Proximal femur replacement (PFR) is most performed after a large resection of the proximal femur to remove tumor and is known to have high complication rates and worse function than a primary total hip replacement (THA). Many surgeons feel that current billing practices fail to adequately differentiate this procedure from a THA. This study aims to examine patients undergoing a primary THA or oncologic PFR and compare the relative economic impact and complication rates between cohorts.