How Much Does a Knee Replacement Cost? A Data Analysis of 98 U.S. Hospitals
Published May 2026 · Analysis of 98 hospitals across 37 states, CPT 27447 cash prices
Hospitals post cash prices for a total knee replacement (CPT 27447) ranging from $1,025 to $60,617 — a 59x spread for the same procedure code. But read the fine print: the low end is almost always a single facility or surgeon's-fee line, not the all-in cost of the surgery.
A total knee replacement is one of the most common major surgeries in the U.S. — and one of the hardest to get a straight price on. We pulled the cash (self-pay) prices that hospitals publish for CPT 27447 under the federal Hospital Price Transparency Rule (45 CFR 180), across 98 hospitals in 37 states.
One caveat up front, because it matters more for surgery than for a scan: the single posted price for 27447 is frequently just the facility fee or the surgeon's professional fee — not the implant, the anesthesia, the hospital stay, or physical therapy. A realistic all-in self-pay knee replacement usually lands between roughly $15,000 and $40,000 once every component is added. Treat the numbers below as the hospital's posted starting point, and always ask for a bundled, all-in estimate (see below).
National Knee Replacement Cash Prices
Cash-pay (self-pay) prices for the total knee replacement code, filtered to a $1,000–$150,000 plausibility window. Click the procedure to compare every hospital's price side by side.
| CPT | Procedure | Min | Median | Max | Hospitals |
|---|---|---|---|---|---|
| 27447 | Total Knee Replacement | $1,025 | $5,797 | $60,617 | 98 |
Values below $1,000 were excluded as copay fragments, deposits, or single line-item component fees (26 hospitals posted such values). Even within the window, a posted price may reflect only the facility or professional component — see Methodology.
The Transparency Paradox
The federal Hospital Price Transparency Rule took effect in 2021 to make hospital prices comparable. Five years on, a total knee replacement — the same CPT, 27447 — is posted at $1,025 at East Carroll Parish Hospital in Lake Providence, Louisiana and $60,617 at MountainView Hospital in Las Vegas. That is a 59x gap for the identical procedure code, published publicly by both hospitals under the same rule.
We call this the Transparency Paradox: the data is now public, but it didn't narrow what hospitals charge — and for surgery it added a second problem. Hospitals don't post prices on a consistent basis. Some publish a bundled global price; many publish only the facility fee for the operating room and recovery, leaving the implant, anesthesia, and surgeon as separate, unposted bills. So two hospitals can both "publish their 27447 price" and mean completely different things by it.
Why Knee Replacement Cost Varies So Much
- What the posted price actually covers. This is the biggest driver of the 59x spread. A $1,025 line is a component; a $60,000 line is closer to an all-in bundle. Always ask which one you're being quoted.
- The implant. The artificial joint itself can run $3,000–$8,000+ and varies by manufacturer and whether it's a standard or custom/robotic-assisted implant. Hospitals mark it up differently, and it's often billed separately.
- Inpatient vs. outpatient. Medicare removed total knee replacement from its "inpatient-only" list in 2018, and many are now done as outpatient or at an ambulatory surgery center (ASC). Outpatient/ASC knees are materially cheaper than a multi-day inpatient stay.
- Facility type and ownership. Large for-profit hospital systems post the highest prices; rural and community hospitals and ASCs post the lowest. The most expensive hospitals in our data are metro for-profit facilities.
- Separate professional bills. The surgeon, the anesthesiologist, and the physical-therapy course are typically billed separately from the hospital — and any one of them can be out of network even when the hospital is in network.
- Geography. Urban markets with concentrated hospital ownership charge well above rural markets for the identical operation.
The 10 Most Expensive and 10 Cheapest Knee Replacements
Posted cash prices for CPT 27447, one row per hospital (lowest posted cash price each). Click any hospital to see its full price and compare cash vs. gross vs. insurance-negotiated rates. Remember the cheapest figures are often component-only — confirm what's included.
10 Most Expensive (CPT 27447)
| Hospital | Location | Cash Price |
|---|---|---|
| MountainView Hospital | Las Vegas, NV | $60,617 |
| North Hawaii Community Hospital | Kamuela, HI | $48,133 |
| Jack Hughston Memorial Hospital | Phenix City, AL | $33,740 |
| Las Palmas Medical Center | El Paso, TX | $28,041 |
| Medical City North Hills | North Richland Hills, TX | $26,351 |
| Houston Medical Center | Warner Robins, GA | $25,437 |
| Animas Surgical Hospital | Durango, CO | $23,760 |
| McLaren Flint | Flint, MI | $23,003 |
| Regions Hospital | Saint Paul, MN | $20,784 |
| McLaren Lapeer Region | Lapeer, MI | $18,850 |
10 Cheapest (CPT 27447)
| Hospital | Location | Cash Price |
|---|---|---|
| East Carroll Parish Hospital | Lake Providence, LA | $1,025 |
| Community Hospital of Anaconda | Anaconda, MT | $1,083 |
| HCA Florida Osceola Hospital | Kissimmee, FL | $1,087 |
| Trident Medical Center | Charleston, SC | $1,189 |
| Marion General Hospital | Columbia, MS | $1,253 |
| Witham Health Services | Lebanon, IN | $1,341 |
| Harrison County Hospital | Corydon, IN | $1,343 |
| St. Claire Regional Medical Center | Morehead, KY | $1,472 |
| Baptist Medical Center Jacksonville | Jacksonville, FL | $1,484 |
| Baptist Medical Center South | Montgomery, AL | $1,651 |
The lowest figures here are almost certainly facility- or professional-component charges, not a full surgical bundle — which is exactly why a self-pay patient must get an itemized, all-in estimate before agreeing to a "price."
How to Pay Less for a Knee Replacement
- Ask for a bundled cash "package" price. Many hospitals and ASCs sell a flat self-pay total-knee bundle that includes facility, surgeon, anesthesia, and implant. It is often dramatically less than the sum of separate billed charges — but you usually have to ask for it by name.
- Consider an ambulatory surgery center. If you're a healthy outpatient candidate, an ASC or outpatient program avoids the inpatient facility fee and multi-day stay that drive hospital prices.
- Confirm the implant is included. The artificial joint is a major cost; a quote that excludes it can understate your bill by thousands.
- Get a written good-faith estimate. Under the No Surprises Act, self-pay and uninsured patients are entitled to a good-faith estimate before a scheduled procedure.
- Negotiate and ask about Centers of Excellence. Hospitals settle for less than sticker on self-pay balances, and some employers/insurers steer knee replacements to flat-rate Centers of Excellence at a fixed price.
What to Ask When You Schedule
- Is this an inpatient or outpatient (ASC) knee replacement?
- Does the price you're quoting include the implant, or is that billed separately?
- Is anesthesia included, or a separate bill from a separate group?
- Is the surgeon in my insurance network? The anesthesiologist? The PT provider?
- Is physical therapy after surgery included in this price?
- Do you offer a bundled, all-in self-pay package price for a total knee replacement?
- Can I get a written good-faith estimate of my total out-of-pocket cost?
Frequently Asked Questions
How much does a knee replacement cost without insurance?
Hospitals post cash prices for the knee-replacement code (CPT 27447) ranging from about $1,025 to $60,617 in our data, with a median near $5,797 — but those posted figures are often a single component, not the all-in surgery. A realistic all-in self-pay total knee replacement usually runs $15,000–$40,000 once the facility, surgeon, anesthesia, implant, and physical therapy are added. Ambulatory surgery centers and bundled cash packages are typically the cheapest route.
Why is a knee replacement so expensive?
Three things stack up: the artificial implant ($3,000–$8,000+), the facility fee for the operating room and any inpatient stay, and the separate professional bills for the surgeon, anesthesiologist, and physical therapy. Each is priced independently and marked up differently by each hospital, which is why the same procedure code can cost many times more at one hospital than another.
Is a knee replacement cheaper as an outpatient or at a surgery center?
Usually yes. Medicare removed total knee replacement from its inpatient-only list in 2018, and many knees are now done as outpatient procedures or at ambulatory surgery centers. Skipping the inpatient facility fee and multi-day hospital stay can cut the total cost substantially for healthy candidates.
Does the posted price include the implant?
Often not. The implant (the artificial knee joint) is frequently billed as a separate line and can add several thousand dollars. Always ask whether the quoted price includes the implant, the anesthesia, and post-op physical therapy — a quote that excludes them can understate your bill by a wide margin.
Does Medicare cover knee replacement?
Yes. Medicare Part A and Part B cover medically necessary total knee replacement; you're responsible for the Part A deductible and any Part B coinsurance, which a Medigap or Medicare Advantage plan may reduce. Because the procedure can now be outpatient, whether it's billed under Part A (inpatient) or Part B (outpatient) can change your share — ask how it will be billed.
Can I get one bundled price for the whole surgery?
Increasingly, yes. Many hospitals and ASCs offer a flat self-pay 'package' or 'bundled' price for a total knee replacement that rolls the facility, surgeon, anesthesia, and implant into one number, and some employers route knees to fixed-price Centers of Excellence. Ask for the bundled cash price by name — it's usually far lower than the sum of the separate charges.
Methodology
This analysis uses cash (self-pay) prices for CPT 27447 (total knee arthroplasty) from hospital Standard Charge files published under the CMS Hospital Price Transparency Rule (45 CFR 180). Where a hospital posts multiple cash rows for the code, we use its lowest. The figures reflect files available as of May 2026, across 98 hospitals in 37 states.
Limitations
- The posted price is often a component, not the whole surgery. Hospitals don't post 27447 on a consistent basis — some publish a bundled global price, many publish only a facility or professional fee. The implant, anesthesia, inpatient stay, and physical therapy are frequently separate, unposted bills. Treat the low end especially as partial.
- We filter to a $1,000–$150,000 plausibility window. Values below $1,000 (26 hospitals) appear to be copay fragments, deposits, or single line items rather than a procedure price.
- Cash prices apply to self-pay patients; an insured patient's negotiated rate may differ.
- Hospital reporting quality varies; some publish chargemaster (list) rates in the cash field.
References & Further Reading
- CMS Hospital Price Transparency Rule (45 CFR 180) — the federal requirement that produces the underlying data on this page.
- AAOS OrthoInfo: Total Knee Replacement — patient guidance on the procedure, recovery, and what's involved.
- CMS: No Surprises Act — Good-Faith Estimates — your right to a written cost estimate before a scheduled procedure.
- Medicare.gov: Knee Replacement Coverage — how Medicare covers the procedure and your share of the cost.
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