How Much Does Tommy John Surgery Cost?

Last Updated on March 20, 2024
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

Tommy John surgery, formally known as ulnar collateral ligament (UCL) reconstruction, has become an increasingly common procedure, especially among baseball pitchers and other overhead throwing athletes. However, the surgery and subsequent rehabilitation come with substantial costs.

This article will break down the various expenses associated with Tommy John surgery to help readers understand the financial considerations involved.

Undergoing Tommy John surgery is a major decision for an injured athlete. A complete understanding of the costs allows patients to plan and budget accordingly. With the right financial preparation, athletes can alleviate stress and focus on their surgery recovery and return to sports.

How Much Does Tommy John Surgery Cost?

The total price of Tommy John surgery generally costs between $40,000 to $60,000 on average. However, costs can easily exceed $100,000 in some cases.

Here is a breakdown of the typical expenses:

• Initial Consultation – $200 to $500 for exam and imaging (X-rays, MRI)
• Surgeon’s Fee – $5,000 to $15,000 depending on experience and demand
• Hospital Fee – $15,000 to $35,000 for operating room, equipment, and overnight stay
• Anesthesia – $1,000 to $5,000
• Implants/Grafts – $5,000 or more if using an internal brace
• Post-Surgery Consultations – $200 to $500 per visit
• Physical Therapy – $100 to $200 per session (2 to 3 times a week for 6+ months)

Total: $40,000 to $60,000 on average

However, costs can fluctuate based on your medical team, insurance, and rehabilitation needs.

HealthNews mentions that with insurance, patients can expect to pay anywhere from $500 to $5,000 for Tommy John surgery.

According to Hand Surgery Specialists Of Texas, the average cost of Tommy John surgery without insurance can range from $15,000 to $50,000, depending on the extent of the surgery and the reputation of the surgeon, as reported by various sources.

Tommy John Surgery Overview

Named after the first baseball pitcher to undergo the surgery in 1974, Tommy John surgery repairs a torn or damaged UCL inside the elbow. During this procedure, an orthopedic surgeon grafts a tendon from elsewhere in the body to reconstruct the damaged ligament.

Common graft locations include the palmaris tendon in the forearm or the hamstring tendon behind the knee. The graft acts as scaffolding for regenerating the UCL ligament via stem cells and cell regeneration in the body.

After surgery, athletes begin gradual rehabilitation to slowly stretch, mobilize, and strengthen the elbow and arm. Total recovery takes 12 to 18 months until the patient can return to sports without restriction. Relieving pain and restoring stability allows athletes like baseball pitchers to resume their full pitching ability.

Tommy John surgery gained popularity due to its high success rate. Studies show that between 80 to 85% of patients return to the same or better level of performance in their sport after appropriately dedicated rehabilitation.

The procedure is now common, with 25% to 40% of Major League Baseball pitchers undergoing Tommy John surgery at some point in their careers. However, the road to recovery requires diligent preparation – both physically and financially.

Factors Influencing the Cost of Surgery

Since Tommy John surgery is highly individualized based on the patient’s specific injury and needs, the total expense can vary widely. The major factors that contribute to the final price tag include:

• Surgeon’s fee – More experienced surgeons in demand for the procedure charge $5,000 to $15,000 or more.
• Location – Big cities with higher costs of living tend to result in higher prices versus procedures in small towns.
• Hospital or facility fees – Operating room time, equipment costs, and overnight stays drive up hospital charges between $15,000 to $35,000.
• Type of Graft Used – Traditional grafts cost less but newer internal brace grafts are $5,000+.
• Insurance Coverage – Uninsured patients pay more overall compared to those with health insurance.
• Multiple Procedures – Simultaneous surgeries like Tommy John along with removing bone spurs cost extra.
• Anesthesia Fees – Anesthesia teams charge between $1,000 to $3,000 for their services during surgery.
• Severity of Injury – More extensive damage requires longer, more complex surgical repairs.
• Rehabilitation Needs – More intensive physical therapy over a longer period cost more overall.
• Prescriptions and Medical Devices – Necessary medications, braces, supports, and equipment add expenses.

With many variables at play, patients should use cost estimates as a baseline but expect expenses to vary.

You might also like our article about the cost of surgeries for torn MCL, meniscus tear, or foot corns.

Insurance Coverage and Out-of-Pocket Expenses

Most health insurance plans cover a portion of the costs associated with Tommy John surgery, but policies vary in coverage. Understanding deductibles, copays, pre-authorizations, and reimbursement rates is essential to calculate potential out-of-pocket expenses.

Some considerations regarding insurance coverage include:

• Verifying if the procedure is fully covered or only partially covered.
• The deductible amount that must be paid upfront before coverage kicks in.
• Co-insurance costs, usually a percentage of fees the patient owes.
• Co-pays for the surgeon, facility fees, physical therapy, etc.
• Payment differences between in-network and out-of-network providers.

Out-of-pocket costs for insured patients often total $3,000 to $10,000. Those without insurance may pay the full amount, resulting in bills over $40,000 in some cases. Understanding the insurance landscape is critical for financial planning.

Financing Options and Financial Assistance

For patients facing large out-of-pocket expenses or no insurance coverage, financing options and financial assistance programs exist to help ease the financial burden.

Potential options include:

• Medical Loans – Specialized loans or personal loans used to pay medical bills.
• Payment Plans – Some hospitals and rehab centers offer monthly payment plans.
• Medical Credit Cards – Cards designed for financing medical procedures and bills.
• Non-Profit Organizations – Groups that provide financial aid for medical procedures.
• Crowdfunding – Using social networks or crowdfunding sites to raise money.
• Government Assistance – Federal and state programs providing financial assistance for uninsured patients.

Seeking assistance early allows time to evaluate options and apply for any eligible programs or aid. Consulting with financial counselors at treatment facilities is also recommended.

Planning for Recovery and Rehabilitation

The costs of Tommy John surgery do not end after the operation itself. Significant expenses stem from post-surgery rehabilitation and physical therapy.

Patients will need to budget for costs including:

• Follow-up Appointments – Ranging from $200 to $500 per visit.
• Physical Therapy – $100 to $200 per session, 2-3x a week for 6+ months.
• Assistive Devices – Such as braces and crutches, ranging from $50 to several hundred dollars.
• Strength Equipment – Items for at-home conditioning like resistance bands and small weights.
• Transportation – To and from rehab appointments for several months post-surgery.

Post-surgery rehab takes consistent effort over 12+ months, so budgeting adequately for related costs is critical. Physical therapy plays a major role in achieving a full recovery.

Additional Considerations and Hidden Costs

While the main components of Tommy John surgery are predictable, patients should be ready for potential hidden costs. Additional expenses that may arise include:

• Complications requiring revision surgery or other procedures
• Longer post-op hospital stays should problems occur
• Extended physical therapy if the initial rehabilitation timeline is prolonged
• Specialist treatment if unusual pain, weakness, or mobility issues develop
• Extra imaging tests if recovery benchmarks are not met at follow-up exams

Asking surgeons candid questions about possible complications, additional interventions, and your total recovery outlook can uncover hidden costs. While not common, extra expenses due to complications can put patients in difficult financial situations without adequate planning.

Final Words

Undergoing Tommy John surgery involves understanding both the physical and financial demands of the process. While each patient’s case is unique, the expenses add up quickly between the surgery itself, hospital fees, rehabilitation appointments, insurance deductibles and copays, and other potential costs.

Being aware of the complete scope of charges related to the surgery allows athletes to sufficiently save, budget, and make arrangements to cover anticipated out-of-pocket costs.

Consulting medical experts and insurance providers gives the best assessment of total expenses. With diligent preparation, patients can move past the financial stress and focus on full recovery.

Frequently Asked Questions

What are the cons of Tommy John surgery?

Some potential drawbacks and risks of Tommy John surgery include:

• Long recovery and rehabilitation time, typically 12-18 months until return to sports
• No guarantee of returning to pre-injury performance level
• Potential for complications like infections or nerve issues
• Stiffness, scar tissue, and loss of elbow range of motion
• Added strain on the arm from the rehab process
• Risk of re-tearing the UCL or injuring other ligaments
• Only a temporary fix that may eventually need repeating

How long does Tommy John surgery last?

The Tommy John surgery procedure itself takes 1-2 hours to perform. Patients are under general anesthesia during surgery. Minimally invasive approaches result in smaller incisions and scarring.

However, the full surgical experience and recovery lasts approximately 12 to 18 months. The initial rehabilitation and physical therapy are very gradual, typically starting light range of motion and strength work around 6-8 weeks post-surgery. Progressively increasing activity continues over the course of a year before return to sports is cleared.

Can I drive after Tommy John surgery?

Most patients can expect to begin driving again between 4-6 weeks after surgery, but only once approved by the surgeon. Do not attempt to drive until the doctor clears you.

Factors determining readiness to drive include:

• Good mobility and range of motion restored in the arm
• No longer taking narcotic pain medications
• Ability to make evasive maneuvers with the operative arm
• Confidence gripping the wheel without discomfort
• Stamina to drive for the required duration

Even once driving, the arm remains susceptible to re-injury for many months. Return to driving timelines vary for everyone, so patients should adhere to their surgeon’s specific recommendations.