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How much does ACL reconstruction cost?

 

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Question:

I am considering ACL reconstructive surgery - what kind of cost do I have to expect. I live in the USA.

Answer:

The answer to how much *you* will have to pay varies on many factors, in particular on whether you have health insurance and how much your insurance will cover.

In my case I was diganosed (from an MRI) that I had a torn ACL but my meniscus seemed ok according to the MRI.

During the surgery they found that the meniscus was partially torn (75% tear) and they stitched it.

Every service in this procedure is billed and paid separately:

- your doctor who orders the MRI
- the MRI
- the surgeon who performes the ACL reconstruction
- the anesthesia
- the surgeon's assistant(!)
- the hospital (facility) where it all happens
- afterwards the physical therapy

The following numbers will be first what each instance was billed at, followed in () how much I actually paid. Note that my insurance negotiated in most cases on the billable amount, e.g. the facility was billed by the hospital at $2081 for those 4 hours, my insurance negotiated it down to $1600, the insurance paid $1440 and I paid $160.

- your doctor who orders the MRI
$700 ($260)

- the MRI
fully paid by insurance

- the surgeon who performes the ACL reconstruction and meniscus repair
$2500 ($250)

- the anesthesia
$2000 ($250)

- the hospital (facility) where it all happens
$2000 ($160)

- afterwards the physical therapy
$70 ($15) per visit, expect 16-24 visits = ~ $300 co-pay


I would say that the surgery is definitely worth it if you plan to live an active lifestyle. It sure depends also on at what stage in life you are. After the surgery make sure to get the leg *fully* straight right away or you are looking into several months of painful attempts to stretch a shortened muscle. (That's what happened to me, unfortunately.)


Comments:

You are on page 7 of 11, other pages: 1 2 3 4 5 6 [7] 8 9 10 11
2008-03-27, 11:54:03
anonymous from United States  
I have the following simple advice for those of you without health insurance facing huge bills for ACL surgery: shop around for insurance. I recently shopped for health insurance and found a great plan with low premiums, excellent coverage, low deductibles and NO EXCLUSION FOR PREEXISTING CONDITIONS. The only catch was that it was only available in rural counties around my city.

If I were weighing the difference in cost of a $30,000+ surgery and say, the cost of renting an apartment or room in a rural area, the cost of the insurance premiums, and the inconvenience of driving an hour to go to the doctor, the choice would be pretty clear to me.

It isn't fraud if you take up residence in the area. But no one says how long you have to stay there after your procedure.

So SHOP AROUND. Find a policy that will cover you, and do what it takes to qualify for it. Barring that, get any old coverage today, because all of a sudden it should start looking cheap in comparison to paying out for surgery, and maybe it's your hip that goes out next. And your preexisting condition exclusion will expire before you know it. Take care of yourselves, guys!
2008-04-06, 16:53:58
from Tempe, United States  
I am Canadian (Currently studying in the US) and I don't understand why other Canadians keep knocking our system! I've had 2 knee surgeries (one for the removal of my menisci from my right knee in '97 and one for a repair of my ACL, MCL, PCL and menisci in my left knee in '06). Neither surgery cost me a penny and, yes, there was a little bit of a wait (about a month I think..) for my second surgery, but as long as you make yourself available for cancellations and openings that the surgeon might have, it's not a big deal.. They will work you in (at least mine did). No, our health care system isn't perfect.. But it is SO much better than so many other places... I've always gotten quality care in a reasonable amount of time, we should be thankful for what we have.
2008-04-12, 18:41:22
MILLER from Riceboro, United States  
rating
I tore my ACL and Maniscis and chip the top bone on my Fibia in my right knee. I have insurance with Cigna they footed the bill but it was 20,000 for the hospital, 3,000 for the annistesia, 1,500 for the MRI, 2,500 for the Doctor who perform the surgery, and 200 every time I go to therapy. Oh which I pay 105 out of that. I do not think I came out that bad. Total Cost 27500 and still counting with therapy.
2008-05-03, 22:02:55
[hidden] from Blackshear, United States  
rating
Well at least you didnt tear your ACL in both knees 7 months after the first one. I had complications after the surgery; like according to the doctor, a mild case of staph and a blood clot the size of a baseball. Since I'm only in high school, it seems like a lifetime of doin nothing but sit around the house for a couple weeks. Since My first ACL surgery went so well, i had high hopes of being back to a normal life in 2 to 3 weeks, but its not goin like the other one this time. There was only a 15% of a chance of tearing my ACL on the opposite leg after tearing the first ACL. There is only a less then 1% of complications. Yet I found both


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2008-05-05, 16:59:22
anonymous from Canada  
rating
We live in Canada and, while our system pays for the procedure, we have to wait 1 year! My wife is a fitness instructor and it looks like we'll have to go to the states or Cuba to get the procedure done soon and pay for it out of pocket.
2008-06-07, 19:58:01
anonymous from United States  
Health care should be a right not a privilage for people who can afford it! I injured my ACL and I have no insurance. I have no idea how I am going to cover any kind of surgery. Canadians have it right, universal healthcare. Its worth the wait.
2008-07-29, 14:14:54
anonymous from Australia  
Im american living in Australia the surgery total cost 3700 dollars and thats one of the best surgeons in Australia does pro athletes.
2008-07-30, 14:15:48
anonymous from United States  
While there can be a wait time involved in CANADA it's not that bad when you consider that people like me (in the USA) are forced to sell their homes in order to pay for surgery they need. CANADA is much better than the USA when it comes to health care.

President Kennedy tried very hard when he got into office to change things but the American Medical Association and big insurance companies fought him ever step of the way and he wasn't able to push it through.

Today, I hear the talking heads we are forced to listen to on TV (Beck/O'Reilly/Hannity, etc.) screaming at us about how 'evil' socialized medicine and nationalized energy is. Glenn Beck was yelling about how he was afraid that some 'idiots' might actually want this. He didn't mention that gasoline is 12 cents a gallon in Venezuela. He sort of left the price out of his rant.

I would like: Canadian-style health care in the USA and nationalized oil. No more oil companies. Of course, hypnotized people will scream at me that this is wrong and 'evil' simply because they've been trained to think that way. I'll go with reality instead. I have many Canadian friends and none would stay in the USA for their surgery. They all said they'd go to Canada for it.

The idea that USA is superior in health care because the medical and insurance community are allowed to charge us so much is ridiculous.
2008-08-13, 18:04:25
anonymous from United States  
I playing soccer for 35 years and I know a lot people with torn ACL 90% of then going to Tijuana Mexico, fancy hospital really good doctors and they paid around $ 2,OOO.OO
2008-09-09, 16:34:14   (updated: 2008-09-09, 16:35:04)
anonymous from Canada  
Dont listen to the canadians on here im one and the fact that you have to wait this long to have an MRI(4 months) now looking at 8 months for surrgery if your in need of it go to the states and endure the costs your body will thank you and good pyshio here is not free im spending $80 every visit twice a week multiply that by 18 months welcome to cananda its not free and you have to wait but hey our taxes are going to support another unessacairy election
2008-10-23, 21:54:35
anonymous from United States  
rating
I had my acl repaired after injuring it on a hurdle. I tore my acl all of the way. Doctor Charles Nolte was my surgeon and they decided to put the ACL CADEAVER GRAFT in. It was an Out patient precedure. Dr. Nolte is out of Franscican Skemp in LA CROSSE, WI. Here is my Bill!

Surgeon total-20,000
ACL GRAFT-10,000
Anestia-3,000
Theraphy-2,000
Medical Equipment (knee braces)-1,500
MRI-1,800
Read MRI-200


GRAND TOTAL----$38,500....
2008-10-29, 15:41:28
anonymous from Pittsburgh, United States  
im gettin surgery in about 2 weeks im not really sure about health care and stuff im only 15 but how much is an acl surgery cost if i have 2 insurances????? im kinda worried for my parents
2008-11-04, 19:22:06
anonymous from United States  
for those without insurance, look into financial aid. I don't have health insurance, because I'm too old to be under my parents, 23, and a student so I can't afford it. BUT there are clinics in the US and cost $10 a visit. I tore my acl again and applied for financial aid. They told me it won't cover all of it and have to use the hospital they suggest, but my knee keeps popping out of place and will ask for a payment plan.
2008-11-05, 23:18:18
anonymous from Japan  
rating
I'm a 30 year old American living in Japan. I partially tore my ACL skiing almost 2 years ago. I returned to sports (Kendo and Muay Thai kickboxing) without any trouble. But during a recent amature match I think I tore my ACL more, and now is gives out with sudden twisting motions. My MRI showed that my left ACL was serverly damaged, and if I wanted to continue leading an active life, it would be better to have surgery.

I thought about returning to the US to get my ACL repaired, but after seeing some of these cost, I'm having second thoughts. If I went back to the US, I wouldn't have any insurance so would be paying out of pocket. But recovery would be much easier with my family there to take care of me. Not to memtion everything will be in English.

If I get the operation done in Japan, I'll only have to pay 30% of the total cost (Japan has nation healthcare), but it would be harder, being in a foreign country. Even though my Japanese is fine, just not having any family to be at my side all the time, and not having a car, etc.... will make things a little harder. Plus even the Japanese doctors recommended having the surgery in the US, because they can do a better job there, and recovery time is faster!

Now I I have full range of motion, am able to do everyday things with no problem, and able to jog and do light Muay Thai training (no right leg kicks or knees) without too much discomfort. But I can feel how unstable my knee is. Being able to do normal , everyday activities, without any real pain, also makes me reconsider having surgery in the first place....
2008-11-10, 18:01:18
anonymous from United States  
For those that have torn or partially torn their ACL or any other knee ligament, have any of you experienced only minor pain?

I injured my knee playing football a month ago, and I;m having all the same symptoms as a teamate of mine who has completely torn his ACL once, and is now dealing with a partial tear. We have all the same symptons, except its not extremely painful. it hurt pretty bad when i injured it, but afterwards the pain is only more of a discomfort/nuisance type thing. Any chance i could have partial tear with such minimal pain (i'm hoping not).
You are on page 7 of 11, other pages: 1 2 3 4 5 6 [7] 8 9 10 11

 

 

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