Total cost for hip resurfacing in New York City?

[Angel Romero]

Hello all fellow hippies/hipsters,

I am looking to get my left hip resurfaced in NYC this fall. Determining how much I will pay out of pocket has been challenging to say the least as my insurance company and the Drs office can not give me a straight answer. However, I do know I have to spend a certain percentage of the bill out-of-pocket. Looking for a little help here and wondering if anyone else can share their total hospital bill including anesthesia and all other hospital costs for something comparable to New York City.

Thank you in advance!
Angel

[stevel]

Hi Angel,  I had my right hip resurfaced by Dr. Su on 11/1/19.  The total billed amount was $106,709.  Insurance is still processing the hospital bill.  I have Medicare B and Aetna as supplemental to Medicare B but Aetna is primary to in-patient hospital charges as I don't have Medicare A.  Furthermore, Dr Su has opted out of Medicare.  A bit complicated to say the least.  So far, I have paid $250 out-of-pocket. The hospital bill and related out patient Drs and labs was $76,469.  Dr Su's and his PA bill totaled $30,250.  Dr Su surgery $25,000. PA surgery $5000, out patient visit $250 to total $30,250.  Aetna paid $19,370 with $250 out-of-pocket and no remaining balance.  Aetna intially paid $42,918 of the $69,439 in-patient hospital charges with $415 out-of-pocket but it is being reprocessed through Medicare B and should be resolved soon.

[Angel Romero]

Hey Steve,

Thanks so much for shedding some light on this. I knew the surgeon fee would cost approx $30,000 but wow the incidental charges more than double the surgeons cost!!! Didnt see that one coming and I really wonder what exactly makes up that $70,000. A serious problem with the American healthcare inflated cost system in my humble opinion.

I have heard good things about Dr. Su but not great things about insurance the practice takes but I guess that’s an issue everywhere. Sounds like your on the road to figuring out these costs though. Good luck and hope your fully physically recovered!

Thanks again!
Angel

[stevel]

Hi Angel,  For the billed major costs, the supplies/devices = $33,022, room & board for two nights = $13,300, operating room = $15,500, recovery room = $2261, laboratory = $2,194, diagnostic radiology =$1262, pharmacy = $554, physical therapy =$797 and EKG = $467.  The bill is itemized even more for costs, for instance each drug is itemized.
I am fully recovered enjoying an active physical life (hunting, fishing, skiing, jogging and swimming) with no issues.
I highly recommend Dr Su as he has done both hips par excellence!

[Angel Romero]

Hi Steve,

Just curious, how was your recovery? Any nerve issues - numbness, tingling , sharp pain? Do you still have a limp?

Thanks,
Angel

[stevel]

Hi Angel,  My recovery was great!  No nerve issues and no limp.  Following Dr Su's rehab videos and PT from my physical therapist, I rehabbed muscles and flexibility in two months but waited for bone in-growth before downhill skiing at 3 months, per Dr Su's protocol.  Will be 1 year post-op in two weeks and I don't even think about it, it feels so normal.  Resumed hunting, fishing, skiing, jogging on a treadmill and swimming laps at the pool with no issues.

[dannythebeerman]

Are you without Insurance?  are you in a PPO? HMO? other?  Insurer?  Will you have an open season in December to change plans or carrier January 1?

Maybe you read my recent write up on how me and Dr Gross got my low cost Maryland HMO to give authorization to cover a South Carolina doctor and facility as In Network.  maybe I got lucky, but you should try for Authorization (or whatever term your carrier would use).  It took about a month from the time I sent Dr Gross my Xrays and Consultation form, then 11 days with the Insurer.

As year end is rapidly approaching you should try to get an answer next month, so you can prepare your insurance choice for next year if you have to.

I think the key point for success was Dr Gross in his consulation notes wrote that I had looked in my network, and to the best of his knowledge he didn't know of anyone performing this procedure or had the expertise in my area.

Good Luck!

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