CPT 27130 Surgery - Musculoskeletal

How Much Does Total hip arthroplasty Cost?

Total hip arthroplasty (CPT 27130) costs $1,162 at Medicare rates. Hospital outpatient rate: $13.

Cost Comparison by Payer

How much Total hip arthroplasty costs across different settings and payers

Medicare
Facility rate
$1,162
Hospital Outpatient
OPPS rate
$13
Surgery Center
ASC rate
$9
Medicare (Facility)
$1,162
CMS PFS 2026 national rate
Hospital Outpatient
$13
OPPS rate
Surgery Center (ASC)
$9
Ambulatory surgery center

Total hip arthroplasty Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $1,453 $1,889 — $2,906
AL — ALABAMA $1,060 $1,378 — $2,120
AR — ARKANSAS $1,047 $1,361 — $2,094
AZ — ARIZONA $1,136 $1,477 — $2,272
CA — BAKERSFIELD $1,164 $1,514 — $2,329
CA — CHICO $1,153 $1,499 — $2,306
CA — EL CENTRO $1,154 $1,500 — $2,308
CA — FRESNO $1,153 $1,499 — $2,306
CA — HANFORD-CORCORAN $1,153 $1,499 — $2,306
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $1,220 $1,586 — $2,440
CA — MADERA $1,153 $1,499 — $2,306
CA — MERCED $1,153 $1,499 — $2,306
CA — MODESTO $1,153 $1,499 — $2,306
CA — NAPA $1,265 $1,645 — $2,531
CA — OXNARD-THOUSAND OAKS-VENTURA $1,206 $1,567 — $2,411
CA — REDDING $1,153 $1,499 — $2,306
CA — REST OF CALIFORNIA $1,153 $1,499 — $2,306
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $1,197 $1,556 — $2,394
CA — SACRAMENTO-ROSEVILLE-FOLSOM $1,191 $1,549 — $2,383
CA — SALINAS $1,187 $1,543 — $2,373
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $1,201 $1,562 — $2,403
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $1,315 $1,710 — $2,631
CA — SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) $1,311 $1,704 — $2,621
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) $1,348 $1,752 — $2,696
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $1,329 $1,728 — $2,658

How to Reduce Your Cost for Total hip arthroplasty

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $1,047 to $1,453 depending on location. Commercial rates vary even more.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $9, compared to $13 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

19.11
Work RVU
11.63
Practice Expense RVU
4.05
Malpractice RVU
34.79
Total RVU

Payment = Total RVU (34.79) x CF ($33.40) = $1,162

Frequently Asked Questions

How much does Total hip arthroplasty cost?

The Medicare facility rate for Total hip arthroplasty is $1,162. In a hospital outpatient setting, the rate is $13. At an ambulatory surgery center, the rate is $9. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Total hip arthroplasty cost without insurance?

Without insurance, the cost of Total hip arthroplasty can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Total hip arthroplasty?

Most commercial health insurance plans and Medicare cover Total hip arthroplasty when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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