Knee Replacement Cost in Chicago, IL – 2025 Complete Guide
Facing the possibility of knee replacement surgery can be overwhelming—especially when it comes to understanding the costs involved. If you’re wondering about the cost of knee replacement in Chicago, IL, you’re not alone. Many patients are concerned about affordability, insurance coverage, and what’s included in the total price.
We’ve sourced data from trusted medical authorities, including the American Academy of Orthopaedic Surgeons, CMS.gov, Healthcare Bluebook, and FairHealth.org, to bring you the most accurate and up-to-date information for 2025. This guide is tailored specifically for patients in the Chicago area.
What is the average cost of knee replacement in Chicago, IL?
The average cost of a total knee replacement in Chicago, IL, ranges from $30,000 to $55,000, depending on various factors such as hospital choice, surgeon fees, and insurance coverage. According to Healthcare Bluebook, the fair price for a knee replacement in the Chicago area is approximately $36,000 for an inpatient procedure. However, costs can be significantly higher at private hospitals or if complications arise.
CMS.gov data from 2024 shows that Medicare reimburses hospitals in Illinois an average of $17,500 to $20,000 for knee replacement procedures, which may reflect lower negotiated rates for insured patients. Patients without insurance or with high-deductible plans may face higher out-of-pocket costs.
Local factors such as hospital location, surgeon reputation, and facility type (academic vs. private) can also influence pricing. Urban centers like Chicago often have higher costs than rural areas due to increased overhead and demand.
What factors affect the cost of knee replacement?
Several key elements influence the total cost of a knee replacement procedure. According to the American Academy of Orthopaedic Surgeons (AAOS), these include:
- Type of surgery: Total vs. partial knee replacement
- Hospital setting: Inpatient hospital, outpatient surgical center, or academic medical center
- Surgeon fees: Based on experience, specialization, and demand
- Implant type: Custom or advanced prosthetics may cost more
- Pre- and post-operative care: Imaging, lab work, physical therapy
FairHealth.org reports that hospital facility fees can account for up to 60% of the total cost. Anesthesia, imaging (like MRI or X-rays), and physical therapy can add several thousand dollars to the final bill.
Additionally, patient-specific factors such as overall health, presence of comorbidities (e.g., diabetes, obesity), and recovery time may increase costs due to extended hospital stays or complications.
Does insurance cover knee replacement?
Yes, most major insurance plans, including Medicare, Medicaid, and private insurance, typically 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 related to the procedure.
The American Association of Hip and Knee Surgeons (AAHKS) notes that private insurance plans often require pre-authorization and may have specific criteria, such as documented failure of conservative treatments (e.g., physical therapy, injections) before approving surgery.
Out-of-pocket costs will vary depending on your deductible, co-insurance, and whether your provider is in-network. Patients with high-deductible health plans may pay more upfront, even if the procedure is covered.
Are there payment plans or financing options available in Chicago?
Yes, many hospitals and orthopedic practices in Chicago offer financing options or payment plans to help patients manage the cost of knee replacement surgery. According to Northwestern Medicine, patients can apply for financial assistance or set up interest-free payment plans for up to 12 months, depending on eligibility.
Third-party medical financing companies like CareCredit and Alphaeon Credit also partner with providers in the Chicago area to offer extended payment plans, sometimes with deferred interest for qualified applicants.
Additionally, some nonprofit hospitals in Chicago provide income-based discounts or charity care programs. It’s advisable to speak with a hospital billing representative or financial counselor before scheduling surgery to explore all available options.
How does the cost in Chicago compare to other Illinois cities?
Chicago tends to have higher healthcare costs compared to smaller cities in Illinois. According to Healthcare Bluebook, the average fair price for a knee replacement in Peoria or Springfield is approximately $30,000 to $34,000, while in Chicago, the same procedure averages $36,000 to $40,000.
This price difference is largely due to higher overhead, labor costs, and demand in urban medical centers. Academic hospitals in Chicago, such as Rush University Medical Center and University of Chicago Medicine, may also charge more due to their specialized services and teaching responsibilities.
However, patients in rural areas may have fewer options and may need to travel to larger cities like Chicago for specialized care, which can add to indirect costs like lodging and transportation.
What’s included in the knee replacement cost?
The total cost of a knee replacement typically includes several components. According to FairHealth.org and the AAOS, these may include:
- Pre-operative care: Consultations, imaging (X-rays/MRI), lab tests
- Surgical procedure: Surgeon’s fee, anesthesia, operating room costs
- Implant: Artificial knee joint and related materials
- Hospital stay: Room charges, nursing care, medications
- Post-operative care: Physical therapy, follow-up visits, pain management
According to CMS.gov, Medicare bundles many of these services under a single payment model called the Comprehensive Care for Joint Replacement (CJR), which encourages hospitals to coordinate care and reduce unnecessary costs.
Always ask your provider for a detailed cost breakdown to understand what is and isn’t included in your quote.
Do I need additional procedures, and how much do they cost?
Some patients may require additional procedures before or after knee replacement surgery. These could include:
- Arthroscopy: To assess joint damage before surgery (cost: $5,000–$7,000)
- Physical therapy: Essential for recovery (cost: $100–$350 per session)
- Revision surgery: If the implant fails, costs can exceed $60,000
According to the American Board of Orthopaedic Surgery, about 10% of patients may need a revision surgery within 10–15 years. Preoperative procedures like injections or bracing may also be recommended, depending on the severity of joint degeneration.
Discuss all possible procedures with your orthopedic surgeon to avoid unexpected costs.
How long does the knee replacement process take?
The entire knee replacement process—from evaluation to full recovery—can take several months. According to the AAOS, the typical timeline is:
- Pre-surgical evaluation: 2–4 weeks
- Surgery and hospital stay: 1–3 days
- Initial recovery: 6–12 weeks
- Full recovery: Up to 6 months
Most patients begin walking with assistance within 24 hours post-surgery and can resume daily activities within 6 weeks. However, full strength and mobility may take several months to regain, especially for older adults or those with pre-existing conditions.
Post-operative physical therapy is critical and may last 6–12 weeks, depending on progress.
What is the success rate of knee replacement?
Knee replacement surgery is considered highly successful. According to the American Academy of Orthopaedic Surgeons, more than 90% of patients experience significant pain relief and improved mobility after surgery.
The American Association of Hip and Knee Surgeons reports that over 90% of knee implants last 15–20 years, especially with modern surgical techniques and materials. Success is measured by pain reduction, restored function, and patient satisfaction.
Factors that influence success include the surgeon’s experience, patient compliance with rehabilitation, and overall health. Smokers, diabetics, and individuals with obesity may face higher complication rates.
Are there affordable alternatives to knee replacement?
Yes, several non-surgical treatments may delay or reduce the need for knee replacement. According to the AAOS and Mayo Clinic, these include: