Total knee replacement is one of the highest-cost elective surgeries, and one where the price difference between hospitals is staggering. In Tampa, facility fees range from $8,000 to $45,000 for the same procedure. This is a decision worth researching before you schedule.
Everyone in the OR bills you separately
Your orthopedic surgeon bills a professional fee. The hospital bills the facility fee shown here. The anesthesiologist bills separately. If a surgical assistant is used, they bill separately. Physical therapy during your hospital stay is sometimes billed separately.
Verify every provider's network status in advance. The anesthesiologist is the most common source of surprise out-of-network bills for elective joint replacement.
Implant costs are embedded in the facility fee
The knee implant itself is a major cost component included in the facility fee. Implant costs to hospitals range from $2,000 to $8,000 depending on the manufacturer and model.
You generally cannot choose your implant. Your surgeon selects it. But you can ask what brand they use and whether a comparable implant from a different manufacturer is available. Some hospitals charge significantly more based on implant vendor contracts.
Inpatient vs. outpatient billing
Knee replacements are increasingly performed as outpatient procedures for healthy patients. Outpatient billing uses CPT codes. Inpatient billing uses a DRG.
If your surgeon is planning an overnight stay, ask whether outpatient status is an option. Outpatient knee replacement is often less expensive and recovery outcomes are comparable for appropriate candidates.