Ankle Replacement Cost

Typical costs:

• Without health insurance, an ankle replacement typically would cost $40,000 or more. For example, a major joint replacement for a lower extremity would cost about $29,643 not including the surgeon fee, according to Baptist Memorial Health Care in Memphis, Tennessee. A U.S. Department of Health & Human Services[1] transparency initiative shows that surgeon fees for joint replacements can reach $5,000 or more. And the medical information company Pearl Diver estimates the average total cost at about $43,000.
• Ankle replacement typically is covered by insurance, according to podiatric surgeon Dr. Leonard R. Janis. However, some companies don't cover it. For example, CIGNA[2] considers it an experimental procedure, and Premera BlueCross considers it medically necessary only for patients who fit specific criteria.
• With insurance, ankle replacement costs could consist of doctor visit copays and surgery coinsurance of 30 percent or more for a total of thousands of dollars or the yearly out-of-pocket maximum.

• In a total ankle replacement, the patient usually is placed under general anesthesia or spinal anesthesia plus relaxant. Then the surgeon makes an incision, removes damaged portions of the three ankle bones that comprise the joint, reshapes the remaining bone and places an artificial joint, usually using screws to hold it in place. The inpatient operation takes two or three hours and requires a hospital stay of up to four days.
• The National Institutes of Health[3] has an ankle replacement FAQ.
• After the operation, the patient will need to take two to three weeks off work -- or up to four months for a job that requires standing -- and will have to wear an ankle brace for up to a year.

• Crutches, which are needed for the first few months, cost about $15 to $40 for a basic pair or up to $100 or more for deluxe forearm crutches.
• The doctor probably will either recommend exercises to do at home or suggest physically therapy, which costs about $50 to $75 per session for a total of up to $1,000 or more.
• An artificial ankle joint has a lifespan of 10 to 15 years, so it might need to be replaced in the future.

• Some orthopedic specialists offer discounts for uninsured/cash paying patients. For example, Southern California Orthopedic Institute offers discounted services for cash-paying patients, and Northwest Community Hospital Orthopedic Services Center[4] , in Chicago, offers discounts for prompt payment.

• Look for a board-certified orthopedic surgeon who has chosen to further specialize in foot and ankle surgery, and who has extensive experience performing total ankle replacements. The American Board of Orthopaedic Surgery[5] offers an orthopedic surgeon finder by city, state or zip code. Or, seek out a board-certified podiatric surgeon -- a podiatrist who specializes in surgery on the foot and ankle. The American Board of Podiatric Surgery[6] provides a doctor locator by city or zip code.
• Ask about any financial connections the doctor might have to the manufacturer of hardware that the doctor uses.
• Risks of ankle replacement include reaction to anesthesia, blood clots, amputation and, in rare cases, death. Over time, there also is the possibility of developing sensitivity to the metal or having the implant loosen or fail. Rarely, complications could lead to amputation.

1.  www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareConInit/index....
2.  /cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0285_coverag...
3.  www.nlm.nih.gov/medlineplus/ency/article/007254.htm
4.  www.nch.org/medical-services/orthopedic-services/index.php
5.  www.abos.org/find-a-certified-orthopaedic-surgeon.aspx
6.  www.abps.org/content/resources/FindADoctor.aspx

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