Top hospitals for knee replacement surgery in the United States by state

How Major Rating Organizations Evaluate Knee Replacement Programs

Multiple independent organizations publish hospital-level performance data for knee replacement procedures. Healthgrades evaluates risk-adjusted complication and mortality rates at approximately 4,500 U.S. hospitals annually, recognizing top performers through its Specialty Excellence Awards. 1 For the 2026 cycle, Healthgrades used Medicare inpatient data from the CMS MedPAR file covering years 2022 through 2024 to analyze outcomes across 31 procedures, including total knee replacement (CPT 27447). 2 Separately, Newsweek's America's Best Hospitals for Specialized Care 2026 rankings assess orthopedic programs based on clinical performance, patient outcomes, and expert input, covering conditions affecting bones, joints, and muscles. 3

U.S. News and World Report uses metrics including patient survival rates, discharge-to-home rates, and nurse staffing levels to determine its Best Hospitals specialty rankings. 4 The Healthgrades Specialty Excellence Award recognizes the top 10% of hospitals nationwide across 16 specialties, while the America's 100 Best Hospitals Award identifies the top 100 facilities in 11 specialties, and the America's 50 Best Hospitals Award marks the highest achievement tier in three specialties. 1 Blue Cross Blue Shield's Blue Distinction Center designation adds an additional quality layer, requiring hospitals to meet rigorous postoperative readmission and complication rate standards, as well as demonstrate implementation of Enhanced Recovery After Surgery (ERAS) practices. 5

Nationally Ranked Leaders by State: Top Performers Across Key Regions

According to Newsweek's 2026 orthopedic care rankings, the Hospital for Special Surgery (HSS) in New York City holds the number one position nationally, with standout specialties that include knee replacement surgery, hip replacement surgery, ACL reconstruction, ankle surgery, and nonsurgical orthopedic treatments. 3 HSS has been ranked number one in orthopedics by U.S. News and World Report for a record-breaking 16 consecutive years. 6 NYU Langone Hospitals and NYU Langone Orthopedic Hospital, also in New York City, rank third nationally for orthopedic care and are recognized for knee replacement as a standout specialty. 3

Mayo Clinic in Rochester, Minnesota, holds the second national position in Newsweek's 2026 orthopedic rankings and is recognized for knee replacement, hip replacement, ACL reconstruction, ankle surgery, and nonsurgical orthopedic treatments. 3 Massachusetts General Hospital in Boston ranks fourth nationally, with knee replacement listed as a standout specialty. 3 The Cleveland Clinic in Ohio occupies the fifth position in the national orthopedic rankings and is noted for its standardized protocols in joint replacement that focus on minimizing recovery time and infection rates. 3 Ronald Reagan UCLA Medical Center in Los Angeles ranks sixth nationally in orthopedic care. 3

State-by-State Breakdown: Recognized Hospitals Across the Country

Florida leads all states in volume of recognized orthopedic programs, with 26 hospitals appearing on Healthgrades' Top 100 Best Hospitals for Orthopedic Surgery list for 2026, the highest concentration of any state. 1 These include HCA Florida Aventura Hospital, HCA Florida Bayonet Point Hospital in Hudson, HCA Florida Blake Hospital in Bradenton, HCA Florida Brandon Hospital, HCA Florida Citrus Hospital in Inverness, HCA Florida Fawcett Hospital in Port Charlotte, HCA Florida JFK Hospital in Atlantis, HCA Florida Kendall Hospital in Miami, HCA Florida Mercy Hospital in Miami, and Ascension Sacred Heart Pensacola, among others. 1 AdventHealth Orlando is separately identified as Central Florida's highest-ranked hospital for orthopedics and among the top two statewide, according to U.S. News and World Report, and is the only Florida hospital to appear on the U.S. News America's Best Hospitals Honor Roll. 7

California has the second-largest representation on the Healthgrades list, with recognized programs including Adventist Health Bakersfield, Adventist Health Glendale, Eisenhower Medical Center in Rancho Mirage, Good Samaritan Hospital in San Jose, Hollywood Presbyterian Medical Center, Kaiser Permanente Orange County-Anaheim Medical Center, Los Robles Regional Medical Center in Thousand Oaks, Novato Community Hospital, PIH Health Good Samaritan Hospital, Pomona Valley Hospital Medical Center, Providence St. John's Health Center in Santa Monica, Redlands Community Hospital, Riverside Community Hospital, Torrance Memorial Medical Center, USC Arcadia Hospital, and West Hills Hospital and Medical Center. 1 Cedars-Sinai Medical Center in Los Angeles also maintains a high-volume orthopedic department recognized for robotic-assisted knee replacement procedures. 4 Stanford Health in California offers advanced minimally invasive techniques with high patient satisfaction rates. 4

Texas Orthopedic Hospital: A Case Study in State-Level Leadership

Texas Orthopedic Hospital in Houston earned recognition as one of America's 50 Best Hospitals for Outpatient Joint Replacement and one of America's 100 Best Hospitals for Orthopedic Surgery, Joint Replacement, and Spine Surgery in 2026, according to Healthgrades. 8 The hospital received four Specialty Excellence Awards, placing it in the top 10% nationwide for Overall Orthopedic Services, Joint Replacement, Spine Surgery, and Outpatient Joint Replacement. It also holds five-star ratings for Total Knee Replacement, Total Hip Replacement, Spinal Fusion Surgery, Back Surgery, Outpatient Total Knee Replacement, and Outpatient Total Hip Replacement. 8

Texas Orthopedic Hospital was ranked first in Joint Replacement, second in Spine Surgery, and fourth in Orthopedic Surgery within Texas for 2026. According to CEO Eric Becker, the hospital has been named the number one facility in Texas for Joint Replacement for five consecutive years, from 2022 through 2026. 8 This sustained leadership illustrates how consistently strong clinical performance across multiple years is a defining characteristic of the highest-ranked knee replacement programs at the state level.

Surgical Volume, Robotic Technology, and Outcome Correlation

CMS Medicare data from 2023 recorded 301,654 total knee arthroplasty procedures (HCPCS 27447) performed by 6,740 surgeons across 50 states, representing 57.8% of all joint replacement procedures billed to Medicare that year. 9 Knee replacements outnumber hip replacements nearly two to one nationally, with California, Florida, and Texas alone accounting for approximately 20% of all joint replacement volume. 9 The median Medicare-billed volume per surgeon is 44 procedures per year, while only 60 surgeons nationwide, representing 0.7% of the total, exceed 300 procedures annually. The top 1% of surgeons perform six times the median volume. 9

Robotic-assisted surgery is increasingly a marker of high-performing knee replacement centers. Five-year outcomes data published in 2025 from a study using the MAKO semi-autonomous robotic arm system found that alignment parameters showed deviations of three degrees or less in over 95% of cases, final implanted components matched the planned size in over 99% of cases, and patients experienced an average increase of 4.85 degrees in extension and 18.62 degrees in flexion. 10 Research published in the Journal of Arthroplasty using data from the American Joint Replacement Registry confirmed that institutional surgical volume has a measurable correlation with operative efficiency in robotic-assisted total knee arthroplasty. 11 Leading programs such as those at HSS, Mayo Clinic, Cleveland Clinic, and Rush University Medical Center have integrated these advanced systems alongside long-standing evidence-based protocols.

Regional Cost Benchmarks and Financial Considerations

Hospital-posted cash prices for total knee replacement (CPT 27447) range from $1,025 to $60,617 across 98 hospitals in 37 states, representing a nearly 59-fold spread for the same procedure code. The median posted facility price is $5,797, but realistic all-in self-pay costs, accounting for implants, anesthesia, the hospital stay, and physical therapy, generally fall between approximately $15,000 and $40,000. 12 The national median negotiated rate for CPT 27447 across 114,745 providers is $2,189, with rates ranging from $1,503 at the low end to $3,152 at the high end. 13

State-level cost variation is significant. Massachusetts knee replacement costs average 36% above the national average, with negotiated rates ranging from $1,061 to $6,051 and a median of $2,196. 14 In contrast, Tennessee rates average 19% below the national average, with a median of $1,734, while Missouri averages 20% below the national average at a median of $1,915. 15 Colorado runs approximately 2% below the national average, with a median negotiated rate of $2,049. 16 Florida presents some of the widest intra-state variation, driven by its status as the nation's largest ambulatory surgery center market, with negotiated rates ranging from $35 to $2,438 and an average of $843, roughly 63% below the national average visit rate. 17 Patients are advised to always request a written, all-inclusive bundled estimate covering surgeon fees, anesthesia, and facility costs before committing to a specific facility.

Key Criteria Patients Should Evaluate When Assessing Knee Replacement Programs

Hospital designation programs provide structured frameworks for patient decision-making. Blue Distinction Centers for Knee and Hip Replacement must demonstrate specific postoperative readmission and complication rate benchmarks and must have implemented ERAS practices designed to reduce surgical stress and improve recovery. 5 Healthgrades five-star ratings for total knee replacement indicate that a hospital performs statistically better than expected on risk-adjusted complication rates using clinically validated methodology. 2 Newsweek's orthopedic rankings incorporate Patient Reported Outcome Measures (PROMs), which reflect functional improvement from the patient's own perspective rather than purely clinical metrics. 3

The growing disparity between high-performing and low-performing hospitals carries measurable consequences. Healthgrades estimates that from 2022 to 2024, if all hospitals had performed at the five-star level, 230,466 lives could potentially have been saved and 183,475 complications could potentially have been avoided across all evaluated specialties. 18 Patients should consider not only national prestige rankings but also state-specific awards, Blue Distinction designations, surgical volume data, robotic technology availability, and outpatient eligibility when evaluating knee replacement programs in their region. Eligibility criteria, insurer network inclusion, comorbidity profiles, and post-surgical rehabilitation access all substantially affect outcomes independent of institutional rankings alone.

Sources

1. Becker's Spine Review - The 100 Best Hospitals for Orthopedic Surgery: Healthgrades (beckersspine.com)
2. Healthgrades - Specialty State Rankings Methodology, Updated October 28, 2025 (healthgrades.com)
3. Newsweek - America's Best Hospitals for Specialized Care 2026: Orthopedic Care (rankings.newsweek.com)
4. U.S. News and World Report - Best Hospitals: Orthopedics Specialty Rankings (health.usnews.com)
5. Becker's Spine Review - Riverwood Earns Blue Distinction for Hip and Knee Replacement (beckersspine.com)
6. Hospital for Special Surgery - HSS Ranked #1 in Orthopedics by U.S. News and World Report for 16th Consecutive Year (hss.edu / youtube.com)
7. Becker's Hospital Review - 100 Hospitals and Health Systems with Great Orthopedic Programs 2025 (beckershospitalreview.com)
8. Texas Orthopedic Hospital - Healthgrades Names Texas Orthopedic Hospital a 2026 Leader in Specialty Care (texasorthopedic.com)
9. OrthoProcedures - 522,201 Joint Replacements Across the U.S.: Data Story (orthoprocedures.com)
10. Meditech Today - 3 Top Knee Replacement Specialists and Technology Hubs Across the US (meditechtoday.com)
11. Journal of Arthroplasty / Exa.ai - Institutional Surgical Volume and Operative Efficiency in Robotic-Assisted Total Knee Arthroplasty (doi.org/10.1016/j.arth.2026.04.004)
12. MedicalPriceCheck.com - How Much Does a Knee Replacement Cost? 2026 Data (medicalpricecheck.com)
13. MomentaryLab - How Much Does a Knee Replacement Cost? Self-Pay Rates 2026 (momentarylab.com)
14. MomentaryLab - Knee Replacement Cost in Massachusetts: Self-Pay Rates 2026 (momentarylab.com)
15. MomentaryLab - Knee Replacement Cost in Tennessee and Missouri: Self-Pay Rates 2026 (momentarylab.com)
16. MomentaryLab - Knee Replacement Cost in Colorado: Self-Pay Rates 2026 (momentarylab.com)
17. MomentaryLab - Knee Replacement Cost in Florida: Self-Pay Rates 2026 (momentarylab.com)
18. Healthgrades / PR Newswire - Recognizing Outstanding Care: Healthgrades Names 2026's Top Hospitals for Specialty Care (prnewswire.com)