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Surgery to replace a shoulder joint with an artificial joint. The surgery includes repair to the muscles and tendons around the shoulder.

Treatment venue

In-hospital

Your care options

Public hospital patients:

You have no costs for the procedure as a public patient in hospital with Medicare. Fees and costs shown below do not apply. Learn more about Medicare.(opens in new tab)

Private hospital patients:

You may have out-of-pocket costs for the procedure in a private hospital. The typical fees and costs shown below are for people with Medicare and who have private health insurance for the procedure. See Explanations of fees and costs.


In 2021-22

For patients with private health insurance who had a Shoulder replacement in a private setting across all of Australia, 69% had an out-of-pocket cost. Of those:

Patients typically paid: $700, Medicare paid: $2,000, Insurer typically paid: $2,000. Typical specialists’ fees: $5,300.

Included

  • Specialist fees
  • Assistant surgeon fees*
  • Anaesthetist fees*

*These fees may apply differently if relevant to your situation. See Explanation of fees and costs for more.


Excluded

  • Hospital fees – typically $19,000 for this procedure

Hospital fees may include accommodation, theatre, or medical devices. Your private health insurer will cover all or most of this cost, depending on your level of insurance. You may have to pay an excess or co-payment.

Percent of patients who paid in 2021-22

31% of patients had no out-of-pocket costs

69% of patients had out-of-pocket costs

Low, typical, and high out-of-pocket costs

Of the 69% of people who had an out-of-pocket cost in 2021-22, the typical cost was calculated as follows:

High$4,800
Typical$700
Low$200

The table below shows the following by state and territory:

  • Percent of patients who paid no out-of-pocket cost. The specialist’s fees were paid by Medicare and private health insurance.
  • How much specialists typically charged for this service, when there was an out-of-pocket cost for the patient.
  • How much patients typically paid if they had an out-of-pocket cost.

Some states or territories may not show due to insufficient data available to ensure a specific person is not identified.

This information is for all services using this MBS item by all specialties in 2021-22.

NSWQldVicWASATas
% with no out-of-pocket costs32%16%21%62%38%30%
Typical specialists’ fees$6,000$5,400$5,700$4,400$4,800$4,800
Patients typically paid$2,500$1,000$620$300$300$500

What the fees and costs shown include

The fees and costs include everything provided by each specialist and health provider involved in your hospital stay. Where relevant to the procedure, assistant surgeon and/or anaesthetist costs are included. They are based on data from 2021-22 and represent a typical experience.

Each procedure is linked to one principal number listed on the Medical Benefits Schedule (MBS), called an MBS item number. Other items may be claimed at the same time, but may vary between patients. All figures, including the Medicare benefit amount(opens in new tab) have been rounded to the nearest dollar.

Individual patient costs may vary due to circumstances. You should speak to your specialist for a specific quote.

We show local data by Primary Health Network(opens in new tab) if no person, hospital or provider can be identified. Otherwise, we will show information at a higher level, by aggregating the data. The data might then be at a state and territory level, or across Australia. See our disclaimer for more information.

What the fees and costs shown don’t include

  • Specific tests or treatments you may need. This might include diagnostic imaging or pathology services.
  • Assistant surgeon and/or anaesthetist costs required for the procedure but is not covered by Medicare.
  • Private health insurance excess or co-payments.
  • Aftercare costs.
  • Costs associated with pharmaceuticals and other incidentals.
  • Services before or after the day of the procedure.
  • Hospital charges such as accommodation, theatre, or medical device fees. If you have insurance for this service, your insurer may cover some or all the hospital charges. Please note that some hospitals do not accept insurance payments. Patients may need to pay more for treatment at these hospitals. Learn more about agreement hospitals(opens in new tab) to see if this applies to you and your chosen hospital.
  • For in-hospital services, talk to your private health insurer to find out what costs they cover and what costs you might have to pay.

Why the typical amounts don’t add up

The amounts will not add up to the total specialists’ fees, because they are independent statistics. Each dollar amount is the typical (median) amount for that dataset only, rounded to the nearest dollar. For example, the amount patients typically paid is based on what all patients paid for this service. The typical specialists’ fee is based on all fees charged by specialists that provided this service.

Each service on the website is linked to a number listed on the Medical Benefits Schedule (MBS), called an MBS item. The MBS items mentioned are the main items used for this service. Other items can be claimed at the same time.

MBS item(s) that generally make up a Shoulder replacement.

MBS Item 48918

Surgery to replace a shoulder joint with an artificial joint. The surgery include repair to the muscles and tendons around the shoulder (rotator cuff).