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Medicare pays a surgeon $1376 for a CPT 27130. And depending on the surgeon's overhead, anywhere from 25-50% of that goes to paying his office staff, supplies, office rent, etc. Not sure I find a roofer interested in my roof for this amount. The surgeon gets pennies on the dollar but the hospitals and vendors make out like a bandit because they can bill facility fees.
And if you don't have medicare? Yup, now it gets expensive.... No insurance covers it all, and I wonder what the average deductible is????
Whoa...... A roof repair can cost anywhere between $5K - $40K+ depending on the building and repairs/materials.
A hip replacement has got to be more than that!! (Having said that, I've no idea of the cost, but it involves a lot of medical people/supplies/and room&board)
Quote:
Originally Posted by toofache32
Medicare pays a surgeon $1376 for a CPT 27130. And depending on the surgeon's overhead, anywhere from 25-50% of that goes to paying his office staff, supplies, office rent, etc. Not sure I find a roofer interested in my roof for this amount. The surgeon gets pennies on the dollar but the hospitals and vendors make out like a bandit because they can bill facility fees.
What toofache said is absolutely correct. The average hip replacement costs about $30-$35K in the U.S., and the surgeon is being reimbursed only about $1,500, and out of that amount comes all the overhead. And the amount is static no matter how often the patient is seen (i.e. if a patient has complications and has to come in for several post op visits, for instance).
The vast majority of the cost is attributable to the facility fee (hospital), which in turn is passing along its own overhead and the very high cost of the implant itself. The lucrative orthopedic implant industry is controlled by a primarily small number of companies. The companies are doing a lot of R&D, testing, and their Reps do a significant amount of work directly with surgeons to always have implants ready and available, train the surgeons how to use new ones etc. Is all that worth what they charge?? Debatable.
Last edited by Texas Ag 93; 02-10-2016 at 09:08 AM..
Just venting, and wondering---does anyone else get such remarks about "surgery happy" surgeons?
If I tolerated that kind of nonsense, I'm sure I would get those remarks. When I was in the working world, every performance review I ever got included the phrase, "Does not suffer fools gladly."
Nobody but another RA sufferer is going to fully understand why you need these surgeries. If someone had made the "Doctors are just want the money" remark to me, I probably would have stared at them incredulously and asked if that person thought I had surgery just for the fun of it. Because when it comes right down to it, they're also implying you have every surgery any doctor suggests because you don't know any better. Which of course is not true.
I am happy for you that you get some relief from these procedures.
And if you don't have medicare? Yup, now it gets expensive.... No insurance covers it all, and I wonder what the average deductible is????
I think we are talking about different things. I was referring to the amount paid to a surgeon out of the total bill. I think you are referring to the total bill. I was responding to the idea that some people actually think a surgeon gets thousands of dollars for replacing a hip. Some think they get TENS of thousands of dollars. Just more information relative to the OP's concerns from family members.
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If I tolerated that kind of nonsense, I'm sure I would get those remarks. When I was in the working world, every performance review I ever got included the phrase, "Does not suffer fools gladly."
Nobody but another RA sufferer is going to fully understand why you need these surgeries. If someone had made the "Doctors are just want the money" remark to me, I probably would have stared at them incredulously and asked if that person thought I had surgery just for the fun of it. Because when it comes right down to it, they're also implying you have every surgery any doctor suggests because you don't know any better. Which of course is not true.
I am happy for you that you get some relief from these procedures.
My whole point---which Fluffy seems to get but others don't---is that so many people in my life are critical of me seeking surgical treatment for damaged/destroyed joints. What they don't understand is that surgery is the last resort option when I seek it. Don''t people think I've tried every other option? I don't just waltz on into a surgeon's office and say "how about a hip replacement, doc"? Besides, doctors must get insurance approval. There must be something wrong to justify the surgery to begin with
Every surgery I've ever had has been after a long course of other treatments. The surgeons always remark how did I last that long? It was much worse than they anticipated. Arthritis is such a common disease I guess its misunderstood by the general population. There are many different kinds, some much worse than others. Guess I have the "much worse" variety.
Just FYI, I have HLA B-27 positive ankylosing spondylitis and concurrent psoriatic arthritis. I'm not "grandma" who just needs an excuse for a nip out of the jug!
My surgeon's bill for my hip replacement came to just under $5000. That wasn't the deductible, that was his total charge. My portion came to zero, because my deductibles/copay were already met for that year. The major bill was for the hospital--$75000 for 3 days! My portion was about $3000. BTW, my hip is fine, no problems. At least now I can get around, do shopping, drive, light housework, etc. Also, except some occasional Motrin, I'm now off pain pills.
Don''t people think I've tried every other option?
I don't think most people think.
I don't think most people have a clue about the challenges you face on a daily basis.
I think that most people you speak with are waiting for a chance to interject their own prejudices about the subject at hand. In this case, surgeons who are supposedly living high on the hog from all the "unnecessary" procedures they perform. (OK, there are probably some such. But not all.)
You just need to hang out with cooler people. Hope your hubby is doing well after his experience at MDA.
I don't think most people have a clue about the challenges you face on a daily basis.
I think that most people you speak with are waiting for a chance to interject their own prejudices about the subject at hand. In this case, surgeons who are supposedly living high on the hog from all the "unnecessary" procedures they perform. (OK, there are probably some such. But not all.)
You just need to hang out with cooler people. Hope your hubby is doing well after his experience at MDA.
Hey, Fluffy!
Yes, DH is doing great! He goes for a follow-up cat scan in a few weeks. We were just so fortunate the cancer was detected early. He had tests for another purpose and they detected a kidney tumor, still in its very early stages. They were able to remove it all, about 1 cm. Scans at the time revealed NO metastasis. We were so fortunate that--
we have excellent insurance
we live within a few hours of MDA - world leading cancer treatment center
the tumor was found early
What if we had thought---oh, the evil doctor just wants to make money. I will take care of this myself, I will drink vinegar, the organic kind, of course!
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Just more information relative to the OP's concerns from family members.
My portion was about $3000. BTW, my hip is fine, no problems. At least now I can get around, do shopping, drive, light housework, etc. Also, except some occasional Motrin, I'm now off pain pills.
Hope your hubby is doing well after his experience at MDA.
