Cost Guide
Total knee replacement (total knee arthroplasty) is one of the most commonly performed major orthopaedic procedures in Australia, with more than 50,000 performed each year. The procedure replaces damaged cartilage and bone with an artificial implant to relieve pain and restore mobility.
For patients with appropriate private hospital cover who have served waiting periods, the out-of-pocket cost typically ranges from $3,000 to $9,000, mostly surgeon gap fees and the physiotherapy rehabilitation programme. For self-funded patients without insurance, the total cost is $20,000 to $40,000.
The main cost components interact with Medicare and the Prosthesis List in specific ways, and a few questions are worth asking your orthopaedic surgeon before committing.
The orthopaedic surgeon's fee is the primary variable. Total knee replacement fees range from $3,000 to $9,000 depending on surgeon experience, practice location, and gap arrangement. Surgeons participating in known-gap or no-gap agreements will have lower out-of-pocket costs than those billing above fund rates.
The knee implant (prosthesis) is listed on the Australian Government's Prosthesis List, which sets the minimum benefit private health funds must pay. Most standard implants are fully covered by the Prosthesis List benefit. Premium implants that exceed the listed benefit may attract an additional charge of $1,000 to $5,000.
Knee replacement requires three to five nights in hospital. The facility fee and anaesthetist together typically cost $4,000 to $10,000 for self-funded patients. Private hospital cover absorbs most of this; the anaesthetist gap may still apply.
Physiotherapy rehabilitation begins in hospital and continues as an outpatient for eight to twelve weeks. Inpatient rehabilitation (a short stay in a rehabilitation facility after acute hospital care) adds $1,500 to $5,000 if not fully covered by your fund. Outpatient physiotherapy adds $1,500 to $3,000 over the recovery period.
Anaesthetist fees for a procedure of this length typically run $600 to $1,200 before Medicare and fund contributions. The gap after rebates averages $200 to $600. Ask your surgeon which anaesthetist they work with and whether that anaesthetist participates in no-gap or known-gap arrangements.
| Component | Typical range |
|---|---|
| Surgeon fee (gap after fund rebate) | $2,000 - $8,000 |
| Anaesthetist gap | $200 - $600 |
| Hospital (3-5 nights, with PHI) | $0 - $750 |
| Prosthesis (standard, Prosthesis List covered) | $0 |
| Rehabilitation (outpatient physio, 8-12 weeks) | $1,500 - $3,000 |
| Total with PHI (Gold tier, standard implant) | $3,000 - $9,000 |
Ranges reflect typical patient-reported out-of-pocket costs across Australian cities. Individual quotes may fall outside these ranges.
Total knee replacement is performed under MBS item 49518. Medicare pays 75 per cent of the MBS schedule fee for in-hospital procedures for patients without private cover; the schedule fee represents a small fraction of the surgeon's actual charge. Private hospital insurance (Gold tier or equivalent) is required to cover the hospital facility fee. The Prosthesis List, maintained by the Australian Government, sets minimum benefits that private health funds must pay for knee implants. Most standard implants are fully funded through this mechanism; premium implants above the listed benefit attract a patient contribution. Contact your fund before booking to confirm your policy covers joint replacement surgery and that the 12-month waiting period has been served.
Ask whether your surgeon participates in a no-gap or known-gap arrangement with your fund; this significantly affects your out-of-pocket cost.
Confirm that the knee implant your surgeon plans to use is on the Prosthesis List and whether any premium implant surcharge will apply.
If your fund offers inpatient rehabilitation cover, confirm the number of days approved before your procedure so you can plan post-operative care.
Start pre-operative physiotherapy (prehabilitation) as recommended; stronger quadriceps before surgery is associated with faster recovery.
Ask whether your surgeon uses a computer navigation or robotic assistance system and whether this adds a facility surcharge.
Modern knee implants have a 15 to 20 year lifespan in most patients. Data from the Australian Orthopaedic Association National Joint Replacement Registry shows 10-year revision rates of around 5 per cent for total knee replacements. Younger and more active patients have higher revision rates.
Most patients are mobilising with a walking aid within 24 hours of surgery. Hospital stays are three to five nights. Most people return to light activities at six weeks and full recovery takes three to six months. Rehabilitation physiotherapy is essential throughout recovery.
Yes. Total knee replacement is covered under joint replacement clinical categories, which are required at Gold tier. The fund covers the hospital facility fee and pays the Prosthesis List benefit for the implant. Surgeon gap fees and rehabilitation costs may still apply as out-of-pocket costs.
Yes. Public patients with a valid Medicare card can have knee replacement at no cost in the public system. Waiting times are typically 12 to 24 months for elective joint replacement depending on state and clinical priority. The procedure and implant quality are comparable to the private system.
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