Does Medicare Cover Robotic Knee Replacement?

Medicare Part A and Part B will cover robotic knee replacement in certain situations.

If your doctor recommends the robotic surgery as part of your treatment plan, Original Medicare may cover it if you meet the necessary criteria. Your medical condition must be determined to require a robotic knee replacement surgery, and the procedure must not exceed what Medicare considers “reasonable and necessary.”

Medicare may also cover the cost of a robotic knee replacement if it is deemed a significantly better medical option than traditional knee replacement surgery. 

What Is Robotic Knee Replacement Surgery?

A robotic knee replacement is a minimally invasive surgery with a robotic arm’s help. The main difference between traditional knee replacement and its robotic version is that the latter uses a robotic arm to assist the surgeon.

This enhances precision and ensures the correct knee parts are targeted when inserting the implant. This reduces recovery time and can lead to less pain after the operation, making it a popular choice among patients.

What Are the Benefits of Robotic Knee Replacement?

Besides being a less invasive treatment, robotic knee replacement has additional benefits. It minimizes the risk of human error as the robot assists the surgeon in the surgical procedure. This eliminates the chances of inaccuracies, which could threaten the patient’s health post-surgery.

The recovery time is also reduced, meaning less time spent in the hospital and more at home. Lastly, the procedure is less painful so that patients won’t have extensive discomfort afterward.

What Are the Risks of Robotic Knee Replacement?

Like any surgery, robotic knee replacement has its risks. The risks associated are similar to traditional knee replacement surgery; these include infection, blood clots, and nerve damage.

Since robotic knee replacement is a new technology, there are concerns about the learning curve of the surgeon performing knee joint surgery and the possibility of automated technology malfunctions. That being said, this risk is low and can be mitigated by finding an experienced surgeon.

Bottom Line

Your doctor may recommend robot-assisted surgery because it’s often more precise than traditional surgery. If this is the case, Medicare will cover the procedure as long as your doctor deems it necessary. It’s essential to check your Medicare Part B coverage for outpatient services and co-payment charges.

Ensure you consult an experienced surgeon before considering the procedure to avoid complications. Robotic knee replacement has many benefits, but knowing the risks is necessary.

Sources: Robotic Orthopaedic InstituteHumanaMedical News TodayAARP.org

FAQs

  • How much does a robotic total knee replacement cost?

    The cost of a robotic total knee replacement can vary depending on your situation. Generally, the procedure costs anywhere between $25,000 to $35,000. You may pay less if Medicare covers the procedure or you have private insurance. You can also check with your doctor to determine any additional costs associated with the procedure.

Mark Prip

Since 2003, Mark Prip has been leading  Policy Guide, Inc., providing knowledgeable information about Medicare, life insurance, and dental coverage to clients in over forty states. With his unparalleled hands-on experience aiding countless Medicare beneficiaries in selecting an appropriate health plan, he is a prime example amongst other competitors for expertise and assistance. Mark has held his Florida Health & Life Insurance License (E051889) since 2003. View his license profile on the Florida Department of Insurance website.