Does Medicare Cover Hip Replacement?

Hip replacement is one of the most common and most successful operations in medicine, and the Medicare population accounts for the majority of them. So it’s a relief that the coverage answer is a clean yes — Medicare covers medically necessary hip replacement. The part worth understanding isn’t whether it’s covered, but how, because a change Medicare made a few years ago means two patients getting the same surgery can have very different-looking bills depending on one classification: inpatient versus outpatient.

Get that distinction straight, and you’ll know what to expect before you ever schedule the procedure.

The inpatient vs. outpatient question

Until 2020, total hip replacement was on Medicare’s “inpatient-only” list — it had to be done as a hospital admission. Then Medicare removed it from that list, opening the door to outpatient hip replacements for appropriate patients. Today, both happen routinely:

• Inpatient — you’re formally admitted to the hospital. The surgery and stay are covered under Part A.
• Outpatient — you have the procedure and go home the same day or after a short observation, even if you spend a night. It’s covered under Part B.

Healthier patients with good support at home are increasingly steered toward outpatient hip replacement; patients with more complex health needs are more likely to be admitted as inpatients. Your surgeon and hospital make the call based on your health and the procedure.

Why it matters to you: the setting determines which part of Medicare pays and how your cost-sharing works. So the single most useful question to ask your surgeon’s office before surgery is: “Will this be billed as inpatient or outpatient?”

What you’ll pay

If inpatient (Part A):

• You pay the Part A deductible — $1,676 in 2026 — which covers your hospital stay (up to 60 days; almost no hip patient comes close).
• That’s your main cost. A Medigap policy covers the Part A deductible entirely on most plans.

If outpatient (Part B):

• You pay the Part B deductible ($257 in 2026) if not already met, then 20% coinsurance on the Medicare-approved amount.
• A Medigap policy covers the 20% coinsurance.

For a beneficiary with Medigap, hip replacement often ends up costing little to nothing out of pocket beyond the relevant deductible. For Medicare Advantage members, you’ll pay the plan’s copays/coinsurance up to the annual out-of-pocket maximum, and you’ll need in-network providers — worth confirming, since orthopedic surgery copays on MA plans can be substantial before you hit the cap.

Rehab is covered — and it’s most of the recovery

The surgery is one day; the recovery is months, and physical therapy is the core of it. Medicare covers the rehab through whichever channel fits your situation:

• Outpatient physical therapy (Part B): the most common route. 20% coinsurance, and crucially, no cap on the number of visits when therapy is medically necessary. Most hip patients need weeks of PT to rebuild strength and mobility.
• Home health PT (Part A/B): if you’re homebound during early recovery and need skilled care, home health PT comes to you at $0 coinsurance.
• Skilled nursing facility rehab (Part A): if you were an inpatient for at least 3 days and need daily skilled care, up to 100 days of SNF rehab is covered (days 1–20 free, days 21–100 at $209.50/day, covered by Medigap). This route is less common for routine hip replacements now that many are outpatient — and remember, an outpatient procedure doesn’t satisfy the 3-day inpatient rule for SNF coverage.

See our physical therapy coverage page for the full rehab details, including how the annual therapy threshold works.

Equipment and supplies

Recovery from hip replacement usually requires some durable medical equipment, and Medicare covers the medically necessary items under Part B at 20% coinsurance (Medigap covers the 20%):

• Walker and/or cane
• Crutches if needed
• Sometimes a raised toilet seat or other mobility aids (some items are considered convenience items rather than covered DME — confirm with your supplier)

Get these prescribed by your doctor and obtained from a Medicare-enrolled supplier to ensure coverage.

The pre-surgery and post-surgery care

Coverage extends across the whole episode:

• Pre-op evaluation — the visits, labs, imaging, and medical clearance before surgery are covered under Part B.
• The surgeon and anesthesia — covered as part of the procedure.
• Post-op follow-up visits — covered under Part B.
• Pain medications — covered under Part D (or as part of the inpatient stay under Part A).
• Revision surgery — if the replacement later fails or wears out, the revision is covered on the same basis.

Making it go smoothly

A short checklist before a planned hip replacement:

1. Ask the surgeon’s office: inpatient or outpatient? This tells you whether to expect the Part A deductible or Part B coinsurance.
2. If you have Medigap, confirm your plan covers the relevant deductible/coinsurance (Plan G and most others do).
3. If you’re on Medicare Advantage, verify the surgeon, hospital, and facility are in-network and ask about your specific copays and prior authorization.
4. Plan your rehab — most recovery happens in PT, which is well-covered, so line up a Medicare-enrolled therapy provider.
5. Arrange covered equipment (walker, cane) through a Medicare-enrolled supplier with a doctor’s prescription.

Hip replacement is a high-success, well-covered procedure under Medicare. The only real homework is understanding whether your case is inpatient or outpatient, confirming your supplement or plan covers your share, and lining up the rehab that turns a successful surgery into a successful recovery.