How Much Does Rotator Cuff Surgery Cost?
The rotator cuff is a group of four tendons that helps stabilize the shoulder joints and allow you to raise and rotate your arm. Injuries to the rotator cuff can include strains as well as complete or partial tears. If there is an injury to the rotator cuff, the first thing that will likely be tried is a non-surgical treatment such as physical therapy or muscle building. If these treatments do not work, however, rotator cuff surgery may be required. This surgery will first remove any debris in the rotator cuff, and this debris is normally comprised of tendon fragments. If necessary, the bones around the rotator cuff will be shaved down. This will give the joint more room to move, which will result in less stress on the joint. Finally, if the tendons have been torn, they may be sewn back together.
How much is it?
- Depending on the severity, the costs of rotator cuff surgery can range from as little as $7,000 to as much as $25,000 when everything’s said and done. This is a price range with no insurance coverage.
- If you have health insurance, this procedure will more than likely be covered as long as it is deemed medically necessary. If you do not have a health insurance policy, companies such as eHealthInsurance.com can help you browse through hundreds of policies in your area.
- According to the website NewChoiceHealth.com, the average price for rotator cuff surgery is around $20,000.
- BCBST.com claims that the average rotator cuff surgery usually costs anywhere from $300 to $15,000 for the hospital costs plus $225 to $4,750 for the physician costs.
What is going to be included?
- There are a few different procedures that can be done. This can include an arthroscopic repair (inserting an “arthroscope” into the joint, which can either contain surgical tools or cameras), open surgery, or a mini-open repair.
- During the arthroscopic procedure, the surgeon will make a tiny incision in the shoulder to open up and view inside. Once opened, another small incision will be made to reach the affected tendon. The affected tendon will be split from the deltoid muscle. In some circumstances, metal rivets may be used.
- An open surgery procedure is used in case there has been extensive damage. If the cuff needs reconstruction, the arthroscopic procedure probably will not work.
- A mini-open repair is similar to an arthroscopic procedure, where a small incision is created that is smaller than six centimeters.
- The surgery should take no longer than 2 hours. However, the entire procedure, including pre- and post-operative care, can take up to 8 hours.
- Complications after the surgery can include stiffness in the shoulder, an infection or even loss of motion. 90% of surgeries often see no side effects. Surgeries that are due to overuse and wear and tear of the rotator cuff are not as effective as surgery done to repair a sudden injury to the joint.
- After the procedure, the arm will have to sit in a sling for a few days.
What are the extra costs?
- X-rays, USG or MRIs will be necessary before the procedure begins. These tests will often be separate from the surgery bill.
- A short hospital stay may be required. Hospitals will bill separate from most surgeons. Typically, this is an outpatient procedure and the patient can go home the same day.
- General anesthesia may be a separate fee. All hospitals and surgeons are going to have their own policy, so make sure that you know exactly what you are going to be charged for.
- Physical therapy sessions will be required for weeks after the surgery. This can take up to eight weeks, with assistance at least one to three sessions per week.
- Pain medications will be needed for a few weeks after the surgery has been performed. In addition to pain medication, anti-inflammatory medication will most likely be prescribed.
- A follow-up visit will be necessary to check on the success of the surgery and the progress of the recovery. The stitches will also be removed at this follow up visit.
Tips to know:
- Depending on the patient’s health, it can take upwards of one to three months of recuperation to perform light activities. To do heavy work or play sports, it could take up to 12 months to see a full recovery.
- Having this surgery performed overseas can save you more than 80%. However, if you do go this route, proceed at your own risk. With hundreds of facilities overseas, be sure to research extensively, ask questions and be informed. Your health insurance will not normally cover surgeries that are done overseas.
- When choosing an orthopedic surgeon, make sure that he is part of organizations such as the International Academy of Orthopedic Surgeons.
How can I save money?
- Rotator cuff surgery should be your last resort. If you have to, try to get at least three opinions before doing so. You may find that with enough rest, physical therapy, and exercise, the injury could go away over time.
- Consult with your health insurance provider ahead of time to see what is going to be covered.
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