Does Medicare Cover Hip Replacement Surgery?

If your surgeon determines that your hip replacement requires an inpatient hospital stay, Medicare Part A covers the surgery, hospital room, nursing care, meals, medications administered during your stay, and any necessary lab work or imaging.

In 2026, you pay the Part A deductible of $1,736 per benefit period. After that, you pay $0 coinsurance for days 1 through 60. If your stay extends beyond 60 days (rare for hip replacement), you pay $434 per day for days 61-90. Most inpatient hip replacements involve a 1-3 day hospital stay.

There is no limit on the number of hip replacements Medicare will cover over your lifetime, as long as each is medically necessary. Medicare also covers a second opinion from another surgeon under Part B if you want one before proceeding.

More than half of all hip replacements in the United States are now performed as outpatient procedures, meaning you go home the same day or within 23 hours. CMS removed total hip arthroplasty from the Inpatient-Only list in 2020, making outpatient hip replacement widely available.

Under Part B, you pay 20% of the Medicare-approved amount after meeting your $283 annual deductible. According to Medicare's Procedure Price Lookup tool, the average patient cost for outpatient total hip replacement (CPT 27130) is approximately $2,154 at an ambulatory surgical center and $1,927 at a hospital outpatient department.

Your surgeon's fees, anesthesia, implant costs, and facility fees are all included in the Medicare-approved amount. You do not need a qualifying hospital stay to access outpatient rehabilitation services afterward.

Medicare covers a comprehensive range of recovery services after hip replacement surgery. Outpatient physical therapy is covered under Part B with no annual spending cap, meaning Medicare will continue paying for medically necessary PT sessions as long as your doctor prescribes them. Most patients need 6-12 weeks of physical therapy after hip replacement.

If you need short-term skilled nursing facility (SNF) care after a qualifying 3-day inpatient hospital stay, Part A covers days 1-20 at $0 coinsurance and days 21-100 at $218 per day in 2026. Home health services are covered at $0 cost if you are homebound and need skilled care, including physical therapy, occupational therapy, and medical social services.

Medicare Part B also covers durable medical equipment like walkers, crutches, and canes at 80% of the Medicare-approved amount. Your doctor must certify that the equipment is medically necessary.

A Medicare Supplement (Medigap) plan can dramatically reduce your out-of-pocket costs for hip replacement surgery. With Medigap Plan G, your maximum cost for an inpatient hip replacement is $283 (the Part B deductible) because Plan G covers the Part A deductible, all Part A coinsurance, and all Part B coinsurance.

For an outpatient hip replacement, Plan G covers the 20% coinsurance, so you only pay the $283 Part B deductible instead of $1,927-$2,154. Plan G also covers SNF coinsurance for days 21-100, meaning your rehabilitation stay costs $0. There are no network restrictions with Medigap, so you can see any surgeon who accepts Medicare.

Compare this to Original Medicare alone, where an inpatient surgery costs $1,736 and outpatient costs $1,927-$2,154. For a comparison of how Medigap protects you during major medical events, see our guide on how Medigap covers major surgery compared to Medicare Advantage.