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How Much Does Shoulder Surgery Cost in Australia?
How Much Does Shoulder Surgery Cost in Australia?
Written by
Tina Sendin
Edited by
Ellie Garran
Reviewed by
Andres GutierrezCompare Health Insurance Policies
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What is shoulder surgery?
Long story short
Public is free, but you’ll have to wait
Medicare covers the full cost of shoulder surgery in a public hospital, but you’ll face waiting lists that can stretch for months (if not more than a year).
Private gives you control
Going private lets you choose your specialist and timing, but potentially comes with out-of-pocket costs of more than $1,000 – even with private health insurance.
The level of hospital cover you need depends on the shoulder surgery
Depending on the type of shoulder surgery, a bronze policy or higher could help take care of the costs. But for a shoulder replacement, you’ll need gold cover (or in some cases, a silver plus policy).
What is shoulder surgery?
Shoulder surgery isn’t one single procedure; it’s a broad term covering everything from early surgical repairs to total joint replacements. Generally, it’s the fix for when physiotherapy, painkillers, and even steroid injections haven’t solved issues like chronic pain, stiffness, or injury.
The shoulder is a complex ball-and-socket joint, with a network of muscles, tendons, and ligaments working together to keep it moving freely. But that range of motion also means it’s easy to overuse or injure.
If a persistent shoulder issue’s left alone for far too long, it can turn into some pretty painful problems. Whether it’s arthritis wearing down the cartilage, a rotator cuff tear making lifting your arm impossible, or another injury that just isn’t healing, shoulder surgery could be on the cards to repair the damage or replace the joint entirely.
What are the common types of shoulder surgery?
It’s more than just snapping your dislocated shoulder back in after a mate gets carried away with a footy tackle. Types of shoulder surgery include shoulder replacement, rotator cuff repair, arthroscopic coracoacromial, and synovectomy.
Shoulder replacement
A shoulder replacement removes the damaged parts of your shoulder joint and replaces them with artificial components to relieve pain and improve movement. During the procedure, the surgeon removes the damaged ball of the humerus, assesses the socket, and replaces one or both parts with metal and plastic implants.
It’s usually recommended when severe osteoarthritis or joint damage cause significant pain and stiffness that no longer responds to other treatments.
Rotator cuff repair
Rotator cuff surgery repairs torn or damaged tendons in your shoulder area that help keep your shoulder stable and moving. It’s usually recommended when persistent pain, weakness, or limited movement don’t improve with lifestyle changes, physiotherapy, painkillers, or injections. During the day surgery, the surgeon repairs the damaged tissue using either keyhole (arthroscopic) or open techniques.
Arthroscopic coracoacromial
This is a keyhole surgery to cut a shoulder ligament and remove a small section of the shoulder bone.
Synovectomy
This type of shoulder surgery removes the inflamed membrane in the shoulder joint.
When should I have shoulder surgery?
Deciding to go under the knife is never easy. But you’d generally consider it when:
- pain persists despite rest, physio, and anti-inflammatory meds
- you have difficulty performing everyday tasks like dressing or reaching overhead
- pain keeps you awake at night
- you have a significant injury, like a large rotator cuff tear or fracture
- you experience frequent or recurrent dislocations.
A shoulder surgery can get your mobility back so you can lift your kids, play sport, or simply sleep without pain. A better quality of life, essentially!
What’s the cost of shoulder surgery?
As a public patient, you can get shoulder surgery for free – if it’s medically necessary and you’ve got your Medicare card ready. But as a private patient, the procedure could set you back by around $1,000 or more, according to Medical Costs Finder.
Does Medicare cover shoulder surgery?
If you’re an Australian resident with a Medicare card, shoulder surgery in a public hospital is free. Medicare pays for the surgeon, anaesthetist, hospital stay, and theatre fees.
But here’s the catch: You’re placed on a waiting list. For non-urgent elective surgeries like shoulder replacements, the wait can be long. You also don’t get to choose your specific surgeon; you’re operated on by the scheduled healthcare team.
Choosing the private route gives you speed and choice – but at a cost.
Does private health insurance cover shoulder surgery?
Yes, private health insurance could help pay for your shoulder surgery. In a private setting, Medicare pays 75% of the MBS (Medical Benefits Schedule) fee, and your private insurer pays the remaining 25%. But there are usually still out-of-pocket costs – often around $1,000.
This out-of-pocket cost is also known as the medical gap. It’s worth checking whether a health fund has a medical gap scheme with a healthcare provider, meaning the gap gets reduced or eliminated.
Let’s have a look at how much private patients typically spent for different types of shoulder surgery based on the 2023–24 data from the Australian Government’s Medical Costs Finder. These figures reflect the orthopaedic surgeon and assistant surgeon’s fees – as well as that of the anaesthetist.
Costs of different types of shoulder surgery
| Shoulder reconstruction or repair, including rotator cuff repair | Shoulder replacement | Synovectomy of the shoulder | Arthroscopic coracoacromial | |
| Medical Benefits Schedule (MBS) item number | 48960, 48909, 48906 | 48918 | 48954 | 48951 |
| Typical specialists’ fees | $3,600 | $6,000 | $3,700 | $3,600 |
| Medicare rebates | $1,200 | $2,200 | $1,300 | $1,300 |
| Insurer typically paid | $1,000 | $1,800 | $1,200 | $1,100 |
| Typical out-of-pocket cost | $1,000 | $1,100 | $990 | $890 |
| % of patients with an out-of-pocket cost | 81% | 83% | 84% | 80% |
Sources: Medical Costs Finder – Shoulder reconstruction or repair, including rotator cuff repair; Shoulder replacement; Synovectomy of the shoulder; Arthroscopic coracoacromial
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 February 2026.
Are there other out-of-pocket costs for shoulder replacement surgery?
Yes, the surgical fees are just one piece of the puzzle. You’d also need to consider hospital costs linked to your stay and treatment, and sometimes they’re no pocket change. For instance, a shoulder replacement surgery could involve hospital costs of $19,000. Luckily, private hospital cover could take care of some or all of these costs.
Let’s see what hospital costs look like for different types of shoulder surgery based on 2023–24 figures.
Hospital costs for various types of shoulder surgery
| Procedure | Hospital costs |
| Shoulder reconstruction or repair, including rotator cuff repair | $6,200 |
| Shoulder replacement | $19,000 |
| Synovectomy of the shoulder | $4,800 |
| Arthroscopic coracoacromial | $5,400 |
Source: Medical Costs Finder – Shoulder reconstruction or repair, including rotator cuff repair; Shoulder replacement; Synovectomy of the shoulder; Arthroscopic coracoacromial
Note: Data retrieved February 2026.
There could also be other out-of-pocket costs, including (but not limited to):
- Hospital excess: Depending on your policy, you’ll pay an excess (e.g., $500 or $750) when you are admitted.
- Co-payment: Depending on your policy, you might pay a fixed amount for each day of your hospital stay. Depending on the shoulder surgery, you might have to spend a night or two in the hospital. For instance, most patients undergoing shoulder replacement spend one or two nights (if not more) in the hospital.
- Prostheses: Your orthopaedic surgeon chooses the kind of prosthesis to be used for a total shoulder replacement depending on your age, lifestyle, and anatomy. Most artificial joints are fully covered, either through Medicare or your health fund. However, if you’re an uninsured private patient, this is something you’d need to budget for.
Are there other costs after shoulder replacement surgery?
Recovery is a marathon, not a sprint, and it comes with its own price tag.
- Physiotherapy: You’ll need weeks or months of rehab to regain movement. Outpatient appointments with a private physiotherapist are usually needed as part of rehabilitation, and this normally comes from your own pocket. Extras cover could help take care of some of these costs – if you have it.
- Follow-up appointments: The surgeon will need to see you to check how you’re healing. Medicare covers part of this, but there also might be a gap.
- Pain medications: You might need pain relief post-op.
- Aids and equipment: You might need special pillows, aids, and equipment to help you perform daily activities while your arm is out of action.
Helpful tip
Always ask your surgeon for ‘informed financial consent’ before you book. This is a document that details exactly what they will charge, what you will get back, and what your gap will be. Don’t be afraid to ask about the anaesthetist’s fees at the same time.
Andres Gutierrez
General Manager – Health
How long will I have to wait for shoulder surgery?
In the public system, you’re placed on a waiting list for elective surgery. This could mean having to wait for months – if not more than a year – for an elective shoulder surgery. For context, 2024–25 data from the Australian Institute of Health and Welfare shows 50% of patients throughout the country waited for 86 days to get admitted for orthopaedic surgery, and 10% had to wait more than 371 days to go under the knife. How long you’ll have to wait depends on the urgency, your location, and your local public hospital’s availability.
But as a private patient, you won’t have to wait as long. Private hospital cover could help you skip all the public waitlists and nip the problem in the bud much more quickly. You can also pick your orthopaedic surgeon and hospital.
Just keep in mind that there’s a 12-month waiting period in private health insurance for pre-existing conditions (like osteoarthritis), which applies if you’re new to hospital cover or you’ve upgraded to a higher-tier policy. For new conditions, the waiting period is generally two months.
What level of health insurance do I need to cover a shoulder surgery?
It depends on the type of shoulder surgery. Something like a rotator cuff repair could be covered by any policy with ‘joint reconstructions’, or a shoulder fracture could fall under ‘bone, joint, and muscle’ – both typically found in bronze policies and higher.
But a shoulder replacement requires ‘joint replacements’ cover, which is typically only available in gold-level hospital policies – though some ‘silver plus’ policies may include it in some cases.
It’s worth checking your policy to avoid any gaps in coverage.
Frequently asked questions
What’s the average cost of shoulder replacement surgery without insurance?
If you’re uninsured, the average cost for shoulder replacement surgery could land you almost $3,000 out of pocket for specialist fees alone. The cost of your hospital stay and treatment for the same procedure could be around $20,000. If you do the maths, a shoulder replacement surgery could set you back almost $25,000 without private health insurance. Ouch!
What factors affect the cost of shoulder replacement surgery?
The total cost of shoulder replacement surgery depends on whether you’re going in as a public or private patient, the facility or hospital, your state or territory, your specialists’ fees, the anaesthetic used, and what your policy looks like (e.g. your excess and co-payment amounts).
What types of shoulder joint replacement are available?
There are several types of shoulder joint replacement, including total, reverse, revision and partial shoulder replacements. The right option depends on which part of the joint is damaged and how severe the damage is.
- A total shoulder replacement swaps out the worn or damaged parts of your shoulder joint for artificial ones, helping ease pain and improve movement.
- A reverse shoulder replacement does exactly what it sounds like – it switches the position of the ball and socket. This option is often used when the rotator cuff muscles are badly damaged.
- A revision shoulder replacement is basically a ‘fix‑up’ surgery. It removes old or failing replacement parts and puts new ones in their place.
- A partial shoulder replacement only replaces the head of the arm bone, making it a good option when that’s the only part affected by injury or disease.
Find and compare hospital cover
If you’ve got a shoulder surgery coming up, understanding your options can help take some of the weight off your shoulders. It’s worth getting your health cover sorted so everything sits nicely in the joint when it counts.
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