December 27, 2012

  • Costs for Hip Arthroscopy and Related Expenses

    As much as I can, I'll keep track of these costs related to my hip arthroscopy because I'm getting hits looking for this.  I hope this helps give you an idea of what you may be facing if you're having this procedure soon or you can tell me if this billing is way off compared to your procedure.  I saw on another blog where similar surgery was around $15k with an overnight stay in the hospital ($10k for the procedure alone, $5k for the overnight stay).  Total out of pocket for the hospital/surgery was $5k.  This did not include PT or follow up visits which I am including below.

    Background    :  I have out of state insurance in California through my full-time job and I have to say, it's the best insurance I've had so far.  The company pays a great majority of the premiums and the co-pays are normally around $10 for doctor office visits (not counting labs or x-ray).  I have one chronic illness, asthma, and I have my regular annual physical check-ups.  Pre-existing conditions were not a hinderance to my coverage. 

    I am aggregating the cost from day 1 seeing a new orthopedic surgeon about mystery pain in my hip related to running to release from post-surgery physical therapy.  I've been having pain running since 2009 and by intermittent rest breaks, taping, constant rotation of new shoes and braces, I made it to mid-2012 where I couldn't take it anymore.  My procedure was for hip arthroscopy to repair a torn labrum and hip impingement.  This is the cost from July 31, 2012 to current day.

    I am using the insurance claims and claims pending online as a framework for now.  Please keep in mind the billed amounts are probably marked up for insurance coverage.  If paying straight out of pocket, hospitals and doctors may negotiate a different amount with the patient. 

    My ability to pay: I am full-time employed and have been for several years.  I am a single mother with a child in university, never married and self-sufficient.  In the process of purchasing a home which I do not recommend you do when you have surgery during a holiday season. 

    So now for the nitty gritty:

    Initial doctor/new patient visit, the protocol to rule out other causes and physical therapy:
    7 physical therapy sessions - $70, without insurance $3,450
    3 doctor visits w/o XRay - $30, without insurnace $154
    X-ray during doctor visit - $10, without insurance $74
    Total to Rule Out Pathology - $110/about $3,678

    Diagnosis:
    MRA at hospital- TBD - bill pending at $130, without insurance $3,274
    Radiologist - $0, without insurance $379
    Doctor visit for result/prognosis: $10, without insurance $70
    Total of diagnosis $140/$3,723

    Day of Surgery (updated 12/27)
    Hospital $459.18/$22,590.15
    Surgeon1 $104.11/$3,812
    Surgeon2 Pending/$2,528
    Radiology $10/$60
    Other?
    Total: $575 (not including pending)/$28,990


    Physical Therapy
    TBD, projected at 6-9 months total recovery

    Follow up visits
    Doctor visit - TBD