How much does a knee replacement cost?

Replacement of a knee joint with an artificial (prosthetic) knee joint.

Hospital cover

1

Procedure costs

2

Specialists & hospitals

3

 Preparing for hospital

4

Planning your recovery

5

~ This pie chart was compiled using the median figure for Medibank cost, Medicare cost, Excess, and out-of-pocket costs based on data for eligible+ members.

+ The above costs for a knee replacement reflect MBS item numbers 49519 and 49518. Medibank pays benefits towards in-hospital medical services based on the MBS. 

For Medibank to pay benefits towards this procedure, your hospital cover must include Joint Replacement as an Included or Restricted service. For Included services, we pay benefits towards the treatment, but you may still have some out-of-pocket costs. For Restricted services, we pay the minimum amount set by the government, which can mean higher out-of-pocket costs. You must also have served the relevant waiting period(s). Ask your specialist for the MBS item numbers that apply for your treatment. 

Two women power walking and smiling

No Gap Joint Replacement program

Eligible members with hospital cover1 pay no out-of-pocket costs2 for included treatments and services as part of hospital admission3 for elective surgery for a hip or knee replacement at participating hospitals with participating surgeons, where clinically appropriate.

Find out more

Further reading

Better Knee, Better Me

A program designed to help eligible Medibank members with painful knee osteoarthritis to reduce knee pain, improve their quality of life, and lower the chances of requiring joint replacement surgery. 

Read more
Do I need a knee replacement?

Do I need a knee replacement?

Use this checklist to see if your osteoarthritis symptoms might improve with total knee replacement surgery.

Read more
Comparing public and private hospital options for tooth extractions

Comparing public and private hospital options for joint replacements

We explain how the public and private healthcare systems differ when it comes to costs, waiting times and choice of specialist.

Read more

Now that you’ve covered

☑ Understanding hospital cover

☑ Out-of-pocket costs

☑ Procedure costs

 

You might like to explore

☐ Choosing specialists and hospitals

☐ Preparing for hospital

☐ Planning your recovery

 

Looking for something else?

Find more tools and information in the Going to Hospital hub, from planning through to recovery.

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Things you need to know

1 Must have hospital cover that includes Joint Replacement Surgery. Waiting periods apply.

2 An excess or co-payment may still be payable, depending on the product a member has chosen and whether they are claiming under their hospital cover for the first time in a calendar year. The Medibank Member Guide and Fund Rules sets out hospital benefit exclusions, which apply to all hospital admissions for Medibank members. There may be out-of-pocket expenses associated with outpatient appointments, such as your initial visit with a participating surgeon in their consulting rooms.

3 Excludes joint replacements resulting from an emergency admission.

** For eligible hospital members who have served waiting periods. Treating doctor must consider it appropriate. Services are subject to provider availability. Providers are not located in all areas and may change without notice. Additional treatment may incur out-of-pocket costs.

While we hope you find this information helpful, please note that it is general in nature. It is not health advice, and is not tailored to meet your individual health needs. You should always consult a trusted health professional before making decisions about your health care. While we have prepared the information carefully, we can’t guarantee that it is accurate, complete or up-to-date. And while we may mention goods or services provided by others, we aren’t specifically endorsing them and can’t accept responsibility for them. For these reasons we are unable to accept responsibility for any loss that may be sustained from acting on this information (subject to applicable consumer guarantees).