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And yet there he was this year, as the patient, home after a few hours. A physician friend pierced his skin at 8 a.m. at a Seattle-area surgery center. By lunch, Dr. Kirschenbaum was resting at his friend’s home, with no pain and a new knee.

“I’m amazed at how well I’m doing,” Dr. Kirschenbaum, 59, said recently in a phone interview, nine weeks after the operation.

What felt to Dr. Kirschenbaum like a bold experiment may soon become far more standard. Medicare, which spends several billions of dollars a year on knee replacements for its beneficiaries — generally Americans 65 and older — is contemplating whether it will help pay for knee replacement surgery outside the hospital, in either free-standing surgery centers or outpatient facilities.

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