How Much Does Torn MCL Surgery Cost?

Last Updated on February 8, 2024
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

Suffering a torn medial collateral ligament (MCL) in your knee can be extremely painful and debilitating. Unfortunately, many MCL tears require surgery to properly repair the ligament and restore stability and function to your knee. But how much does MCL surgery actually cost? The prices can range quite a bit depending on your location, surgeon, hospital, and insurance coverage. This article will break down the typical costs associated with MCL repair surgery, factors that influence the price, ways to manage expenses, and insurance considerations.

Highlights

• Total costs range from $4000 to over $20,000 depending on the extent of damage and insurance. Expect to pay thousands.
• Arthroscopic procedures are generally cheaper than open surgery. Ask about minimally invasive options.
• Location and choice of surgeon greatly impact pricing as well. Shop around.
• Physical therapy accounts for significant costs during recovery. Factor in rehab costs.
• Managing insurance details and shopping around for care is crucial. Seek cost estimates upfront.

How Much Does Torn MCL Surgery Cost?

The average cost of torn MCL surgery is between $12,000 and $20,000+ if you’re uninsured, and $4000 to $12,000 with insurance.

Many factors affect the final costs like location, surgical techniques used, and insurance coverage. MCL surgery at an outpatient surgery center is generally cheaper than a hospital. The least expensive option is an arthroscopic procedure that utilizes minimally invasive techniques.

For example, an MCL repair at an orthopedic surgical center may cost $8,500 while a full reconstruction at a hospital is $18,000. Here are some real-world cost examples:

• Dr. Lee’s Surgical Center in Los Angeles – $6,000 arthroscopic MCL repair
• San Francisco General Hospital – $15,000 MCL reconstruction
• OrthoIllinois Surgery Center in Chicago – $12,000 ligament reconstruction
• Rothman Orthopaedics in New York City – $17,800 MCL repair surgery

The average cost of MCL surgery in Seattle is around $11,300, while prices in New York City average $17,800. Location makes a big impact.

On MDsave for example, the cost of a Medial Collateral Ligament (MCL) Repair ranges from $5,304 to $16,567.

Turquoise Health notes that the average cash price for Reconstruction medial collateral ligament is $12,089. However, the price can vary based on location and insurance coverage.

According to NCBI, patients who underwent concomitant collateral ligament (MCL) repair or reconstruction had the highest costs for both immediate procedure, with a median cost of $12,473.

What Makes MCL Surgery So Expensive?

MCL surgery, also known as MCL reconstruction, is considered a major orthopedic procedure. As with most surgeries, high costs come from multiple components:

• Surgeon’s Fees – The orthopedic surgeon performing your knee ligament repair will charge anywhere from $2,000 to $4,000 for their services. More complex procedures performed by top specialists can exceed $5,000. For example, Dr. Smith may charge $2,500 while Dr. Lee’s fee is $3,800.
• Anesthesia – You will be under general anesthesia during the operation, which involves an anesthesiologist monitoring you at all times. This can add $600 to $1000 to the bill. A standard anesthesia fee may be around $800.
• Operating Room – Use of the operating room itself can cost $1500 to $3000 per hour. MCL surgeries typically last 1-2 hours. A hospital OR may be $2,500 per hour, while a surgery center is lower at $1,800 per hour.
• Medical Devices – Any hardware implanted during surgery, such as screws or plates, increases costs. Most MCL procedures utilize arthroscopic tools too, adding $500 or more.
• Overnight Stay – Many patients stay 1 night in the hospital post-surgery, which adds $2000 or more per day. A standard single room often costs $2,500 per night.
• Medications & Medical Supplies – IV fluids, surgical dressings, knee braces, and post-op prescription medications contribute to the overall bill as well. Expect another $500-$1,000 in supplies.
• Physical Therapy – After surgery, most patients require 6-12 physical therapy sessions over 2-3 months. At $100 per session, rehab adds significantly to the total costs. With 12 visits, that’s $1,200 more.

What Does Insurance Cover for MCL Surgery?

Most health insurance plans cover MCL surgery, but the amount you pay out-of-pocket depends on your:

• Deductible – The amount you pay before insurance kicks in, often $1,000 to $2,500 or more. A standard deductible is $2,000.
• Co-pay – The fixed amount per visit, usually 10-30% of the total bill. A 20% copay on a $15,000 surgery would be $3,000.
• Co-insurance – Similar to a co-pay but a percentage of expenses. This could be 20% of costs.
• Out-of-network charges – Seeing a provider outside your plan’s network increases costs significantly. Opt for in-network surgeons.

Many insurers consider MCL surgery medically necessary, but pre-authorization is required or you risk much higher expenses. Discuss your options with providers in your network when possible. Consider getting cost estimates in writing beforehand too.

You might also like our articles about the cost of a meniscus tear surgery, foot corn removal surgery, or brachymetatarsia surgery.

Other Expenses to Account For

Aside from the surgery itself, you will likely incur costs for:

• MRIs – Imaging tests before surgery can run $500 to $1,500 or more. Expect an MRI to be around $1,000.
• Surgeon consultations – Expect to pay a $100 to $200 copay per office visit before scheduling a procedure. Initial consult might be $150.
• Custom knee braces – These are often prescribed post-surgery and cost $100 to $500 without insurance. A high-quality brace starts around $300.
• Physical therapy – As mentioned above, rehab and PT for 6-12 weeks quickly adds up. With 2 visits per week at $100 per session, that’s $1,200-$2,400 more.

Strategies for Managing MCL Surgery Costs

Don’t let the high price tags overwhelm you. Here are tips for reducing expenses:

• Check if any financial assistance programs can help cover out-of-pocket costs. Ask your provider about available resources.
• Ask about discounted cash rates if you have no insurance. See if you can negotiate a lower price.
• Seek in-network orthopedic surgeons and facilities to prevent unexpected charges. Verify providers are in your plan’s network.
• Negotiate payment plans or financing options with the hospital. Many allow monthly installments.
• Get multiple cost estimates before choosing where to have the surgery. Compare prices at different locations.

Frequently Asked Questions

Do I need surgery if I tore my MCL?

Many minor MCL tears can heal without surgery using a brace, rest, ice, compression, and elevation. But complete ligament ruptures or tears that displace the knee joint often require surgical repair.

Your orthopedic surgeon will examine the grade of the MCL tear and degree of instability to determine if operating is necessary. Surgery is typically recommended for high-level athletes or very active individuals to prevent future knee damage.

Can an MCL tear repair itself?

In some cases, yes. Low-grade partial MCL tears with minimal separation of the ligament fibers can heal over time without surgical intervention. Wearing a knee brace to immobilize the joint for 4-8 weeks allows scar tissue to form and repair the tear.

However, complete MCL ruptures with significant instability are less likely to heal properly without surgery. Your doctor will assess if self-repair is possible based on severity.

Is tearing your MCL worse than ACL?

An ACL (anterior cruciate ligament) tear is considered more severe because that ligament provides front-to-back stability within the knee joint itself. The MCL (medial collateral ligament) controls sideways knee movement.

ACL tears almost always require prompt surgery, while some MCL tears can heal without operating depending on grade and activity level. Both injuries can be equally painful though. Recovery also takes many months for both ligament tears.