Knee Replacement: Preparing for the Procedure and Costs

Before a big procedure like a knee replacement, patients will likely have many questions about what to expect during the surgery and what the recovery period looks like. But, patients don’t always ask about the cost ahead of time.

Severe pain in the knee joint – often caused by osteoarthritis – can be relieved by a knee replacement. If your doctor has recommended a knee replacement as part of your treatment for these or other conditions, you’ll want to ask what to expect from the surgery and after you have recovered. You’ll also want to know what costs to expect and reduce the chance of a surprise bill.

On the Wear The Cost website, the knee replacement “episode of care” includes the total cost of all covered services related to the procedure, whether the service takes place in a hospital or in an outpatient facility. This total cost includes consultation prior to surgery, tests, and the surgery itself, and nursing care following the surgery. It also includes costs that may occur after being discharged from the hospital/outpatient facility, including follow-up doctor appointments and physical therapy.

By including the related services before, during, and after the surgery, Wear The Cost captures the total cost of care of a knee replacement. The costs are based on health insurance claims data, which reflects what health insurers actually paid providers for their services and the patients’ out-of-pocket costs.

In Maryland, the cost of a knee replacement can range from about $23,200 to over $33,800, depending on the hospital where the procedure takes place. These costs include things you expect, like radiology, surgery, and physical therapy. They also include treatments for complications that you hope not to experience and could potentially be avoided. Common potentially avoidable complications for knee replacements include infections at the operation site, pressure ulcers or bed sores, clots in leg veins, re-operations to adjust the joint, and complications of joint prosthesis. Some hospitals have more costs associated with potentially avoidable complications than others.

Knowing both the costs associated with the procedure and the rate of potentially avoidable complications can help patients as they consider where to get their surgery – something everyone should think about.

To learn more about what knee replacements cost in Maryland and which hospitals may offer a better value, check out https://www.wearthecost.org/knee_replacement.html. Or create your own custom report to compare hospitals: https://www.wearthecost.org/report_step1.html.