This is a patient demand report for hip and joint replacement practice owners and marketing leads. It shows what patients pay for hip resurfacing and total hip replacement, what the evidence says, and what they 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.
A total hip resurfacing has no procedure code of its own. Aetna’s policy lists it under the total hip code, CPT 27130, citing the American Academy of Orthopaedic Surgeons, and lists a femoral-only resurfacing under the partial hip code. (Aetna policy 0661) A separate resurfacing code, HCPCS S2118, exists for private payers, and the CMS 2026 fee schedule file marks it not valid for Medicare. So Medicare pays the same for a resurfacing as for a total hip.
One South Carolina practice reported that across 485 outpatient resurfacings, the average payment at its surgery center was $26,000, against $50,000 average reimbursement for hip replacement at local hospitals. (Musculoskeletal Surgery, 2021)
The patient pool is narrow. The leading device’s maker now aims it at men under 65 who need a femoral head of 50mm or larger, after it pulled the smaller sizes in 2015. (Smith & Nephew, 2015)
Device news moves search. After the 2010 recall of one resurfacing implant, searches for hip recall terms rose sharply in the US, the UK, Australia and Ireland. (European Journal of Orthopaedic Surgery & Traumatology, 2014)
The practice explainers that rank for this comparison, in my check, showed no price at all.
What those mean together for your practice is for you to work out. If you track where your joint replacement leads come from, my orthopedic marketing KPI dashboard shows how I set that up.
If you want to see how your hip pages answer that question 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
When I reviewed the pages that rank for “hip resurfacing vs total hip replacement cost” and “how much does hip resurfacing cost” on 2 October 2026, the results were a 2021 outpatient cost study, price aggregators, a statistics site comparing countries, and explainers from practices and the AAOS patient site. Two practice explainers and the AAOS patient page I checked had no dollar figure on the page. One surgeon’s blog gave ranges with no source. No page put current Medicare rates, a posted price and the registry evidence together.
I found no practice posting a separate cash price for resurfacing. The posted self-pay bundles patients find are for total hip replacement. ATX Orthopedics in Austin lists $23,000 under the total hip code, covering surgeon, surgery center, implants, assistant, anesthesia and 90 days of follow-up. (ATX Orthopedics) Syracuse Orthopedic Specialists posts $20,500 for a total hip at its own surgery center. (SOS) Neither page says whether a resurfacing is priced the same.
So a patient comparing the two has one published payment figure for resurfacing, the $26,000 surgery center average above, and has to infer the rest.
Insured patients pay a share of the negotiated rate, set by their deductible and coinsurance. Because resurfacing is billed under the same code as a total hip, the patient’s share follows whatever the plan pays for that code.
What Medicare pays your practice
Medicare pays the facility and the surgeon separately, so the figures add together.
| Total hip replacement | Total hip resurfacing | |
|---|---|---|
| Procedure code | Total hip code | Same total hip code |
| Medicare 2026 surgeon fee, national | $1,162.02 | $1,162.02 |
| Medicare 2026 hospital outpatient payment | $13,116 | Same code, same rate |
| Medicare 2026 surgery center payment | $9,614 | Same code, same rate |
The surgeon fee comes from the CMS 2026 Physician Fee Schedule (October release), national facility rate before geographic adjustment. The AAHKS summary lists $1,167 for the same relative value, which matches the higher conversion factor for surgeons in advanced payment models. Facility rates come from the AAHKS 2026 Medicare summary. A femoral-only resurfacing, billed as a partial hip, carries a 2026 surgeon fee of $1,035.76.
Adding the two sides, either operation in a hospital outpatient department comes to about $14,278 ($13,116 plus $1,162). In a surgery center it is about $10,776 ($9,614 plus $1,162).
Few resurfacing patients are on Medicare. Aetna limits coverage to members under 65, and the device maker’s own target group is under 65. For most of these patients the commercial contract sets the payment, and the Medicare figure is the reference point.
What the evidence patients read says
Patients who research resurfacing find the device history first, then registry and trial data. The data do not all point the same way.
The device history. The FDA approved the Birmingham Hip Resurfacing system in May 2006 and the Cormet system in July 2007. (FDA PMA P040033, FDA PMA P050016) DePuy recalled its ASR resurfacing and ASR XL hip systems worldwide in August 2010. (Clinical Orthopaedics and Related Research, 2015) Australia’s registry found 10.9% of ASR resurfacings revised at five years, against 4.0% for other resurfacing devices. (Journal of Bone and Joint Surgery, 2011) The FDA’s page says two FDA-approved metal-on-metal resurfacing devices are available, and that no metal-on-metal total hip is approved and marketed in the US. (FDA)
Trials. A 2024 meta-analysis of eight randomized trials, 844 patients followed for a mean of 7.7 years, found no significant difference in revision, infection or loosening, and fewer dislocations after resurfacing. (International Orthopaedics, 2024) A 2023 review of six level 1 studies found fewer complications after resurfacing, no difference in revision, and higher cobalt and chromium levels in the blood. (European Journal of Orthopaedic Surgery & Traumatology, 2023)
Registries. In England and Wales, 9,574 resurfacings in men with heads above 48mm had 92.7% survival at 18 years, against 94.2% for matched total hips, with a higher adjusted revision risk. (Bone & Joint Journal, 2025) Australia’s registry compared 4,790 Birmingham resurfacings in men under 65 with the three best-performing total hips and found nearly three times the revision risk; the authors suggested a proven total hip may be the better choice for patients worried about durability. (Clinical Orthopaedics and Related Research, 2020) A later Australian analysis of another resurfacing device found 94% survival at 17 years and no significant difference from the best total hips in men under 65. (Journal of Orthopaedics, 2025)
A US series. At Washington University in St. Louis, 224 patients followed for a mean of 14 years had 96.0% survival free of revision at 15 years, with patient-reported results similar to matched total hips. (Journal of Bone and Joint Surgery, 2025)
Cost models. A 2010 US model put resurfacing under $50,000 per quality-adjusted life year for men younger than 65 and women younger than 55. (Clinical Orthopaedics and Related Research, 2010) A 2013 Canadian model favored resurfacing at age 50 but favored a total hip at age 60 or for women. (Value in Health, 2013)
Ceramic designs. A ceramic resurfacing studied in 604 patients across several countries showed 98.0% survival in the 128 hips followed to five years, with no difference by sex or head size. The authors call for longer follow-up. (Bone & Joint Journal, 2025)
Who patients are
Resurfacing patients are younger and mostly male. In Australia’s registry, the Birmingham group averaged 52 years against 56 for the comparison total hips. (Clinical Orthopaedics and Related Research, 2020) Aetna’s policy covers resurfacing for physically active adults under 65 with advanced joint disease and normal femoral bone shape.
Sex and size shape the market. Smith & Nephew’s 2015 notice said revision rates for men needing heads of 46mm or smaller, and for all women, exceeded the UK benchmark. A 2024 review reported that FDA warnings in 2011 and 2016 led US surgeons to limit resurfacing in women. (Archives of Bone and Joint Surgery, 2024)
A resurfacing caps the femoral head and keeps most of the patient’s own bone. A total hip removes the head and places a stem in the thigh bone. Patients who are comparing approaches for a total hip are covered in my page on anterior vs posterior hip replacement cost, and younger patients searching hip options also compare hip arthroscopy cost.
Questions patients ask before they book
These are the questions your page and your front desk need to answer.
- Is the patient a candidate, given their age, sex and head size? A good page states the practice’s criteria plainly.
- Does the practice use a device with FDA approval, and which one? A good page names it and links the FDA record.
- How much more does resurfacing cost the patient? A good page explains that it bills under the same code and shows the price.
- What will the patient owe on Medicare, on a commercial plan, or paying cash? A good page answers all three, or says who on staff will.
- How many resurfacings does the surgeon do a year, and how are metal levels followed? A good page states the volume and the follow-up plan.
For the total hip on its own, my page on hip replacement cost shows what patients find for that search.
What a page that wins this search includes
- Both operations on one page, priced side by side, because no ranking page does that today.
- A posted cash or bundled price for resurfacing, or a plain line saying it is quoted the same as a total hip.
- The device history addressed directly: the ASR recall, the 2015 size withdrawal, and the FDA status of the device used.
- The candidacy criteria in plain terms, with the surgeon’s annual resurfacing volume.
- The registry and trial data linked, stated neutrally and left disputed where it is disputed.
Frequently asked questions
Is hip resurfacing more expensive than a total hip replacement? Medicare pays the same, because a total resurfacing is billed under the total hip code. In 2026 that is about $14,278 in a hospital outpatient department and $10,776 in a surgery center, facility and surgeon together.
Does Medicare cover hip resurfacing? It pays under the total hip code. Commercial policies such as Aetna’s cover metal-on-metal resurfacing with an FDA-approved device for active adults under 65 who meet set criteria.
Is hip resurfacing still done in the US after the recalls? Yes. The FDA’s page lists two approved metal-on-metal resurfacing devices as available. The ASR resurfacing system was recalled worldwide in 2010.
Does resurfacing last as long as a total hip? Registries disagree in degree. England’s registry found 92.7% survival at 18 years against 94.2% for matched total hips, while an Australian analysis of one device found no significant difference in men under 65.
Who is a typical hip resurfacing patient? Mostly men under 65 with larger femoral heads. Australia’s registry recorded an average age of 52 for one leading device.
