HOW MUCH DOES A KNEE REPLACEMENT COST IN AUSTRALIA?

Cost of Knee Replacement Surgery in Australia

Knee Replacement cost
It is crucial for everyone thinking about undergoing knee replacement surgery to understand the financial implications of this major medical treatment. The purpose of this guide is to provide information on the cost of a knee replacement in different Australian healthcare settings. Please visit our knee replacement (
Total Knee Replacement & Transplant Surgery Perth | Knee replacement Operation Perth (rhysclark.com.au)) page for more clinical details regarding the actual surgery.

1st Choice: Public SystemWhat Is the Cost of a Knee Replacement?

Your general practitioner can start the process by referring you for a knee arthritis assessment if you are eligible for Medicare. This referral is sent to a hospital that services your area after being reviewed through a centralised system and triaged according to urgency (knee arthritis usually obtains a low priority). Appointment waiting times can be long, sometimes lasting from several months to years.

After your initial appointment, you may require further diagnostic procedures, such as X-rays. An orthopaedic doctor will examine you and determine if you should get a knee replacement. You will be placed on a waiting list for surgery after giving your agreement. This surgical waitlist can be months or years before you get your knee replacement. 

  • Benefits: Since Medicare covers this option, there are no out-of-pocket expenses associated with surgery.
  • Cons: You are not allowed to choose your surgeon, and there may be long wait times.
  • Note: In some rural areas and some states there are no public outpatient clinics in the hospital, so patients are directed to private surgeon rooms. Direct referrals to private surgeons who can put patients on public waiting lists may come with upfront payments.

2nd Choice: Private System – How Much Does a Knee Replacement Cost Australia?

Private health insurance holders can expedite the procedure. Your general practitioner will recommend a private surgeon, with appointments typically available in four to six weeks. If a knee replacement is advised after evaluating your needs, surgery can usually be scheduled six weeks after your visit to accommodate pre-operative physical therapy.

You will receive all the information you need to confirm coverage and potential excess fees with your insurance carrier during your booking, including the MBS code and anesthetist’s details.

The difference between the surgeon’s price and what your insurance pays is known as the “gap fee,” and it varies. I don’t charge extra because I work on a no-gap basis, matching my costs to what your insurance will pay. Some surgeons set a much higher fee than what the health fund will pay, which results in a large gap that the patient pays. Please note that a larger gap does not mean that you get a better surgeon, rather that a surgeon chooses to set their fees higher.

3rd Choice: Self-Funded – How Much Does a Knee Replacement Cost?

Self-funding is an alternative if you do not have private insurance and would rather not wait for treatment through the public system. This entails paying cash for all associated services. The entire cost of a knee replacement, including hospital stays, the prosthesis, and surgery expenses, often falls between $25,000 and $35,000.

About one-third of these expenses should be covered by Medicare payments.