Total Hip Replacement Cost in New York
Total hip arthroplasty
$14,279Hospital 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
New York Medicare physician rate (2026)
+10.7% vs nationalAverage of 5 localities. Office range $1,102.42–$1,392.21.
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 $3,503 on the Medicare allowed amount for total hip 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 New York
New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.
What total hip replacement costs at hospitals near you
Everything above is a national average. The hospital you pick in New York 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 New York
Where New York ranks for this CPT
CPT 27130 by New York locality
| Locality | Office |
|---|---|
| nyc suburbs/long island | $1,392.21 |
| manhattan | $1,345.07 |
| queens | $1,333.36 |
| poughkpsie/n nyc suburbs | $1,256.05 |
| rest of new york | $1,102.42 |
PE GPCI ranges from 0.950 to 1.189 in New York. That index is why the same CPT is not one price statewide.
Total Hip Replacement and how New York is priced
New York has one of the most complex locality maps in the country, with around five payment areas: Manhattan is its own locality, Queens is separately priced, the NYC suburbs and Long Island form another high-cost locality, the Poughkeepsie area has its own, and the rest of the state, including Buffalo, Rochester, Syracuse, and Albany, shares a distinctly lower-priced upstate locality. The spread between Manhattan and upstate adjustments is among the widest within any state. A knee MRI or office visit is approved at meaningfully different amounts in Manhattan, Mineola, and Rochester. Upstate New York prices closer to the Midwest than to the five boroughs.
New York City is a global medical capital with world-famous academic medical centers competing within blocks of each other, while upstate cities each center on their own regional academic hubs. Long Island and the lower Hudson Valley support dense suburban hospital markets of their own. The upstate-downstate divide runs through everything in New York health care, including what providers charge and what patients can access locally.
This procedure: Total hip replacement removes a worn or damaged hip joint, usually destroyed by arthritis, and replaces it with a metal, ceramic, and plastic implant. It is one of the most successful operations in medicine for relieving pain and restoring walking. The surgery takes one to two hours under general or spinal anesthesia; many patients now go home the same day or after one night, then spend several weeks in physical therapy.
What Is Total Hip Replacement?
Total hip replacement removes a worn or damaged hip joint, usually destroyed by arthritis, and replaces it with a metal, ceramic, and plastic implant. It is one of the most successful operations in medicine for relieving pain and restoring walking. The surgery takes one to two hours under general or spinal anesthesia; many patients now go home the same day or after one night, then spend several weeks in physical therapy.
What Affects the Cost
- –The implant itself is a major cost component, and prices vary widely between manufacturers and hospitals.
- –Same-day discharge at an ambulatory surgery center can cost dramatically less than an inpatient hospital stay.
- –Post-operative physical therapy, whether at home, outpatient, or in a rehab facility, is a significant separate expense over weeks.
- –The anesthesia team bills by time, and spinal versus general anesthesia can affect both cost and recovery.
- –Pre-surgical clearance testing, such as labs, an ECG, and imaging, generates its own set of charges.
- –Robotic-assisted or computer-navigated surgery may carry additional facility charges at some hospitals.
Questions to Ask Before Booking
- 1.Am I a candidate for same-day or outpatient surgery, and how much would that reduce the facility charge?
- 2.What implant brand do you use, and does my choice affect what I pay?
- 3.Has prior authorization been approved, including documentation of the conservative care I already tried?
- 4.What will physical therapy cost after surgery, and how many visits does my plan cover?
- 5.Does my insurer have a designated joint replacement center with lower out-of-pocket costs?
Other featured procedures in New York
Total Hip Replacement in other states
Total Hip Replacement in New York: questions
The 2026 Medicare physician office rate for CPT 27130 averages $1,285.82 across 5 New York localities, from $1,102.42 in REST OF NEW YORK to $1,392.21 in NYC SUBURBS/LONG ISLAND. The hospital physician rate averages $1,285.82. Enter a ZIP for the exact locality.
Yes. CMS splits New York into 5 payment localities. For this CPT the office physician fee spans $289.79 from the lowest to highest locality. New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $257 for the office physician line or $257 for the hospital physician line in New York. Medigap may cover that 20%. This is not the hospital facility fee.
No. $1,285.82 is only the physician's share. Adding Medicare's facility payment brings the total to about $14,279 in a hospital outpatient department, or about $10,776 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. New York ranks #49 of 51 states on the physician line (11% above the national office rate of $1,162.02).