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Cost of Lumbar Fusion surgery - $90 K

LumbarLynneLLumbarLynne Posts: 67
edited 06/11/2012 - 7:34 AM in Back Surgery and Neck Surgery
Just thought I would post this in case anyone out there does a search to find out the cost of a lumber fusion surgery. I am sure it can differ depending on location and exact type of surgery but I thought I would post a ball park in case anyone is interested.

My insurance, of course paid the U&C cost - it was $5500.00 to the surgeon (instead of the $30K billed) and $24K to the hospital (1 night) instead of the $60K billed.



  • My hospital billed BC/BS $93,000 for surgery costs and 3 day stay in the hospital. Of that, the insurance paid $61,000.

    My doctor billed the insurance $19,400 and was paid about $6000.

    The anesthesiologist charged $5000, but was paid $2000.

    This surgery is expensive.
  • mine was 115,000 to hosp. insurance paid all but 250. had 2 dr.s to begin with ended up with 6. All of them paid at 100% being 2500. each surgeon and the other 4 Drs were in the nieghborhood of 800. each. stayed 21 days.
  • My surgery total was $160,000

    Of that:

    Titanium Implants: $130,000
    Surgeons Fee: $20,000
    Hospital Stay: $10,000
  • I had a plif, decompression and cyst removal. In operation for 6 hours. 3 nights. BCBS billed hospital $189 K and paid $110. Did not include surgeon's fee etc. Unbelievable. This was in a small town north of Atlanta, GA.
  • Hey,

    I saw you had a surgery involving titanium. I'm having something similar in September. Can you read my post and give me your thoughts? I'm a young person *much like yourself* and wanted to know if this was indeed something that worked. I'm 23 and don't want to live with the pain I'm in now, but I also don't want to have surgery if it isn't totally necessary. What are your restrictions?


    Here is my post: http://www.spine-health.com/forum/back-surgery-and-neck-surgery/hit-drunk-driver-dynesys-stabilization-surgery-opinions

    Estimated Cost of my Surgery: 70k-90K
    Dynesys Stabilization at L5/S1
  • I ended up with two surgeries - the first one from the back to place the rods and screws, the second, four days later through the front to put in the dowels of bone graft for the fusion. I was in the hospital a week, and my bill was $160,000 also.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • Hi everyone I just had an L2 L3 L4 L5 Laminectomy Revision and Fusion with instrumentation with Bone graft on April 27 2011 and the cost of the Hospital stay for 7 days was $124,000 now I was scheduled to get out on Saturday a 3 day stay but lucky me I got a bad infection and need emergency surgery on Saturday morning thus the 4 extra days...the Surgery itself cost approx $225,00 my Dr. was paid approx $90,00 from Ins, Co. the Anestethiologis was $6000 paid $3000 then the extra surgery was $40,000 for drain,clean out and removal of some more lamina and re-sutured and staples...the Anest...for that $3000 paid $1500 plus some other things were included...so over all the cost was approx $400,000 luckily we had good ins..and will only pay approx $2000 I have S.S disability part A which paid the entire Hospital stay...
  • Wow, getting up to speed, since my last surgery for ACDF in 1995 was $42,000 3-levels can't recall pay-offs

    My pending possible C-Spine surgery:

    anterior + posterior, 3 levels of instrumentation front and 4 levels instrumentation back, estimated surgery time 9-11 hrs, 24-48 hr hospital stay (prevent infection risks)

    Out-of-State Hilton Hotel Pre-Surgery & Post Surgery + Airfare = Est. $1,800 out of pocket

    I have Medicare & Anthem BC BS, I cringe to see what my balance I'd pay !!?!

    Anyone venture to guess?

  • I had my plif of L5/S1 done in March 18th, 2011. I stayed 2 nights. Surgery was 6 hours. One level so 4 screws and 2 rods.

    Hospital charged insurance $63,000. Harware was $54,000. Surgeon was $35,000. Other charges for scans, x-rays, MRI, and other things was around $15,000.

    I agree that this is one expensive surgery. The costs are still rising since I am starting PT and will still have continuing x-rays being taken.

    Then 5 weeks after my back surgery, I had appendicitis so my insurance is seeing another $16,000 tagged on to my insurance claims. lol

    Next, I have to have a few female problems taken care of so who knows how much that will be.

    I don't think my insurance company will like me very much by the end of this year. lol
  • $140K by the time all done with L5/S1 ALIF here in NYork!

  • Even though CA work comp dragged their feet on my surgery and made me jump through 500 hoops...I'm glad I'm not going to see a bill after reading all these posts....#:S
  • the costs you all have through insurance are outrageous.

    Here in the uk, only last year, i was quoted £20,000 for a PLIF L5/S1 with rods and screws which includes the surgeon fees, follow up xrays, anesthetists, theatre staff, equipment and ward stay.

    I know here in uk, the mention of insurance, everyone hikes they're prices up, but crikes!

    I had a alif l5/s1 done instead via our nhs which cost me personally nothing, but i do pay my taxes so it does cost me indirectly.

    L5/s1 discectomy & decompression 2009
    ALIF l5/s1 2011
    Awaiting X-ray & consultant to see if fused, but experiencing a lot of pain again :( 2013
  • This thread just proves that everything in life is negotiable. So for those that don't have good insurance OR for those that want to use a surgeon that might be out-of-network (US), you can negotiate. I know it seems silly with surgery but it's possible.

    For my first surgery, the surgeon was out-of-network. I negotiated with him that he'd accept whatever my insurance would take and I would only pay the out-of-network deductable. They also told me they'd negotiate the 2nd surgery rate with me but I opted to switch surgeons for other reasons.
  • BotzBotz Central FloridaPosts: 223
    My SCS total cost was $76,000 paid by insurance. My copay was $125.00
  • If you have no or little insurance you can go to the hospital and negotiate. You can negotiate with the surgeon but that seems a lot less. Also the PT places have insured and non-insured rates. They don't advertise it though.

    The insurance companies all have different rates negotiated with the hospitals and surgeons. They know ahead of time that they are not getting the rate they bill at. The same surgery on 2 patients each with different carriers will result in different payouts to the hospitals and doctors.

    Hospital stays, operating room are pretty high. Hardware is flat out ridiculous. I saw the surgeon was actually low man on the totem pole for payout.
  • Wow, what co-pay was that? I was just told on the 16th that I was a great (prime) candidate for the SCS, but my insurance won't cover it and I can't say that I blame them..though this is debatable.

    My surgeon always accepted what the ins. paid as 'pd. in full' (back when I had good ins.), though this should be discussed prior to surgery, because this is not necessarily always the case. Often you can talk to them about it and work it out.

    EDIT to add; What I meant by my insurance not covering the SCS and me not blaming them is that I am a medicaid patient. The taxpayers work very hard and I can understand (though like I said, debatable) the gov't not funding the high cost of the SCS for medicaid patients.
    That's all I meant by that!
  • I shudder to think what my surgery might have cost.
    I had it done at Kaiser so the cost is a black box. I had a L4-S1 ALIF/PLF with tension bands anteriorly and titanium screws and rods posteriorly.

    The grafts were donor bone/BMP.

    Hospital stay was 6 days.

    I had an IVC filter placed day before surgery and retrieved two weeks later.

    My co-pay was $1200.00.

    Conventional cost figures don't really apply to Kaiser. They are such a mammoth health care system that they can achieve great economies of scale. So, in a conventional setting, the bill for this kind of care might have approached $200k, but Kaiser's cost might be more like tens of thousands - more like the NHS in the UK.
  • I have had 3 fusions and the first two were $100,000. Thank goodness for insurance. Of course that is only surgeons, hospital and anesthesia. All the stuff leading up like MRI's and injections and then PT after is additional. My 3rd fusion is so recent I have not seen the bills but it should be less as the hospital stay was less. Still an expensive way to spend my spring vacation when I was supposed to be going to Cabo!! ~X(


    Spinal stenosis, spondolysis, spondolythesis, L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion with instrumentation and bone graft from hip, L1/S1 fusion with replacement disc put in and a nice bolt from my spine to my pelvis; PT, accupuncture, prolotherapy, many cortisone injections, 4 rhizotomies. Currently on tramadol.
    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • SpineAZSpineAZ WiscPosts: 1,084
    With my 2010 L3-S1 fusion with 8 days in the hosptial I didn't even ask for the detailed bill but in summary billing saw that it was about $90,000 and actual pay out was closer to $65,000
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I am looking at a double cervical fusion, and I need to get how much it will cost prior to add in for my MVA claim..
    I am going to call Billing at the hospital and see if they can tell me. From what I have read costs for this keep going UP!!
  • What's really crazy is, my spine fusion of 4 levels was cheaper than the same day surgery of my hip arthroscopy of my torn labrums. 150,000$ for 3 hour surgery and I didn't even stay in the hospital!!! Talk about a $$$ profession to be!!
    28 F. Chicago. Fusion from t-12 l-4 from scoli in June 2013. Torn bilateral hip labrums. Arthroscopy to fix labrums January 2013 and march 2013. SI pain from hip surgery Lupus, RA, antiphosphidlipid antibody- hypermobility syndrome ( Marfan syndrome)
  • av8tore71aav8tore71 Posts: 1
    edited 04/09/2015 - 7:21 AM
    I have had 4 lower back surgeries (L5-S1) area 1 of which was a fusion. Mine did not cost me anything because it was all service connected while I was in the US Army so all my surgeries but 1 was performed at the xxxx Hospital. My first was in xxxx. I really feel for everyone who had to have surgeries who had to pay or have health insurance and still have to pay a portion. If you decide to have this type of surgery please make sure this is what you really need cause all of mine did not work and now not only am I having chronic pain and I am on pain meds but now I am not able to work or play with my daughter who is only 6. I had no choice other then going to a military type hospital and I get a doc I have never met you can get 2 or 3 or even 4th opinion. Good luck to you who does have this type of surgery you will be in my thoughts and prayers!!!!
  • I'm un th UK.

    Always resented paying £4k per year in national insurance taxes.

    However, in 2012 I had a knee arthroscopy. In 2013 I had a second knee arthroscopy. In 2014 I had a septoplasty. In 2014 I spent a total of 42 days in hospital, had 3 lumbar nerve blocks and a discectomy. In 2015 I spent a total of 21 days in hospital and had 1 lumber nerve block and a lumbar fusion. Over those three years I've been prescribed in excess of £2k worth of opiate and neuropathic drugs, as well as benzodiazepines, among others.

    So, I think I've had my money's worth!

    L5-S1 herniation. Both knee meniscus tear. L4-5 herniation - 2 x nerve block injections. L4-5 discectomy. L1-2 nerve block injection. L4-5 reherniation - TLIF fusion. 2016: L1-2 and L5-S1 retrolistheses and multiple facet joint degeneration.
  • coachphilccoachphil Los AngelesPosts: 1
    I see a lot of costs for insurance companies for surgery that did not go well. I hadl4 l5s1 decompression first and then fusion 2 years later on l5s1. Im sure ill have to get l4l5 at some point also. I played football so my bottom 2 discs are worthless. The best spine doctors are out of network. I did my research. I stayed in a.surgical center for 23 hours to save money and they ended up asking me for 35k out of pocket and billed my insurance close to 500k...yes I mean 500,000! paid 5k to my surgeon and called up the surg center and went off and told them to kiss my backside. They came back and are asking for 15k...But im pissed. They told me that they bill that much to get like 2 percent of it. Im trippin off how they really tried to get me for 35 when stayin less than a day and being at the surg center that was supposed to save me money. Now they cool wit 15? But its not sounding cgeaper than the hospital to me. Any thoughts?
  • I'min sticker shock. 
    I am in middle Georgia and had my C4 - C5 and L5 - S1 really exacerbated by a car collision. It looks like I will need a microdiscechtomy on L5 - S1 and fusion for C4 - C5 and I am trying to be prepared for what the sticker price of all of this will be. I have BCBS but can't really find any info... until I stumbled upon this sight. Any insights?
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