The Cost of Medicare Spine Surgery

The Cost of Medicare Spine Surgery

The Cost of Medicare Spine Surgery

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In this age of Healthcare cost transparency,  few people really know what the US Government is really paying the doctors.

In 2013,  Bedlani et al published a fascination article called The Patient Perceptions of Physician Reimbursement for Spine Surgery.   In the study,  200 consecutive patients of an outpatient clinic were provided an anonymous survey on what they thought a surgeon would get reimbursed for a typical spine surgery procedure.  The reimbursement amounts were only for the surgeon fee,  not the hospital.

On average,  the survey respondents thought surgeons received $21,299 for a lumbar disk surgery,  but with medicare reimbursements,  it was assumed the government would only pay $12,336 to the surgeon.

The average person will be very surprised that Medicare reimbursed the Surgeon $971 for a discectomy procedure.  Further surveys showed 92% of respondents thought the $971 was too low.

 

A 2015 study by Goz, et al titled  Geographic Variations in the cost of Spine Surgery reviewed  the total cost of anterior cervical disectomy and fusion (ACDF) surgery and lumbar fusion (PSF) surgery by location.  Medicare Utilization and Payment data was collected from each state,  and the all inclusive cost of the procedure (surgeon’s fee,  anesthesia fee and facility fee) was calculated.  In other studies,  the charges by the providers were used,  and the costs were estimated based on a discount to the charge.  In this study,  the actual payment to the providers were identified.

These was some variation in the total costs from state to state,  but in general,   the total cost to Medicare for ACDF was $13,899 nationally,  and $12,040 in Florida.

The total cost for PSF was $25,858 nationally and $22,383 in Florida.  Remember that this is the total cost,  Surgeon fee,  anesthesia,  and hospital or surgery center.

Throughout the USA,  some Surgeons are no longer participants in Medicare secondary to these low reimbursement rates.  Then again,  many still are participants in the Medicare system.

Many Physicians feel their fees have been inappropriately targeted.  Based on this information,  I will leave it to the consumer to decide if they agree.

 

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  1. This might explain why many doctors milk the treatment with many unnecessary office visits as well as inhouse X-rays, MRIs etc. I am preparing for a Laminectomy and I would like to believe my doctor is receiving more than $900.00 for the procedure. It does explain the multiple visits prior to treatment.

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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