How Much Does ACL Surgery Cost in 2026?
ACL surgery (anterior cruciate ligament reconstruction) costs between $20,000 and $50,000 in the United States without insurance, with the national average falling around $35,000. Patients with private health insurance typically pay $2,000 to $6,000 out of pocket after deductibles and coinsurance. These figures are based on data from the Healthcare Cost and Utilization Project (HCUP) and Fair Health consumer cost databases.
ACL tears are one of the most common knee injuries in the U.S., with an estimated 200,000 to 250,000 occurring annually. The vast majority of complete tears require surgical reconstruction, making this one of the most frequently performed orthopedic procedures. The total cost varies significantly based on the type of graft used, facility type, geographic location, and whether additional repairs (such as meniscus surgery) are needed.
Understanding the full cost picture — from pre-operative imaging to months of physical therapy — is essential for planning your finances. Below, we break down every cost factor so you can make an informed decision.
ACL Surgery Cost by Type
The type of ACL reconstruction you undergo significantly impacts the total price. Here are the most common surgical approaches and their associated costs:
| Surgery Type | Average Cost | Cost Range |
|---|---|---|
| Patellar Tendon Autograft | $33,000 | $20,000 – $45,000 |
| Hamstring Tendon Autograft | $32,000 | $19,000 – $44,000 |
| Allograft (Donor Tissue) | $37,000 | $23,000 – $50,000 |
| ACL Reconstruction + Meniscus Repair | $40,000 | $25,000 – $55,000 |
| Revision ACL Reconstruction | $42,000 | $28,000 – $60,000 |
Autograft procedures (using your own tissue) are generally less expensive than allografts because they eliminate the cost of donor tissue procurement, which can add $2,000 to $5,000 to the bill. Revision surgeries are the most complex and costly due to longer operative times and additional hardware.
ACL Surgery Cost by State
Geographic location is one of the biggest drivers of surgical cost in the U.S. Prices in major metropolitan areas and coastal states can be 40-60% higher than in rural areas and the Midwest. Here's a state-by-state comparison:
| State | Average Cost | Cost Range |
|---|---|---|
| California | $42,000 | $28,000 – $55,000 |
| New York | $45,000 | $30,000 – $58,000 |
| Texas | $33,000 | $20,000 – $45,000 |
| Florida | $34,000 | $22,000 – $46,000 |
| Illinois | $36,000 | $24,000 – $48,000 |
| Pennsylvania | $35,000 | $23,000 – $47,000 |
| Ohio | $28,000 | $18,000 – $38,000 |
| Georgia | $31,000 | $20,000 – $42,000 |
| North Carolina | $30,000 | $19,000 – $40,000 |
| Arizona | $32,000 | $21,000 – $43,000 |
| Mississippi | $25,000 | $17,000 – $34,000 |
| Colorado | $34,000 | $22,000 – $45,000 |
States like Ohio, Mississippi, and North Carolina consistently offer the most affordable ACL surgery prices, while New York and California are among the most expensive due to higher cost of living and facility overhead.
Insurance vs. No Insurance
Your insurance status dramatically affects what you'll actually pay for ACL surgery. ACL reconstruction is almost always classified as medically necessary, which means most insurance plans will cover it after prior authorization.
| Coverage Type | Typical Out-of-Pocket Cost | What's Covered |
|---|---|---|
| Private Insurance (PPO/HMO) | $2,000 – $6,000 | Surgery, anesthesia, facility, follow-up visits; subject to deductible and coinsurance |
| Medicare | $3,000 – $7,000 | Part A covers hospital; Part B covers surgeon at 80% after deductible; Medigap reduces costs further |
| Medicaid | $0 – $500 | Full coverage in most states; minimal or no copay; may have limited surgeon/facility choice |
| No Insurance | $20,000 – $50,000 | Full cost responsibility; cash-pay discounts of 20-40% often available; payment plans may be offered |
If you're uninsured, always ask about self-pay or cash-pay discounts. Many hospitals and surgery centers offer reductions of 20-40% for patients who pay upfront or arrange payment before the procedure.
ACL Surgery Cost Breakdown
The total cost of ACL surgery is made up of multiple components. Understanding each line item helps you identify where savings are possible:
| Cost Component | Typical Cost Range |
|---|---|
| Surgeon's Fee | $3,000 – $8,000 |
| Anesthesia | $1,500 – $3,500 |
| Facility/Operating Room Fee | $10,000 – $25,000 |
| Implants and Hardware | $1,500 – $4,000 |
| Allograft Tissue (if applicable) | $2,000 – $5,000 |
| Pre-Op MRI | $500 – $3,000 |
| Post-Op Knee Brace | $200 – $800 |
| Physical Therapy (6-9 months) | $1,000 – $5,000 |
| Follow-Up Visits | $200 – $600 |
| Medications | $50 – $300 |
The facility fee is typically the single largest expense, often accounting for 40-50% of the total bill. This is why choosing an ambulatory surgery center over a hospital can yield significant savings.
Factors That Affect ACL Surgery Cost
Geographic Location
Healthcare costs vary dramatically by region. Urban medical centers in New York City or San Francisco can charge 50-100% more than facilities in smaller cities or rural areas. Even within the same state, prices can differ by thousands of dollars between metro and suburban locations.
Facility Type
Hospital-based ACL surgery costs 30-50% more than the same procedure at an ambulatory surgery center (ASC). ASCs have lower overhead costs and typically offer bundled pricing. Since most ACL reconstructions are outpatient procedures, an ASC is often the most cost-effective choice.
Graft Type
Autograft procedures (patellar tendon or hamstring) are generally less expensive than allograft (donor tissue) because they avoid tissue procurement fees. Your surgeon will recommend the best graft type based on your age, activity level, and anatomy — not just cost.
Additional Repairs
Approximately 50% of ACL tears involve concurrent meniscus or cartilage damage. If your surgeon needs to repair a torn meniscus during the same procedure, expect the total cost to increase by $3,000 to $10,000.
Surgeon Experience and Specialization
Fellowship-trained sports medicine orthopedic surgeons who perform high volumes of ACL reconstructions may charge higher fees but often deliver better outcomes and lower revision rates. The long-term value of choosing an experienced surgeon typically outweighs the upfront cost difference.
Insurance Plan Details
Your specific deductible, coinsurance percentage, and out-of-pocket maximum determine your actual cost. A plan with a $1,500 deductible and 20% coinsurance will cost you significantly more than one with a $500 deductible and 10% coinsurance, even if both cover the procedure.
How to Save Money on ACL Surgery
- Get Multiple Quotes: Request itemized estimates from at least 3 surgeons and facilities. Prices for the same procedure can vary by $10,000 or more within the same metro area.
- Choose an Ambulatory Surgery Center: ASCs typically charge 30-50% less than hospitals for outpatient ACL reconstruction. Ask your surgeon if they operate at an ASC.
- Ask About Bundled Pricing: Many facilities offer a single all-inclusive price that covers the surgeon, anesthesia, facility, and implants. Bundled prices are often lower and eliminate surprise bills.
- Negotiate Cash-Pay Discounts: If you're uninsured or have a high deductible, ask for a self-pay discount. Many providers offer 20-40% off for upfront cash payment.
- Time Your Surgery Strategically: If you've already met your annual deductible, having surgery before year-end maximizes your insurance benefits. Conversely, if you haven't met your deductible, consider whether early January timing could help you apply costs to a fresh deductible year when you'll also need PT.
- Use In-Network Providers Exclusively: Verify that your surgeon, anesthesiologist, and facility are all in-network. A single out-of-network provider can add thousands in unexpected costs.
- Consider Traveling for Surgery: If you live in a high-cost area, traveling to a lower-cost state or city for surgery can save $10,000-$20,000 even after accounting for travel expenses.
Financing Options for ACL Surgery
| Option | Details | Typical Terms |
|---|---|---|
| Hospital/Surgeon Payment Plan | Interest-free monthly payments arranged directly with the provider | 6-24 months, 0% interest in many cases |
| CareCredit | Medical credit card accepted by most orthopedic practices | 6-60 months; 0% APR promotional periods available for 6-24 months |
| Prosper Healthcare Lending | Fixed-rate medical loans with no prepayment penalties | 24-84 months; rates from 5.99% APR |
| HSA/FSA | Pre-tax dollars for medical expenses; ACL surgery is a qualified expense | Tax savings of 20-35% depending on bracket |
| Personal Loan | Unsecured loan from bank or credit union | 12-60 months; rates from 6-15% APR based on credit |
If you're using a promotional 0% APR offer, make sure you can pay off the balance before the promotional period ends. Deferred interest can result in retroactive charges on the full original balance.
Pro Tips from Orthopedic Surgery Experts
Verify all providers are in-network before surgery day. It's common for the anesthesiologist or assistant surgeon to be out-of-network even when the primary surgeon and facility are in-network. Call your insurance company and confirm every provider who will bill you.
Don't skip physical therapy to save money. PT is the single most important factor in your surgical outcome. Cutting corners on rehabilitation increases your risk of re-tear, stiffness, and poor functional recovery. Budget $1,000-$5,000 for 6-9 months of PT and treat it as a non-negotiable part of the total cost.
Request an itemized bill and review it carefully. Medical billing errors are common. Studies suggest up to 80% of hospital bills contain mistakes. Look for duplicate charges, incorrect procedure codes, and charges for services you didn't receive. Dispute any errors with the billing department before paying.
Ask your surgeon about their ACL reconstruction volume. Research consistently shows that surgeons who perform more than 50 ACL reconstructions per year have lower complication and revision rates. A high-volume surgeon may charge slightly more but can save you the cost — and pain — of a revision surgery down the road.