Chi Phí Phẫu thuật thay khớp gối Là Bao Nhiêu?
Total knee replacement, also known as total knee arthroplasty, is a surgical procedure to resurface a knee damaged by arthritis or injury. Metal and plastic parts are used to cap the ends of the bones that form the knee joint.
Không Bảo Hiểm
$35,000
Có Bảo Hiểm
$10,500
Medicare
$8,000
Trung Bình Quốc Gia
$25,000
By Elena Bellini, MPH, Health Policy & Management · Last reviewed 2026-04-16 ·
Sources: CMS Medicare Provider Utilization and Payment Data 2025 · Methodology · Editorial standards Tổng quan
Total knee replacement (total knee arthroplasty, or TKA) is one of the most common orthopedic surgeries in the United States, with roughly 800,000 procedures performed per year. It replaces the diseased cartilage and bone of the knee joint — most commonly damaged by osteoarthritis — with metal and polyethylene components. The operation itself takes 1–2 hours under regional or general anesthesia. Most surgeons perform TKA on an outpatient basis at an ambulatory surgery center for appropriate candidates, with recovery at home and structured physical therapy over 6–12 weeks; higher-risk patients may stay 1–3 nights in the hospital. The total allowed amount spans the preoperative workup, the surgery itself, the implant hardware, the anesthesia, the facility, and the bundled postoperative visits — each of which may be billed by a different provider.
Yếu tố ảnh hưởng đến chi phí
- Site of service: ambulatory surgery center (ASC) episodes are typically 30–50% cheaper than inpatient hospital surgery for eligible patients.
- Bundled vs unbundled billing: a bundled surgical package covers surgeon, anesthesia, and facility in one negotiated rate; unbundled episodes are billed piece by piece.
- Implant choice: standard cobalt-chrome and polyethylene components cost less than custom or robotic-assisted implants.
- Use of robotic assistance: robotic-arm-assisted TKA can add $1,500–$3,000 to the facility fee.
- Complexity and revision status: revision knee replacement is materially more expensive than a primary replacement.
- Post-acute care: discharge to a skilled nursing facility or inpatient rehab adds substantial cost versus home-based PT.
Cách Tiết Kiệm
- Ask the surgeon whether an ambulatory surgery center is clinically appropriate for your case — it is the single biggest cost lever.
- Request a bundled Good Faith Estimate that includes surgeon, anesthesia, facility, implant, and 90-day post-op care.
- Verify every participant — surgeon, anesthesiologist, facility, any assistant surgeon — is in-network.
- For insured patients, ask about surgery Centers of Excellence programs; many employer plans waive cost-sharing at designated centers.
- If uninsured, ask the facility about self-pay bundled surgery rates — these are often 40–60% below the chargemaster.
- Schedule the procedure after your deductible has been met for the year if the timing is clinically reasonable.
Ghi chú về bảo hiểm và phạm vi bảo hiểm
Knee replacement is covered by Medicare Part A (inpatient) or Part B (outpatient), commercial insurance, and most Medicaid programs when medical necessity criteria are met. Commercial plans virtually always require prior authorization, and many plans apply step-therapy requirements (documented trials of conservative management including physical therapy, weight management, and intra-articular injections). Medicare removed TKA from the inpatient-only list in 2018, which means Medicare will reimburse outpatient TKA at ambulatory surgery centers where appropriate. Patients should obtain a written Good Faith Estimate or Advanced Explanation of Benefits before scheduling, because the bundled rate often exceeds the annual out-of-pocket maximum in a single episode.
Data sources for this page
Cost figures on this page are compiled from the following sources, triangulated per the rules in our methodology:
- CMS Medicare Provider Utilization and Payment Data 2025 — primary CMS reference used as the Medicare-rate anchor.
- Hospital Price Transparency machine-readable files (HPT MRFs) from a sample of major hospitals in each state, per the federal Hospital Price Transparency rule.
- Transparency in Coverage payer in-network rate files for commercial-rate cross-validation.
- State All-Payer Claims Database (APCD) summaries where published (Colorado, New Hampshire, Massachusetts, Minnesota, Maine, Utah, Vermont, Rhode Island, Washington, Oregon).
Last reviewed 2026-04-16. See editorial standards for our fact-checking process and correction policy.
Range: $25,500 to $48,000 · 50 states shown
Chi Phí Theo Tiểu Bang
| Tiểu Bang | Không Bảo Hiểm | Có Bảo Hiểm | Medicare |
|---|---|---|---|
| Mississippi | $25,500 | $7,650 | $5,850 |
| Arkansas | $26,000 | $7,800 | $5,950 |
| West Virginia | $26,000 | $7,800 | $5,950 |
| Oklahoma | $26,500 | $7,950 | $6,050 |
| Alabama | $27,000 | $8,100 | $6,200 |
| Kentucky | $29,500 | $8,850 | $6,750 |
| Louisiana | $30,000 | $9,000 | $6,900 |
| Iowa | $30,500 | $9,150 | $7,000 |
| New Mexico | $30,500 | $9,150 | $7,000 |
| South Carolina | $30,500 | $9,150 | $7,000 |
| South Dakota | $30,500 | $9,150 | $7,000 |
| Kansas | $31,000 | $9,300 | $7,100 |
| North Dakota | $31,000 | $9,300 | $7,100 |
| Idaho | $31,500 | $9,450 | $7,200 |
| Nebraska | $31,500 | $9,450 | $7,200 |
| Tennessee | $31,500 | $9,450 | $7,200 |
| Indiana | $32,500 | $9,750 | $7,400 |
| Missouri | $32,500 | $9,750 | $7,400 |
| Utah | $32,500 | $9,750 | $7,400 |
| Wyoming | $32,500 | $9,750 | $7,400 |
| Georgia | $33,000 | $9,900 | $7,500 |
| Montana | $33,000 | $9,900 | $7,500 |
| North Carolina | $33,000 | $9,900 | $7,500 |
| Michigan | $33,500 | $10,050 | $7,700 |
| Arizona | $34,000 | $10,200 | $7,800 |
| Maine | $34,500 | $10,350 | $7,900 |
| Ohio | $34,500 | $10,350 | $7,900 |
| Wisconsin | $34,500 | $10,350 | $7,900 |
| Texas | $35,000 | $10,500 | $8,000 |
| Florida | $35,500 | $10,650 | $8,100 |
| Minnesota | $35,500 | $10,650 | $8,100 |
| Illinois | $36,000 | $10,800 | $8,200 |
| Pennsylvania | $36,000 | $10,800 | $8,200 |
| Delaware | $36,500 | $10,950 | $8,350 |
| Nevada | $36,500 | $10,950 | $8,350 |
| Vermont | $36,500 | $10,950 | $8,350 |
| Virginia | $36,500 | $10,950 | $8,350 |
| Colorado | $37,000 | $11,100 | $8,500 |
| New Hampshire | $37,000 | $11,100 | $8,500 |
| Oregon | $37,500 | $11,250 | $8,600 |
| Maryland | $38,500 | $11,550 | $8,800 |
| Rhode Island | $39,000 | $11,700 | $8,900 |
| Washington | $39,000 | $11,700 | $8,900 |
| Connecticut | $42,000 | $12,600 | $9,600 |
| New Jersey | $42,000 | $12,600 | $9,600 |
| California | $46,000 | $13,800 | $10,500 |
| Massachusetts | $46,500 | $13,950 | $10,600 |
| Alaska | $47,000 | $14,100 | $10,800 |
| New York | $47,500 | $14,250 | $10,900 |
| Hawaii | $48,000 | $14,400 | $11,000 |
Câu Hỏi Thường Gặp
Chi phí phẫu thuật thay khớp gối không bảo hiểm là bao nhiêu?
Chi phí trung bình của phẫu thuật thay khớp gối không bảo hiểm tại Hoa Kỳ là $35,000. Chi phí khác nhau đáng kể theo tiểu bang.
Bảo hiểm có chi trả phẫu thuật thay khớp gối không?
Hầu hết các gói bảo hiểm y tế chi trả phẫu thuật thay khớp gối khi cần thiết về mặt y tế. Với bảo hiểm, chi phí tự trả trung bình là $10,500.
Medicare có chi trả phẫu thuật thay khớp gối không?
Medicare Part B thường chi trả phẫu thuật thay khớp gối khi có chỉ định của bác sĩ. Số tiền Medicare phê duyệt trung bình là $8,000.
Được xem xét bởi Elena Bellini · Xem xét lần cuối: 2026-04-16
Dữ liệu từ CMS Medicare Provider Utilization and Payment Data 2025. Cập nhật lần cuối: 2026-03-01. Thông tin này chỉ mang tính giáo dục và không phải lời khuyên y tế. Trang web này chỉ mang tính chất thông tin và không cấu thành lời khuyên y tế. Luôn tham khảo ý kiến chuyên gia y tế có trình độ.