Hip Replacement Cost - Medicare & The Price Of Surgery

By: Edward Neeman
Published: Monday, November 26 2018
Last Updated: 19 days ago

Hip replacement surgery is considered a common procedure, with more than 300,0000 people getting a hip replacement each year in the United States alone. The surgery is performed for a number of health conditions, including hip fractures and osteoarthritis. Many people who qualify for this surgery find their joint is stiff and painful. This limits the range of motion the joint can achieve and reduces the ability to perform daily activities.

Hip replacement is the procedure chosen when a less invasive option will not improve existing damage to the hip joint. The cost of hip replacement surgery can get pretty expensive, but just how badly will it hit your pocket? Before getting into coverage options and pricing, let’s take a deeper look at what the surgery entails.

What Does Hip Replacement Surgery Entail?

Hip replacement surgery is a process where a surgeon removes an injured or painful hip joint, which is then replaced by an artificial hip joint. This artificial hip joint can be made of plastic or metal components depending on the surgeon's recommendations and the needs of the patient. Typically, this surgery is performed when other treatment methods are unable to provide pain relief that allows the person to perform daily activities.

Hip replacement surgery can be performed using two different approaches. The first approach is considered minimally-invasive and is performed using a laparoscopic method. The second approach uses the standard replacement method. The primary difference between the procedures is the size of the incision and the resulting scar.

The standard procedure is performed under general anesthesia. In some cases, patients are given a spinal anesthesia as well to prevent any pain experienced during the procedure, and for a duration of time after the procedure is done. The surgical approach will depend greatly on the amount of damage that exists inside of the hip joint and will be decided by the surgeon. Their plan may change during the procedure to accommodate any new information they obtain during the exploratory portion of the surgery.

Is It Common?

Hip replacement is a very common procedure, especially in the aging population. Over 300,000 hip replacements are performed in the United States each year. The surgery is more popular in those who are over 65 years of age.

How Much Will Hip Replacement Cost You?

The average hip replacement cost was last reported to be approximately $30,124. This includes the cost of surgery, hospitalization, and the cost of post-surgical rehabilitation. In some states, hip replacement cost is much lower. For example, in the state of Alabama, the overall hip replacement cost is close to $16,000. However, in states like New York, the overall cost can be as high as $60,000.

Keep in mind when you are researching hip replacement costs that these figures include total cost, and are not a representation of out-of-pocket expense.

Additional Costs

When you have any surgery, you should always expect to incur costs that were not brought up previously by your doctor. These costs could be associated with your hospital stay, physical therapy, or a stay in a rehabilitation center. Depending on your condition, you may require more extensive physical therapy and physical rehabilitation services, which could increase the overall price of your procedure.

Is Hip Replacement Surgery Covered By Medicare?

Medicare hip replacement charges are covered under certain conditions. For Medicare to cover hip replacement cost, certain criteria have to be met. Medicare hip replacement requires your physician to provide detailed information about your condition and about the different treatments you have had. They also require detailed information about medications you have tried and whether they were successful or not.

Once Medicare has approved the surgery, you will be responsible for any Part A or Part B deductibles associated with your Medicare hip replacement. You will also be responsible for the copayments, coinsurance, and other out-of-pocket expenses associated with physical therapy and any medications your surgeon and doctor prescribe to you. It is extremely important to gather all of your medical records in one location. This will ensure that your doctor has adequate information to fill out the forms requested by Medicare to make sure your surgery is covered.