Knee Replacement Cost in West Virginia (2026): Average Prices & What You'll Pay
What does a knee replacement cost in West Virginia?
Expect roughly $3,596 to $13,759 for a knee replacement in West Virginia if you're commercially insured — that range already folds in both the facility charge and the physician fee. The median reported facility price across 27 hospitals is $2,515. It's built from CMS fee schedules and federally mandated hospital price transparency data.
WVU Medicine and CAMC (Charleston Area Medical Center) are the primary academic systems, with Thomas Health and Highmark's West Penn Allegheny network providing additional coverage. West Virginia has one of the lowest wage indices in the country, which depresses Medicare-adjusted rates significantly — but commercial rates don't always follow the same pattern. Many rural facilities are critical access hospitals.
Knee replacement is a high-cost elective procedure where facility selection has an outsized impact on total cost. Hospital outpatient and ambulatory surgery center rates for knee replacement have converged on outcomes but diverged further on price — ASC rates are typically 30–50% below hospital rates for the same implant and surgeon. Medicare Advantage plans increasingly direct patients to designated bundled-payment facilities where your out-of-pocket liability is capped.
The same knee replacement that costs $536 at Cabell Huntington Hospital, Inc. in Huntington reaches $71,188 at Weirton Medical Center Inc in Weirton — a 132.8× gap across the 27 West Virginia hospitals reporting prices. The median West Virginia price is $2,515. Most facilities fall between $1,149 and $7,307. There's a gap between the sticker and the real price here: a median cash quote of $6,180 sits above the $1,149 insurers negotiate — about 5.4× higher, so asking for the cash or insurer-negotiated rate is often the single biggest lever on your bill. Even within West Virginia, Webster Springs ($606) and Elkins ($7,016) are 11.6× apart on the median price.
Forecast your out-of-pocket cost
- Lower-cost hospitals (bottom 25%): under $1,149
- Median hospital: $2,515
- Higher-cost hospitals (top 30%): $7,307+
That's a 6× spread for the same procedure — driven entirely by which facility you choose, not by clinical complexity.
- Patient A (higher-rate plan or out-of-network): ~$7,307
- Patient B (lower-rate in-network plan): ~$1,176
Where knee replacement costs vary in West Virginia
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby ambulatory surgery centers, imaging centers, and other facilities (colored by type). Click any pin for facility name and estimated cost range.
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Cheapest Knee Replacement Providers in West Virginia
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | Thomas Memorial Hospital | South Charleston, WV | $803 | -$1,712 |
| 2 | Wetzel County Hospital, Inc. | New Martinsville, WV | $866 | -$1,649 |
| 3 | Wetzel County Hospital, Inc. | New Martinsville, WV | $866 | -$1,649 |
| 4 | Thomas Memorial Hospital | South Charleston, WV | $884 | -$1,631 |
| 5 | United Hospital Center, Inc | Bridgeport, WV | $1,139 | -$1,376 |
| 6 | United Hospital Center, Inc | Bridgeport, WV | $1,139 | -$1,376 |
| 7 | City Hospital, Inc. | Martinsburg, WV | $1,149 | -$1,366 |
| 8 | City Hospital, Inc. | Martinsburg, WV | $1,149 | -$1,366 |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
The facility you choose matters more than almost anything else — the same procedure, same quality, same state can cost 5× more at one hospital versus the one down the road.
→ Compare all procedure costs → Knee Replacement costs nationwide
Check YOUR hospital's pricing → Estimate YOUR exact cost →
What you'll actually pay — example scenarios
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met (pay in full) | ~$6,547 |
| Deductible met — 20% coinsurance | ~$1,309 |
| Out-of-network provider | $14,403+ |
Based on a typical episode cost of $6,547 (facility + physician fees). Your actual cost depends on your plan deductible, coinsurance rate, and network tier. Get YOUR personalized estimate →
What this means for you
If you haven't met your deductible, you are effectively a cash-pay patient.
That means:
- You should verify your hospital is in-network before an elective visit when possible
- The cheapest facility can save you $2,107+ vs. the median.
This is the single biggest lever most patients have to reduce their cost.
Lower-cost options in West Virginia start around $1,149 or below. Most hospitals cluster between $1,149 and $8,544. A smaller group reports prices above that — often academic medical centers or high-cost markets.
If you're comparing specific hospitals, the lowest self-pay rates reported in this dataset include: Broaddus Hospital Association Inc in Philippi (cash price from $2,187); Potomac Valley Hospital of WV, Inc. in Keyser (cash price from $2,293); Sistersville General Hospital in Sistersville (cash price from $2,432). These are declared cash prices — contact each facility for a formal quote before scheduling.
How where you go changes what you pay for knee replacement
The same knee replacement bundles different services depending on the setting — facility fee, surgeon fee, and anesthesia each arrive as separate bills. Estimated ranges below reflect the typical full bundled cost, including all expected charges.
- Facility fee $578–$31,070
- Professional fee $1,205–$6,940
Estimated from CMS fee schedules + commercial rate multipliers
- Facility fee $408–$34,953
- Professional fee $1,205–$6,940
Estimated from CMS fee schedules + commercial rate multipliers
- Best value hospitals (lowest prices): Cabell Huntington Hospital, Inc.: $408; Broaddus Hospital Association Inc: $2,187; Webster Memorial Hospital Inc: $606
- Most expensive (outpatient): Weirton Medical Center Inc: ~$31,070; Raleigh General Hospital: ~$17,267
→ Choosing the right facility can save $2,107+ vs. the state median.
West Virginia Knee Replacement prices by facility
All prices below come from hospital chargemasters — the official price lists each hospital must publish under federal law. Gross charge is the undiscounted list price; cash price is the self-pay rate; negotiated range covers the spread across insurance contracts.
- Cash price — the self-pay rate you can actually negotiate and pay
- Negotiated rate — if reported by the hospital across insurance contracts
- Gross charge — fallback only; this is the inflated list price few people pay
This reflects the real prices patients encounter — not inflated chargemaster rates.
| # | Facility | City | Your Price | vs Median | Gross Charge |
|---|---|---|---|---|---|
| #1 | Cabell Huntington Hospital, Inc. | Huntington, WV | $408 | -$2,107 | $544–$581 |
| #2 | Broaddus Hospital Association Inc | Philippi, WV | $2,187 | -$328 | $578–$2,725 |
| #3 | Webster Memorial Hospital Inc | Webster Springs, WV | $606 | -$1,909 | $606–$1,912 |
| #4 | Mon Health Medical Center | WV | $34,953 | +$32,438 | $34,953–$60,109 |
| #5 | Thomas Memorial Hospital | South Charleston, WV | $803 | -$1,712 | $1,878 |
| #6 | Wetzel County Hospital, Inc. | New Martinsville, WV | $866 | -$1,649 | $2,166 |
| #7 | United Hospital Center, Inc | Bridgeport, WV | $1,139 | -$1,376 | $1,899–$2,591 |
| #8 | City Hospital, Inc. | Martinsburg, WV | $1,149 | -$1,366 | $1,916 |
| #9 | Reynolds Memorial Hospital, Inc. | Glen Dale, WV | $1,179 | -$1,336 | $1,966 |
| #10 | Grant Memorial Hospital Inc | Petersburg, WV | $2,295 | -$220 | $2,834 |
| #11 | St. Marys Medical Center | Huntington, WV | $11,100 | +$8,585 | $11,100–$28,753 |
| #12 | Potomac Valley Hospital of WV, Inc. | Keyser, WV | $2,293 | -$222 | $4,586 |
| #13 | Sistersville General Hospital | Sistersville, WV | $2,432 | -$83 | $1,699–$3,705 |
| #14 | Davis Medical Center | Elkins, WV | $2,598 | +$83 | $578–$14,994 |
| #15 | Beckley ARH Hospital | WV | $3,383 | +$868 | $5,639–$6,291 |
| #16 | Camden-Clark Memorial Hospital Corporation | Parkersburg, WV | $3,798 | +$1,283 | $1,933–$30,561 |
| #17 | Community Health Association | Ripley, WV | $4,700 | +$2,185 | $9,401 |
| #18 | Logan Regional Medical Center | Logan, WV | $5,420 | +$2,905 | $13,552 |
| #19 | West Virginia Health Care Cooperative Inc. | Summersville, WV | $6,180 | +$3,665 | $2,834–$12,360 |
| #20 | West Virginia University Hospitals, Inc. | Morgantown, WV | $8,435 | +$5,920 | $1,805–$16,871 |
| #21 | Marion Neighborhood Hospital | White Hall, WV | $8,580 | +$6,065 | $17,160 |
| #22 | STONEWALL JACKSON HOSPITAL | WV | $8,835 | +$6,320 | $8,835–$28,113 |
| #23 | HAMPSHIRE MEMORIAL HOSPITAL, INC | Romney, WV | $11,008 | +$8,493 | $11,008 |
| #24 | WAR MEMORIAL HOSPITAL, INC | Berkeley Springs, WV | $11,934 | +$9,419 | $11,934 |
| #25 | Boone Memorial Hospital | Madison, WV | $16,934 | +$14,419 | $33,869 |
| #26 | Raleigh General Hospital | WV | $17,267 | +$14,752 | $43,168–$55,589 |
| #27 | Weirton Medical Center Inc | Weirton, WV | $31,070 | +$28,555 | $62,141 |
Unlock all 22 remaining West Virginia hospitals
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Source: CMS hospital price transparency machine-readable files. vs Median = savings or premium relative to the state median price. Gross Charge = undiscounted list price for reference.
Received a bill? Check it for errors → Estimate YOUR cost before you go →
Compare other procedures in West Virginia:
Where you can save the most on knee replacement in West Virginia
These facilities have the lowest declared prices relative to the state median — they represent the best opportunities to reduce your out-of-pocket cost for this procedure.
| Facility | City | Your Price | vs Median |
|---|---|---|---|
| Cabell Huntington Hospital, Inc. | Huntington, WV | $408 | -$2,107 |
| Broaddus Hospital Association Inc | Philippi, WV | $2,187 | -$328 |
| Webster Memorial Hospital Inc | Webster Springs, WV | $606 | -$1,909 |
| Mon Health Medical Center | WV | $34,953 | +$32,438 |
| Thomas Memorial Hospital | South Charleston, WV | $803 | -$1,712 |
How to choose a lower-cost facility
- Choose independent outpatient centers when possible — freestanding ASCs (ambulatory surgical centers) consistently charge less than hospital outpatient departments for identical procedures.
- Ask for the cash price if your deductible isn't met — self-pay rates are often lower than what insurance pays before your deductible is satisfied, especially at facilities that have a high cash-price discount.
- Avoid hospital outpatient departments for routine cases — hospital-owned locations add a facility fee that freestanding centers don't charge, often adding $500–$1,500 to the same procedure.
Most expensive knee replacement providers in West Virginia
These facilities report the highest prices for this procedure. Academic medical centers and specialty hospitals often top this list — their gross charges rarely reflect what anyone actually pays, but understanding the spread helps you negotiate.
| Facility | City | Price | vs Median |
|---|---|---|---|
| Mon Health Medical Center | WV | $34,953 | +$32,438 |
| Weirton Medical Center Inc | Weirton, WV | $31,070 | +$28,555 |
| Raleigh General Hospital | WV | $17,267 | +$14,752 |
| Boone Memorial Hospital | Madison, WV | $16,934 | +$14,419 |
| WAR MEMORIAL HOSPITAL, INC | Berkeley Springs, WV | $11,934 | +$9,419 |
Why prices vary this much
A small number of hospitals (2) report very high prices above $19,636, which drives much of the overall price range. Excluding these, most facilities cluster in a significantly tighter band.
Setting drives much of the gap in West Virginia: the median outpatient price is $2,598 versus $2,598 inpatient, so where a procedure is performed often matters more than which hospital you choose. Of the West Virginia facilities reporting prices, 13 fall in a low-cost tier (up to $1,149) while 12 sit in a high-cost tier ($8,544 and up) — a lower-priced option almost always exists within the same state.
Among the cities with the most reporting hospitals, Huntington has a median reported price of $2,041 across 4 facilities, while facilities in Webster Springs tend to report lower prices (median: $606). City-level variation within a state often reflects local market structure, not procedure complexity.
The spread comes from how each hospital sets its chargemaster (the undiscounted list price), what cash discounts it applies, and what rates it negotiates with each insurer. Facility classification matters too — a hospital-owned outpatient center adds a facility fee that a freestanding clinic does not. Understanding these mechanics is the first step to paying less.
Learn more:
→ Allowed amount vs negotiated rate — what your EOB is really saying
→ How to read your medical bill
→ Why hospital prices are so hard to find — and what to do about it
How insurance changes what you actually pay
Hospital list prices are only part of the picture. What you pay out of pocket depends on your deductible, your plan's out-of-pocket maximum, whether the facility is in-network, and whether your plan classifies the visit as outpatient or inpatient. A lower gross charge doesn't guarantee a lower bill if the facility is out-of-network or adds facility fees your plan doesn't cover.
Understand your cost before you go:
→ Deductible vs out-of-pocket max
→ EOB vs medical bill — complete guide
→ How to stop medical bill problems before they start (in-network vs out-of-network)
Knee Replacement Costs by Metro Area in West Virginia
Prices vary across West Virginia metro areas based on local hospital competition, wage adjustments, and facility mix. Explore detailed facility price data for each metro area:
- Knee Replacement Cost in Charleston, WV
- Knee Replacement Cost in Huntington, WV
- Knee Replacement Cost in Morgantown, WV
- Knee Replacement Cost in Parkersburg, WV
- Knee Replacement Cost in Weirton, WV
Compare knee replacement costs in nearby states
Frequently asked questions: knee replacement costs in West Virginia
How much does a knee replacement cost in West Virginia?
Across 27 West Virginia hospitals that publish prices, a knee replacement ranges from $536 to $71,188, with a median of $2,515. Most facilities fall between $1,149 and $7,307. What you pay depends on the facility, your insurance, and whether you have met your deductible.
Where is the cheapest place to get a knee replacement in West Virginia?
Based on declared prices, the lowest-cost facility in our West Virginia data is Cabell Huntington Hospital, Inc. in Huntington at about $408. By metro, Webster Springs has the lowest median ($606). Freestanding ambulatory surgery and imaging centers are often cheaper still and may not appear in hospital price data — ask your doctor whether one is an option.
Why is a knee replacement so much cheaper at some West Virginia hospitals?
Prices vary up to 132.8× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In West Virginia, the median cash (self-pay) price is $6,180 versus a median negotiated rate of $1,149 — about 5.4× higher. Asking for the cash price or your insurer's negotiated rate is often the single biggest lever on what you pay.
How much will I actually pay out of pocket for a knee replacement in West Virginia?
Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network — not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.
Explore all knee replacement cost data
→ See knee replacement costs across all states
Other West Virginia Hospitals and ambulatory surgery centers for Knee Replacement
These hospitals and ambulatory surgery centers are registered in the CMS National Provider Identifier (NPI) registry as active hospitals and ambulatory surgery centers in West Virginia. Cost estimates use the bundled service model for each place of service. Contact them directly for a formal quote.
| Provider | City | Type | Est. Cost | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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ACUITY SPECIALTY HOSPITAL - OHIO VALLEY, LP
3042385750 |
WHEELING, WV | Long Term Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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ACUITY SPECIALTY HOSPITAL - OHIO VALLEY, LP
3049194300 |
WEIRTON, WV | Long Term Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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ACUITY SPECIALTY HOSPITAL - OHIO VALLEY, LP
3049194300 |
WEIRTON, WV | Long Term Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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ACUITY SPECIALTY HOSPITAL - OHIO VALLEY, LP
3042385750 |
WHEELING, WV | Long Term Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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ALECTO HEALTHCARE SERVICES FAIRMONT LLC
3043677109 |
FAIRMONT, WV | General Acute Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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ALECTO HEALTHCARE SERVICES WHEELING LLC
3042348663 |
WHEELING, WV | General Acute Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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ANWAR EYE CENTER, INC
3048450908 |
MOUNDSVILLE, WV | Ambulatory Surgical Center | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BECKLEY SURGERY CENTER, INC
3042552724 |
BECKLEY, WV | Ambulatory Surgical Center | — | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BECKLEY VAMC
8282572333 |
BECKLEY, WV | General Acute Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BLUEFIELD HOSPITAL COMPANY LLC
3043271100 |
BLUEFIELD, WV | General Acute Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BLUEFIELD REGIONAL MEDICAL CENTER
3043271100 |
BLUEFIELD, WV | General Acute Care Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BRAXTON COUNTY MEMORIAL HOSPITAL
3043645156 |
GASSAWAY, WV | Critical Access Hospital | $1,783–$38,010 bundled est. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
▼ Show 122 more West Virginia hospitals and ambulatory surgery centers
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Est. cost = bundled estimate (facility fee + professional fee + anesthesia where applicable) based on CMS fee schedules and commercial rate multipliers. Contact each provider for an actual quote.
Source: CMS NPPES NPI Registry. NPI numbers can be verified at npiregistry.cms.hhs.gov.
Where You Get a Knee Replacement Matters
Hospital outpatient departments typically charge 2–4× more than ASCs or independent centers for the same procedure — same outcome, very different bill.
Ambulatory Surgery Center
Ambulatory Surgery Center typically carries a mid-range price for a knee replacement. Typically 40–60% less than hospital OP for surgical procedures. Anesthesia billed separately. You can shop here — call ahead and ask for a self-pay or cash quote.
Hospital Inpatient
Hospital Inpatient typically carries the highest price for a knee replacement. DRG-based billing bundles most services. Professional fees billed separately. Length of stay drives cost.
What's Actually on Your Knee Replacement Bill
A knee replacement involves multiple providers — each bills separately. Understanding each line item helps you verify your Explanation of Benefits and catch billing errors.
Asc
- ASC Facility Fee — Device-intensive (J8 payment indicator) — ASC payment = OPPS payment minus device offset. MRF data shows 30–70% less than hospital OP in some markets.
- Orthopedic Surgeon Professional Fee
- Anesthesia
- Implant Device Cost
Hospital Inpatient
- Drg Facility Stay — DRG 470 (major joint replacement without MCC) most common.
- Orthopedic Surgeon Professional Fee
- Anesthesia
- Implant Device Cost
Knee Replacement Cost by Type
Which type your doctor orders changes the billing code — and what you pay. Here's how the common types differ.
Total Knee Replacement
A recognized variation that can change the billing code and what you owe. Most common. Replaces entire joint surface.
Partial Knee Replacement (Unicompartmental)
A recognized variation that can change the billing code and what you owe. Less invasive when only one compartment is damaged. Faster recovery.
Knee Revision Surgery
A recognized variation that can change the billing code and what you owe. Replacement of a failed implant. Significantly more complex and expensive.
This Procedure Is Shoppable — Choosing the Right Facility Can Save Thousands
Knee Replacement is elective and schedulable. You have time to compare facilities — and hospital outpatient prices often run 2–4× higher than ASC for identical clinical outcomes.
How to shop: Ask your doctor for the CPT code, then call 2–3 facilities and request an out-of-pocket cost estimate. Confirm your insurance is accepted. If uninsured, ask for the cash-pay rate — it's usually 20–50% below the list price.
Prior Authorization Is Usually Required
Most commercial and Medicare Advantage plans require pre-approval for knee replacement before scheduling. If your doctor submits the order without prior authorization — or if the authorization lapses — your insurer can deny the entire claim, leaving you responsible for the full cost.
Action step: Call the member services number on your insurance card before scheduling. Ask: "Does this procedure require prior authorization?" Get the authorization number in writing and confirm it's attached to the claim before your appointment.
The Implant Is the Largest Cost Driver
For knee replacement, the implant or device typically accounts for 40–70% of the total hospital bill. Surgeons have preferred device relationships that affect which implant is used — and different implants can vary by $5,000–$15,000 in cost.
What to ask: Request an itemized estimate that breaks out the implant separately. Ask your surgeon whether a comparable implant is available at a lower cost.
Who performs this: Knee Replacement is typically performed by a Orthopedic Surgery. The specialist's professional fee is billed separately from the facility charge — you will likely receive separate bills from each.
CostKits compiles hospital price transparency data to help families make informed decisions. If you've received a bill for this procedure:
→ Analyze your medical bill for errors
→ How to negotiate your medical bills
→ Track and manage your healthcare costs (free account)
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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