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How much does ACL reconstruction cost?

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.)


Generated 4:01:36 on Dec 18, 2018