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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 8 of 11, other pages: 1 2 3 5 6 7 [8] 9 10 11
2008-11-13, 22:39:38
anonymous from Japan  
rating
I'd say the only way to know for sure is to go and have a doctor look at it. Then he will probably recommend an MRI scan. I think I partially tore my ACL with the first injury, and tore it more, the second time.

Now, I don't have any real pain. If my leg get streched or turned a certain direction, there is some pain. The real problem is my knee 'giving out' during certian activites which require stress put on the knee for example, piviting, twisting, cutting or changing direction quickly, and kicking with all weight supported on the weak knee.

Better not to second guess, and have a doc look at it.
2008-11-26, 11:29:23
UNES from Ifrane, Morocco  
Hi all,

I think i have an ACL tear as well, i just had the MRI today, and from first assessemnt,,,it appears that i have a partial and not a total tear,,,will get the final results tomorrow. am from Morocco , but had my bachelor from Nebraska, Omaha (UNO)... (btw, it cost me about $350 just for MRI)am so glad i could find all these info. here.
I would like to ask if I will be in need for a surgery or not, bearing in my mind that i play soccer a lot,

Also, will I be able to do swimming with this partial ACL??

thank you
2008-12-02, 09:54:57
anonymous from Temple, United States  
I tore my ACL in September, and just had my reconstruction surgery about 2 weeks ago. The initial diagnosis was unsure...my knee/leg was not behaving as a knee with a torn ACL would. The normal tests used didn't really give any solid evidence that it was torn. I had an MRI and it confirmed any suspicions of a tear. I was extremely lucky....I had no meniscal damage or bone damage. Just the ACL.

Surgery went well. The first two to three days after surgery were the most painful. I used crutches, and I was allowed to bear weight immediately after surgery. I wasn't allowed to walk without crutches until I could walk without a 'significant limp.'

I was directed to sleep with my brace locked out so my knee would be completely straight. It was extremely uncomfortable, but now I can straighten my knee pretty much all the way. I can bend it to 90 degrees on my own, but anything further than that is a little painful. I don't have much pain, except for a dull ache when I've been on it a lot.

I was lucky to have a fantastic doctor. He does most of the orthopedic surgery for central Texas. He was very professional yet very personable.

I have excellent insurance, so I only had to pay a $100 copay for the surgery. I also paid a $100 copay for the MRI. I got the bill, and the total for surgery so far was a little over $16,000. That includes the anesthesia, the OR room, the recovery room, the pain meds injected into my knee, and the stuff used during surgery (the allograft, screws, bandages, etc). I also received a brace, crutches, a CPM machine (rental), and a Cryocuff (cold/compression). The only thing I have to return is the CPM machine.

I will find out today about my physical therapy.

If I were you, UNES, I would definitely have the surgery if a) the doctor recommends it, and b) you want to have an active lifestyle. Considering that the ACL prevents your tibia from sliding out of place, you can sustain further injuries by not having it reconstructed. You can tear your meniscus or other ligaments that stabilize your knee. There should be no problems swimming, as that is a very low to no impact activity. Biking is another good exercise. Running and any cutting or sharp movements could cause problems.

Hope this was helpful! Good luck! :)
2008-12-07, 23:05:17
anonymous from Atlanta, United States  
If value is what your looking for, i had my ACL repaired in Jan 2006, 1month after tearing it playing some pickup bball in SE asia, while working overseas. Had it repaired in Bumrungrad Hospital in Bangkok, Thailand, hamstring graft (no visual scar). Total costs for the surgery ininsured was $4600, not including travel. The hospital is American managed and had quality service, included was 2days in hospital stay. I then spent an extra $45 per day for 10days off outpatient stay at their service hotel nearby. Physical therapy was $20 or so for 2hr sessions per day. Great experience in the middle of Bangkok, especially if anyone is looking for medical tourism. Can visit their website and email them for quotations.
2008-12-15, 18:32:25
anonymous from Canada  
I was just diagnosed with an acl cyst. I can't seem to find any info on it on the net. Does anyone else have any info on it? Thanks
2008-12-22, 16:29:13
[hidden] from United Kingdom  
I ruptured my left ACL in 2006 (At that time, i didn't know that i have ruptured it). It was swelling for a weeks and got better. I play sport again after a month and it was never the same again. I have the feeling that the knee would falling apart. Check with my doctor, they said nothing serious injury (they only took an x-ray for it). Because of the discomfort, i stop playing soccer and chose to play not so demanding sport ie badminton. I play quite actively since with the badminton and in fact i play for my college for two whole year. Anyway, i still prevent myself to do certain movements that cause pain especially twisting the knee and jump/landing really hard. After more than 2 years, i gained confident on my knee and i start playing soccer again. it was alright for about a month and disaster struck when i tried to kick the ball really hard. I had a sharp pain and the knee was swelling really bad. I couldn't move the knee much.

Went to see the doctor and this time the doctor (different doctor) suspect i'm having an ACL torn and refer me to MRI scan. Result came and indicate i have a ruptured ACL as well as a torn menisci. So, the doctor refer me for a surgery.

So, I just had my surgery 3 weeks ago. The surgeon took my hamstring tendon and use a minimal surgery. The surgery went really well. In fact, i can already lift my leg and bend my knee more than 90 degree on the very same day which surprised the surgeon and physio. This is probably because i have a big gap year between the surgery and injury which might have strengthen my other ligaments to compensate.Now, after three weeks, i already can walk without crutch and driving on my own.

I'm a student in the UK and qualify for the low income health care benefit. Thus, the surgery is free.
2008-12-30, 15:51:37
gailchoo@yahoo.com from United States  
rating
Has anyone had ACL repair under MEDICARE???? I may be over the hill, but at 67 am not at all ready to sit in a chair and knit the rest of my life as the first ortho doc suggested. Yes, I knit, but I also RV, kayak, and garden extensively. Found a better doc with less age bias, but no info on costs as yet.
2009-02-18, 12:07:03
anonymous from United States  
what are your thoughts on using a cadaver vs. using the hamstring for ACL reconstruction?? Is one any stronger? Is recovery time any different? or pain factor?
thanks!!
2009-03-20, 13:57:36
anonymous from United States  
I tore my ACL skiing 2 weeks ago and the specialist is basically leaving it up to me whether I should have surgery or not. I am leaning toward it, but the cadaver tissue vs. my own has been concerning me as well. I hear the recovery time is longer and harder if you use your own graft, because then you have to heal in two locations. The cadaver graft is easier on the patient and the surgeon. But it still scares me a little. Any one else have input about this? Thanks so much!
2009-04-02, 18:03:59
anonymous from United States  
I had ACL surgery 2 months ago (Feb. 3, 2009). I am basically back to work now. My insurance said they didn't cover it but after researching my policy I was able to get the bulk of it covered. The total of everything came in at a bit over $46,000. The basic surgery cost was about $39,000 and everything else was about $7,000. I used a cadaver ligament because of my age (48). I could not imagine not doing the surgery at almost any age since my knee joint would constantly pop out of joint if I did anything to coax it that way.
Some of the costs other than the surgery were; Physical therapy (about 30 sessions at $85each), icing machine, leg brace, Anesthesiologist, MRI, doctors visits, meds and I'm sure more I can't remember right now. I don't know how the cadaver ligament was billed or how much it was but it took 1 week after it is ordered. With my insurance problems it took me an extra month to schedule the surgery. I needed help for at least 3-4 days after the surgery but the real pain only lasted a couple days. I was able to drive after that but couldn't use my clutch leg for about 2 weeks. It was outpatient surgery and I think I was in the hospital a total of about 5 hours.
I considered living with the problem if I couldn't get my insurance to pay but that would not have been feasable with my activity level. I run, ski(how it happened), motocross ride, bike and kayak. I don't beleive the joint would ever have gotten strong enough without the surgery to lead a normal life. In the month+ before the surgery I tore my MCL some just because the joint was pushing on it when it would come out. That seems now to be the longest thing to heal but they said it will heal on its own. I also had some meniscus tearing and the surgeon said that was easy to clean up during the surgery.
I live in Santa Barbara, CA, and I don't know if the price was higher because of the cost of living here.
2009-04-18, 11:51:55
anonymous from Carlsbad, United States  
Went in for a torn meniscus - not a major tear, I have a individual PPO plan:


Doctor visits; pre surgery and exams (total 3) $512 (my cost: $150)
MRI $992.00 (my cost: 382)
Hospital $4,909 (my cost: $2,196)
Anesthesia 718.20 (my cost: $0)
Doctor Charge: $3591 (surgery) (my cost: $349)

total amounts billed to insurance: 10,722.20

MY TOTAL OUT OF POCKET EXPENSE AFTER INSURANCE: $3,077
2009-04-20, 03:47:39
anonymous from United States  
After reading all 8 pages of posts. My biggest concern is CAN I RETURN TO THE GAME (basketball)? How well will my knee hold up? I know its probably not going to be 100% but maybe 70%-80% I would be happy.
2009-04-21, 22:05:23
anonymous from United States  
rating
I am considering a tracheotomy. I was wondering what a tracheotomy would cost me including hospitial stay, doctor fees, ect.......thank you for your help
2009-06-16, 16:45:33
anonymous from United States  
the cadaver is for sure the best way to go although the only main issue is re-tear. it starts off incredibly strong and gets progressively worse until about 8 weeks and your body recognizes it. as far as returning to the game you should be more then 100% as long as you lift and get the muscles surrounding very very strong. i have been lifting 2 hours a day since i had my surgery. and i have never felt better. i am only 17 so i know how you feel although i am an internationaly ranked skier. i dont play basketball. but work hard and you will be better then ever

2009-06-27, 22:32:00
anonymous from United States  
I had ACL reconstruction (Cadaver Graft) in March of 2008. The total cost for everything including Doctors visits, MRI, Surgery, Physical Therapy, etc... was $57,000. This was done near Kansas City, MO. If you are athletic like i am i would not have the surgery with the use of the cadaver graft. I tore my ACL for a second time 10 months after the first surgery. I am very athletic and i found out the hard way that the cadaver graft is not as strong as the pattelar tendon graft or the hamstring graft. I am going to have a second surgery in Kentucky. i have been told the estimated price would be aournd $15,000 not including physical therapy. I hope i helped someone out. Once again if you like to run, jump, pivot, etc.. do not get the cadaver graft.
You are on page 8 of 11, other pages: 1 2 3 5 6 7 [8] 9 10 11

 

 

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