Search thousands of topics on CostHelper.com

BROWSE ALL TOPICS >> appliances babies & children  cars  consumer electronics health & personal care home & garden personal finance  pets  schools small business weddings
CostHelper > Health & Personal Care  > Orthopedics and Injuries > Shoulder Replacement

Shoulder Replacement Cost


How Much Does Shoulder Replacement Cost?

 
average costWith Health Insurance: Copay + 10%-50% Coinsurancehigh costWithout Health Insurance: $7,000-$21,000+
post E-mail post Post   Comments (4)

Shoulder replacement surgery is used to treat chronic shoulder pain and stiffness caused by degenerative joint disease, arthritis and other conditions. During the procedure, a metal ball and polyethylene cup is used to replace the head of the upper arm bone and its socket. According to the American Academy of Orthopaedic Surgeons[1] , shoulder replacement may be an option if non-operative treatments such as arthritis medications and physical therapy don't help.

Typical costs:

  • Shoulder replacement surgery typically costs $7,000-$21,000 or more, depending on the type of implants used and the hospital in which the procedure is performed. According to a 2007 study[2] by researchers from Johns Hopkins University, a shoulder replacement's total costs, on average, are $10,351. A more recent report [3] by Zimmer, a manufacturer of orthopedic prosthetics including those used in shoulder replacements, notes that in 2011 Medicare typically paid between $10,919 and $13,413 for total, partial and reverse shoulder replacements. In Vermont community hospitals, costs for this class of surgery ranged from about $7,000 to more than $21,000.
  • Shoulder replacement surgery typically is covered by health insurance. For insured patients, out-of-pocket costs typically consist of a specialist copay, possibly a hospital copay of $100 or more, and coinsurance of 10%-50% for the procedure, which could reach the yearly out-of-pocket maximum. According to the Kaiser Family Foundation[4] , the average hospital copay is $132 for outpatient surgery and for $232 inpatient surgery. The average coinsurance rate is 17%-18%.
Related articles: Physical Therapy, EKG, Health Insurance

What should be included:
  • According to the Cleveland Clinic[5] , patients who are interested in shoulder replacement would have an initial appointment with an orthopedic surgeon. The visit may include a series of x-rays, a physical examination and a thorough review of the patient's medical history.
  • Shoulder replacement surgery[6] is an inpatient procedure. It is typically scheduled in advance, lasts about two hours, and brings an average hospital stay of one to three days. A series of pre-operative tests, including blood tests, an electrocardiogram and a physical exam will be scheduled a few weeks before surgery.
  • Depending on the damage to the cartilage, the surgeon may decide to replace only the ball of the joint. Patients who have severe arthritis, completely torn rotator cuffs, or had a previous shoulder replacement that failed, may also be advised to get a reverse total shoulder replacement[7] in which a metal ball is attached to the shoulder bone and a plastic socket to the upper arm bone.
Additional costs:
  • Physical therapy following surgery can help to improve the shoulder's range of motion. For insured patients out-of-pocket costs typically consist of a copay of $10 -$75 per session or coinsurance of 10%-50% or more. For uninsured patients it typically costs$50 -$350 or more per session.
Discounts:
  • Many hospitals offer discounts of 30% of more to uninsured/cash-paying patients. At St. Joseph Hospital[8] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges. They'll also be offered an additional 10% discount if payment is made within 10 days of receiving a bill.
Shopping for shoulder replacement:
  • The American Academy of Orthopaedic Surgeons features an orthopedic surgeon finder[9] .
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.
 
post E-mail post Post   Comments (4)
CostHelper News


7 Ways to Stretch Your Reduced Food Budget
End of the year budgets are tight for everyone, especially in this economy.It's especially hard for the millions of Americans who depend on government programs like food stamps to help make ends meet. || Posted November 11 2013


7 Lesser-Known Discounts for the 50+ Crowd
As they age, members of the Baby Boomer generation don't like to admit that they're senior citizens, but they love getting discounts. It's kind of a quandary, because some of the best deals available are reduced prices for older folks. || Posted October 21 2013

‣ All CostHelper Blog Posts


What People Are Paying - Recent Comments
replacement criteria for insurance coverage
Amount: $0.00
Posted by: Doris Leggett in Batesville, AR.Posted: June 8th, 2016 03:06PM
my daughter has been told she must have had 3 arthroscopys before receiving a shoulder replacement. Is this correct She is 46 and this would be the 5th surgery on her rt shoulder.
Was this post helpful to you?   yes     no Report prohibited or spam
Shoulder Rep,acement
Amount: $0.00
Posted by: Mamamia in NY, NY.Posted: April 22nd, 2016 09:04AM
Insurance Carrier: Empire BlueProvider:
Total cost (2/16) was $67K hospital (1 night) and $26K Doctor. Basically painless (nerve block). PT charges not included
Was this post helpful to you?   yes     no Report prohibited or spam
shoulder replacement
Amount: $0.00
Posted by: Carolyn R Nelson in Mercer, PA.Posted: July 21st, 2015 12:07PM
Insurance Carrier: CompProvider: Comp.
I have had many experiences with the comp people concerning my left shoulder. I would like to know the quick ans. if shoulder replacement is an offer. Cost of lowest amt and the highest amt.
Was this post helpful to you?   yes     no Report prohibited or spam
shoulder replacement
Amount: $100,000.00
Posted by: robert foley in Amarillo, TX.Posted: May 24th, 2015 03:05AM
Insurance Carrier: N.O.V.Provider: Cigna
My shoulder replacement was extremely expensive. Up to 150,000. With pt. But the ins. Co. Fought the cost every time a bill came out. So the bottom line is how much did the ins. Co. Pay the total cost???
Was this post helpful to you?   yes     no Report prohibited or spam


 

Comment On Your Experience With Shoulder Replacement
 
Subject:  *
Amount Spent:  *
Insurance Carrier: Provider: 
Comments: 
Purchased:  Year: 
City:  * State:  *
 
Information about you:
Email:  * Email addresses are not displayed.
Name:  This is the name we'll display with your post.
me on this computer
*=required field.
 



External Resources:
  1.  orthoinfo.aaos.org/topic.cfm?topic=A00094
  2.  www.ncbi.nlm.nih.gov/pubmed/16980898
  3.  www.zimmer.com/web/enUS/pdf/Shoulder_Coding_Guide_7-21-11.pdf
  4.  kff.org/health-costs/report/employer-health-benefits-2012-annual-survey/
  5.  my.clevelandclinic.org/services/shoulder_replacement/hic_total_shoulder_joint_replaceme...
  6.  my.clevelandclinic.org/services/shoulder_replacement/hic_total_shoulder_joint_replaceme...
  7.  orthoinfo.aaos.org/topic.cfm?topic=A00504
  8.  www.sjo.org/For-Patients/Your-Hospital-Bill/Self-Pay-Discount-Program.aspx
  9.  www7.aaos.org/member/directory/directory.aspx
More Health & Personal Care Topics
Check Out All Costs for Health & Personal Care How Much Does Growing Medical Marijuana Outdoors Cost? How Much Do Crutches Cost? How Much Do Eyeglasses Cost?

Search Thousands of Topics on CostHelper.com

 
Today's Featured Cost Articles

About CostHelper
CostHelper is based in Silicon Valley and provides consumers with unbiased price information about thousands of goods and services. Our writers are experienced journalists who adhere to our strict editorial ethics policy.

CostHelper Community
Sinus Infections - Steroid shot and sent home
Paid: 2753.00
I woke up having breathing problems. I went to nearby non-hospital THH office. Nurse took blood pressure and temperature. Dr came in the room and spent less than 10 minutes and stated I had sinus infection... [more]
-Bill Moore
Emergency Room Visit Cost
Mold Testing Pacific Palisades, CA
Paid: 800.00
It cost us 800. We were pleased with Knight Environmental consulting who we hired. They were very thorough. Friendly and respectful of our home.They checked everywhere in our 7000ft home and tested the air... [more]
-AMY SCHWARTZ
Mold Inspection Cost
extraction
Paid: 739.00
Had 3 extractions yesterday. The cost was 304.00 each extraction but with some kind of insurance plan you could get 30% off. The plan was 75.00 annually and came at a huge savings on the work as my final cost with the plan was 814... [more]
-Dental mess
Tooth Extraction Cost
McHenry MD - Suburban Propane
Paid: 3300.00
Just got my bill and in 5 weeks we supposedly used 356 gals. Hard to do when you are not there the entire time and you turned the thermostat to 60. They charged $.35 more per gallon then from 5 weeks ago. $3.42 per gallon... [more]
-Check your bill with Suburban
Propane Tank Cost
Laceration from stick
Paid: 25.00
Slipped and fell on a stick while running around on a hill, and recieved 2 lacerations on my right leg, one about an inch long and one about 2 inches long. Called my insurance asap (Kaiser) and they directed me to one of their Urgent Cares... [more]
-
Stitches Cost
Urinalysis was asked of me
Paid: 3920.00
This was supposed to cost $250. Total!$3,675. for a urinalysis. Not mentioned anywhere on ANY search was this required to get a card... [more]
-Nellie28
Medical Marijuana Card Cost