Knee Replacement Cost in Cleveland, OH – 2025 Complete Guide
Facing the cost of knee replacement in Cleveland, OH can feel overwhelming—especially when you’re already dealing with pain and mobility issues. In 2025, understanding what you might pay for this life-changing procedure is more important than ever. This guide pulls together the most up-to-date information from trusted sources like the American Academy of Orthopaedic Surgeons, CMS.gov, and Healthcare Bluebook to help you make informed decisions. Whether you’re insured, uninsured, or somewhere in between, we’re here to break it all down in plain language.
What is the average cost of knee replacement in Cleveland, OH?
The average cost of a total knee replacement in Cleveland, OH ranges from $25,000 to $55,000, depending on the facility, surgeon, and insurance coverage. According to Healthcare Bluebook, the fair price for a knee replacement in the Cleveland area is approximately $32,000 in 2025. However, this can vary significantly based on whether the procedure is performed in a hospital or outpatient surgical center.
CMS.gov data shows that Medicare typically reimburses hospitals around $13,000 to $17,000 for knee replacements, which may be lower than the total billed amount. Private insurance often negotiates rates that fall somewhere between Medicare rates and full charges. The Cleveland Clinic and University Hospitals—two major medical centers in the region—offer bundled payment options that can influence the total cost.
Ultimately, the cost you pay will depend on your insurance plan, the facility you choose, and whether you need additional services like physical therapy or imaging.
What factors affect the cost of knee replacement?
Several key factors influence the total cost of a knee replacement in Cleveland, OH. First, the type of facility—hospital vs. ambulatory surgical center—can make a significant difference. According to the American Academy of Orthopaedic Surgeons (AAOS), outpatient procedures tend to be less expensive due to lower facility fees.
Second, the complexity of your case matters. A standard total knee replacement will cost less than a revision surgery or a bilateral procedure. The presence of comorbidities like diabetes or obesity can also increase costs due to the need for additional care and monitoring.
Third, your insurance coverage plays a major role. The Cleveland Clinic notes that patients with high-deductible plans or limited out-of-network benefits may face higher out-of-pocket expenses. Other cost drivers include surgeon fees, anesthesia, imaging, pre-op testing, and post-operative physical therapy.
Finally, geographic variations and market competition in Cleveland can affect pricing. Larger health systems may offer bundled pricing or discounts for self-pay patients.
Does insurance cover knee replacement?
Yes, most insurance plans—including Medicare, Medicaid, and private insurance—typically cover medically necessary knee replacement surgery. According to CMS.gov, Medicare Part B covers 80% of approved costs after the deductible is met, while the remaining 20% is the patient’s responsibility unless they have supplemental coverage.
Private insurance plans vary in their coverage, but most will cover knee replacement if conservative treatments like physical therapy or injections have failed. The American Association of Hip and Knee Surgeons (AAHKS) advises patients to obtain preauthorization from their insurer to confirm coverage and understand their financial responsibility.
Medicaid coverage in Ohio also includes knee replacement, though prior authorization and proof of medical necessity are typically required. Be sure to check with your insurance provider and the surgical facility in Cleveland to get a detailed breakdown of what’s covered and what’s not.
Are there payment plans or financing options available in Cleveland?
Yes, many hospitals and orthopedic practices in Cleveland offer payment plans and financing options for knee replacement surgery. According to the Cleveland Clinic, patients can apply for interest-free payment plans through their billing department, often extending payments over 6 to 24 months.
Additionally, third-party healthcare financing companies like CareCredit and Alphaeon Credit are widely accepted in the region. These services allow patients to finance medical procedures with deferred interest or fixed monthly payments, depending on credit approval.
Some providers also offer self-pay discounts or bundled pricing for uninsured patients. University Hospitals in Cleveland, for example, has financial assistance programs for qualifying low-income individuals. It’s important to ask your provider about all available options before scheduling surgery to avoid unexpected bills.
How does the cost in Cleveland compare to other Ohio cities?
Compared to other major cities in Ohio, the cost of knee replacement in Cleveland is generally in the mid-to-high range. According to FairHealth.org, the average cost in Columbus is slightly lower, ranging from $24,000 to $50,000, while Cincinnati’s costs are comparable to Cleveland’s, often between $26,000 and $55,000.
Smaller cities and rural areas in Ohio may offer lower prices due to reduced facility fees and less overhead. However, these locations may not have access to advanced surgical techniques or top-tier orthopedic specialists. The American Hospital Association notes that urban centers like Cleveland often have higher costs but also provide access to specialized care and advanced technology.
Ultimately, the decision may come down to balancing cost with quality and convenience. Traveling for a lower-cost procedure may save money but could complicate follow-up care and rehabilitation.
What’s included in the knee replacement cost?
The total cost of knee replacement surgery typically includes several components: surgeon’s fees, anesthesia, facility fees, pre-operative testing, post-operative care, and physical therapy. According to Healthcare Bluebook, these bundled services are often included in a comprehensive quote, especially at facilities offering bundled pricing.
Surgeon fees in Cleveland usually range from $2,500 to $5,000, while anesthesia services may add another $1,000 to $2,000. Facility fees—especially in hospitals—can be the largest portion, ranging from $10,000 to $30,000. Post-operative physical therapy, which is essential for recovery, may cost an additional $1,500 to $3,000 if not fully covered by insurance.
Some providers offer “global billing” or bundled packages that include all services from pre-op to rehab. The American Academy of Orthopaedic Surgeons recommends asking for a detailed cost breakdown to understand what’s included and what might be billed separately.
Do I need a partial or total knee replacement, and how much does it cost?
Whether you need a partial or total knee replacement depends on the extent of joint damage. According to the American Association of Hip and Knee Surgeons, partial knee replacement is suitable when only one compartment of the knee is affected, often due to localized osteoarthritis.
Partial knee replacement is generally less invasive, with a shorter recovery time and lower cost—typically ranging from $18,000 to $30,000 in Cleveland. In contrast, total knee replacement, which involves replacing all joint surfaces, can cost between $25,000 and $55,000, as noted by Healthcare Bluebook and CMS.gov data.
Your orthopedic surgeon will determine the most appropriate procedure based on imaging studies and physical examination. While partial replacements are less expensive, they may not be suitable for patients with widespread arthritis or joint deformity.
How long does the knee replacement process take?
The full knee replacement process—from initial consultation to full recovery—can take several months. According to the Cleveland Clinic, the surgical procedure itself typically lasts 1 to 2 hours. Most patients stay in the hospital or surgical center for 1 to 2 days, although some outpatient procedures allow same-day discharge.
Pre-surgical preparation, including diagnostic imaging, lab tests, and physical evaluations, may take several weeks. After surgery, the initial recovery period lasts about 6 to 12 weeks, during which physical therapy plays a critical role. Full recovery, including return to normal activities, can take 3 to 6 months depending on age, health status, and adherence to rehab protocols.
Planning ahead for time off work, transportation, and home modifications can help ensure a smoother recovery process.
What is the success rate of knee replacement?
Knee replacement surgery has a high success rate, with most patients experiencing significant pain relief and improved mobility. According to the American Academy of Orthopaedic Surgeons, more than 90% of total knee replacements are still functioning well 10 to 15 years after surgery.
In Cleveland, major institutions like University Hospitals and the Cleveland Clinic report outcomes that align with or exceed national averages. Factors that influence success include the surgeon’s experience, the patient’s overall health, and post-operative rehabilitation adherence.
Complication rates are low but can include infection, blood clots, or implant loosening. The American Board of Orthopaedic Surgery recommends choosing a board-certified orthopedic surgeon to optimize your chances of a successful outcome.
Are there affordable alternatives to knee replacement?
Yes, several non-surgical treatments may provide relief for knee pain before considering replacement. According to the American Academy of Orthopaedic Surgeons, options include physical therapy, corticosteroid injections, hyaluronic acid injections, and platelet-rich plasma (PRP) therapy.
These treatments vary in cost and effectiveness. For example, corticosteroid injections typically cost $100 to $300 per session, while PRP injections may cost $500 to $1