How much does back surgery cost?
This is a common question that, unfortunately, doesn’t have a straightforward answer. While most people tend to think of the cost strictly in terms of the bill they receive, there are a multitude of other costs as well. Keep reading to learn what they are—including the hidden costs that are not well understood.
The Cost Of Back Surgery: The Bill
The cost of any type of surgery—not just back surgery—tends to be a mystery thanks to the lack of transparency in our current healthcare system. Also, the amounts people pay vary greatly depending in part on their geographic area, their medical insurance plan, and their deductible amounts.
In addition, the cost of back surgery has two components: those of the hospital and those associated with your doctors (surgeon, anesthesiologist, pathologist). The cost of a single-level lumbar fusion in a less expensive part of the country could be as little as $65,000 for medicare or around $100,000 with private insurance. In more expensive areas like New York or LA, these costs can grow by 2 or 3 times. Sometimes high cost is associated with high-cost regions. In other areas, high cost can be a function of scarcity, such as we see in eastern Wyoming and Alaska. Furthermore, “surprise” medical bills are not uncommon; it’s also not a given that your insurance provider will agree to pay.
Looking for an alternative to fusion? Find out if an innovative new procedure called the BalancedBack Total Joint Replacement might be right for you.
Wondering how much back surgery costs for a herniated disc? It could range anywhere from $15,000 to $45,000. And anterior cervical surgery (the most common type of neck surgery) ranges from $20,000 to $70,000. (If you’re interested in knowing the average cost of minimally invasive back surgery, it would be the same as for a conventional open surgery because insurance companies don’t distinguish between the two.)
Will your insurer pay for back surgery?
Today, it’s common for commercial insurance companies to refuse to approve a fusion at the outset. Why? Because it is one of the most expensive types of surgery and, as a growing number of studies indicate, it has not been shown to produce good outcomes.1 As a result, insurance companies are cutting back on the number of fusions they approve; a lengthy (and possibly expensive) appeal process may be required to gain coverage.
The Hidden Costs Of Back Surgery
While the surgical bill is rightly the most important financial concern for most people, there are other costs associated with back surgery that extend beyond this operation—both for you as an individual and for society.
Less than a third of the money spent on fusions is for the procedure itself. Back surgery patients also pay significantly for:
- The activities before and after surgery—Primary care visits, anti-inflammatories and muscle relaxants, chiropractors, epidural injections, medication, and physical therapy are all costly endeavors that lead up to, and in some cases follow, surgery.
- Time lost from work—Many patients miss work before surgery due to pain; others don’t go back to work for three months. Studies have also shown that fusion is associated with a significant increase in prolonged work loss.2
- Surgical complications and/or additional surgery—A recent study showed that one out of five patients are rehospitalized within 30 days of spine surgery (most commonly lumbar decompression and fusion patients). Nearly 60% were emergency room visits, usually for infection and unmanageable pain. Over 26% of those patients returned to the operating room for additional surgery.3
When taken together, these points mean the surgery itself isn’t necessarily the end of the spending for a particular patient, their employer, or their insurer.
Cost To Society
Society as a whole also has costs to bear in relation to the epidemic of back pain and treatment:
- Opioid dependence is prolonged for fusion patients—Recent studies have shown that the use of opioids after lumbar fusion surgery is largely due to the failure of fusion to relieve pain.4 Chronic opioid users are contributing to the current opioid epidemic in the U.S., which is significantly impacting the workforce and our economy.
- Low back pain is the leading cause of disability in the U.S. and around the world; it is regarded as a major public health issue.
- We spend more than $10 billion on spinal implants every year in the U.S.
Transparent Health Care
The rising cost of healthcare is a major public health issue—one that affects every person and every family. We designed the BalancedBack Total Joint Replacement to make every aspect of care better, from surgery to recovery and beyond. Our patients know the exact cost of their care upfront, because we manage the entire episode of care as one fixed charge, including the cost of travel, doctors, and your hospital stay. If you’d like to learn more about this procedure, visit our website or talk with a clinician.
1 Maruenda, J. I., Barrios, C., Garibo, F., & Maruenda, B. (2016). Adjacent segment degeneration and revision surgery after circumferential lumbar fusion: outcomes throughout 15 years of follow-up. European Spine Journal, 25(5), 1550-1557.
2 Nguyen, T. H., Randolph, D. C., Talmage, J., Succop, P., & Travis, R. (2011). Long-term outcomes of lumbar fusion among workers’ compensation subjects: a historical cohort study. Spine, 36(4), 320-331.
3 Adogwa, O., Elsamadicy, A. A., Han, J. L., Karikari, I. O., Cheng, J., & Bagley, C. A. (2017). 30-day readmission after spine surgery: an analysis of 1400 consecutive spine surgery patients. Spine, 42(7), 520-524.
4 Deyo, R. A., Hallvik, S. E., Hildebran, C., Marino, M., OʼKane, N., Carson, J., ... & Wakeland, W. (2018). Use of prescription opioids before and after an operation for chronic pain (lumbar fusion surgery). Pain, 159(6), 1147-1154.