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Package

Knee replacement - total

Package

Knee replacement - total

Knee replacement (total) is surgery that replaces all surfaces of the damaged knee joint with metal and plastic implants to relieve pain and restore function. It is typically recommended for severe arthritis, widespread joint damage, or limited mobility that has not improved with other treatments. The procedure is performed under anesthesia and usually involves a short hospital stay followed by physical therapy to rebuild strength and movement. Most patients experience significant improvement in pain and daily function as they progress through recovery.
You'd pay up to
$48,531 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

$48,531

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest
$21,124
Highest
$66,552
Cash price
up to $48,531

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Knee replacement - total Standard Service Package (SSP MS000). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS C1776 Facility Fee Implantable Joint Device for Motion Restoration
HCPCS J3490 Facility Fee Pharmaceuticals without Categories
HCPCS 97116 Facility Fee Therapeutic gait training of 1+ areas for 15 min each
HCPCS J7030 Facility Fee Intravenous infusion of 1000cc of normal saline
HCPCS 80048 Facility Fee Basic metabolic panel including calcium, bicarbonate, chloride, creatinine, glucose, potassium, sodium and BUN
HCPCS J1100 Facility Fee Intramuscular injection of 1mg dexamethasone sodium phosphate
HCPCS J1885 Facility Fee Intramuscular injection of 15mg ketorolac tromethamine
HCPCS 73560 Facility Fee X-ray imaging of knee, 1-2 views
HCPCS 97162 Facility Fee Physical therapy evaluation, moderate complexity with patient-specific data, assessments, and functional outcomes
HCPCS 97530 Facility Fee Dynamic one-on-one therapeutic activity to improve functioning, 15 min each
HCPCS 36415 Facility Fee Collection of blood from a vein via puncture
HCPCS J0690 Facility Fee Intramuscular injection cefazolin sodium, 500mg
HCPCS J3010 Facility Fee Intramuscular injection of fentanyl citrate, 0.1mg
HCPCS J2704 Facility Fee Intramuscular injection of 10mg propofol
HCPCS J0665 Facility Fee Injection of numbing medication for pain relief
HCPCS J2405 Facility Fee Intramuscular injection of ondansetron hydrochloride, 1mg
HCPCS J2250 Facility Fee Intramuscular injection of 1mg midazolam hydrochloride
HCPCS 82962 Facility Fee Fda-cleared Home Glucose Monitoring Device-measured Blood Glucose
HCPCS 97110 Facility Fee Rehabilitative exercises for strength, endurance, range of motion and flexibility
HCPCS 85025 Facility Fee Complete blood count (CBC) with differential WBC
HCPCS 97165 Facility Fee Low Complexity Ot Eval Including Occupational Profile, Medical/Therapy History, Assessment(s), and Decision Making
HCPCS 27447 Facility Fee Replace Medial and Lateral Knee Joint Surfaces Plus Potential Patella Resurfacing
HCPCS 27447 Professional Fee Replace Medial and Lateral Knee Joint Surfaces Plus Potential Patella Resurfacing
Revenue Code 250 Facility Fee Pharmacy (Also see 063X, an extension of 250X) - General
HCPCS 99024 Professional Fee Postoperative Evaluation and Management Follow-up

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to
$48,531 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Contact us to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Knee replacement - total
Service Codes HCPCS C1776, HCPCS J3490, HCPCS 97116, HCPCS J7030, HCPCS 80048
Insurance I'm not using insurance
Location Southern Ohio Medical Center
When you contact us, you can say:
"Hi, I'm calling to verify a price for Knee replacement - total I found through Southern Ohio Medical Center's price estimate tool. Here are the codes I’m looking at: HCPCS C1776, HCPCS J3490, HCPCS 97116, HCPCS J7030, HCPCS 80048. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"
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