Hip replacement in Australia: cost, wait times and the cover you need

How long is the public wait for a hip replacement in 2024–25?

In Australian public hospitals, the median wait for a total hip replacement was 130 days in 2024–25. Half of patients were admitted sooner and half waited longer. The Australian Institute of Health and Welfare (AIHW) also reports that 13.0% of patients waited more than 365 days, and that 12,180 people were admitted for the operation from public waiting lists that year (MyHospitals elective surgery data, read 8 November 2026).

The wait has shortened since the pandemic years. The table sets 2024–25 against the prior year and against 2020–21.

Source: AIHW MyHospitals, elective surgery datasets ES 2020-21, ES 2023-24 and ES 2024-25, total hip replacement, national. Last verified 8 November 2026.

The AIHW counts the wait from the day a surgeon places the patient on the list as ready for surgery, not from the first GP visit (AIHW waiting times overview, last updated 25 November 2025). Time spent waiting for a first public specialist appointment is not in these numbers. As at 8 November 2026 the AIHW had not published 2025–26 figures, so 2024–25 is the latest year.

Which state has the longest wait for a hip replacement?

New South Wales had the longest public wait for a total hip replacement in 2024–25: a median of 265 days, three times the 89 days in Victoria. One in five NSW patients, 20.9%, waited more than a year. The AIHW figures below cover public hospital elective surgery in each Australian state and territory.

Source: AIHW MyHospitals, ES 2024-25 and ES 2023-24, total hip replacement, by state. “Not published” means the AIHW withheld the figure because too few patients met its reporting rules. Last verified 8 November 2026.

Every state with figures in both years shortened its median except New South Wales, which lengthened by 40 days. Victoria fell by 18 days and Tasmania by 16. Waits also vary between hospitals inside a state, and the AIHW publishes hospital-level figures on its MyHospitals site. For how the public list works for any operation, see our guide to public vs private hospital care.

How much does a hip replacement cost with private health insurance?

For an insured private patient in Australia, a hip replacement typically leaves a gap of A$1,000 for the doctors’ fees. That is the 2023–24 median on the Medical Costs Finder, run by the Department of Health, Disability and Ageing, among the 84% of insured patients who paid anything at all. The other 16% paid nothing for their doctors (read 8 November 2026).

Source: Medical Costs Finder, hip replacement and hip replacement (bilateral), national, 2023–24 data. Values are medians and percentiles of different groups, so they do not add up. Last verified 8 November 2026.

The hospital fees cover the stay, the operating theatre and treatment in hospital. A policy that covers joint replacements pays most or all of them at a hospital that has an agreement with the insurer, less any excess the policy carries. The gap on doctors’ fees depends on whether each doctor bills under the insurer’s gap scheme, which our guide to gap fees explains doctor by doctor.

How much does a hip replacement cost in each state?

The typical gap for an insured hip replacement in 2023–24 ranged from A$500 in South Australia to A$4,800 in the ACT, according to the Medical Costs Finder. Western Australia stands out: almost half of insured patients there, 47%, paid nothing for their doctors.

Source: Medical Costs Finder, hip replacement, by state, 2023–24 data. Tasmania and the Northern Territory are not shown on the Finder. Last verified 8 November 2026.

Set these Medical Costs Finder figures against the AIHW public waits and the trade-off for a hip replacement changes by state. In New South Wales the public median wait was the longest in 2024–25, at 265 days, and the private gap was the second highest, at A$2,900. In Victoria the public median was 89 days and the private gap A$2,100. The ACT gap was 8 times the Western Australian one. The Finder accepts a postcode, so a reader can see the figures for their own area.

How much does a hip replacement cost without insurance?

An uninsured patient who chooses to go private for a hip replacement in Australia pays the hospital and the doctors directly, less what Medicare pays toward the doctors. Medicare still pays 75% of the MBS fee for each doctor’s item for a private patient. Medicare pays nothing toward a private hospital’s charges.

Using the Medical Costs Finder’s 2023–24 national figures as a rough guide, hospital fees were typically about A$20,000 and specialists’ fees A$5,600, with Medicare typically paying A$2,000. Plain Cover’s indicative arithmetic: A$20,000 + A$5,600 − A$2,000 = about A$23,600 for one hip. For both hips at once, the same arithmetic gives A$33,000 + A$10,000 − A$3,200 = about A$39,800. Because these are medians of separate figures, the real bill can be well above or below them. A hospital quotes its own fee before admission.

The public route costs nothing for the operation or the hospital stay. A public patient in a public hospital in Australia has no costs for the procedure under Medicare, after the public wait for their state (Medical Costs Finder, read 8 November 2026).

What Medicare pays: the MBS items for a hip replacement in 2026–27

Every doctor’s bill for a hip replacement in Australia is built on Medicare Benefits Schedule items. The surgeon bills the operation’s item. The assistant surgeon and the anaesthetist bill their own. For a private patient, Medicare pays 75% of each MBS fee and an insurer whose policy covers the treatment pays at least the remaining 25%. The fees below took effect on 1 July 2026 (MBS Online, read 8 November 2026).

Source: MBS Online, schedule fees updated 1 July 2026. The insurer column is Plain Cover’s calculation: fee minus the 75% benefit. Last verified 8 November 2026.

The assistant surgeon bills item 51303, set at one fifth of the operation’s fee. For item 49318 that is A$1,577.30 ÷ 5 = A$315.46. Doctors in Australia set their own fees, and the typical A$5,600 in specialists’ fees for one hip in 2023–24 was about 3.6 times the surgeon’s schedule fee alone. The gap is the difference.

Which level of hospital cover pays for a hip replacement?

In Australian private health insurance, a hip replacement falls in the clinical category called joint replacements. PrivateHealth.gov.au defines it as surgery for joint replacements, “including revisions, resurfacing, partial replacements” and removal of prostheses (read 8 November 2026). Gold is the only tier that must include it.

Source: PrivateHealth.gov.au product tiers table, no date shown on the page. Last verified 8 November 2026.

Two rules follow. First, the Plus label alone does not tell you whether a policy covers a hip replacement. Our guide to Silver Plus and Bronze Plus shows how two policies with the same label can differ. Second, the category is all or nothing. PrivateHealth.gov.au lists 61 MBS items in joint replacements, 18 of them for hips, and a policy that covers the category must cover everything in it. The full list of categories by tier is in our clinical categories guide.

Why hospital cover may not pay for a hip replacement at all

The most expensive mistake on this topic is assuming that any hospital policy in Australia pays for a hip replacement. Most tiers are allowed to leave the category out. What the insurer then pays depends on whether the policy excludes joint replacements or restricts them.

The Department of Health, Disability and Ageing uses hip replacement as its own example (page last updated 27 April 2026, read 8 November 2026). If a policy restricts hip replacement, the patient is covered as a private patient in a public hospital. In a private hospital the insurer “will only pay a small part of your hospital accommodation fees” and the patient pays all other costs. If a policy excludes it, the insurer pays none of the costs.

Source: Department of Health, Disability and Ageing, hospital cover and product tiers; Medical Costs Finder 2023–24 national figures (A$5,600 fees − A$2,000 Medicare = A$3,600, Plain Cover calculation). Last verified 8 November 2026.

The policy’s Private Health Information Statement says which of the three applies.

What waiting period applies before cover pays for a hip replacement?

When someone in Australia takes out hospital cover, or upgrades to a policy that adds joint replacements, the insurer can make them wait before it pays. The legal maximums are 2 months for most hospital treatment and 12 months for a pre-existing condition (PrivateHealth.gov.au waiting periods page, read 8 November 2026).

A condition is pre-existing if the person had signs or symptoms of it at any time in the six months before joining or upgrading. The decision is made by “a medical practitioner appointed by your insurer”, not by the person’s own GP or surgeon, although that practitioner considers their information. A diagnosis is not needed. Hip pain or stiffness noted in the six months before the start date is enough for an insurer to apply the 12-month wait.

Rehabilitation has a shorter maximum: 2 months, “even for a pre-existing condition”. Switching to another insurer at the same level of cover does not restart a wait already served. The Department of Health, Disability and Ageing states that insurers must not add extra waiting periods for the same level of benefits, “even if you change insurer” (page last updated 26 April 2023, read 8 November 2026). Moving up from a policy without joint replacements is an upgrade, so the wait applies to the new category. Our guides to hospital waiting periods and pre-existing conditions cover how the decision is made and challenged.

Worked example: upgrading after hip pain has started

Here is one Australian case with the dates worked through. The person is illustrative; every rule and figure is from the sources cited.

Graham is 61 and lives in Newcastle, New South Wales. He holds a Bronze Plus policy that excludes joint replacements. His hip started aching in March 2026 and his GP noted it in May 2026. On 1 December 2026 he upgrades to a Gold policy.

1. Is it pre-existing? He had symptoms in the six months before 1 December 2026, so the insurer’s appointed practitioner can rule the hip pre-existing.
2. When does Gold pay for the hip? 12 months after the upgrade: 1 December 2027, which is 365 days later. If the hip were not pre-existing, the 2-month wait would end on 1 February 2027, 62 days later.
3. What about rehabilitation? The rehabilitation wait is 2 months even for a pre-existing condition, so it ends on 1 February 2027.
4. What does the public list offer? The NSW median public wait for a total hip replacement was 265 days in 2024–25, and 20.9% of NSW patients waited more than 365 days (AIHW). That clock starts when a public surgeon lists him, not when his GP refers him.
5. What does going private cost after the wait? In NSW the typical gap among insured patients who paid one was A$2,900 in 2023–24, and 16% paid nothing (Medical Costs Finder), plus his policy excess and a year of the higher Gold premium.

So Graham is choosing between at least 365 days and a likely gap of A$2,900, or a NSW public median of 265 days at no charge. A treating doctor decides whether and when surgery is clinically needed; this example only compares the insurance and waiting rules.

How many hip replacements are done in Australia, and how many come off public lists?

Australian hospitals performed 63,280 hip replacements in 2025, 2,165 more than in 2024, according to the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2026 Annual Report, which covers procedures up to 31 December 2025. Primary total hip replacements made up 82.0% of them, partial hip replacements 11.1% and revisions 6.9%. For primary total conventional hips, the mean patient age was 67.9 years, and osteoarthritis was the main reason for 88.1% of primary total hips.

Set that against the AIHW count and a pattern appears. 82.0% of 63,280 is about 51,890 primary total hips in 2025. Public waiting lists supplied 12,180 total hip replacements in 2024–25. Plain Cover’s indicative calculation: 12,180 ÷ 51,890 = about 23%, or roughly one in four. The two counts cover different 12-month periods, and the registry count includes operations done as emergencies or outside waiting lists. So the figure is a rough guide only. It still suggests most total hip replacements in Australia are done outside the public elective surgery lists.

Does private health insurance cover a hip revision?

A hip revision is a second operation to replace or repair part of an artificial hip. In Australian private health insurance it sits in the same joint replacements category as the first operation. PrivateHealth.gov.au’s list for the category includes revision items from 49372 to 49398, and a policy that covers joint replacements must cover all of them (read 8 November 2026). A policy that excludes joint replacements excludes revisions too.

The registry figures show how often revisions happen. The AOANJRR 2026 Annual Report found that of primary total conventional hip replacements done for osteoarthritis, 4.1% had been revised by 10 years, 5.9% by 15 years and 7.7% by 20 years. Across all hip operations, revisions fell from 12.9% of the total in 2003 to 6.9% in 2025.

The MBS fees for revision range widely. From 1 July 2026, exchanging a head or liner (item 49372) carries a schedule fee of A$1,104.05, and revising both components with major bone grafting (item 49382) carries A$3,470.05. The same 75% Medicare and 25% insurer split applies. For anyone dropping joint replacements from their policy after a first hip replacement, revision cover is the part that goes with it.

Why the hip replacement costs quoted online often do not add up

Many Australian pages on hip replacement cost quote Medical Costs Finder figures as if they were one bill. They are not. The Finder publishes medians: the middle value for each item, measured across different groups of patients. For one hip in 2023–24, typical specialists’ fees were A$5,600, Medicare typically paid A$2,000, the insurer A$1,800 and the gap A$1,000. A$2,000 + A$1,800 + A$1,000 = A$4,800, not A$5,600. Nothing is missing. The A$1,000 gap is the median among the 84% who paid one, so the parts were never meant to sum.

The second common fault is the year. Public wait figures for hip replacement that still circulate in Australia include 175 days, labelled 2022–23, and 135 days, labelled 2023–24. Others carry no year at all, or come from charts that end in 2016–17. The AIHW’s current figure is 130 days for 2024–25. Every figure on this page carries its period and the date it was checked, 8 November 2026, so a reader can tell when it goes out of date.

How do people weigh going private for a hip replacement?

There is no single answer for Australians facing a hip replacement, but the published figures narrow it down. This table maps common situations to what the 2023–24 and 2024–25 data says. It is general information, not advice about anyone’s own health, cover or finances.

People in these situations typically set the length of their state’s public list against the gap, the excess and the premium. A treating doctor decides the clinical questions: whether surgery is needed, which operation and when. Readers who want to look at policies that include joint replacements can compare hospital cover. Our guide on moving from Gold to Silver Plus covers what dropping joint replacements gives up later.