Total Knee Replacement Cost in Illinois
Total knee arthroplasty
$14,276Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Illinois Medicare physician rate (2026)
+9.6% vs nationalAverage of 4 localities. Office range $1,201.29–$1,339.63.
What the whole procedure costs
The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.
Choosing a surgery centre over a hospital saves about $3,724 on the Medicare allowed amount for total knee replacement. Ask whether your procedure can be done at an ambulatory surgery centre.
Medicare pays the hospital a single comprehensive amount for this procedure, covering the facility's share of the encounter including implants and supplies. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Illinois
Enter a ZIP code to see which Illinois locality applies to you, whether Chicago proper, the suburban collar counties, the Metro East near St. Louis, or downstate cities like Springfield, Peoria, and Champaign.
What total knee replacement costs at hospitals near you
Everything above is a national average. The hospital you pick in Illinois moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.
National vs Illinois
Where Illinois ranks for this CPT
CPT 27447 by Illinois locality
| Locality | Office |
|---|---|
| chicago | $1,339.63 |
| suburban chicago | $1,277.91 |
| east st. louis | $1,264.55 |
| rest of illinois | $1,201.29 |
PE GPCI ranges from 0.913 to 1.027 in Illinois. That index is why the same CPT is not one price statewide.
Total Knee Replacement and how Illinois is priced
Illinois uses one of the more detailed locality maps in the Midwest: Chicago has its own locality, the suburban collar counties are priced separately, the East St. Louis area carries its own locality tied to the St. Louis market, and the rest of the state shares a fourth. Approved amounts step down noticeably from the city and suburbs to downstate, so the same procedure prices differently in Chicago, Naperville, Belleville, and Springfield. This four-way split makes Illinois one of the states where a ZIP-level check genuinely changes the answer. Downstate rates align more closely with neighboring rural states than with Chicagoland.
Chicago is one of the country's great medical hubs, with multiple academic medical centers and deep specialist supply, and its suburbs support large competing systems of their own. Downstate Illinois is a different market: smaller cities like Peoria, Springfield, and Champaign serve wide rural areas, and the Metro East suburbs orient toward St. Louis providers. Where you sit on that map shapes both price and choice.
This procedure: Total knee replacement resurfaces the ends of the thigh and shin bones and usually the kneecap with metal and plastic components after arthritis has worn away the cartilage. It is among the most common elective surgeries in the United States. The operation lasts one to two hours under spinal or general anesthesia, and recovery is more demanding than hip replacement: expect several months of dedicated physical therapy to regain bending and strength.
What Is Total Knee Replacement?
Total knee replacement resurfaces the ends of the thigh and shin bones and usually the kneecap with metal and plastic components after arthritis has worn away the cartilage. It is among the most common elective surgeries in the United States. The operation lasts one to two hours under spinal or general anesthesia, and recovery is more demanding than hip replacement: expect several months of dedicated physical therapy to regain bending and strength.
What Affects the Cost
- –Physical therapy is a bigger cost driver here than for almost any other surgery, because knee recovery typically requires more visits over more months.
- –Facility choice, hospital inpatient versus outpatient surgery center, can swing the total by a large margin.
- –The implant system and any patient-specific or robotic-assisted instrumentation add to the facility charge.
- –Nerve blocks for post-operative pain control are billed by anesthesia as separate procedures.
- –A stay in a skilled nursing or inpatient rehab facility, if you cannot go straight home, adds a substantial per-day cost.
- –Manipulation under anesthesia, needed by a minority of patients whose knee stiffens, is an additional procedure with its own charges.
Questions to Ask Before Booking
- 1.How many physical therapy visits will I realistically need, and how many does my plan cover per year?
- 2.Can my surgery be done outpatient, and what is the price difference at each facility you operate in?
- 3.Is prior authorization fully approved, including the conservative treatment documentation?
- 4.Will I get a nerve block, and is the anesthesia group in my network?
- 5.If I need a rehab facility stay instead of going home, what would that cost under my plan?
Other featured procedures in Illinois
Total Knee Replacement in other states
Total Knee Replacement in Illinois: questions
The 2026 Medicare physician office rate for CPT 27447 averages $1,270.85 across 4 Illinois localities, from $1,201.29 in REST OF ILLINOIS to $1,339.63 in CHICAGO. The hospital physician rate averages $1,270.85. Enter a ZIP for the exact locality.
Yes. CMS splits Illinois into 4 payment localities. For this CPT the office physician fee spans $138.34 from the lowest to highest locality. Enter a ZIP code to see which Illinois locality applies to you, whether Chicago proper, the suburban collar counties, the Metro East near St. Louis, or downstate cities like Springfield, Peoria, and Champaign.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $254 for the office physician line or $254 for the hospital physician line in Illinois. Medigap may cover that 20%. This is not the hospital facility fee.
No. $1,270.85 is only the physician's share. Adding Medicare's facility payment brings the total to about $14,276 in a hospital outpatient department, or about $10,553 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Illinois ranks #47 of 51 states on the physician line (10% above the national office rate of $1,159.35).