Title:
Knee Replacement Cost in Raleigh, NC – 2025 Complete Guide
Introduction:
Facing the possibility of knee replacement surgery can be overwhelming—especially when you’re unsure about the costs involved. If you’re wondering about the cost of knee replacement in Raleigh, NC, you’re not alone. Many patients are concerned about affordability, insurance coverage, and what to expect financially. We’ve sourced data from trusted medical and healthcare pricing authorities to bring you a clear, up-to-date guide for 2025.
What is the average cost of knee replacement in Raleigh, NC?
The average cost of a total knee replacement in Raleigh, NC typically ranges from $30,000 to $55,000, depending on the facility, surgeon fees, and insurance coverage. According to Healthcare Bluebook, the “fair price” for a knee replacement in the Raleigh area is approximately $36,000 for an inpatient procedure. However, outpatient procedures—now more common—can sometimes be more cost-effective.
CMS.gov data from Medicare claims shows that the national average for inpatient knee replacement surgery is around $31,000, but local costs can be higher due to facility fees and regional demand. Academic centers like Duke Health and UNC Health in nearby cities may also have different pricing structures based on their teaching hospital status.
What factors affect the cost of knee replacement?
Several variables influence the total cost of a knee replacement. The type of procedure—partial vs. total knee replacement—has a major impact. According to the American Academy of Orthopaedic Surgeons (AAOS), partial replacements are generally less expensive and involve shorter recovery times.
Other cost factors include the surgeon’s fees, anesthesia, hospital or surgical center charges, and the type of implant used. The American Association of Hip and Knee Surgeons (AAHKS) notes that newer, custom implants or robotic-assisted surgeries may increase costs.
Additionally, whether the procedure is performed on an inpatient or outpatient basis can significantly alter the price. Outpatient knee replacements, often done in ambulatory surgical centers, tend to be less expensive due to reduced facility fees.
Does insurance cover knee replacement surgery?
Most health insurance plans, including Medicare and private insurers, do cover knee replacement surgery when deemed medically necessary. According to CMS.gov, Medicare Part A covers inpatient hospital stays, while Part B covers outpatient services and doctor visits related to the surgery.
Private insurance coverage varies by plan. Pre-authorization is usually required, and you may be responsible for deductibles, co-pays, or coinsurance. FairHealth.org recommends checking with your insurer to understand your specific out-of-pocket costs and network restrictions.
Medicaid coverage in North Carolina may also include knee replacement, but eligibility and coverage details should be confirmed with the North Carolina Department of Health and Human Services.
Are there payment plans or financing options available in Raleigh?
Yes, many Raleigh-area hospitals and orthopedic clinics offer payment plans or third-party financing for knee replacement surgery. According to Duke Health, patients can apply for financial assistance or set up monthly payment plans based on income and need.
Additionally, third-party financing companies like CareCredit or Alphaeon Credit partner with providers to offer low- or no-interest payment options. Some facilities may also offer sliding scale fees or charity care programs for uninsured or underinsured patients.
It’s important to ask the billing department of your chosen provider about available financial assistance programs before scheduling your procedure.
How does the cost in Raleigh compare to other North Carolina cities?
The cost of knee replacement in Raleigh is generally comparable to other urban centers in North Carolina but may be higher than in rural areas. According to Healthcare Bluebook, the fair price in Charlotte is around $35,000, while in Greensboro it may be slightly lower at $33,000.
Raleigh’s higher costs can be attributed to a concentration of advanced medical centers and higher living expenses. However, the presence of academic hospitals like UNC Health and Duke Health in the Triangle area may offer more options for financial assistance or clinical trials, which could reduce patient costs.
What’s included in the knee replacement cost?
The total cost of knee replacement generally includes several components: surgeon’s fees, anesthesia, hospital or surgical center charges, pre-operative testing, post-operative care, and physical therapy. According to the American Academy of Orthopaedic Surgeons, post-surgical rehabilitation is a critical part of recovery and may be billed separately.
Some providers offer bundled pricing, which includes all services from initial consultation through post-operative follow-up. FairHealth.org notes that bundled care models can help patients better understand and manage their total financial responsibility.
Always ask for a detailed cost breakdown from your provider to avoid unexpected charges.
Do I need physical therapy, and how much does it cost?
Yes, physical therapy is essential after knee replacement surgery to restore mobility and strength. According to the American Physical Therapy Association, most patients require 6 to 12 weeks of therapy, with sessions 2–3 times per week.
The cost per session in Raleigh ranges from $100 to $250, depending on the facility and whether insurance covers it. Medicare and many private insurers cover physical therapy, but co-pays may apply. According to CMS.gov, Medicare Part B covers 80% of the approved amount for outpatient therapy after the deductible is met.
Some Raleigh providers offer in-home or virtual physical therapy, which may be more convenient and cost-effective.
How long does the knee replacement process take?
The entire knee replacement process—from evaluation to full recovery—can take 3 to 6 months. The surgical procedure itself typically lasts 1 to 2 hours, followed by a hospital stay of 1 to 3 days for inpatient procedures, or same-day discharge for outpatient surgeries.
According to the American Association of Hip and Knee Surgeons, most patients begin walking with assistance within 24 hours and start physical therapy immediately. Full recovery and return to normal activity levels can take up to 6 months, depending on age, health status, and adherence to rehab protocols.
What is the success rate of knee replacement surgery?
Knee replacement is one of the most successful orthopedic procedures. According to the American Academy of Orthopaedic Surgeons, over 90% of patients experience significant pain relief and improved mobility after surgery.
Long-term outcomes are also favorable. The American Association of Hip and Knee Surgeons reports that 90–95% of knee implants last 10 to 15 years, and many last even longer with proper care. Factors that affect success include the patient’s overall health, weight, activity level, and adherence to post-operative care.
Are there affordable alternatives to knee replacement?
Yes, several non-surgical options may help delay or avoid knee replacement. According to the AAOS, alternatives include physical therapy, corticosteroid injections, hyaluronic acid injections, weight loss, and medications like NSAIDs.
Regenerative treatments such as platelet-rich plasma (PRP) or stem cell therapy are also being explored, though they are often not covered by insurance and can be costly. According to a 2022 study published in the Journal of Orthopaedic Research, these therapies show promise but are not yet standard care.
Discuss these options with your orthopedic specialist to determine the most appropriate treatment for your condition and budget.
How can I find a qualified orthopedic surgeon in Raleigh?
To ensure the best outcome, look for a board-certified orthopedic surgeon with experience in knee replacement. The American Board of Orthopaedic Surgery allows you to verify credentials online. You can also check with the North Carolina Medical Board for licensing and disciplinary records.
Hospitals like UNC Rex Healthcare, WakeMed, and Duke Raleigh Hospital have orthopedic departments with surgeons who specialize in joint replacement. Patient reviews, hospital ratings, and referral from your primary care physician can also help guide your decision.
What is the recovery like after knee replacement?
Recovery from knee replacement involves a combination of rest, physical therapy, and gradual return to daily activities. According to the AAOS, most patients can resume normal activities like walking and driving within 4 to 6 weeks, though full recovery may take up to 6 months.
During the first few weeks, you may need assistive devices like a walker or cane. Pain and swelling are common but manageable with medication and therapy. Long-term, most patients report significant improvements in pain, mobility, and quality of life.
Conclusion: