The average cost of knee replacement surgery in the United States is estimated at USD$40,000 (£26,000). For those with health insurance, out-of-pocket costs can be substantially lower, ranging from a few hundred to a few thousand dollars. A cheaper alternative for the uninsured would be to have the surgery done in Mexico (the nearest alternative) or India, or any of 30 or so other countries.
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What is knee replacement surgery?
Knee replacement surgery involves the replacement of the joint of a knee with a prosthetic. The femur is replaced with a metal shell and the tibia by a plastic piece with a stem. Sometimes a plastic "button" is added under the surface of the kneecap. Such surgery is done when there is chronic inflammation or deformity or extreme pain or when movement is impeded by arthritis or injury.
Knee replacement costs in the USA
The cost of knee replacement surgery in the United States for the uninsured can be less than the average because of discounts given by some medical institutions. For example, the Tulane University Hospital and Clinic can have a discounted price between $29,000 (£18,850) and $34,000 (£22,100), while the Kapiolani Medical Center in Hawaii (where the full price is $33,000 (£21,450)) can have a discounted price of $20,000 (£13,000) to $24,000 (£15,600). A partial knee replacement can cost anywhere from one-half to the same amount of a total knee replacement.
Out-of-pocket costs for the insured
Health insurance usually covers the costs of knee surgery if a doctor orders the surgery; if done for experimental purposes, costs are not covered. For those with insurance, the deductibles and coinsurance determine whether out-of-pocket costs are a few hundred or a few thousand dollars. At Dartmouth-Hitchcock Medical Center in New Hampshire, a knee replacement on a patient with Medicare could be charged $4,500 (£2,925) out of pocket, or only $3,000 (£1,950), or even lower if the insurance company is able to negotiate lower rates with the provider.
A cheaper alternative
For the uninsured, having knee replacement abroad is an alternative that can lessen costs substantially. In Mexico, the cost is $12,500 (£8,125), in Costa Rica $10,500 (£6,825) and in India $7,000 (£4,550). These, and many other countries, have excellent facilities and doctors who have worked in Europe and the United States, with a lot of experience performing such surgeries. There are now medical tourism companies that help patients make arrangements for knee replacement abroad, including vacations during recovery.
Other Costs To Consider
Patients who undergo knee surgery, whether in the United States or elsewhere, must ascertain whether the costs quoted include the additional days needed in the hospital for recuperation. In addition, a few preparations in the place where the patient lives or stays may be needed, such as arm support for rising from the toilet seat, bath or shower safety bars, a stable bench in the shower and first-floor living quarters so as to avoid having to go upstairs or downstairs. These are added costs for the uninsured and, if not covered, for the insured or for those opting to go abroad for the surgery.
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