The researchers looked at Medicare data from 2012 to see how much an anterior cervical discectomy and fusion (ACDF) and a posterior lumbar fusion cost (PLF). Patients with pain and/or instability in the upper (ACDF) or lower (PLF) spines are commonly treated with these two procedures.
Total knee arthroplasty (TKA), another popular orthopedic operation that does not involve the spine, was also evaluated for comparison. The study focused on direct expenses, which are the amounts paid by Medicare or other payers to health-care providers (such as surgeons or hospitals). The majority of prior cost-benefit assessments of spinal surgery have focused on chargesthe amount that physicians bill payers.
A single-level ACDF operation cost around $14,000 on average in the United States, while a single-level PLF cost around $26,000. (These total costs accounted for both professional and facilities expenses.) The average cost of KA was around $13,000, with TKA costing $22,000 in patients with other significant medical issues.
“The cost of each surgery varied significantly across the country,” write Dr. Spiker and coauthors. ACDF expenditures ranged from $11,000 to $25,000, whereas PLF costs were between $20,000 and $37,000. The cost of TKA for patients without serious medical problems ranged from roughly $11,000 to $19,000.
Except for ACDF, all procedures had considerable regional variations, with the lowest costs in the Midwest and the highest expenses in the Northeast. PLF expenses ranged from $24,000 to $28,000 in the Midwest and the Northeast. Primary TKA cost $12,000 versus $14,000, while TKA with serious medical problems cost $21,000 compared $25,000.
Total expenditures for all four procedures were strongly associated with the state’s cost of living index at the state level, but not with the population of the state.
For Medicare and other payers, spinal fusion operations such as ACDF and PLF are a substantial source of expenses. In the United States, an estimated 3.6 million spinal fusions were performed between 2001 and 2010, costing more than $287 billion.
The new study is one of the first to look at costs rather than charges when it comes to spinal fusion surgery. According to Dr. Spiker and colleagues, the reported total expenditures for these treatments are around twice as high as the typical costs.
The findings reveal that Medicare pays for spinal fusion surgery at a wide range of prices. The TKA cost figures reveal that the differences aren’t just restricted to spinal surgery.
Although the state cost-of-living index is one associated aspect, the study does not show what is underlying the cost discrepancies. According to Dr. Spiker and his coauthors, “Studying the elements that allow these states to deliver care at a lower cost may prove useful in the goal of cost optimization and the larger pursuit of value driven healthcare.”
How much is back surgery for a herniated disc?
A laminectomy, which is commonly conducted to cure spinal stenosis, costs $50,000 to $90,000 for people who do not have health insurance. Fortunately, most health insurance policies include back surgery if it is recommended by a doctor. Most insurance plans cover spinal surgery, and Medicare covers back surgery in most cases. If the deductible has been reached, typical out-of-pocket costs for patients insured by insurance would be a co-insurance payment of between 10% and 40% of the procedure, for a total of $200 to $2,000 or more, up to the yearly out-of-pocket maximum.
A herniated disc operation that isn’t covered by insurance can cost anywhere from $20,000 to $50,000, depending on the surgeon, anesthesiologist, and facility fees. A minimally invasive outpatient microdiscectomy is on the low end of the spectrum, while an inpatient open discectomy with a hospital stay is on the high end. If ordered by a doctor, herniated disc surgery is usually covered by health insurance. If the deductible has been reached, typical out-of-pocket costs for patients insured by insurance would be a co-insurance payment of between 10% and 40% of the procedure, for a total of around $2,000, up to the yearly out-of-pocket maximum.
A spinal fusion, which is often done to treat issues such as a slipped vertebrae or other spinal instability, normally costs between $80,000 and $150,000 for those without health insurance, and sometimes even more! A procedure that uses high-end titanium implants instead of a donor’s bone is usually more expensive. Fortunately, the operation would cost around $5,000 depending on your insurance.
How much does spinal surgery cost in USA?
- A laminectomy, which is commonly done to treat spinal stenosis, a narrowing of the spine that occurs largely in persons over 50, costs $50,000 to $90,000 for those without health insurance.
- For people without health insurance, spinal fusion, which is often used to repair issues like a slipped vertebra, fractured vertebra, or other spinal instability, can cost anywhere from $80,000 to $150,000 or more; a surgery that uses high-end titanium implants instead will cost even more.
- Back surgery is performed to address a physical abnormality, such as removing pressure from a nerve root or the spinal cord, stabilizing an unstable section of the back that is causing discomfort, or correcting a scoliosis. Lumbar laminectomy and lumbar spinal fusion are two of the most common back operations.
- A laminectomy is described by the Mayo Clinic, and spinal fusion is described by the North American Spine Society.
- The majority of patients need two to six weeks to recuperate. A back brace, which is occasionally necessary, can cost up to $200.
- Physical therapy, which costs $50 to $100 a session or more, can add $1,000 or more to the bill.
- During rehabilitation, pain medication will almost certainly be prescribed, and equipment such as a walker, which can cost anywhere from $50 to $100 or more, may be required.
- Self-paying patients who agree to prepay or pay within a particular time period may receive discounts from some providers.
- If there are signs of nerve injury, such as pain, numbness, or weakness in the arms and legs, or loss of bowel or bladder control, it is crucial to contact with a specialist to evaluate whether surgery is the best option. A guide to deciding whether or not to have back surgery is available from the Mayo Clinic.
- The American Academy of Orthopaedic Surgeons has a zip code-based surgeon locator. Alternatively, the American Board of Neurological Surgery has a neurosurgeon finder.
- Back surgery has risks, including the likelihood that the surgery will not fix the disease; the possibility of spinal fluid leaks, hemorrhage, or infection; and, in rare situations, paralysis or death.
Spinal Decompression costs vary depending on the severity of the condition and the area being treated. Most patients will see results after 20 treatment sessions spread out over a six-week period, costing between $1500.00 and $2000.00. Depending on the specific policy, insurance may cover a percentage of these costs. Difficult situations can be more expensive since they demand more office visits. It’s worth noting that the overall out-of-pocket expenditures of spinal decompression are typically much lower than the deductibles and co-insurance payments connected with surgery. Our staff will be pleased to discuss payment options with you, including savings for pre-paid treatment sessions.
Our clients frequently inquire about the cost of spinal decompression and whether it is appropriate for their circumstances. Dr. Sands is ready to perform an assessment and determine the cost of spinal decompression for you, as well as devise a strategy that is tailored to your specific needs and insurance coverage. Our objective at Sands Chiropractic in Pompano Beach, Florida, is to provide you with accurate information so that you can consider your spinal surgery alternatives.
What is L5 S1 surgery?
A spinal fusion is a surgical procedure in which one or more vertebrae (bones in the spine) are fused together by screws, bolts, and/or plates. The hardware can be attached to the spine from the front (anterior) or the back (posterior). Often, the disc between the vertebrae is removed and replaced with bone or a spacer. The L5 S1 Fusion refers to the surgical level.
What is the recovery time for back surgery?
Your ability to recover after lumbar decompression surgery will be determined by your degree of fitness and activity before to surgery. This is why, prior to the operation, physiotherapy may be prescribed.
The day after surgery, you’ll be urged to walk and move around, and you’ll most likely be discharged 1 to 4 days later.
You should be able to return to your previous level of mobility and function in 4 to 6 weeks (this will depend on the severity of your condition and symptoms before the operation).
Your back may feel sore when you wake up following lumbar decompression surgery, and you’ll most likely be connected to one or more tubes.
- Intravenous drip: a drip that delivers fluids directly into a vein to keep you hydrated.
- If you have trouble peeing, you may need a urinary catheter, which is a thin, flexible tube put into your bladder.
Is herniated disc surgery worth it?
- Back and leg discomfort are frequently caused by a herniated disc in the lower back. With or without treatment, most people’s symptoms improve with time.
- Many people can control their symptoms by changing how they do things, taking painkillers, exercising, getting physical therapy, or getting steroid injections. You can try something different or mix several of these if one of them doesn’t work.
- Nonsurgical treatments may not be able to reduce your pain as quickly as surgery. When alternative therapies have failed and symptoms have lasted at least 6 weeks and are making it difficult to complete your daily activities, surgery may be a possibility.
- In terms of reducing pain and other symptoms, surgery and nonsurgical therapies are nearly equal in the long run.
- Back surgery carries various dangers, including infection, nerve damage, and the possibility that your problems will not be relieved. Even if surgery helps you feel better, there’s a chance you’ll develop new issues in the future.
- If you don’t select surgery right now, you can alter your mind later if your symptoms don’t improve or worsen despite other therapies.
What happens if a herniated disc goes untreated?
If you ignore a herniated disc, you could suffer from excruciating symptoms, partial paralysis, or the inability to control bowel motions in potentially life-threatening scenarios.
Is walking good for a herniated disc?
The following Q&A provides quick answers to some of the most frequently asked questions about herniated discs and exercise. Scroll up to the preceding article for more details, or click on the links inside each answer below for more information.
What exercises can I do if I have a herniated disc?
You can undertake the same exercises for a herniated disc as you would for a bulging disc, but your motions may be limited by discomfort because herniated discs are more difficult. Leg-strengthening exercises, low-impact aerobic activities, and stretches may be beneficial depending on the severity of your problem and the level of pain you are experiencing. A trained health practitioner can also do spinal decompression therapy.
What happens if a herniated disc goes untreated?
The majority of herniated discs heal on their own. According to studies, over 80% of herniated disc cases resolve after six weeks, but it could take much longer, even several months longer. If the disease looks to be improving significantly after two to three weeks, there’s a good chance it’ll go away on its own. Some people, however, may require surgery; these decisions are made in consultation with your doctor and are based on the level of discomfort and motor impairment.
Can I make a herniated disc worse?
Yes. Exercising inappropriately or engaging in activities that place excessive pressure on the affected joints can worsen a herniated disc and increase pressure on nearby nerves. Lifting heavy weights, bending, and twisting can all exacerbate the symptoms of a degenerating disc. Sit-ups, leg lifts, and high-impact aerobic activities are also should be avoided.
Is walking good for a herniated disc?
Absolutely. Walking is a great exercise for those who have herniated discs because it increases blood flow and oxygen to the cells. It also aids in the hydration of your discs, which is crucial for healing. Swimming and cycling are two other low-impact aerobic sports to try. (However, if any of these activities make your discomfort worse, stop doing them and visit your doctor.)
If you’re still unsure about which exercises to avoid if you have a herniated, slipped, or bulging disc (or lower back pain), consult your doctor for more information.
Does insurance cover back surgery?
According to Modern Healthcare, a common back surgery can cost upwards of $100,000. If you were to pay it out of pocket, that’s a large sum. Most health insurance coverage, fortunately, cover back surgery when it is medically necessary.
Consider not only the expense of surgery, but also the price of drugs, MRIs, and other testing, as well as rehabilitation and disability. The upfront expenditures are staggering, ranging from $169,000 for a lumbar fusion to $112,000 for a cervical fusion.
Learn how to discuss back surgery and other medically necessary procedures with your health insurance company. When the paperwork is completed correctly, insurance coverage runs more smoothly. The procedure is relatively easy to follow:
- The paperwork is completed and submitted to your carrier by the SSI billing staff.
- The cost is paid by the insurance company, minus any co-pays and deductibles that you are responsible for.
SSI’s professional team will ensure that the documentation necessary by your insurance company are completed correctly. Invest your time and efforts in preparing for your back surgery and subsequent rehabilitation. The SSI team will warn you about any potential problems before your surgery, such as:
Insurance companies have an appeals mechanism that you and your doctor can use if you believe the decision was made incorrectly. In most cases, an appeal will be successful if:
- The insurance company was given inaccurate information, which your doctor has addressed.
- Your doctor offers peer review paperwork regarding the surgery’s appropriateness and effectiveness.
- Your doctor presents further data to support the surgery’s medical necessity.
- Your doctor contacts the insurance company’s medical director to clear up any misunderstandings.
Your SSI team works tirelessly to ensure that you receive the care you require to live a pain-free life. We bring you up to date on your physical and financial progress. Take the steps below to make your insurance coverage work as smoothly as possible. We’ll take care of the rest:
- Make sure your SSI and insurance have your current address and phone number.
- Tell your SSI team about all of your insurance policies, including Medicare, which covers the majority of medically essential surgeries, and any other supplemental insurance plans.
- Notify your doctor’s office if you have any gaps in your premium coverage.
- Request a cost estimate before to surgery so you can budget for any co-payments.
- If your insurance doesn’t cover the necessary back surgery, ask for information about helpful government agencies.