How Much Do Joint Replacements and Reconstructions Cost?

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What is joint replacement and reconstruction surgery?

How much do joint replacement and reconstruction surgeries cost?

Are there other out-of-pocket costs for joint replacement and reconstruction surgeries?

Are there ongoing costs after joint replacement and reconstruction surgeries?

How long will I have to wait for joint replacement or reconstruction surgery?

What level of health insurance do I need to cover joint replacement and reconstruction surgeries?

How do I choose health insurance for joint replacements and reconstructions?

Where can I find and compare health insurance?

Long story short

Joint replacement and reconstruction surgeries can make daily life a little easier

They’re often used to treat arthritis, sports injuries, and other musculoskeletal issues.

Surgery costs vary in the private hospital system

In the public system, surgery is free, but you might have to wait longer.

After surgery, an extras policy might help pay some of your rehabilitation costs

Seeing a physio or occupational therapist can be an important step to making a full recovery.

What is joint replacement and reconstruction surgery?

A joint reconstruction is a procedure to mend your joint, while joint replacement surgery replaces the joint with a synthetic option. Orthopaedic surgeons handle both kinds of surgeries.

The human body has lots of joints, unlike most action figures or Barbies. Common joint reconstruction and replacement procedures centre on the hips, knees, shoulders, and ankles.

If you’re sick of joint pain or your stiff joints mean everyday tasks are extra tricky, these surgeries might be a solution. They’re popular treatments for a range of conditions, including arthritis, sports injuries, and musculoskeletal trauma. Keep in mind, though, that you’ll need to be a good candidate for the procedure. This includes how old you are – reconstructions are usually only an option for younger folks.

How much do joint replacement and reconstruction surgeries cost?

Unfortunately, joint surgery isn’t quite like a Maccas menu with set prices you can easily look up. Think of it more like a tailored gourmet experience, since your unique situation makes a big impact. Factors at play include:

• which joint is affected
• whether it’s a reconstruction or a replacement
• whether you’re treated as a public or private patient.

Some joints can be a little more complex, or downright fiddly, to deal with. And as you can imagine, more complicated surgery usually comes with a higher price tag. Just like you, surgeons expect to be paid extra for a more difficult job. At the same time, it’s worth knowing that a reconstruction can be a less involved – so potentially less costly – procedure than a replacement. After all, with this surgery, doctors aren’t needing to pop in a prosthetic.

But how do the public and private systems factor in? Well, in Australia, public hospital patients have their care covered by Medicare. That means no out-of-pocket costs (at least for the surgery and hospital components).

Private hospital patients get a helping hand from Medicare, too, for their surgery bill. If they have suitable private health insurance, their insurer will also contribute to the cost of surgery. Your insurer might also cover hospital accommodation fees and other elements of your hospital stay, if you are treated in a hospital that partners with your health fund. But it’s still possible to have out-of-pocket costs as a private patient. For instance, your surgery might cost more than what Medicare and your insurance covers.

At the end of the day, it’s your unique situation, including the policy you’ve chosen, that determines whether you have any out-of-pocket costs. The table gives an idea of how much you might need to keep on hand if you’re looking to go private.

Typical out-of-pocket costs for private patients in 2023–24

Sources: Medical Costs Finder – Ankle arthroscopy; Ankle replacement; Hip arthroscopy; Hip replacement; Knee reconstruction; Knee replacement; Shoulder reconstruction; Shoulder replacement 

Note: These are the amounts patients typically paid for these services, rounded to the nearest dollar. They do not include hospital payments such as excesses, co-payments, or other payments. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in these figures. Data retrieved November 2025.

While it might seem odd to run the risk of out-of-pocket costs as a private patient when Medicare offers the procedure for free, value can be about more than money. For instance, private hospital patients can choose their treating surgeon and have the chance at a private room. These perks can make the process a little less intimidating and overwhelming.

Are there other out-of-pocket costs for joint replacement and reconstruction surgeries?

As a private patient, you might have a couple of other out-of-pocket costs. It depends on your policy.

For instance, you may have an excess to pay. This is a fee paid when you’re admitted to hospital. Like other types of insurance, your excess will be listed in your policy documents and is something you pick ahead of time.

Similarly, you could have a co-payment. This fee is paid for each day you’re in hospital. Thankfully, joint reconstructions tend to be same-day discharge affairs or only require a day or two in hospital. Some kinds of joint replacements can mean a slightly longer stay, but not much longer. So, if you do have a co-payment listed in your policy, chances are you won’t have to pay it too many times over for these kinds of surgeries.

Are there ongoing costs after joint replacement and reconstruction surgeries?

Unlike other kinds of surgeries, joint surgeries often come with homework, and you might have out-of-pocket costs for this pleasure.

Task one is to have a follow-up appointment with your treating specialist. This is a chance for them to check in on how you’re travelling and whether you need any further help. Private health insurance can’t cover out-of-hospital specialist appointments, unfortunately.

Task two is usually some form of mobilisation and rehabilitation therapy to get you up and moving again sooner. You might need to see a physiotherapist, occupational therapist, exercise physiologist, or a combination of these allied health professionals regularly for a while. As part of this, you might also need to pay for mobility aids to help you stay as independent as possible. With these kinds of costs, your extras cover might pay some of the bill, making it easier to give recovery your best shot.

And while we’re talking future costs, it’s worth mentioning that a further joint surgery could be in your future. Joint reconstructions can help stabilise your joint, but they might only delay the need for a joint replacement. Similarly, joint replacements, when well cared for, can last for around a decade. But then, they can become too worn out and another replacement (and surgery) is needed. Replacing a replacement is known as a revision.

Helpful tip

Despite what they’re capable of in pop culture, crystal balls are only useful as Stevie Nicks–inspired decor. But if you really want to try and predict whether a joint surgery is in your future, there are a couple of things you can consider. 

First, has anyone in your family ever needed one? Lots of health conditions can be inherited from family members. Your genes might come with a tendency for arthritis or another musculoskeletal condition.  

Similarly, have you played lots of fast-paced sport that involves body contact or quick stops and fast turns? These kinds of movements can put stress on your joints, particularly if you don’t stretch or give them time to recover. 

Andres Gutierrez

General Manager – Health

How long will I have to wait for joint replacement or reconstruction surgery?

Like the cost of your surgery, your wait time depends on a few specifics, including your type of surgery and whether you’re going public or private. For instance, in 2023–24, public patients had a median wait of 92 days for orthopaedic surgery. Meanwhile private orthopaedic patients at public hospitals only had a median wait of 37 days.¹Australian Institute of Health and Wellbeing – Admitted patient care 2023–24: What procedures were performed?

Essentially, using your health insurance to go private might be your ticket to skipping the queue. After all, when you’re not feeling your best, patience tends to be in short supply.

If you do go the private route, keep in mind any waiting times attached to your policy. As a general rule, new policies come with a maximum waiting period of two months for joint replacements and reconstructions. The exception is pre-existing conditions. Then you’ll have a maximum wait of 12 months.

What level of health insurance do I need to cover joint replacement and reconstruction surgeries?

Although health insurance policies can differ somewhat in coverage, there are minimum categories each tier needs to include. As a result, you’ll find that gold policies always include joint replacements. You may also see them offered on some lower tier policies, such as silver or silver plus, but this will depend on the insurer since it isn’t compulsory.

If you’re only after a joint reconstruction, you’ll find bronze, silver, and gold cover all offer it. You may even come across some basic cover policies that also offer it, but this cover can be restricted.

How do I choose health insurance for joint replacements and reconstructions?

If you’re keen to treat yourself to health insurance, along with that new joint, there are a few things you could try to narrow down a policy.

Check the premiums

Balance cover with your budget and whether you feel like you’re getting value for money. Remember, your plan could include treatments and support for both before and after your surgery.

Look at inclusions and exclusions

You might find you get more value out of a policy that offers more cover or, conversely, you might prefer the promise of something cheaper with fewer services you don’t think you’ll be using.

Remember gaps and other costs

Along with out-of-pocket costs, you may want to take into account other fees, like your excess or co-payment for each day you’re in hospital, as well as check for any eligible no-gap schemes.

Don’t forget the waiting period

While insurers can’t make you wait more than 12 months for a pre-existing condition for surgery in hospital, you may find that some offer no waiting periods or only two-month waiting periods for things like physiotherapy, which could help you manage your condition while you wait.

Where can I find and compare health insurance?

It’s no secret that finding health insurance can be tricky and time-consuming, but iSelect is here to help. Using our online comparison tool, you can check out a range of policies from our different providers in a matter of minutes. You can also call one of our comparison experts on 1800 784 772 if you’d prefer.