Orthopedic surgery in the United States typically costs between $20,000 and $50,000 before insurance, depending on the procedure, where it’s performed, and what hardware is involved. With insurance, most patients pay between $1,500 and $4,500 out of pocket. That’s a wide range, and the final number depends on several factors you can actually influence.
Cost Ranges for Common Procedures
The total price tag varies significantly by procedure. ACL reconstruction runs between $20,000 and $50,000, which includes the surgeon’s fee, anesthesia, facility charges, and follow-up care. The surgeon’s fee is actually a small slice of that total, typically $500 to $1,000. Anesthesia adds $1,000 to $2,500. The bulk of the bill comes from facility charges, which range from $15,000 to $40,000.
Arthroscopic rotator cuff repair averages about $25,350. If the surgeon also performs a subacromial decompression (a common add-on to create more space in the shoulder joint), that adds roughly $5,000 to the total.
Joint replacements carry their own pricing structure, largely driven by the cost of the implant itself. Hip replacement implants range from about $2,400 to $12,650 per case, and in some hospitals the implant alone accounts for up to 87% of total surgical costs. Knee replacement implants fall in a similar range, from roughly $1,800 to $12,100. The wide spread reflects differences in implant brands, materials, and hospital purchasing agreements.
Where You Have Surgery Changes the Price
One of the biggest cost factors is whether your procedure is performed at a hospital or an ambulatory surgery center (ASC), which is a standalone outpatient facility. For Medicare patients undergoing sports medicine procedures, total costs at ASCs were 40% lower on average compared to hospital outpatient departments. Facility fees specifically were 45% lower, and patient payments dropped by 37%.
The savings vary by body part. Shoulder procedures at ASCs cost about 42% less than the same procedures at hospitals. Knee procedures were 36% cheaper, and hip procedures saw the largest gap at 46% lower costs. Not every surgery can safely be done at an ASC, particularly complex revisions or procedures on patients with serious health conditions. But if your surgeon offers the choice, it’s worth asking about.
What You’ll Actually Pay With Insurance
Your out-of-pocket cost depends heavily on the type of insurance plan you carry. A study published in the Journal of the American Academy of Orthopaedic Surgeons tracked what patients actually paid across different plan types for major orthopedic procedures. The differences were substantial.
For total hip replacement, patients on comprehensive plans paid an average of $1,769 out of pocket. Those on PPO plans paid $2,782. Patients with high-deductible health plans paid the most at $4,072. The pattern held across other procedures: high-deductible plans consistently resulted in out-of-pocket costs roughly double what comprehensive plans required.
For total knee replacement, overall average out-of-pocket costs were $2,733. For hip replacement, the average was $2,884. Spinal procedures like cervical fusion and lumbar fusion ran slightly higher, averaging $3,180 and $3,166 respectively. These numbers include deductible payments, copays, and coinsurance combined.
If you’re planning elective surgery and have a choice of insurance plans during open enrollment, the math is worth doing. Switching from a high-deductible plan to a comprehensive plan could save you $2,000 or more on the surgical episode alone.
Costs That Don’t Show Up on the Surgical Bill
The quoted price for surgery rarely captures everything you’ll spend. Physical therapy is the most predictable additional cost, and for orthopedic procedures it’s not optional. Without insurance, PT sessions run about $125 each. Major post-operative rehab programs, like those following ACL reconstruction or joint replacement, can require dozens of sessions over several months. That adds up to thousands of dollars in rehabilitation costs alone.
Other expenses that catch people off guard include pre-surgical imaging (MRIs, X-rays), the initial consultation and any second opinions, post-op medications, braces or assistive devices, and follow-up office visits. If your surgery requires an overnight hospital stay, room charges add significantly to the facility portion of the bill.
How to Get the Lowest Price
If you’re uninsured, ask about cash-pay or self-pay rates. Many surgical centers offer bundled pricing that’s considerably lower than the itemized charges they bill to insurance companies. Some facilities now advertise all-inclusive packages for common procedures like knee and hip replacements.
For insured patients, the most effective strategies are choosing an ASC over a hospital when your surgeon agrees it’s appropriate, confirming that every provider involved in your surgery (surgeon, anesthesiologist, assistant) is in-network, and timing elective surgery for after you’ve already met your annual deductible from other medical expenses. Getting a detailed cost estimate in advance, including the facility fee, is also worth the phone calls. Facility fees are the single largest line item on most orthopedic surgery bills, and they vary enormously between locations even within the same city.