How Much Does Meniscus Tear Surgery Cost?

Last Updated on February 7, 2024
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

Suffering a torn meniscus, the cartilaginous cushion between the thigh and shin bones, is a common knee injury. While some tears can heal without surgery, others require surgical repair.

If you’ve been told you need meniscus surgery, you’re probably wondering what it will cost. This guide breaks down the factors that impact meniscus tear surgery pricing and provides tips for managing the costs.

A meniscus tear often occurs during sports that involve sudden stops, pivots or twists. Symptoms include knee pain, swelling, catching or locking of the knee joint. If the tear is minor, it may heal with rest, ice, compression and elevation.

But larger, complex tears often require arthroscopic surgery to trim or repair the meniscus. The procedure involves small incisions for the insertion of instruments to visualize and fix tears.

How Much Does Meniscus Tear Surgery Cost?

While each patient’s situation is unique, we can look at typical pricing ranges for meniscus surgery. The average Meniscus Tear surgery costs anywhere between $2,000 and $35,000, depending on the complexity of the surgery, whether or not you’re insured, your geographical location, and more. Here’s what to expect:

For an uncomplicated arthroscopic meniscectomy performed in an outpatient setting, average costs break down as follows:

• Surgeon’s fee: $2,000 – $4,000
• Facility fee: $6,000 – $15,000
• Anesthesia: $1,000 – $2,000
• Total: $9000 – $21,000

For a more complex suture repair surgery, average costs are higher:

• Surgeon’s fee: $3,000 – $8,000
• Facility fee: $8,000 – $25,000
• Anesthesia: $1,000 – $2,000
• Total: $12,000 – $35,000

Patients with insurance can expect to pay:

• Deductible: $1,000 – $3,000
• Copay: 10%-50% of remaining costs
• Total out-of-pocket: $2,000 – $10,000

The uninsured may pay the full surgical package rates, resulting in out-of-pocket fees of $9,000 – $35,000.

NCBI writes that the average total charges for meniscus surgery were reported to be $61,004, with a range of $31,403 to $97,914. The cost breakdown by meniscus surgery type is provided in the article.

According to Joint-surgeon.com, the cost of meniscus tear surgery and rehabilitation in Germany is reported to be about 1,500 to 2,000 Euros.

On MDsave, the cost of a Knee Arthroscopy with or without Meniscectomy is reported to be $6,213.

Many factors create price variances between procedures, including:

• Surgeon’s skill level and number of surgical cases performed annually
• Geographic location and cost of living in the region
• Type of medical facility utilized (hospital versus surgicenter)

Insurance Coverage and Out-of-Pocket Expenses

The right health insurance plan can help minimize out-of-pocket expenses for meniscus surgery. On average, insurance policies like Medicare cover 80-90% of medical costs for a meniscus tear repair after you meet your deductible, usually $1,000 – $3,000. You will also have a copay of 10-50% of any remaining balances.

Some plans require preauthorization for knee surgeries. Your provider may need to submit clinical notes outlining the injury, MRI results and required repair technique. If approved, you’ll have a clearer picture of your potential medical bills.

Also read about the cost of bunion surgery, brachymetatarsia surgery, and foot corn surgery.

Talk to your insurer to determine deductible amounts, copays, preauthorization requirements and in-network facilities and surgeons. This allows for better financial planning and budgeting for meniscus tear repair costs.

Factors Influencing Meniscus Tear Surgery Costs

Many elements factor into how much meniscus surgery costs. The major pricing variables include:

• Type of surgery: Meniscectomy (removal of damaged tissue) versus meniscal repair
• Surgeon’s fees: Experience level and geographical region impact rates
• Facility charges: Hospital outpatient versus ambulatory surgical center
• Diagnostic testing: MRI versus CT scan for injury imaging
• Insurance coverage: Impacts out-of-pocket expenses
• Rehabilitation required: Physical therapy needed after surgery

Additional Costs to Consider

The surgical package price does not reflect the complete picture. You should also budget for:

• Diagnostic testing: MRIs to evaluate injury prior to surgery cost approximately $500-$1000.
• Physical therapy: Post-surgical rehab averages $100-$200 per session for about 8-12 weeks.
• Follow-up doctor visits: Periodic appointments to assess recovery average $100-$200 each.
• Braces and crutches: May be needed for supporting the knee post-surgery, adding $100-$500.

Accounting for these additional expenses allows you to plan for the total costs associated with meniscus repair surgery.

How to Manage Meniscus Surgery Costs

If the projected expenses for your knee surgery seem overwhelming, here are tips for managing the costs:

• Review your insurance policy and speak with representatives to determine out-of-pocket fees.
• Ask your healthcare provider for an itemized cost estimate for the procedure.
• Negotiate costs by inquiring about cash-pay discounts or creating a payment plan.
• Search for financial assistance programs like Medicaid that may help cover medical bills.
• Open a dedicated savings account like an HSA or FSA to save for surgery expenses.
• Price shop for the procedure at different in-network facilities to compare pricing.

Choosing the Right Healthcare Provider

Selecting the right orthopedic surgeon and facility is about more than cost – quality counts. Factors to consider include:

• Surgeon’s experience performing meniscus repairs annually
• Board certification in orthopedics
• Hospital or surgery center credentials
• Recommendations from your primary doctor
• Ratings and reviews from other patients

While an experienced surgeon may initially seem more expensive, the success rate is higher. A good outcome means faster recovery and fewer complications or repeat procedures down the road. This results in greater value long-term.

Conclusion

A meniscus tear often requires prompt surgical intervention for optimal results. While you research treatment options, also prepare financially by estimating potential costs.

The price of meniscal surgery ranges widely based on factors like complexity, providers involved, and insurance coverage. Additional costs like physical therapy also add up.

By understanding the variables that drive meniscus surgery pricing, reviewing your insurance benefits, and budgeting accordingly, you can alleviate money concerns and focus on recovery. Don’t hesitate to negotiate costs or seek financial assistance if needed.

With the right surgeon and self-education on the expenses involved, you can proceed confidently with surgery knowing you have the resources to cover meniscus repair costs.

Frequently Asked Questions

Is surgery for meniscus tear worth it?

Surgery for a meniscus tear can absolutely be worth it for several reasons. First, it can relieve painful symptoms and improve knee function. Removing or repairing torn meniscus tissue can reduce catching, locking and instability.

Surgery also prevents the tear from worsening over time and developing into knee arthritis prematurely. If nonsurgical treatments haven’t resolved issues, arthroscopic knee surgery provides a more permanent solution.

While there are costs involved, the value of regained mobility and avoided future joint problems makes meniscus repair surgery a worthwhile option.

Why avoid meniscectomy?

There are a few reasons one may want to avoid or delay surgery for a meniscus tear. If the tear is small and your symptoms are mild, nonsurgical treatments may work. Undergoing surgery too soon could lead to removal of repairable meniscus tissue.

You’ll also want your knee to be inflammation-free before surgery. The recovery is difficult, with restricted activity for 6-8 weeks. And of course, the procedure comes with risks, costs and inconvenience. However, if conservative treatment fails to reduce pain and improve function, surgery is likely your best option for finding relief.

What is a Grade 3 meniscus tear?

A Grade 3 meniscus tear is the most severe type of tear through the meniscal cartilage of the knee. It refers to a tear that extends all the way through the meniscus from the inner border through the upper surface.

Grade 3 tears usually cause knee locking, catching, pain and swelling that limits activity. Because the tear fragments the meniscus into several pieces, repair is unlikely. Surgery usually involves removing the damaged sections.

Rehabilitation focuses on regaining knee mobility while avoiding reinjury. A Grade 3 meniscus tear often accelerates joint degeneration. But prompt surgical treatment can help reduce this risk and restore function.