The Cost of Knee Replacement Surgery: 5 Key Factors


When considering complete knee replacement surgery, the cost is an important factor to consider. Many people’s insurance will pay the cost, although some out-of-pocket charges may be. So, what are those key factors that play a vital role in the overall cost of knee replacement surgery? In this article, we will talk about those factors in detail. 

  1. Your Health-Care Coverage

Your health insurance coverage will heavily influence the cost of your knee replacement. As a result, you should thoroughly examine your insurance coverage before starting the treatment. If you want your knee replacement to be reimbursed by insurance, it must be “ordered” by a doctor. This order informs your insurance company that knee replacement surgery is required to alleviate or manage your knee discomfort and loss of function. Your cost-share for these types of covered treatments will be determined by your unique health insurance plan, as well as if it includes copays, deductibles, or coinsurance. Costs may also vary depending on how much medical care you’ve already had to pay for throughout the plan year.

2. Type of Knee Replacement Procedure 

There are three kinds of knee operations, each with a different level of complexity and equipment requirements:

  • Partially knee replacement
  • Knee replacement surgery
  • Knee revision (or complicated) replacement

Your orthopaedic physician will consult with you to identify the best form of knee replacement for you.

They will guide you through the process and provide suggestions based on various criteria such as your knee condition, goals, age, lifestyle, and the likelihood of future revision surgery. While a full knee replacement surgery appears to be the most expensive, a revision operation is really the most expensive. The final cost of any operation will vary depending on the intricacy of the procedure, among other considerations. Still, a partial knee replacement generally costs 10% to 50% less than a total knee replacement.

3. Your ‘classification’ for knee replacement surgery

Inpatient procedures and outpatient surgeries are the two forms of knee replacement surgery. Often, “inpatient” refers to a hospital stay following surgery, whereas “outpatient” refers to being discharged the same day as your procedure. However, your insurance provider may not classify your procedure in this manner. In reality, knee replacement surgery is an outpatient procedure. If they satisfy specific conditions and their insurance supports it, many patients can go home the same day as their operation. Even if a patient spends the night in the hospital, their procedure will most likely be outpatient. This may affect the overall amount you’re liable for.

4. Where will you get your knee replacement surgery perform?

You can get knee replacement surgery in hospitals as well as surgical centres.

A surgical centre is a facility that specialises in same-day procedures and may or may not be affiliate with a hospital. Surgery facilities may specialise in certain treatments. However, in order to have your treatment performed in a surgical facility, you must fulfil certain medical requirements. This typically indicates that you are not a high-risk patient. If you have your surgery at a hospital, the operating room costs might significantly impact the overall cost. In some circumstances, the length of stay in the hospital might affect prices. 

All of this being said, it usually is less expensive – both for you and your insurance company – to have your operation performe in a surgical centre.

5. Your recovery strategy

Where you go to recover soon after surgery can impact overall expenditures.

If you have surgery in a hospital, your insurance provider has most likely already factored in one or more overnight stays into a fixed-rate payment. This means that the insurance company pays the hospital the same amount regardless of how long you remain. Moreover, it also means you won’t have to worry about paying additional expenditures if your physicians recommend that you stay in the hospital for a day or two.

However, as previously said, if you have your surgery at a surgical centre, you will be discharge the same day. That means you’ll be returning home to begin your recovery unless you choose transitional care. Exercises and stretches in physical therapy helps in enhancing knee function and mobility. The frequency with which you see your physical therapist and the length of time you require physical treatment are also financial concerns.

Making the choice to get a knee replacement is a huge one. And it’s critical to know ahead of time how much your operation will cost so you can be prepare. If you want to know the best and affordable packages for knee replacement cost in India, book a live consultation at Lyfboat and get all answers to your queries.

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