Cost of Knee Replacement in Winston-Salem, NC – 2025 Complete Guide
Facing a knee replacement can be overwhelming—especially when you’re unsure about the cost. The cost of knee replacement in Winston-Salem, NC, can vary widely, and understanding what affects the price is key to making informed decisions. This 2025 guide uses data from trusted sources like the American Academy of Orthopaedic Surgeons, CMS.gov, and Healthcare Bluebook to help you navigate your options. Whether you’re insured, uninsured, or somewhere in between, this guide is tailored to your needs in the Winston-Salem area.
What is the average cost of knee replacement in Winston-Salem, NC?
The average cost of a total knee replacement in Winston-Salem, NC, ranges from $28,000 to $55,000, depending on the facility and insurance coverage. According to Healthcare Bluebook, the fair price for a total knee replacement in this region is approximately $36,000. However, costs can vary significantly based on whether the procedure is performed at a hospital or an outpatient surgical center.
CMS.gov data shows that Medicare reimburses hospitals in North Carolina an average of $17,000–$20,000 for knee replacement procedures, which can influence pricing for other payers. The American Academy of Orthopaedic Surgeons (AAOS) also notes that regional cost variations are common due to differences in provider fees, implant types, and facility charges.
Patients should also consider whether they are undergoing a partial or total knee replacement, as partial procedures tend to be less expensive. Always request a detailed cost breakdown from your provider to understand what’s included.
What factors affect the cost of knee replacement?
Several key factors influence the cost of knee replacement surgery in Winston-Salem. According to the American Association of Hip and Knee Surgeons (AAHKS), the type of procedure—partial versus total knee replacement—can significantly impact the price. Total replacements are generally more complex and costly.
Another major factor is the type of facility. Procedures done in outpatient surgical centers often cost less than those performed in hospitals. The surgeon’s experience, the type of implant used, and whether robotic assistance is involved also affect pricing. According to FairHealth.org, the use of advanced technology or premium implants can increase costs by several thousand dollars.
Insurance coverage, deductibles, and whether the provider is in-network also play a crucial role. Additional costs may include pre-operative imaging, physical therapy, and post-operative care. Always ask for a comprehensive estimate that includes all phases of care.
Does insurance cover knee replacement?
Yes, most insurance plans, including Medicare and private insurance, cover knee replacement surgery when deemed medically necessary. According to CMS.gov, Medicare Part A covers inpatient hospital costs, while Part B may cover outpatient services and pre-surgical consultations. Patients are typically responsible for deductibles, copays, and coinsurance.
Private insurance plans vary, but most cover the procedure if conservative treatments like physical therapy or injections have failed. The American Academy of Orthopaedic Surgeons notes that prior authorization is often required, and coverage may depend on whether the provider is in-network.
If you have Medicaid, coverage may be more limited and vary by state. North Carolina Medicaid typically covers knee replacement for eligible patients, but pre-approval is usually necessary. Always check with your insurance provider to understand your specific benefits and out-of-pocket responsibilities.
Are there payment plans or financing options available in Winston-Salem?
Yes, many orthopedic practices and surgical centers in Winston-Salem offer payment plans or financing options to help manage the cost of knee replacement. According to Healthcare Bluebook, providers often partner with third-party financing companies like CareCredit or offer in-house installment plans.
These options can be especially helpful for uninsured or underinsured patients. Some hospitals also offer income-based financial assistance or charity care programs. For example, Atrium Health Wake Forest Baptist provides financial counseling and may offer discounts based on household income and financial need.
Before committing to surgery, ask your provider about available financing options, interest rates, and repayment terms. It’s also wise to consult with a financial counselor at the facility to explore all available resources.
How does the cost in Winston-Salem compare to other North Carolina cities?
Winston-Salem’s knee replacement costs are generally in line with or slightly below other major cities in North Carolina. According to FairHealth.org, the average cost in Charlotte ranges from $30,000 to $60,000, while in Raleigh it can go as high as $65,000 depending on the facility and surgeon.
Greensboro, which is nearby, has similar pricing to Winston-Salem, with average costs ranging from $28,000 to $52,000. The American Academy of Orthopaedic Surgeons notes that urban centers often have higher costs due to increased demand and facility fees.
Patients willing to travel within the state may find lower-cost options, particularly in smaller towns or outpatient surgical centers. However, it’s important to balance cost with quality and convenience when choosing a provider.
What’s included in the knee replacement cost?
The total cost of knee replacement surgery typically includes several components. According to the American Association of Hip and Knee Surgeons, the bundled cost often covers the surgeon’s fee, anesthesia, hospital or surgical center charges, and the cost of the implant itself.
Additional expenses may include pre-operative imaging (such as X-rays or MRIs), lab tests, physical therapy, and post-operative medications. Healthcare Bluebook notes that some providers offer “bundled pricing,” which includes all services from pre-op to post-op care, while others bill each component separately.
Make sure to ask for an itemized estimate to understand what’s included and what may be billed separately. This is especially important for patients with high-deductible insurance plans or those paying out-of-pocket.
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 damage in your knee joint. According to the American Academy of Orthopaedic Surgeons, partial knee replacements are suitable for patients with damage confined to one compartment of the knee, while total replacements are necessary for more widespread arthritis or injury.
Partial knee replacements are generally less invasive and have a shorter recovery time. They also tend to cost less—typically between $20,000 and $35,000 in Winston-Salem, compared to $28,000 to $55,000 for a total knee replacement, based on data from Healthcare Bluebook.
Your orthopedic specialist will use imaging and physical exams to determine the most appropriate procedure. Always seek a second opinion if you’re unsure about the recommendation.
How long does the knee replacement process take?
The timeline for a knee replacement includes several phases: evaluation, preoperative preparation, surgery, and recovery. According to the American Association of Hip and Knee Surgeons, the entire process can span several months.
After your initial consultation, you may undergo physical therapy or other conservative treatments for 4–6 weeks. Once surgery is scheduled, pre-op testing and education usually occur within 2–3 weeks. The surgery itself takes about 1–2 hours, but you may stay in the hospital for 1–3 days, depending on your health and the surgical setting.
Post-operative recovery varies. Most patients begin walking with assistance the same day or next day. Full recovery can take 3–6 months, with physical therapy playing a crucial role. Outpatient surgery options may reduce hospital time and speed up recovery for eligible patients.
What is the success rate of knee replacement?
Knee replacement is one of the most successful orthopedic procedures. The American Academy of Orthopaedic Surgeons reports that over 90% of patients experience significant pain relief and improved mobility. Most implants last 15–20 years or longer, especially with advances in surgical techniques and materials.
According to peer-reviewed studies published by the Journal of Bone and Joint Surgery, patient satisfaction rates exceed 85%, particularly when patients follow post-operative rehabilitation protocols. Success is also influenced by factors like age, weight, activity level, and the presence of other medical conditions.
Choosing a board-certified orthopedic surgeon and adhering to a personalized recovery plan can significantly enhance your outcome. Discuss your goals and expectations with your provider to ensure the best possible results.
Are there affordable alternatives to knee replacement?
Yes, there are several non-surgical alternatives that may delay or eliminate the need for knee replacement. According to the American Academy of Orthopaedic Surgeons, these include physical therapy, weight loss, anti-inflammatory medications, corticosteroid injections, and hyaluronic acid injections.
Regenerative therapies like platelet-rich plasma (PRP) or stem cell injections are also gaining popularity, although they are often not covered by insurance and can be expensive. FairHealth.org notes that PRP injections can cost between $500 and $2,000 per session in North Carolina.
These options are typically best for patients with mild to moderate arthritis. If conservative treatments fail to provide relief, knee replacement may be the most effective long-term solution.