Knee Replacement Cost in San Diego, CA – 2025 Complete Guide
Facing knee replacement surgery can be overwhelming—especially when you’re unsure about the cost. The cost of knee replacement in San Diego, CA, varies widely, leaving many patients uncertain about what to expect. This 2025 guide brings together trusted data from leading medical associations and government sources to help you make informed decisions. Whether you’re planning ahead or urgently seeking care, this resource is tailored to the San Diego area and up-to-date for 2025.
What is the average cost of knee replacement in San Diego, CA?
The average cost of a total knee replacement in San Diego, CA, ranges from $30,000 to $65,000, depending on several factors including hospital choice, insurance coverage, and whether the procedure is inpatient or outpatient. According to Healthcare Bluebook, the fair price for a total knee replacement in the San Diego region is approximately $36,000. However, costs can rise significantly in private hospitals or when complications occur.
The Centers for Medicare & Medicaid Services (CMS.gov) reports that Medicare reimburses around $12,000–$15,000 for a knee replacement, which is often less than what private insurers or uninsured patients pay. Academic institutions like UC San Diego Health may offer bundled pricing or financial assistance programs, which can slightly reduce the overall cost.
Patients should always request a detailed cost estimate from their provider, as pricing can vary even within the same ZIP code due to facility fees, surgeon fees, and implant choices.
What factors affect the cost of knee replacement?
Several variables influence the total cost of knee replacement surgery in San Diego. According to the American Academy of Orthopaedic Surgeons (AAOS), key factors include the type of knee replacement (partial vs. total), the setting (inpatient vs. outpatient), and the type of implant used. Surgeon experience and hospital reputation also play a role in pricing.
Geographic location within San Diego County can affect facility fees. For example, private hospitals in La Jolla may charge more than community hospitals in East County. The American Hospital Association notes that facility fees, anesthesia, imaging, and physical therapy services can significantly impact the final bill.
Insurance coverage, deductible status, and whether the provider is in-network also influence out-of-pocket costs. Patients with high-deductible health plans may face higher upfront expenses. Additionally, pre-existing conditions or the need for additional imaging or lab work can increase the total cost.
Does insurance cover knee replacement?
Yes, most insurance plans—including Medicare, Medicaid, and private insurers—typically cover knee replacement surgery when deemed medically necessary. According to CMS.gov, Medicare Part A covers inpatient hospital stays and surgery, while Part B covers outpatient services and post-operative care like physical therapy.
Private insurance plans vary, but most will cover the procedure if conservative treatments (like physical therapy or injections) have failed. The American Association of Hip and Knee Surgeons (AAHKS) notes that prior authorization is often required, and patients may need to meet specific clinical criteria before approval.
Out-of-pocket costs depend on your plan’s deductible, coinsurance, and whether your provider is in-network. It’s essential to contact your insurance company beforehand to confirm coverage details and obtain a pre-authorization if needed.
Are there payment plans or financing options available in San Diego?
Yes, many hospitals and orthopedic clinics in San Diego offer payment plans or financing options to help manage the cost of knee replacement surgery. According to Scripps Health, patients can apply for interest-free payment plans or third-party financing programs like CareCredit, especially if they are uninsured or underinsured.
Nonprofit hospitals may also offer income-based financial assistance programs. UC San Diego Health, for example, provides financial counseling and sliding-scale fees for qualifying patients. Additionally, some providers offer bundled pricing, which includes pre-op, surgery, and post-op care in one fixed cost, making it easier to budget.
It’s crucial to ask about financing during your initial consultation, as terms and eligibility can vary by provider. Always request a written estimate and clarify what services are included in the payment plan.
How does the cost in San Diego compare to other California cities?
The cost of knee replacement in San Diego is generally higher than in smaller California cities but comparable to other major metropolitan areas like Los Angeles and San Francisco. According to FairHealth.org, the average cost in San Diego is around $36,000, while in Fresno or Bakersfield, the same procedure might cost closer to $28,000–$32,000.
Los Angeles and San Francisco often have higher facility fees, pushing the average cost above $40,000. However, rural areas may have fewer orthopedic specialists, which can limit access to competitive pricing. The California Health Care Foundation notes that urban centers like San Diego offer more options for bundled pricing and outpatient surgery centers, which may reduce costs for some patients.
Patients willing to travel may find lower prices in nearby cities, but should weigh that against the convenience and continuity of local care.
What’s included in the knee replacement cost?
The total cost of knee replacement typically includes several components: pre-operative consultations, imaging (like X-rays or MRIs), the surgical procedure, anesthesia, hospital or surgical center fees, the implant itself, and post-operative care such as physical therapy. According to the American Academy of Orthopaedic Surgeons (AAOS), these bundled services can vary by provider and setting.
Some San Diego providers offer all-inclusive pricing packages that cover everything from pre-op assessments to follow-up visits. However, not all costs may be included—lab tests, durable medical equipment (like walkers), and extended rehabilitation may be billed separately.
Patients should ask for a detailed breakdown of what’s included in the quoted price. This helps avoid unexpected bills and ensures a more accurate understanding of total financial responsibility.
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 replacements are typically recommended when arthritis is limited to one compartment of the knee. According to the American Association of Hip and Knee Surgeons (AAHKS), partial replacements often result in quicker recovery and less post-operative pain.
Cost-wise, partial knee replacements are generally less expensive. Healthcare Bluebook estimates the fair price for a partial knee replacement in San Diego at around $28,000, compared to $36,000 for a total replacement. However, not all patients are candidates for the partial procedure.
Your orthopedic surgeon will use imaging and clinical evaluation to determine the best option. Choosing the right type of surgery can impact both your recovery and long-term joint function, so it’s essential to discuss all options thoroughly.
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 American Academy of Orthopaedic Surgeons (AAOS), the surgery itself typically lasts 1–2 hours. Most patients stay in the hospital for 1–3 days, although outpatient procedures are increasingly common in San Diego.
Pre-operative preparation may include physical therapy, lab work, and medical clearance, which can take 2–4 weeks. Post-surgery, most patients begin walking with assistance within 24 hours and start physical therapy immediately. Full recovery usually takes 3–6 months, depending on age, overall health, and adherence to rehab protocols.
San Diego providers like Scripps Health and UC San Diego Health offer enhanced recovery programs that may shorten hospital stays and improve outcomes.
What is the success rate of knee replacement?
Knee replacement surgery is highly effective, with success rates exceeding 90%. According to the American Association of Hip and Knee Surgeons (AAHKS), more than 90% of knee replacements are still functioning well 10–15 years after surgery. Advances in surgical techniques and implant materials have contributed to improved outcomes and longevity.
In San Diego, top-tier hospitals report outcomes that are consistent with or better than national averages. UC San Diego Health, for example, uses robotic-assisted surgery to enhance precision, which may contribute to better alignment and longer-lasting results.
Patient satisfaction is also high, with most individuals reporting significant pain relief and improved mobility. However, outcomes depend on factors like surgeon experience, patient health, and adherence to rehabilitation protocols.
Are there affordable alternatives to knee replacement?
Yes, there are several non-surgical alternatives that may delay or eliminate the need for knee replacement. These include physical therapy, weight loss, corticosteroid injections, hyaluronic acid injections, and regenerative therapies like platelet-rich plasma (PRP). According to the American Academy of Orthopaedic Surgeons (AAOS), these treatments can be effective for early to moderate osteoarthritis.
In San Diego, many orthopedic clinics offer these services, often at a lower cost than surgery. For example, a single corticosteroid injection may cost $100–$300, while PRP therapy ranges from $500–$1,500 per session. These treatments are usually not covered by insurance, especially regenerative options.