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CostHelper > Health & Personal Care  > Orthopedics and Injuries > ACL Reconstruction

ACL Reconstruction Cost


How Much Does ACL Reconstruction Cost?

 
average costWith Insurance: Can Run $800-$3,000high costWithout Insurance: Usually Around $20,000-$50,000
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A tear of the anterior cruciate ligament (ACL), one of the four main ligaments in the knee that connect the femur to the tibia, is one of the most common knee injuries. There is a relatively high incidence of ACL injury in athletes who participate in sports such as basketball, skiing and soccer, and studies have shown that female players have ACL injuries at higher rates than male players in some sports. Whether to get ACL reconstruction can be a difficult decision, and depends on the individual.

Typical costs:

  • For patients not covered by health insurance, the cost of ACL reconstruction, including the surgeon's fee, facility fee, anesthesia and graft, if needed, ranges from just under $20,000 to $50,000.
  • ACL reconstruction usually would be considered medically necessary and covered by health insurance.
  • For patients covered by health insurance, out-of-pocket costs typically include a hospital admission fee, copays for pre- and post-surgical doctor visits, a copay or coinsurance for the surgery and anesthesia. Out-of-pocket costs can range from $800 to $3,000 or more.
Related articles: Knee Replacement, Hip Replacement

What should be included:
  • Before surgery, the patient usually must undergo several weeks of physical therapy.
  • During the operation, the surgeon will either prepare the graft, if from a cadaver or harvest it from another area of the patient's body. Then the surgeon places an arthroscope in the knee to examine the joint. Any cartilage injuries are repaired, then the surgeon removes the torn ACL stump, drills into the femur and tibia, puts the ACL graft in place and attaches it. The surgeon then checks to make sure the graft has good tension and the knee has full range of motion.
  • The American Academy of Orthopaedic Surgeons[1] offers an overview of ACL injury and treatment options, including surgery.
Additional costs:
  • Medical equipment such as a knee brace and crutches can add $500 or more to the total if you are not covered by insurance.
  • Physical therapy at $50 to $75 or more per hour can add $1,000 or more to the cost.
  • Pain medication usually is prescribed during recovery.
  • Injury or graft failure could result in the need for a second ACL reconstruction.
Discounts:
  • For surgery, most hospitals will negotiate a discounted fee for patients who pay with cash or a credit card instead of using insurance.
Shopping for acl reconstruction:
  • First, it is important to decide whether you want to have the surgery and consult with a doctor. Some people choose to wait and see if months of physical therapy can help resolve the problem. However, if you wait too long, you could develop chronic ACL deficiency where the knee becomes unstable and might give out periodically, and a doctor might be unable to operate successfully.
  • WebMD [2] offers a decision guide on whether to get ACL reconstruction surgery.
  • Your family doctor or sports medicine doctor can refer you to a board-certified orthopaedic surgeon and the American Board of Orthopaedic Surgery[3] offers a surgeon locator by state.
  • Possible complications of ACL reconstruction include: a life-threatening blood clot; infection; knee pain; knee stiffness or loss of motion, which has been reported in between 5 and 25 percent of cases; and weakness or numbness in the leg or foot.
  • ACL surgery is becoming more common in young athletes, especially girls. However, in patients not finished growing, there is a risk of growth plate injury that could lead to bone growth problems. It is possible to delay the surgery until growth is finished; however, this can be risky because waiting too long can cause degeneration and make successful surgery impossible in the future.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
 
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What People Are Paying - Recent Comments
My daughter had 2nd ACL (removal of 1st & replacmt with patella tendon)
Amount: $46,000.00
Posted by: S Hume in Jacksonville, FL.Posted: July 16th, 2012 07:07AM
Type of Treatment: Repeat ACLMedical Center: Baptist Med Ctr, Jacksonville, FL
Hosp chg $32k+. After ins disc & 80% cov, my pmt was $3,500. Dr chg $10k+. After discounts & 80% cov, I paid $1,600. Her MRI there that dr set up was a whopping $3,800! And cost ME $750 after insurance. BEWARE--NEVER have an MRI/X-ray at a hosp facility(unless emrgncy) before checking standalone ctrs for cost. Would have been under $800 in charges & less than $100 for me.All in, was over $6k for us with in-network coverage before therapy chgs.
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ACL reconstruction using same side hamstring graft
Amount: $1,916.00
Posted by: mbinct in micddletown, CT.Posted: March 6th, 2012 11:03AM
Type of Treatment: hamstring graftMedical Center: MCAOS Middletown, CT
Total procedure was about $35,000. My out of pocket for my deductible ($1100) and co-pay was $1916. That includes initial visits, Pre-op Physical Therapy, Surgery, knee brace, imobilizer, crutches, medication, follow-up appointments and post-op physical therapy.
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ACL Recocnstruction
Amount: $3,000.00
Posted by: a user in Lake Shore, MD.Posted: January 25th, 2010 06:01AM
Type of Treatment: ACL Recocnstruction AutographMedical Center: SurgCenter of Glen Burnie
ACL Reconstruction using an autograph (my own patella tendon from the injured knee). My insurance covered 90% after the copay. The remaining 10% was under $300 for each charge (MRI, surgery center, surgeon, anes, knee brace, misc). The physical therapy is covered 100% after the $15 copay for each visit. I attend PT 3x's a week which equals $180 a month and happens to be my highest expense. I look at it this way, I need my knee the rest of my life and I'm young, so I don't want to have continuing pain or problems. The expense is worth it, even with my insurance.
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ACL SURGERY
Amount: $75,000.00
Posted by: kbelle in Reidsville, GA.Posted: July 13th, 2009 11:07AM
My daughter had ACL surgery after a cheerleading accident.The pain block didn't take and we had to stay overnight following the procedure.(total 22hrs in hospital/only 1.5hrs for the surgery)
I was taken back when the the bills came in. The expense wasn't in the procedure itself but from the hospital. The facility is owned by the doctors group that did the surgery.I felt sure that when the bills were submitted through the PPO that adjustments would follow however apparently this one slipped through indetected.
MRI $1958.00
surgeon $4893.00
anesthelogist $1680.00
hospital $73662.00
therapy $2679.00
total. . . . .$84872.00
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External Resources:
  1.  orthoinfo.aaos.org/topic.cfm?topic=A00297
  2.  www.webmd.com/a-to-z-guides/should-i-have-surgery-for-an-anterior-cruciate-ligament-acl...
  3.  /www.abos.org/find-a-certified-orthopaedic-surgeon.aspx
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