Tommy John Surgery Cost
Last Updated on September 13, 2021 | Written by CPA Alec Pow
First Published on February 18, 2021 | Content Reviewed by 
CFA Alexander Popivker
Tommy John surgical treatment also referred to as ulnar collateral ligament reconstruction (UCLR) surgery, is a treatment normally carried out to restore the torn ligament in the elbow.
The condition, which is primarily associated with baseball and tennis players, usually occurs when too much force is continuously put on the elbow, ultimately causing it to end get hurt.
The treatment was called after Tommy John, the baseball player who was the very first individual to go through this surgical treatment in 1974.
Just how much does it cost to have Tommy John surgery?
The expense of a non-surgical elbow treatment can be $500 to $5,000 with insurance coverage, but for clients without an insurance plan, the expenses can vary anywhere from $10,000 to $26,000 or more. The treatment for elbow injuries should normally be covered by insurance plans, except for the more advanced types of treatment.
You might also like our article about the cost of surgeries for torn MCL, meniscus tear, or foot corns.
If you do have medical insurance, you should talk to your provider to see what they are going to cover. If you are searching for a brand-new plan or do not have protection, think about utilizing services such as eHealthInsurance that enable you to check out numerous policies all on one website.
According to PlacidWay, elbow surgical treatment costs as much as $50,000, consisting of hospitalization, anesthesia, and physical therapy treatment.
According to a Times Free Press report, the expense of Tommy John surgery alone will be more than $15,000 at Georgia Sports Orthopedic Specialists Center.
A client who had actually gone through Tommy John surgical treatment in Overlake did the math on the expenses sustained throughout the day of the treatment. According to his post, when the center fee, physician’s cost, physician’s assistant charge, and anesthesia were factored in, the grand total was $15,053.25, however as an insured patient, his overall expense amounted to just $649.23.
Elements that impact the cost
Professional costs
Surgeon’s charges are generally on a case-to-case basis and will vary from one surgeon to another. In general, the rates depend upon the experience and competence of the surgeon.
Center
The expense of elbow ligament reconstruction surgery is specific to the center where the treatment is performed. Getting the treatment done as an in-patient in a medical facility can contribute to the total expense. Many health centers need their elbow surgical treatment patient to stay overnight after the surgical treatment. Nevertheless, clients can still get the treatment performed in the medical facility for a lower cost, however as an outpatient. For patients who want to go for the least pricey technique, they can get Tommy John surgery carried out on them at a certified outpatient center.
Medical facility costs
These differ from one hospital to another and consist of operating room charges, lab tests, X-rays, medications, and any screening that the medical professional orders before and after the surgical treatment.
Insurance protection
Some surgeons and medical centers accept basic Medicare insurance coverage. For clients with medical insurance, a specific part of the expense will be covered. Nevertheless, they might be expected to pay a co-payment or co-insurance, unless they are enrolled in a number of insurance companies. They might also have to pay for all services that are not covered.
Tommy John surgery summary
Before going through the surgical treatment, the patient will be examined and a thorough medical evaluation consisting of a range of diagnostic tests will be carried out. An x-ray is done to try to find bone or fracture abnormalities, while an MRI is carried out to take a look at the soft tissues in the elbow. The result of the evaluations will show if surgical treatment is required.
Throughout the surgery, which generally takes an hour, a cut is made on the inner area of the elbow joint and the damaged ligament is replaced with a tendon taken from another part of the client’s body, such as the lower arm, hamstring, knee or foot. Sometimes, donor tissue is utilized.
The whole treatment can take up to an hour to get done.
What are the additional expenses?
Rehabilitation therapy of a minimum of one year typically starts a couple of weeks after the surgical treatment, depending upon the client’s condition. Although there is a normal rehabilitation program, every client is provided one customized to their condition. Each session, without insurance coverage, can be in the $100 to $150 range. At a bare minimum, one Times Free Press short article stated you need to be ready to go through a minimum of 3 months of physical treatment sessions.
Clients normally will require to pay a co-pay for every single doctor’s visit, for an MRI (if not included in the bundle) in addition to the physical treatment.
Pain and discomfort medications might also be recommended after the surgery to aid clients to get over the discomfort in addition to prescription antibiotics to prevent infection.
An elbow brace could also be recommended after the surgical treatment to keep the joint in a fixed position and aid in the recovery process.
Tips to keep in mind
Do your own research about the physician who will be carrying out the Tommy John surgical treatment. They, at a minimum, must be a board-certified surgeon with a specialty in elbow medical diagnosis and treatment. If you’re uncertain where to look for a professional, talk with a local orthopedic surgeon for a recommendation.
Tommy John surgical treatment is covered by numerous medical insurance plans, however, be sure to talk to your insurance company first. If you are spending for the treatment yourself, the expenses to be sustained will be incurred and might be authenticated in writing.
Ask the hospital or medical center for a quote ahead of time, and make certain that it consists of the surgeon’s cost, the anesthesiologist’s cost, and other charges to be sustained.
When opting for surgeons, make sure to base your choice on certifications and experience and that they have actually carried out the treatment enough times to be extremely experienced with great results.
Before you go through the treatment, make sure to understand what your post-surgery payments will be and prepare for any emergency situation, such as any complications, as it might substantially increase the overall expense of the treatment.
Pertinent questions to ask your medical professional
- What do I have to bring to my doctor’s appointment?
- How quickly can I get a consultation?
- What kinds of payments do you accept?
- Do I have to have private health insurance?
- Just how much will the surgical treatment cost me after the insurance pays its share?
- What is the maximum on my insurance coverage and will the surgical treatment meet that limitation?
- What equipment and tests will the insurance plan cover?
- Do I have disability insurance?
- What are my prescription expenses after the surgical treatment?
How can you save some money?
Consider the idea of the Tommy John surgical treatment performed in an outpatient setting. This considerably lowers the expense given that there are no hospital room charges and other healthcare facility fees added.
Tommy John surgical treatment is much cheaper if you have an insurance plan that covers the treatment. Make sure to ask about the information before choosing to go through the surgical treatment. If you do not have insurance coverage, ask about any discount rate or see if the health center works with those who meet earnings requirements.
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