Does Medicare Cover Hip Replacement?

Jun 10th, 2017     Medicare

Medicare covers many necessary medical surgeries and other related doctor’s services. This includes hip replacement surgery which is done by orthopedic surgeon. Before undergoing any surgery, it is a good option to research about the best surgical doctors who participate in medicare program.

To find out the list of orthopedic surgeons who accept patients with medicare insurance, refer to our website //

To qualify for this surgery, the person’s doctor will have to provide detailed information and medical records to show hip replacement is medically required for the patient.

What is the cost for hip replacement surgery?

For surgeries or procedures, it’s difficult to estimate costs in advance because no one knows what kind of service is needed for the patient. If you or any member of your family is having surgery or a procedure, you can do some things in advance to figure out approximately how much it will cost for the complete procedure.

  • Ask the doctor, hospital, or facility how much the patient has to pay for the surgery and any care afterward.
  • Understand if the patient will be treated as an inpatient or outpatient because costs (and insurance) may vary accordingly.
  • Check with any other insurance the patient may have (like a Medicare Supplement Insurance (Medigap) policy, Medicaid, or coverage from his/her or spouse’s employer) to see what it will pay. If the patient belongs to a Medicare health plan (part C), contact his/her plan for more information.
  • Check the patient’s Part A deductible if he/she expects to be admitted to the hospital.
  • Check the patient’s Part B deductible for a doctor’s visit and other outpatient care.
  • Patient needs to pay the deductible amounts before Medicare will start to pay. After Medicare starts to pay, he/she may have have to pay co-payments for the care.

What does Medicare cover for Hip replacement surgery?

Medicare covers for the following services.

  • An evaluation consultation with an orthopedic surgeon.
  • Pre-surgery consultation including diagnostic studies and lab tests.
  • The surgery including fees for the doctor, anesthesia, hip implant, and operation room.
  • Postoperative hospitalization.
  • Safety bars and other medical equipment setup at home after postoperative recovery.
  • Rehabilitation and physical therapy services.

If you have any questions, please post in the comments below and we will be happy to answer them.

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.