Objective To analyze the impact of the national centralized procurement policy for orthopedic medical devices on the hospitalization costs of patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods The total cost invoices of patients undergoing TKA and THA in our hospital from January 2021 to September 2023 were collected. The patient's total hospitalization expenses and various expenses such as fees of consultation, bed, blood transfusion, consumables, medication, nursing, surgery, examination and treatment were counted. Patients were grouped based on whether they were admitted before or after May 1, 2022. The differences in the above indicators between the two groups undergoing the same surgery were compared and analyzed. Results After the implementation of the centralized procurement policy, the total hospitalization costs of patients who underwent TKA were decreased from 66912.73 yuan to 31548.25 yuan. The total hospitalization costs of patients who underwent THA were decreased from 78931.39 yuan to 33817.89 yuan. The costs were decreased by 52.85% and 57.16% , respectively (P< 0.05). Among the total costs, the consumables costs for TKA patients were decreased from 49301.77 yuan to 13487.45 yuan, and the surgical fees were decreased from 5344.12 yuan to 4174.07 yuan. These costs were decreased by 72.64% and 21.89% , respectively ( P< 0.05). For THA patients, the consumables costs were decreased from 62668.77 yuan to 16951.31 yuan, and the surgical fees were decreased from 5251.43 yuan to 3989.08 yuan. These costs were decreased by 72.95% and 24.04% , respectively ( P < 0.05). However, the consultation fees, bed fees, nursing fees, treatment fees and examination fees for TKA patients, and the consultation fees, treatment fees and examination fees for THA patients were slightly increased after the centralized procurement (P<0.05). Conclusions Following the implementation of the joint prosthesis centralized procurement policy, the total hospitalization costs for patients who underwent TKA or THA surgeries are significantly decreased. The decrease in total costs was mainly driven by reductions in consumables costs and surgical fees, while other fees are slight increased.