A state-by-state look at top knee replacement surgery hospitals in the United States: What the available evidence shows

A state-by-state look at top knee replacement surgery hospitals in the United States shows that no single ranking answers every patient’s question. Specialty awards, orthopedic reputation, joint-replacement volume, complication rates, readmissions, staffing, and patient experience measure different aspects of care, so hospital comparisons require attention to the underlying methodology rather than a headline position.

How hospitals are evaluated

Healthgrades’ 2026 Specialty State Rankings include Joint Replacement and Orthopedic Surgery among 18 specialty areas. The analysis used Medicare inpatient data from the Centers for Medicare and Medicaid Services for 2022 through 2024 and examined risk-adjusted outcomes across virtually every hospital in the country. Its state rankings identify leading hospitals in eligible states, while its national awards recognize hospitals with better-than-expected performance in defined specialties. 1

U.S. News & World Report describes a different framework. Its 2026-2027 Best Hospitals release places greater statistical weight on risk-adjusted outcomes such as survival and complications, and introduces a regional Orthopedics specialty ranking. Earlier guidance in the supplied research also identifies procedure volume, nurse staffing, patient survival, and other quality indicators as relevant to whether a hospital is categorized as high performing for knee replacement. 2

Notable hospitals by state

The available research identifies several nationally recognized institutions, but it does not provide a complete 50-state recipient list for knee replacement. The hospitals below therefore represent documented examples rather than an exhaustive state-by-state league table. Each institution should be assessed using the current procedure, surgeon, and outcome data applicable to the patient’s specific diagnosis and insurance arrangement.

Northeast and Midwest centers

New York, Massachusetts, Pennsylvania, Minnesota, Illinois, and Ohio contain several of the prominent centers named in the supplied research. HSS is repeatedly described as a leading orthopedic institution, while Massachusetts General Hospital is associated with research-oriented joint replacement. Rothman, commonly affiliated with Jefferson Health, is characterized as a high-volume musculoskeletal organization. In the Midwest, Mayo Clinic, Rush, and Cleveland Clinic are described in terms of specialized expertise, standardized pathways, multidisciplinary care, and reported outcome performance. 3

These descriptions should not be read as proof that one hospital is superior for every patient. A complex revision, severe deformity, inflammatory arthritis, infection risk, or major medical comorbidity may require a different level of specialization than an uncomplicated primary replacement. Hospital choice also involves travel, postoperative therapy, caregiver availability, surgeon availability, and whether the facility participates in the patient’s coverage network.

Western states and regional access

California is represented in the research by Cedars-Sinai in Los Angeles and Stanford Health Care. Cedars-Sinai is described as a highly rated destination for orthopedic and knee-replacement care, while Stanford is noted for patient-experience performance and low 30-day readmission rates after knee surgery. These are institution-level descriptions, not a complete comparison of every California hospital or a guarantee of an individual outcome. 4

Geographic access matters because national reputation does not necessarily correspond to practical access. The supplied U.S. News report states that 505 regional hospitals were recognized across 49 states and Washington, D.C., underscoring the importance of regional care. Healthgrades, by contrast, reported specialty state rankings only in eligible states and across selected specialty categories, so absence from a particular list does not establish poor performance. 5

Volume, outcomes, and procedure variation

OrthoProcedures’ 2023 Medicare physician data recorded 301,654 knee replacements nationally, compared with 161,633 hip replacements and 58,914 shoulder replacements. The dataset included 6,740 surgeons performing knee replacements and showed a median of 44 total joint procedures per surgeon across procedure types, while the highest-volume surgeon recorded 844 joint replacements. These figures cover Medicare fee-for-service billing and do not represent all-payer activity. 6

State procedure patterns also vary. The supplied data reports a national knee-to-hip replacement ratio of 1.87 to 1, with Oklahoma and Arkansas at 2.6 to 1 and Vermont and Hawaii near 1 to 1. Differences may reflect population age, disease patterns, referral networks, practice composition, and access to surgeons. Volume can provide context, but it should be considered with risk-adjusted complications, mortality where applicable, readmissions, infection data, and the surgeon’s experience with the relevant procedure.

Costs, oversight, and practical risks

Hospital price transparency data illustrate why posted procedure figures require careful interpretation. A review of 98 hospitals in 37 states found published cash prices for CPT 27447 ranging from $1,025 to $60,617, with a median of $5,797. The source cautions that these figures often represent a facility or professional component rather than an all-in episode including implants, anesthesia, hospitalization, and rehabilitation. 7

A separate cost index lists an illustrative national estimate of $35,000 without insurance, $10,500 with insurance, and $8,000 under Medicare for knee replacement surgery, but such figures are generalized reference values rather than hospital-specific quotations. Medicare-certified hospitals are subject to CMS reporting and quality oversight, while public hospital-rating platforms may summarize CMS data. Patients and clinicians must also consider eligibility, medical clearance, implant selection, rehabilitation adherence, infection, blood clots, stiffness, persistent pain, revision surgery, and the possibility that a replacement may not resolve every source of knee symptoms. 8

How to interpret a hospital comparison

A responsible comparison begins by confirming whether the evidence concerns total knee arthroplasty, outpatient joint replacement, orthopedic surgery generally, or a broader hospital rating. Healthgrades states that its underlying 31-condition analysis uses risk-adjusted complication and mortality measures, while U.S. News emphasizes outcomes and regional specialty comparisons. Leapfrog is another independent quality-evaluation source identified in the research, with measures relevant to hospital safety and quality. 9

• Verify the reporting period and whether the data cover Medicare patients or all payers.

• Distinguish hospital-level performance from an individual surgeon’s results.

• Ask whether the quoted amount includes the implant, anesthesia, facility, professional fees, therapy, and follow-up.

• Review the hospital’s experience with primary versus revision replacement and with relevant medical risks.

• Consider travel, postoperative support, rehabilitation access, and insurance participation.

In practical terms, the strongest candidate is not necessarily the institution with the most recognizable name. The more defensible choice is the facility whose documented outcomes, orthopedic capability, care pathway, follow-up structure, and access conditions fit the patient’s clinical circumstances. Mayo Clinic, Cleveland Clinic, Rush, HSS, Duke, Cedars-Sinai, Stanford, Massachusetts General, and Rothman-related care are prominent examples in the supplied research, but current local evidence remains essential. 10

Sources

1. Healthgrades, Recognizing Outstanding Care: Healthgrades Names 2026’s Top Hospitals for Specialty Care
2. U.S. News & World Report, 2026-2027 Best Hospitals announcement
3. Healthgrades, Specialty State Ranking Award Methodology
4. Cedars-Sinai and Stanford Health Care orthopedic program information
5. U.S. News & World Report, regional hospital and specialty ranking information
6. OrthoProcedures, 522,201 Joint Replacements Across the U.S.
7. MedicalPriceCheck, How Much Does a Knee Replacement Cost?
8. CareCostIndex, Medical Procedure Costs 2026
9. The Leapfrog Group, hospital ratings information
10. Mayo Clinic, Cleveland Clinic, Rush, HSS, Duke, Massachusetts General Hospital, and Rothman Orthopaedics program information