How Much Does a Knee Replacement Cost in Australia?
Public: no surgical cost, but long waits. Private: your fund's excess, with no surgeon gap from Dr Rhys Clark. Self-funded: published estimates run from about $20,000 to $35,000. What each pathway costs.
Cost of Knee Replacement Surgery in Australia
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 page for more clinical details regarding the actual surgery.
1st Choice: Public System – What 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 anaesthetist’s details.
The difference between the surgeon’s fee and the combined Medicare and insurer benefits 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. Published estimates for the entire cost of a knee replacement in a private hospital, including the hospital stay, the prosthesis and the doctors’ fees, run from about $20,000 to $35,000. The Australian Government’s own estimate was reported as around $23,200 in February 2025 (Canstar), and a May 2026 cost guide gives $20,000 to $35,000 (TreatCompare). The range is wide because it depends on the hospital, the implant, your length of stay and the complexity of your case, so ask the hospital for a written quote.
Medicare does not pay for the hospital or the prosthesis. It pays a rebate of 75% of the Medicare Benefits Schedule fee for the doctors’ services. As a historical example, in February 2025 the knee replacement item (49518) had a schedule fee of $1,501.30 and a rebate of $1,126, with separate items for the anaesthetist and assistant. Those figures are out of date: schedule fees are indexed each July, and the Medicare Benefits Schedule has the current amounts. Links checked 13 October 2026.
Does robotic knee replacement cost more?
This is asked often enough to answer on its own. It does not change the surgeon’s fee. Dr Clark uses the Mako and VELYS systems as part of how the operation is performed, not as an optional extra billed separately, and he works on a no-gap basis for privately insured knee replacement patients — matching his fees to what the insurer pays.
What varies is everything around it, and it varies for the same reasons it would without a robot:
- Hospital and prosthesis depend on your pathway and your health fund, not on whether robotic assistance was used.
- The anaesthetist and surgical assistant bill independently, which is the most common source of an unexpected account either way.
- In the public system there is no surgical out-of-pocket cost, though which hospitals have the systems available varies.
Robotic knee replacement covers how the planning and the systems actually work, and what the evidence does and does not yet show.
Before you commit to any of the three
Whichever route you take, ask for informed financial consent — a written estimate of your total out-of-pocket cost, covering the surgeon, anaesthetist, assistant, hospital and prosthesis, before you commit. The anaesthetist and assistant bill independently, which is the most common source of an unexpected bill.
How to Choose a Knee Replacement Surgeon covers what else is worth asking at that first appointment, including case volume and whether a partial knee replacement is an option for your knee.
Does robotic knee replacement cost more?+
Not in what you pay the surgeon. Dr Clark works on a no-gap basis for privately insured knee replacement patients, matching his fees to what the insurer pays, and robotic assistance is part of how he performs the operation rather than an item billed on top. What does vary is the hospital and the prosthesis, and that depends on your pathway and your health fund rather than on whether a robot was used. In the public system there is no surgical out-of-pocket cost either way, though which hospitals have the systems available varies.
How much does a knee replacement cost in Australia?+
It depends on the pathway. Through the public system under Medicare there are no out-of-pocket surgical costs, but wait times can run from months to years. Privately insured patients pay whatever excess and gap their fund leaves; Dr Clark works on a no-gap basis, matching his fees to what the insurer pays. Published estimates for a self-funded knee replacement in a private hospital run from about $20,000 to $35,000 in total, covering the hospital stay, prosthesis and doctors' fees, and the Australian Government's own estimate was reported as around $23,200 in February 2025. Medicare rebates cover part of the doctors' fees only, not the hospital or the prosthesis, so they are a small share of the total.
What is a gap fee?+
The gap is the difference between the surgeon's fee and the combined Medicare and health insurer benefits paid for that service. It varies between surgeons. Dr Clark charges no gap, setting his fees to match the insurer's payment. A larger gap does not indicate a better surgeon — only that the surgeon has chosen to set higher fees.
How long is the wait for a knee replacement in the public system?+
Potentially a long time. Your GP refers you for assessment, the referral is triaged centrally, and knee arthritis usually receives a low priority. Waiting for the initial appointment can take months to years, and there is then a further surgical waiting list which can also run to months or years.
How much faster is going private?+
Considerably. Appointments with a private surgeon are typically available within four to six weeks, and if a knee replacement is recommended, surgery can usually be scheduled about six weeks after that visit — the interval allowing time for pre-operative physiotherapy.
Does Medicare cover a knee replacement?+
In the public system Medicare covers the surgery, so there are no out-of-pocket surgical expenses. For self-funded patients, Medicare pays a rebate of 75% of the Medicare Benefits Schedule fee for the doctors' services, but nothing towards the hospital stay or the prosthesis. As a historical example, in February 2025 the knee replacement item (49518) had a schedule fee of $1,501.30 and a rebate of $1,126; fees have been indexed since, so check the current amount on the Medicare Benefits Schedule. There are separate items for the anaesthetist and assistant, and the rebates are a small share of the total bill.
Can I choose my surgeon in the public system?+
No. Choosing your own surgeon is one of the main differences between the private and public pathways, along with the wait time.