Knee Replacement Cost in Philadelphia, PA – 2025 Complete Guide
Facing the possibility of knee replacement surgery can be overwhelming—especially when you’re unsure about the cost. The cost of knee replacement in Philadelphia, PA, can vary widely, and understanding what to expect financially is just as important as preparing for the procedure itself. This 2025 guide brings together trusted data from government sources, medical associations, and academic institutions to help you make informed decisions with confidence. Whether you’re insured, uninsured, or somewhere in between, this resource is designed to give you clarity in your healthcare journey.
What is the average cost of knee replacement in Philadelphia, PA?
The average cost of a total knee replacement in Philadelphia, PA, ranges from $25,000 to $55,000, depending on the facility, surgeon fees, and whether the procedure is inpatient or outpatient. According to Healthcare Bluebook, the fair price for a total knee replacement in the Philadelphia area is approximately $33,000. However, costs at academic medical centers or private hospitals may be higher due to specialized care and advanced surgical techniques.
The Centers for Medicare & Medicaid Services (CMS) reports that Medicare typically reimburses around $11,000 to $13,000 for knee replacement procedures, which can influence what private insurers and hospitals charge. FairHealth.org also notes that uninsured patients may face higher out-of-pocket costs unless they qualify for financial assistance programs.
Patients should also be aware that prices can vary significantly between hospitals and outpatient surgery centers in the region, so it’s essential to request itemized estimates before scheduling your procedure.
What factors affect the cost of knee replacement?
Several key factors influence the total cost of knee replacement surgery in Philadelphia. First, the type of procedure—whether it’s a total knee replacement or a partial (unicompartmental) replacement—can significantly affect pricing. The American Academy of Orthopaedic Surgeons (AAOS) notes that partial replacements are generally less expensive due to shorter surgery times and hospital stays.
Other cost drivers include the surgeon’s experience, the hospital or surgical facility chosen, anesthesia fees, and post-operative care such as physical therapy. According to the American Hospital Association, facility fees can account for nearly 60% of the total cost, especially in urban settings like Philadelphia.
Insurance coverage, implant type (standard vs. custom), and whether the procedure is performed on an inpatient or outpatient basis also play a role. Some Philadelphia-area hospitals now offer outpatient knee replacements, which can reduce costs by eliminating overnight stays.
Does insurance cover knee replacement?
Yes, most insurance plans—including Medicare, Medicaid, and private health insurance—cover knee replacement surgery when deemed medically necessary. According to CMS.gov, Medicare Part A typically covers inpatient hospital costs, while Part B covers outpatient services and physician fees. Patients with supplemental Medigap plans may have reduced out-of-pocket expenses.
Private insurers like Independence Blue Cross and Aetna also cover knee replacement procedures, but coverage levels and copays vary based on your specific plan. The American Academy of Orthopaedic Surgeons advises patients to verify preauthorization requirements and confirm network participation with both the surgeon and the facility.
Medicaid coverage in Pennsylvania includes knee replacement surgery, but patients may need to meet certain criteria and obtain prior approval. Always contact your insurance provider ahead of time to understand your benefits and potential out-of-pocket costs.
Are there payment plans or financing options available in Philadelphia?
Yes, many hospitals and orthopedic practices in Philadelphia offer payment plans or financing options for patients undergoing knee replacement surgery. According to the American Hospital Association, nearly 60% of U.S. hospitals now provide structured payment plans to help patients manage high out-of-pocket costs.
Major health systems in Philadelphia, such as Penn Medicine and Jefferson Health, offer financial counseling services to assist with payment arrangements. Some practices also partner with third-party medical financing companies like CareCredit, which allow patients to spread payments over several months or years, often with low or no interest for qualifying applicants.
Uninsured patients may qualify for income-based discounts or charity care programs. It’s recommended to speak with the hospital’s billing department or a financial counselor before your procedure to explore all available options.
How does the cost in Philadelphia compare to other Pennsylvania cities?
Philadelphia tends to have higher knee replacement costs compared to other cities in Pennsylvania, largely due to its concentration of academic medical centers and urban hospital systems. According to FairHealth.org, the average cost of a total knee replacement in Pittsburgh ranges from $22,000 to $48,000, while in smaller cities like Harrisburg or Allentown, the range is closer to $20,000 to $45,000.
The Pennsylvania Health Care Cost Containment Council (PHC4) reports that Philadelphia hospitals often charge more due to higher overhead, staffing costs, and the availability of advanced surgical technologies. However, patients may also benefit from access to nationally ranked orthopedic programs in the city.
If cost is a significant concern, some patients explore options in nearby suburban or rural hospitals, where facility fees and provider charges may be lower. Always weigh the potential savings against travel time, recovery logistics, and provider quality.
What’s included in the knee replacement cost?
The total cost of knee replacement typically includes several components: pre-operative consultations, imaging (such as X-rays or MRIs), the surgeon’s fee, anesthesia, hospital or surgical facility charges, the prosthetic implant, and post-operative care like physical therapy. According to Healthcare Bluebook, these bundled services are often priced together in a comprehensive package, especially for insured patients or those paying cash.
The American Academy of Orthopaedic Surgeons notes that physical therapy can add $1,000 to $3,000 to the overall cost, depending on the duration and frequency of sessions. Implant costs alone can range from $4,000 to $8,000, influenced by the type and brand used.
Patients should request a detailed, itemized estimate to understand what is and isn’t included—especially when comparing prices between facilities. Some hospitals in Philadelphia offer all-inclusive pricing for self-pay patients, which can simplify budgeting and reduce unexpected bills.
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. Partial knee replacement is typically recommended when arthritis or injury affects only one compartment of the knee. According to the American Association of Hip and Knee Surgeons (AAHKS), partial replacements result in quicker recovery and less post-op pain but are only suitable for about 10–15% of patients.
Cost-wise, partial knee replacements are generally less expensive. FairHealth.org reports that the average cost for a partial knee replacement in Philadelphia ranges from $20,000 to $40,000, compared to $25,000 to $55,000 for a total replacement.
Your orthopedic surgeon will use imaging and clinical evaluation to determine the best surgical option. Choosing the appropriate procedure not only affects your recovery but also your long-term outcome and cost.
How long does the knee replacement process take?
The entire knee replacement process—from initial consultation to full recovery—can span several months. The surgery itself typically takes 1 to 2 hours. According to the American Academy of Orthopaedic Surgeons, most patients stay in the hospital for 1 to 3 days, although outpatient procedures are becoming more common in Philadelphia.
Pre-operative preparation may take 2–4 weeks and includes imaging, lab work, and medical clearance. Post-operative recovery varies by individual but generally involves 6 to 12 weeks of physical therapy. Full recovery, including return to normal activities, can take up to 6 months.
Some Philadelphia hospitals offer enhanced recovery after surgery (ERAS) protocols that aim to shorten hospital stays and improve outcomes. Be sure to ask your provider about the expected timeline based on your health status and surgical plan.
What is the success rate of knee replacement?
Knee replacement surgery is considered highly successful, with most patients experiencing significant pain relief and improved mobility. The American Association of Hip and Knee Surgeons reports that over 90% of total knee replacements are still functioning well 15 years after surgery.
Success rates in Philadelphia align with national averages, particularly at high-volume centers like Penn Medicine and Rothman Orthopaedic Institute. According to a study published in The Journal of Bone and Joint Surgery, patients treated at specialized orthopedic centers tend to have fewer complications and better long-term outcomes.
Factors that influence success include the surgeon’s experience, patient adherence to rehab, and overall health. Discuss your individual risk factors and expected outcomes with your orthopedic specialist to set realistic expectations.
Are there affordable alternatives to knee replacement?
Yes, several non-surgical and minimally invasive treatments may help manage knee pain before considering replacement. These include physical therapy, corticosteroid injections, hyaluronic acid injections, platelet-rich plasma (PRP) therapy, and lifestyle modifications such as weight loss and low-impact exercise.
According to the American Academy of Orthopaedic Surgeons, these treatments can delay or even eliminate the need for surgery in early to moderate cases of osteoarthritis. Costs vary: physical therapy may cost $100–$200