Ever Wonder How Much Medicare Pays for Hip and Knee Replacement Friday, June 8th, 2012 Between 1998 and 2007, the Medicare reimbursement rate decreased 21 percent for total hip arthroplasty and 20 percent for total knee arthroplasty, according to the report. The researchers surveyed 1,120 patients in an outpatient office setting, asking patients what they thought orthopedic surgeons should receive for total joint arthroplasty and how much they thought Medicare actually paid surgeons. Patients were also asked the same questions about cardiac surgeons who perform open heart coronary bypass surgery and surgeons who perform appendectomy. In another section of the survey, patients were told the average Medicare reimbursement rate for orthopedic surgeons performing total hip arthroplasty was $1,375 and $1,470 for total knee arthroplasty and asked to rate whether they thought it was low, high or about right. The patients on average thought orthopedic surgeons should be paid $14,358 for performing total hip arthroplasty and estimated Medicare reimbursed at $8,212. The patients on average thought orthopedic surgeons should be paid $13,332 for total knee arthroplasty and estimated Medicare actually paid $7,196. According to the report, most of the respondents thought the Medicare reimbursement for total hip arthroplasty and total knee arthroplasty was too low. Based on patient demographics, patients with a higher education level or those who had PPOs or HMOs as their primary insurance more often perceived the value of total knee arthroplasty as higher than patients with less education, no insurance or government payors. Total knee arthroplasty patients who were happy with their surgical outcomes perceived the value as higher than patients who were unhappy.
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