Knee Replacement Cost in San Francisco, CA – 2025 Complete Guide
Facing a knee replacement can be overwhelming—especially when you’re unsure about the cost. The cost of knee replacement in San Francisco, CA, can vary widely, leaving many patients anxious about affordability and coverage. In this 2025 guide, we break down everything you need to know using data from trusted medical authorities like the American Academy of Orthopaedic Surgeons, CMS.gov, and Fair Health. Whether you’re insured, uninsured, or somewhere in between, this article is designed to help you make informed decisions about your care in the Bay Area.
What is the average cost of knee replacement in San Francisco, CA?
The average cost of a total knee replacement in San Francisco ranges from $35,000 to $70,000, depending on the facility and type of procedure. According to Fair Health, the average out-of-pocket cost for an uninsured patient in the San Francisco area is approximately $45,000. For insured patients, out-of-pocket expenses can vary from $3,000 to $10,000 based on plan specifics and deductibles.
The Centers for Medicare & Medicaid Services (CMS.gov) reports that Medicare typically reimburses around $12,000 to $15,000 for a standard inpatient knee replacement, though this doesn’t include physician fees or post-operative care. Academic medical centers, such as UCSF Health, may charge on the higher end due to their advanced facilities and specialized care teams.
These costs reflect 2025 estimates and may vary based on hospital pricing transparency data and negotiated insurance rates.
What factors affect the cost of knee replacement?
Several factors can influence the total cost of a knee replacement procedure in San Francisco. These include the type of knee replacement (total vs. partial), the surgical setting (inpatient hospital vs. outpatient surgery center), and the surgeon’s experience. According to the American Academy of Orthopaedic Surgeons (AAOS), newer techniques like robotic-assisted surgery may increase costs but could offer improved precision and outcomes.
Additional cost drivers include anesthesia, imaging, physical therapy, and post-operative care. The American Hospital Association notes that geographic location also plays a significant role—urban centers like San Francisco often have higher facility fees and labor costs than rural areas.
Insurance coverage, deductible status, and whether the provider is in-network also significantly impact your final bill. Patients with high-deductible health plans may face higher upfront costs before insurance benefits apply.
Does insurance cover knee replacement?
Yes, most insurance plans—including Medicare, Medicaid, and private insurance—cover knee replacement surgery when deemed medically necessary. According to CMS.gov, Medicare Part A covers inpatient hospital costs, while Part B covers outpatient services and physician fees. Patients are typically responsible for deductibles, coinsurance, and any non-covered services.
Private insurers like Blue Shield of California and Kaiser Permanente offer coverage for knee replacement, but out-of-pocket costs can vary based on your plan’s network and benefits. The California Department of Insurance recommends that patients confirm pre-authorization requirements and obtain a detailed estimate from their provider before undergoing surgery.
Medicaid coverage is more limited and subject to eligibility and state-specific rules. In California, Medi-Cal may cover knee replacement, but patients may need to obtain prior approval and use designated providers.
Are there payment plans or financing options available in San Francisco?
Yes, many hospitals and orthopedic practices in San Francisco offer payment plans or financing options to help patients manage the cost of knee replacement. According to UCSF Health, patients can apply for financial assistance or set up interest-free monthly payment plans through their billing department.
Third-party financing companies like CareCredit and Alphaeon Credit are also commonly accepted by orthopedic providers. These options may offer deferred interest or extended payment terms, depending on credit approval. The Healthcare Financial Management Association (HFMA) recommends reviewing all terms carefully and comparing options before committing to a financing plan.
Some nonprofit hospitals in the Bay Area may offer sliding scale fees or charity care for qualifying low-income patients. Always ask your provider’s billing office about available programs before scheduling surgery.
How does the cost in San Francisco compare to other California cities?
San Francisco typically ranks among the most expensive cities in California for knee replacement surgery. According to Healthcare Bluebook, the fair price for a total knee replacement in San Francisco is approximately $48,000, compared to $42,000 in Los Angeles and $38,000 in Sacramento.
Higher facility fees, labor costs, and cost of living contribute to the elevated pricing in the Bay Area. The California Health Care Foundation reports that urban centers like San Francisco often have higher negotiated insurance rates than suburban or rural regions.
Patients willing to travel may find more affordable options in nearby cities like Oakland or San Jose, where outpatient surgery centers may offer competitive pricing without sacrificing quality.
What’s included in the knee replacement cost?
The total cost of a knee replacement generally includes several components: pre-operative consultations, imaging (such as X-rays or MRIs), the surgical procedure, anesthesia, hospital or facility fees, surgeon and assistant fees, and post-operative care like physical therapy. According to Fair Health, these bundled services can vary by provider and insurance plan.
Some facilities offer “global packages” that include all services from diagnosis through post-op rehab, which may reduce overall costs. The American Academy of Orthopaedic Surgeons notes that patients should ask for a detailed cost breakdown to understand what is and isn’t included—such as durable medical equipment (e.g., walkers or braces) or extended rehabilitation services.
Unexpected complications or extended hospital stays may result in additional charges, so it’s important to discuss potential scenarios with your care team in advance.
Do I need a partial or total knee replacement, and how much does it cost?
The type of knee replacement you need depends on the severity and location of joint damage. A total knee replacement involves replacing the entire joint, while a partial (unicompartmental) knee replacement targets only the damaged portion. According to the American Association of Hip and Knee Surgeons (AAHKS), partial replacements are typically recommended for younger patients with localized arthritis.
Cost-wise, partial knee replacements are generally less expensive. Fair Health reports that the average cost for a partial knee replacement in San Francisco is around $30,000–$50,000, compared to $35,000–$70,000 for a total replacement. However, not all patients are candidates for the partial procedure, and long-term outcomes may differ.
Your orthopedic surgeon will use imaging and physical exams to determine the most appropriate option for your condition and lifestyle.
How long does the knee replacement process take?
The entire knee replacement process—from initial consultation to full recovery—can take several months. According to UCSF Health, the surgical procedure itself typically lasts 1 to 2 hours. Most patients stay in the hospital for 1 to 3 days, although outpatient procedures are becoming more common.
Pre-operative preparation may take several weeks and include imaging, lab work, and physical assessments. Post-operative recovery varies but often includes 6 to 12 weeks of physical therapy. The American Academy of Orthopaedic Surgeons notes that most patients resume normal daily activities within 3 months, although full recovery may take up to a year.
Planning ahead for time off work, home support, and rehabilitation is essential for a successful outcome.
What is the success rate of knee replacement?
Knee replacement is one of the most successful orthopedic procedures. According to the American Association of Hip and Knee Surgeons, over 90% of total knee replacements are still functioning well 15 to 20 years after surgery. Success rates are even higher when patients follow post-operative care instructions and engage in physical therapy.
Factors that influence outcomes include the patient’s age, weight, activity level, and overall health. The Journal of Bone and Joint Surgery reports that patient satisfaction rates for knee replacement exceed 85%, with significant improvements in pain relief and mobility.
Choosing a board-certified orthopedic surgeon and a high-volume facility can also improve your chances of a successful outcome.
Are there affordable alternatives to knee replacement?
Yes, there are several non-surgical or less invasive alternatives to knee replacement, depending on the severity of your condition. According to the American Academy of Orthopaedic Surgeons, conservative treatments like physical therapy, corticosteroid injections, hyaluronic acid injections, and weight management can help manage symptoms of knee arthritis.
Platelet-rich plasma (PRP) therapy and stem cell injections are emerging options, though they are often not covered by insurance and can cost $1,000 to $5,000 per treatment. Bracing and assistive devices may also provide relief for some patients.
These alternatives are generally more affordable upfront but may not provide long-term relief for advanced joint damage. Your orthopedic specialist can help determine whether these options are appropriate based on imaging and symptom severity.
How can I find a qualified orthopedic surgeon in San Francisco?
To find a qualified orthopedic surgeon in San Francisco, start by checking credentials