This is a patient demand report for hip and knee practice owners and marketing leads. It covers what patients pay for anterior and posterior hip replacement, what Medicare pays your practice, what the evidence says and what patients find when they search before they call. The practice-side facts come first; the patient detail below is the evidence behind them.
For practice owners: what this search looks like from your side
Some facts, side by side.
In a survey of 996 AAHKS members, 56.2% performed anterior hips. Of those who did, 76.1% said it increased their patient market share, and 65.8% of surgeons who did not said they had lost share. (Journal of Arthroplasty, 2019)
Of 1,855 AAHKS member websites, 22.8% mentioned the anterior approach. Those sites claimed benefits such as faster recovery about 9 times more often than any risk, and 3.6% of them cited supporting research. (Journal of Arthroplasty, 2018)
In Google’s “People Also Ask” results, 52.2% of the questions were about the anterior approach, and 61.7% of the anterior websites answering them were practice or surgeon sites. (Journal of Arthroplasty, 2024)
Among Hip Society members who had used the anterior approach, 42.9% had since abandoned it. (Bone & Joint Journal, 2020)
Medicare pays the same $9,614 at a surgery center for either approach in 2026, and the surgeon’s fee fell 7.3%. I cover the surgery center side in marketing total joint replacement in an ASC.
What those mean together for your practice is for you to work out.
If you want to see how your hip pages answer this search today, book a 30-minute call. I will look at your site and your market before we talk. You can also read what a page like this is worth to an orthopedic practice.
What patients pay
In an anterior hip replacement, the surgeon works from the front of the hip, between muscles rather than through them, sometimes on a special traction table with live X-ray. In a posterior hip replacement, the surgeon works from the back and side of the hip on a regular table. The new joint can be identical. What changes is the route in, the time it takes and the complications patients read about.
Medicare and insurers pay by code, not by approach, so an insured patient’s share depends mostly on their deductible and coinsurance. Patients paying cash can find a few practices that post all-in prices.
| Where | What is listed | Posted price |
|---|---|---|
| Dr. Andrew Wickline, APEX Surgery Center | Anterior total hip | $21,300 |
| Dr. Andrew Wickline, St. Elizabeth Medical Center | Anterior total hip | $25,495 |
| ATX Orthopedics, Austin, Texas | Total hip (CPT 27130), surgery center | $23,000 |
| Syracuse Orthopedic Specialists, Central New York | Total hip, surgery center | $20,500 |
| The Orthopaedic Surgery Center, Youngstown, Ohio | Total hip | $21,424 |
Sources: Dr. Wickline self-pay page, ATX Orthopedics self-pay bundles, SOS self-pay joint replacement, The Orthopaedic Surgery Center price list.
The inclusions are where these prices differ. ATX and SOS both include the surgeon, facility, anesthesia and implant. The Youngstown center warns some procedures carry extra fees, such as implants. Only the Wickline page names the approach, and it lists the HANA table and X-ray fluoroscopy as included in the anterior price.
What Medicare pays your practice
| Anterior | Posterior | |
|---|---|---|
| Procedure code | CPT 27130 | CPT 27130 |
| Medicare 2026, hospital outpatient | $13,116 | $13,116 |
| Medicare 2026, surgery center | $9,614 | $9,614 |
| Medicare 2026, surgeon fee (national average) | $1,167 | $1,167 |
For 2026, Medicare raised the hospital outpatient rate for a total hip 2.0% to $13,116 and the surgery center rate 1.8% to $9,614. The surgeon’s national average fee fell 7.3%, from $1,259 to $1,167. An inpatient stay without major complications (DRG 470, which covers hip and knee) pays $13,025. (AAHKS summary of the 2026 OPPS and ASC final rules) These are national averages. None change with the approach, so neither does what a Medicare patient owes.
Why the same code? CPT 27130 describes replacing the hip socket and the top of the thigh bone. It does not name an approach. Researchers who studied only anterior cases found them under 27130 (Arthroplasty Today, 2024), and a national study of 750,695 hip replacements noted that billing data could not tell the approaches apart. (Arthroplasty Today, 2024) So the claim your billing team sends does not change with the approach.
What a case costs the hospital, and why studies disagree
The study that ranks near the top for this search followed 98 anterior and 69 posterior cases at one Albany, New York hospital in 2013, one experienced surgeon per approach. (Arthroplasty Today, 2017)
- The raw direct cost was $1,002 higher for anterior: $13,342 against $12,340.
- The biggest gap was operating room supplies and implants, $8,801 against $7,308.
- Anterior patients went home slightly sooner, 2.12 days against 2.4.
- Once the authors adjusted for implant and drug prices, posterior cases cost $580 more.
The authors concluded the main driver of the difference was the surgeon’s implant choice, not the approach itself.
A 2021 meta-analysis pooled the published trials and came out the other way. Anterior cases cost $588 to $887 more in operating room time and $248 to $1,162 more in blood transfusion, while the shorter stay, a mean of 13.4 hours, saved only $192 to $218. (Bone & Joint Journal, 2021)
Medicare claims for 26,773 patients from 2013 to 2014 showed average total episode costs of $22,517 for anterior and $22,068 for posterior, a difference the authors called negligible. (Journal of Arthroplasty, 2016) Another Medicare study found post-acute payments of $4,139 after anterior surgery by experienced surgeons, against $7,465 for matched patients of every approach. (Journal of Medical Economics, 2018) A 2023 systematic review could not settle it. The studies measured different costs, so the effect of approach on cost-effectiveness is unknown. (EFORT Open Reviews, 2023)
Operating room time and the traction table
Across 24 randomized trials with 2,010 patients, anterior surgery took about 17 minutes longer than posterior on average, and patients stayed about a third of a day less. (European Journal of Orthopaedic Surgery & Traumatology, 2023) The traction table is optional. In a study of 322 anterior hip replacements, 217 done on a specialized table and 105 on a regular one, operating times were 87 and 90 minutes and complication rates did not differ. (Arthroplasty Today, 2024)
What the evidence patients read says
The early edge goes to anterior. In the 24-trial analysis, Harris Hip Scores were 8 points higher at six weeks, and dislocation, fracture and blood clot rates did not differ. (European Journal of Orthopaedic Surgery & Traumatology, 2023) By 12 months, an umbrella review found no significant difference in pain or function. (Orthopedic Reviews, 2025) Longer trials agree:
- Mayo Clinic, 93 of 101 patients followed a mean of 7.5 years. No clinically meaningful difference. There was 1 dislocation after anterior surgery and 3 after mini-posterior. (Journal of Arthroplasty, 2024)
- Australia, 73 patients randomized, 5 years. No difference in scores, and implant survival was 97% in both groups. But 8 of 23 anterior patients reported numbness on the outer thigh, from the lateral femoral cutaneous nerve. (Clinical Orthopaedics and Related Research, 2021)
Wound problems are where the evidence splits. A meta-analysis of 30 trials and 11,562 patients found higher rates of overall complications, revision surgery and wound problems after anterior surgery. (Hip International, 2023) A 2026 meta-analysis limited to 18 randomized trials found fewer wound complications after anterior. (BMC Surgery, 2026) In a cohort of 1,722 patients, anterior surgery carried about three times the odds of delayed wound healing but lower odds of revision. (Archives of Orthopaedic and Trauma Surgery, 2025) Across 35,300 anterior hips, superficial infection occurred in 1.34%. (JAAOS, 2026)
Who patients are
Much of the cost data patients find describes Medicare patients. The claims study above covered 26,773 fee-for-service beneficiaries, and every 2026 rate in this report is Medicare’s.
Body weight shows up repeatedly in the anterior research. In the 1,722-patient cohort, the risk of delayed wound healing rose with body weight, and across the 35,300 anterior hips, obesity and female sex were the most common risk factors for wound problems.
Questions patients ask before they book
These are the questions your page and your front desk need to answer.
- Which approach does the surgeon do most, and how many a year? A good page gives both.
- Does the patient’s weight, anatomy or past surgery favor one approach? A good page explains how the surgeon decides.
- Can it be done at a surgery center, and is there a bundled price? A good page posts the bundle if there is one.
- What does the quote include? A good page lists implants, the table, anesthesia and therapy, since these are sometimes billed separately.
- What are the surgeon’s own rates of dislocation, thigh numbness and wound problems? A good page publishes them.
The wider price questions are covered in my reports on hip replacement cost, hip arthroscopy cost and knee replacement cost.
What a page that wins this search includes
When I reviewed the pages that rank for this comparison, most were hospital and surgeon explainers from places like HSS, IU Health, St. Charles, Mather and Richmond University Medical Center. The ones I checked compared incisions and recovery well but gave no prices at all. The most specific numbers came from a 2017 hospital cost study, covered above, and the rest were general hip replacement cost guides. None put posted prices, Medicare rates and trial results for both approaches on one page. This one does.
A page that wins this search includes:
- The billing answer up front. Both approaches bill as CPT 27130, which answers the cost question in one line.
- A posted or bundled price with every inclusion listed. Only one of the five posted prices above names the approach.
- Surgeon volume and the surgeon’s own complication rates, by approach.
- Medicare, commercial and self-pay explained separately.
- The evidence linked, with risks next to benefits. In the 2018 study, member websites claimed benefits about 9 times more often than risks.
If you want me to check your hip pages against this list, book a 30-minute call.
Frequently asked questions
Is anterior hip replacement more expensive than posterior? Not to Medicare, which pays by procedure code, and both are billed as CPT 27130. Studies of hospital costs disagree, and Medicare episode costs were $22,517 and $22,068, a negligible gap.
How much does Medicare pay for a hip replacement in 2026? About $13,116 in a hospital outpatient department and $9,614 in a surgery center, plus a national average surgeon fee of about $1,167.
Is recovery faster after anterior hip replacement? In the first weeks, usually. Across 24 randomized trials, function was better at six weeks, but by 12 months reviews find no significant difference.
Is the anterior approach safer? Neither approach wins clearly. Pooled trials found no difference in dislocation and studies split on wound problems. Injury to the nerve that supplies feeling to the outer thigh is a recognized higher risk with the anterior approach. (Arthroplasty Today, 2024)
