Total Hip Replacement Cost in Pennsylvania
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
Pennsylvania Medicare physician rate (2026)
+0.6% vs nationalAverage of 2 localities. Office range $1,122.72–$1,215.54.
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 Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What total hip replacement costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania 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 Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 27130 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $1,215.54 |
| rest of pennsylvania | $1,122.72 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Total Hip Replacement and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
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 Pennsylvania
Total Hip Replacement in other states
Total Hip Replacement in Pennsylvania: questions
The 2026 Medicare physician office rate for CPT 27130 averages $1,169.13 across 2 Pennsylvania localities, from $1,122.72 in REST OF PENNSYLVANIA to $1,215.54 in METROPOLITAN PHILADELPHIA. The hospital physician rate averages $1,169.13. Enter a ZIP for the exact locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $92.82 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $234 for the office physician line or $234 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
No. $1,169.13 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. Pennsylvania ranks #35 of 51 states on the physician line (within 2% of the national office rate of $1,162.02).