacement worth it?
In many cases, hip replacement surgery greatly improves a person’s quality of life. And research suggests it’s more cost-effective to have the surgery than not for older people with severe hip arthritis.
Also, the quality of care around hip replacements has improved over time. Outpatient complication rates improved by 36% for hip procedures between 2013 and 2017, according to the previously mentioned Blue Cross Blue Shield report.
To evaluate whether or not a particular hospital would be a good place to have the procedure, look into:
Complication rates
Procedure volume
Patient ratings
Readmission rates
Success rate
How much of the cost of a hip replacement does insurance cover?
Most insurance policies cover at least a part of the costs of medically necessary care, including Medicare and Medicaid.
When it comes to hip replacement surgery, insurance plans typically cover a portion of the costs associated with:
Evaluation with an orthopedic surgeon
Pre-operative tests
Surgical costs including the provider’s fee and the costs for anesthesia, the operating room, and the implant
Hospitalization after surgery
Home preparations for necessary safety materials and medical equipment
Rehabilitation and/or physical therapy
Medicare and Medicaid require a prior authorization for hip replacement surgery. Medicare Advantage and private insurance may also require a prior authorization.
Check to see if your plan limits coverage on implant brands, the number of physical therapy sessions, or after-care supplies.
How much does a hip replacement cost out of pocket?
If you’re uninsured or plan to pay for the procedure without using your insurance, you’re entitled to a good-faith estimate of costs under the No Surprises Act. Healthcare providers have to give you a breakdown of costs after you request the estimate or when you schedule the surgery. If you choose to have the surgery with the provider and the bill exceeds the estimate by $400 or more, you can dispute it.
If you’re insured and want to estimate out-of-pocket costs, pay attention to your deductible. The timing of your surgery can make a difference in how much you pay. (Generally, the earlier in the calendar year that you have the procedure, the better it is for your coverage and finances.) You also can ask your healthcare provider to help you plan for copays and coinsurance for surgery and post-operative visits.
You can pay some out-of-pocket costs for adaptive equipment (like a hip kit) using a tax-advantaged flexible spending account (FSA), health savings account (HSA), or health reimbursement account (HRA).
Will supplemental health insurance help cover the cost of a hip replacement?
Medicare supplement insurance, or Medigap, can help those with traditional Medicare cover the cost of Part A and Part B deductibles, copays, and coinsurance associated with hip replacement care. For people with commercial health insurance, supplemental coverage, such as critical illness insurance, covers a limited number of diagnoses and doesn’t generally cover hip replacement.
How much does a hip replacement cost with Medicare?
People with Medicare are responsible for monthly premiums for Part B, and sometimes Part A, in addition to out-of-pocket costs. If you had Medicare Advantage or a traditional Medicare plan with a Part D (medication coverage) and a supplemental policy, you may still pay a portion of the costs for hospital care, prescription medications, and rehabilitation care after a hip replacement.
How much a person with Medicare pays for hip replacement surgery depends on the specifics of their plan and the factors involved in the procedure. For example, there may be a cost difference depending on the kind of outpatient facility you use. Medicare.gov finds that, on average, an ambulatory surgery center costs more out of pocket — $2,067, compared with $1,819 — than a hospital outpatient department. That estimate includes surgeon and facility fees, but more costs may apply.
How long does a total hip replacement last? Is it permanent?
According to one study, a hip replacement device will last for about 25 years in almost 60% of patients.
Another study found that about 5% of people needed a hip surgery revision in the first 10 years after surgery. By the 20-year mark, 15% of people needed additional surgery. In those who were older than 70 when they had the hip replacement, the lifetime risk of a second surgery was about 5%. But that risk was higher for younger people, especially men. Up to 35% of men who were in their early 50s when they had the procedure needed a second operation on the same joint.
Although, it is important to note that this study — and these numbers — come from data collected between 1991 and 2011. Surgical techniques and device technology have improved since that time, so it’s possible that revision rates have decreased since then.
What follow-up care and equipment is needed after hip replacement surgery?
Hip replacement recovery can include:
Post-operative medication
Devices such as an ice machine, cane, handheld shower head with long hose, and deep venous thrombosis (DVT) prevention aid
Complications, including infections, can increase costs — as can how and where you recover. Of the nearly 139,000 hip replacement patients in 2008, 18% were discharged to their homes, 34% received home health care, 35% went to extended-care facilities, and 13% stayed for inpatient rehabilitation.
Advancements in telehealth have reduced the need to travel for follow-up care. A 2021 study that compared traditional rehabilitation with telehealth for rehabilitation after a hip replacement found that the costs and outcomes were about the same. Though, another study found that telehealth rehabilitation cost about 28% less.
Talk to your provider if you’re interested in doing physical therapy from home, which may help you save on the costs of a hip replacement.
The bottom line
The cost of a hip replacement varies based on factors like the hospital you choose, how long you stay after the procedure, and how quickly you recover. The surgery may cost a lot less if you are eligible to be hospitalized for under 24 hours and if you can do rehab at home. A local medical equipment loan program may help you afford after-care items such as a bedside commode and a hip kit.
Why trust our experts?
References
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