This page is a practical guide for individuals exploring private orthopedic surgical care in Ontario. You'll find an overview of public wait times, regulatory considerations, and a list of accredited surgeons practicing in Ontario.
Orthopedic surgeons specialize in conditions affecting the musculoskeletal system—bones, joints, ligaments, tendons, and muscles. Common concerns that bring patients to an orthopedic specialist include:
It may be time to see an orthopedic surgeon if:
An estimated 600,000 surgeries are performed in Ontario each year, with over 250,000 Ontarians on wait lists. Tens of thousands of which are waiting on orthopedic surgeries.
All medically necessary orthopedic surgeries are delivered through the publicly funded Ontario Health Insurance Plan (OHIP), because private surgical options in Ontario are restricted. Ontario surgeons may not accept payment for medically necessary surgeries from Ontario residents.
Unlike most provinces, Ontario explicitly prohibits its surgeons from 'opting out' of OHIP, which would allow them to see Ontario residents within the province. Accordingly, anyone interested in private pay surgery must travel out-of-province for any medically necessary procedure.
Private pay for purely elective surgeries (e.g., cosmetic procedures, LASIK) is permitted under current regulations.
Current regulations: Ontario maintains some of the stricter regulations around private surgery in Canada. The Commitment to the Future of Medicare Act (CFMA) prohibits physicians from charging patients for OHIP-insured services, and enforcement has historically been rigorous. Unlike BC, QC, AB, Ontario has seen less legal challenge to these restrictions, and the private surgical landscape remains more constrained.
It depends on the procedure and setting. For purely elective, non-essential surgeries (such as cosmetic and ophthalmology), Ontario residents can pay out of pocket for surgery within Ontario.
But for essential surgeries (e.g. hip replacements, knee arthroscopy, ACL reconstruction, etc.), the answer is no. That is why all Ontarians who seek private surgery go out-of-province.
Yes. Note: the surgeon will likely require medical information and diagnostics (imaging, lab tests, etc.) before the consultation.
Generally, private surgeries performed in Canada are paid for out-of-pocket or via private insurance/ employer benefits.
Provincial plans (like OHIP, MSP, or AHCIP) typically do not cover procedures at private clinics, though some exceptions exist for WCB (Workers' Compensation) claims or specific inter-provincial programs.
Private insurance
Standard extended health benefits (e.g. Sun Life, Manulife) typically do not cover the cost of the surgery itself. However, they often cover related costs such as:
Health spending account
If your employer provides a Health Spending Account (HSA) or "flex account," you can often use these funds to pay for the surgery. Unlike standard benefits, HSAs are usually flexible enough to cover CRA-eligible medical expenses, including private facility fees.
Tax Credits (Federal & Provincial)
You may be able to get some financial relief at tax time.
Please consult a tax professional before claiming any private surgery fees on your taxes.
The costs for orthopedic surgery are substantial.
They vary considerably depending on the procedure, your underlying health conditions, the experience of the surgeon, type of anesthesia, etc., and can cost anywhere from $5,000 to $50,000+.
For an overview on private surgery costs, see our Resources on Private Surgery Costs.
Private surgeons typically charge a consultation fee because a surgical consult involves clinical work before, during, and after the appointment.
A surgical consultation isn’t a “meet and greet.” It’s a formal medical assessment where the surgeon may:
In a private setting, the surgeon generally isn’t billing OHIP for that time, so the consultation fee compensates them for expert assessment and diagnostic decision-making.
Private clinics also cover operating costs that public hospitals don’t fund in the same way, including:
The consultation fee helps support these resources and the infrastructure required to provide timely, organized care outside publicly funded hospital operations.
Wait times depend on urgency, imaging, and OR capacity.
If you’re over 60 with degenerative arthritis, you may be triaged differently than a younger patient with a locked knee or acute ligament injury. The fastest path usually comes from: clear diagnosis + complete imaging + documented failed conservative care.
In the Canadian medical system, wait times are divided into two distinct stages:
Ontario tracks b
In Ontario, surgical wait times are not determined on a first-come, first-served basis. Instead, they are managed through a standardized provincial system called the Wait Time Information System (WTIS), overseen by Ontario Health.
When a surgeon recommends you for surgery, they assign a Priority Level (1–4) based on clinical criteria. This priority level determines your target wait time—the maximum recommended time between your decision to proceed with surgery and the procedure itself.
Priority levels are not assigned automatically—they are clinical decisions made by your surgeon. However, surgeons must follow Ontario's "Access to Care" guidelines, which consider three main factors:
1. Disease Progression
2. Severity of Symptoms
3. Adverse Risk of Delay
In Ontario, there are an estimated 40,000 people waiting for orthopedic surgeries. In general, Ontario is one of the faster provinces at processing surgical wait lists, but the wait is still long for many.
For hip replacements, 78% of patients treated within target time. Priority 4 patients are seen within 16 weeks; Priority 3 patients are seen within 12 weeks; Priority 2 patients are seen within 11 weeks.
For knee replacements, 79% of patients are treated within target time. Priority 4 patients are seen within 17 weeks; Priority 3 patients are seen within 12 weeks; Priority 2 patients are seen within 10 weeks.
Note: the above estimates do not include the Wait 1 period, which adds an additional 9-11 weeks for hip replacements and 5-14 weeks for knee replacements.