Richard W. Vanis, MD

Surgical Costs

If you have questions regarding insurance, costs and reimbursement, do not hesitate to call our office. We have people to talk to you and if they are not immediately available, they will call you back. Arrangements can be made to make your cost concern less intimidating.

Cost of Total Knee and Total Hip Replacement

Charges associated with TKR (knee) or THR (hip) include the surgeon's fee for total knee replacement (27447) or total hip replacement (27130), surgeon fee for computer navigation (20985), surgical assistant's fee (12-20% of the surgeon payment, not fee), anesthesiologists fee, hospital fee and physical therapy fee. The codes after the procedures are insurance codes to identify the procedure and are used for billing. They are helpful when dealing with the insurance companies or surgeons. Surgeon's fees vary as does the amount the insurance company pays also varies.

A physician who accepts assignment from Medicare will be reimbursed $1597.56 from Medicare in California for CPT code 27447; for 27130 (total hip) the payment is $1493.15; these fees are regularly revised and presently are scheduled for a 22.5% reduction in payment to the doctor in November, 2010. Included in the payment for surgery (knee or hip) is the surgery payment and 3 months of post operative care by the doctor. Medicare then pays 80% of the amount they call "usual and customary/authorized" and your secondary insurance should pay the balance. The Medicare A deductible for the first 60 days of hospitalization in 2010 is $1100.00.

Hospital payments are typically 25-50% of hospital charges. Do not be aghast when receiving the statement for your surgeon, assistant surgeon, anesthesiologist or hospital/surgery center. Once the fees are adjusted bythe payer (Medicare and all other insurances) the cost will be reasonable and affordable for most budgets. Surgeon payment varies between insurers. Their payments, however, are usually 25-50% of the surgeon's stated fees. Dr. Vanis' charges are available upon request; call our office 626-574-9745.

Medical Financing for Orthopaedic Procedures

Medical Financing for orthopaedic procedures is available. Frequently, people need surgery and have no insurance, have high deductibles or co-pays. We have arranged for reasonable financing to eliminate the stress of dealing with a medical problem and not having the money to get care. We want to assure that you get the best treatment at the needed time and return quickly to a full and active life. This loan is specifically for medical needs that can be applied for at the time of your office visit. The rates are reasonable and authorization is immediate, if you qualify. We want to make affordable medical/orthopaedic care available to you.