A study was undertaken to determine the relative work input and risk involved in doing primary total hip arthroplasty compared with revision total hip arthroplasty. These data were compared with the reimbursement to the hospital and to the surgeon. Parameters examined included operative time, length of hospital stay, blood loss, use of bone graft, and incidence of complications requiring further treatment. Revision total hip arthroplasty required significantly more work and risk on the part of the surgeon and significantly more hospital resources. The estimated hospital cost was more than the diagnosis-related group reimbursement for primary cases and dramatically more for revision cases. Actual surgeon reimbursement was less than prosthetic cost and was not significantly higher for revision than primary cases.