Difference Between Estimated Purchase Price and Insurance Payments for Knee and Hip Implants in Privately Insured Patients Younger Than 65 Years

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common procedures with charges ranking first and eighth among all procedures in the United States.¹ The cost of the implant device is typically the largest expense associated with these procedures,² but insurance companies pay without knowledge of either price or even the device model. We compared allowed insurance payments for these devices to an estimated price at which the hospital purchased the implant from the manufacturer to estimate the discrepancy.