Total Knee Replacement Cost in Massachusetts
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
Massachusetts Medicare physician rate (2026)
+3.9% vs nationalAverage of 2 localities. Office range $1,162.80–$1,245.78.
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 Massachusetts
Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.
What total knee replacement costs at hospitals near you
Everything above is a national average. The hospital you pick in Massachusetts 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 Massachusetts
Where Massachusetts ranks for this CPT
CPT 27447 by Massachusetts locality
| Locality | Office |
|---|---|
| metropolitan boston | $1,245.78 |
| rest of massachusetts | $1,162.80 |
PE GPCI ranges from 1.053 to 1.194 in Massachusetts. That index is why the same CPT is not one price statewide.
Total Knee Replacement and how Massachusetts is priced
Massachusetts is priced through two localities: metro Boston and the rest of the state. Boston's locality carries clearly higher geographic adjustments, reflecting some of the highest medical wages and office costs in the nation, while Worcester, Springfield, and the Cape share the lower rest-of-state factors. The split means the fee schedule itself acknowledges what everyone in the state already knows about Boston prices. Even so, rest-of-state Massachusetts still prices above most of the country.
Boston has arguably the densest concentration of academic medical centers anywhere, and its teaching hospitals pull referrals from all of New England and beyond. That prestige comes with a high-cost market structure that state policymakers have scrutinized for years. Western Massachusetts operates more like a regional market centered on Springfield, and Cape and islands residents contend with seasonal capacity strain.
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 Massachusetts
Total Knee Replacement in other states
Total Knee Replacement in Massachusetts: questions
The 2026 Medicare physician office rate for CPT 27447 averages $1,204.29 across 2 Massachusetts localities, from $1,162.80 in REST OF MASSACHUSETTS to $1,245.78 in METROPOLITAN BOSTON. The hospital physician rate averages $1,204.29. Enter a ZIP for the exact locality.
Yes. CMS splits Massachusetts into 2 payment localities. For this CPT the office physician fee spans $82.98 from the lowest to highest locality. Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $241 for the office physician line or $241 for the hospital physician line in Massachusetts. Medigap may cover that 20%. This is not the hospital facility fee.
No. $1,204.29 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. Massachusetts ranks #43 of 51 states on the physician line (4% above the national office rate of $1,159.35).