How Much Does An ORIF On An Ankle Cost?

Last Updated on February 12, 2025
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

Suffering a serious ankle fracture often requires surgery to properly realign the bones and stabilize them while they heal. This procedure, called open reduction internal fixation (ORIF), comes with considerable costs that patients should understand when weighing their treatment options.

In this guide, we’ll break down the typical ORIF ankle surgery costs with and without insurance, what’s included, and ways to reduce expenses. Read on for a full overview of what this reconstructive ankle surgery involves and how much it costs on average.

How Much Does An ORIF On An Ankle Cost?

The total cost of an ORIF on an ankle surgery ranges widely, with prices spanning anywhere from $10,000 to $40,000 on average in the United States based on the clinical details and complexity of each unique case.

Many factors such as geographic location, hospital and staff fees, implants required, insurance coverage, and post-op physical therapy all contribute to the final price tag. Let’s closely examine the typical cost components:

Surgeon Professional Fees

As a complex orthopedic procedure requiring extensive decision-making and operative expertise, the ORIF surgeon bills for their services based on the intensity of the case:

• Simple ORIF for an isolated fibula fracture: $2,000 – $4,000
• Standard ORIF for a bimalleolar fracture: $4,000 – $6,000
• Highly complex ORIF such as for pilon fractures with plates, grafts, and external fixators: $6,000 – $8,000

The physician’s fee accounts for their time and skills in the operating room setting the ankle fractures.

Hospital or Facility Charges

The costs of the operating room, surgical equipment, medications, supplies, and nursing care make up a significant portion of the total ORIF surgery price.

Outpatient Surgical Centers: $5,000 – $10,000

Hospital Inpatient ORIF: $10,000 – $20,000

Inpatient ORIF requiring an overnight hospital stay unsurprisingly brings much higher facility charges.

Anesthesia Expenses

General anesthesia is administered for all ORIF procedures to keep the patient fully unconscious and pain-free during surgery. Fees are based on OR time:

• Basic ORIF under 2 hours: $800 – $1,500
• Longer complex ORIF over 2 hours: $1,500 – $2,500

Diagnostic Imaging Costs

X-rays, CT scans, and MRI studies help diagnose ankle fractures and guide surgical planning. Common imaging costs:

• X-rays: $200 – $500
• CT scan: $1,000 – $1,500
• MRI: $2,000 – $3,000

Implants and Internal Hardware

The plates, screws, and fixation rods used to stabilize the ankle bones during ORIF surgery are costly but integral:

• Basic hardware kit: $1,000 – $3,000
• Extensive hardware for complex fractures: $3,000 – $5,000

Post-Op Medications and Supplies

Crutches, knee scooters, medications, braces, and walking boots needed for protecting the ankle after surgery tally up. Expect to spend $500 – $1,500 on these recovery supplies.

Post-Surgery Physical Therapy

Vital for regaining ankle strength and motion after ORIF. Typical costs:

• Individual therapy: $50 – $200 per session
• Group therapy rates: $25 – $75 per session

Revision Surgery for Hardware Removal

Some patients require an additional surgery to remove painful internal fixation devices after the bones heal, costing an extra $5,000 – $15,000.

When considering ORIF surgery, patients should think about both the immediate procedure and costs associated with the lengthy healing, therapy, and potential complications afterwards.

MDsave reports that the cost of an open treatment for ankle fracture/dislocation ranges from $5,307 to $18,684. This variation is due to differences in location and whether patients have insurance or are on high deductible health plans.

A study published on PubMed notes that total surgical costs for ORIF procedures averaged $6,537.62, while adding arthroscopy increased this to $6,886.46. Direct costs including operating room time were slightly lower at $6,212.34 and $7,312.10, respectively.

Another study available through PMC found significant differences in ORIF costs based on whether the procedure was performed by an orthopaedic surgeon or a podiatrist. Orthopaedic surgeons generally had lower costs per case compared to podiatrists.

On Sidecar Health, cash prices for ankle repair surgery vary widely by state and facility type—ranging from approximately $6,081 to $12,064 depending on these factors. Additionally, they note that average cash prices are about $6,839 at surgery centers versus around $9,544 at outpatient hospitals.

Lastly, a study published in a journal via SAGE Journals reported mean total direct costs of about $11,466 per case for inpatient ORIF procedures involving room and board charges.

What is ORIF Surgery?

ORIF stands for open reduction internal fixation. It is a surgical procedure performed to repair severe ankle fractures that cannot be properly aligned without intervention.

During ORIF surgery, the orthopedic surgeon will:

• Make an incision over the ankle to access the fracture site directly.
• Reposition the broken bone fragments back into their normal alignment.
• Secure the bones together with plates, screws, and/or rods to stabilize them during healing.

ORIF allows precise realignment and provides rigid internal fixation to aid bone healing compared to non-surgical casting or bracing. It is typically recommended for:

• Bimalleolar fractures – breaks involving both the inner and outer ankle bones
• Trimalleolar fractures – breaks of the inner, outer, and back of the ankle bones
• Certain tibia fractures extending into the ankle joint
• Severe displaced fibula fractures where the bone heals in a shortened position without surgery

Reconstructing severely displaced ankle fractures via ORIF facilitates proper healing and helps restore mobility or prevent arthritis after trauma.

What Affects ORIF Ankle Surgery Costs?

Many factors influence the final price tag for ORIF ankle surgery:

Surgical Complexity and Hardware Needed – More extensive ankle fractures require more operating room time, expensive implants, and technical expertise by the orthopedic surgeon, increasing costs.

Inpatient Hospital Stay – Inpatient ORIF procedures allowing post-op monitoring and pain control in the hospital can add $5,000 – $15,000 compared to outpatient surgical centers.

Location and Facility Costs – Urban hospitals and academic medical centers with specialized orthopedic trauma teams often charge more for services than community hospitals.

Insurance Coverage and Deductibles – Uninsured patients tend to pay the most out-of-pocket for ORIF surgery, while those with top-tier insurance pay the least.

When budgeting for ORIF ankle surgery, patients should account for both upfront surgical costs and long-term recovery expenses.

You might also like our articles about the cost of Achilles tendon surgery, foot levelers, or crutches.

Health Insurance Coverage

Insurance coverage makes a major difference in what patients pay for ORIF out of their own pockets:

Private Insurance ORIF Costs

• Covers 60% – 90% of approved ORIF expenses depending on the plan.
• Out-of-pocket costs are dictated by deductibles ($1,000 – $5,000) and coinsurance (10% – 40%).
• Better insurance = lower patient responsibility.

Medicare and Medicaid ORIF Coverage

• Cover essential ORIF procedures but at lower negotiated reimbursement rates for providers.
• Choice of surgeons and hospitals may be limited compared to private insurance.
• Minimal out-of-pocket costs thanks to supplemental coverage.

Uninsured ORIF Patient Costs

• Must pay the full “sticker price” which can be extremely expensive for ORIF.
• Can negotiate self-pay discounts with hospitals to reduce costs up to 30%.
• Payment plans and financial assistance are vital resources.

While having health insurance defrays costs, ORIF patients should thoroughly understand their policy’s deductibles, copays, and exclusion clauses to estimate their potential share of surgery bills.

Total Cost of ORIF Ankle Surgery

Considering both the upfront surgical bills AND ensuing post-op care, the total cost of an ORIF ankle procedure easily ranges from $15,000 to $60,000+ in total.

To understand the full scope, let’s examine sample itemized cost scenarios:

Typical Inpatient Bimalleolar ORIF – Uninsured Patient

• Surgeon’s Fee: $6,000
• Hospital Charges: $18,000
• Anesthesia: $2,000
• Implants: $4,000
• Imaging: $2,500
• Medications & Supplies: $1,000
• 12 Weeks Physical Therapy: $4,800
• Total: $38,300

Outpatient Fibula ORIF – Insured Patient

• Surgeon’s Fee: $3,500
• Facility Fee: $7,500
• Anesthesia: $1,200
• Hardware: $2,000
• Brace & Crutches: $350
• Copays: $700
• Deductible: $1,500
• Total: $16,750

The extent of ankle damage necessitating repair drastically impacts the bottom line.

Final Words

While a complex orthopedic procedure, ORIF ankle surgery provides the reconstruction needed for severe, unstable ankle fractures to heal properly. The costs reflect extensive surgical care, equipment, and post-op recovery.

With prices ranging from $15,000 to $60,000+ depending on clinical details, patients should check with their insurance providers and talk to financial coordinators at orthopedic hospitals to anticipate ORIF expenses. Seeking cost-saving measures can help offset bills as well.

Answers to Common Questions

Does ORIF need to be removed?

In most cases, the plates, screws, and rods used for ORIF can safely remain in the body long-term without complications. Hardware removal may become necessary if it begins irritating soft tissues after the bones fully heal.

How much does an ankle fracture cost?

A non-displaced or stable ankle fracture treated with a cast or walking boot typically costs between $500 to $3,000 without surgery, including doctor visits, x-rays, and supplies.

How long does an ankle ORIF take to heal?

With rigid internal fixation, ankle bones typically heal in 6-12 weeks. However, recovering full strength and mobility can take several months of gradual physical therapy and rehabilitation after ORIF surgery.