In 2017, spending on planned orthopedic procedures was 25 billions dollars. That figure rose 44 percent in the period from 2010 to 2017. 242 thousand adult BCBS members under the age of 65 had a planned knee or hip replacement in 2017. Quality is improving, but cost is on the rise. Planned knee surgeries increased 17 percent from 2010 to 2017 while planned hip surgeries increased 33 percent in the same period. The average cost (inflation adjusted) for a knee or hip surgery increased by 6 percent and 5 percent, respectively. The inpatient cost for a knee surgery was $30,249 and $19,002 for outpatient. The inpatient cost for a hip surgery was $30,685 and $22,078 for outpatient. Complication rates decreased for both inpatient and outpatient procedures, by 29 percent and 23 percent, respectively, for knee surgeries, and by 32 percent and 36 percent, respectively, for hip surgeries.
Empower yourself and your family.
Use your health plan's doctor and hospital finder tool. If you live in an area with high cost variation for knee and hip replacement surgeries, compare doctors and facilities in your network to uncover potential cost savings or a Blue Distinction Center near you.
Know the difference between inpatient and outpatient care. If outpatient care is right for you, there are significant cost savings with outpatient surgeries without sacrificing quality. Inpatient care requires overnight hospitalization. For outpatient care, patients are typically able to leave once the procedure is over.
Follow your doctor's advice. While it's important to ask questions and do additional research, work with your doctor to select a site of care the best meets your needs.