The Cost Of Back Surgery and How To Negotiate Surgical Cost

Back pain is the 2^nd leading cause of time taken off from work . One million dollars are lost annually due to missed days from work and it’s the most costly injury for employers.

Back pain is the number one cause for people under 45 to limit their activity , the second highest complaint at the doctor’s office , the third leading cause for surgery , and the fifth most common reason for hospitalization .

After 52 weeks of being of work from a back injury /disability the like hood of returning back to work is only 25% , after being of for two years that return rate drops to zero.

The lumbar spine is responsible for 85% for back injuries. Of these injuries 2%-3% will have a herniated disc with 1% having nerve root and leg symptoms .

More than 95% of all spinal surgeries are preformed at the L4-L5 vertebrae .

Re-operation rates on the spine are reported to be 6.9%-37.7% .

Heithoff et al reported that Failed Back Surgery Syndrome cases is costing 25,000-50,000 each year .

A estimated 13 million people will get medical treatment for chronic lumbar back

The Center of Disease Control state that 2.4 million adults are chronically disabled by back pain along with another 2.4 million who will be temporally disabled.

1 In every 5 people will experience some form of back pain while 70 % of the population will experience lower back pain at sometime in their life.

Back pain is more common in men than women. The most common of age for back pain is between 45-64 and is more common in Caucasians & Hispanics than it is among African Americans or Asian Americans.

JAM -Journal of American Medical Association reported in 2010 a 15 fold increase in the number of complex spinal fusion surgeries for lumbar spine stenosis treatment. These type of patients had longer hospital stays , higher rated re- hospitalization rates and three times the rate of serious complications from 2002-2008.

When figuring the cost of back surgery for the insured, the uninsured, those on medicade and medicare there are many factors to take into consideration. There monetary, physical risk factors, and recuperating time factors to consider when making your decision. Surgery should always be consider as a last resort. A good surgeon Dr.Hammil said " Yes you need surgery, but there is not one out there for that will not make you worse. I can though give you the of thirty doctors that will perform surgery on you. When you start to loose control of your bowels, bladder and your legs then some thing will have to be done until than, do what you can and get pain management."

cost's examples:

• laminectomy -$50,000-$ 100,000- without insurance

• spinal fusion 880,000-150,000 - without insurance

• either one of these with insurance- 200-2,000 maxium out of pocket cost

Ask your doctor for the billing codes for the service / procedure's, these are called CPT codes for office visits and the code the hospital will have for the same services / procedures are called DRG codes. The more specific you can be the easier it is to get a price from your provider. Call your hospital and ask to speak with the administrative staff or billing office, give them the names of your procedures and the doctors codes to get a price quote.

Let them know if you will be paying out of pocket or who your insurance provider is. Make sure to ask them for a self pay discount.

If you have a choice of hospital’s and they all provide good service call around and for price’s they more than likely will be different. Once you have decide on the hospital you will be using make sure to get the cost of the surgery in writing.

When figuring your cost the two biggest expenses will be the for the hospital and the surgeon. The operating room, recovery room, ( charge by the hour ) and the room you stay in until released , any pain medication, catheters for long term medication administration via external pump, Anesthesiologist charges for technology and services or supplies used that they used, this a example of some of the charges on your hospital bill.

The anesthesiologist will also send you his own bill for the services he has provided for you during the surgery. For the neruo diagnostic team-they will be monitor your spinal activity. Any specialist will have a team of assitants as well as nurses that will need to be paid.These are the charges just for the day of the surgery and the few days in the hospital there are many more.

Once you get home there will be more expenses that you will need to pay for. You more than likely will have to wear a back brace this can cost $200.00 or more. Pain medication and equipment (walker or cane ) $50.00 -$100.00. Physical therapy-most people have a few sessions these will cost $50.00-$100.00 per session

Time off from work that’s if you can even go back to work and if you go can do the same job at the same pay rate and work the same amount of hours. Jobs that involve any type of lifting you will usually not be able to go back to. Once you have had a back injury /surgery that’s on record you’ll find it very hard to find employment most employer’s don’t want to take on the liability of someone with a injured back.

All of these expenses are if the surgery takes care of your back problem, if it makes it worse and you end up with Failed Back Surgery Syndrome (FBSS ) the cost can not have a price tag put on it.

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