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 |  | With Health Insurance: Copay + 10-50% Coinsurance |  | Without Health Insurance: $7,400-$9,000+ |
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The menisci are pieces of cartilage in the knee that, among other things, prevent the shinbone and thighbone from rubbing together and help absorb pressure put on the knee joint. They can become torn through sudden twisting motions. Though this type of injury can happen at any age, according to the Cleveland Clinic[1] , tears are more likely to affect athletes and people over 30, because the menisci weaken with time. Treatment depends on the severity and location of the tear.
Typical costs: | - Over-the-counter aids to address mild pain caused by a torn meniscus typically cost $2-$25. For example, the Ace Instant Cold Compress costs $2.79. Other remedies, including non-steroidal anti-inflammatory drugs such asibuprofen and Ace Elastic Bandages can cost about $5-$25, depending on the quantity and whether the patient buys a name brand or its generic equivalent.
- Arthroscopic surgery[2] , the standard outpatient treatment for more troublesome tears, typically costs about $7,400-$9,000 or more, depending on the age of the patient, the severity and exact location of the injury, whether related injuries are present, and the hospital where the procedure is performed. According to the Healthcare Cost and Utilization Project[3] , a series of medical databases sponsored by the Agency for Healthcare Research and Quality, outpatient arthroscopic surgery typically costs $8,970. At the Kapiolani Medical Center[4] in Aiea, HI, the average charges for arthroscopic meniscus repair are $7,450.
- 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[5] , the average hospital copay is $132 for outpatient surgery and $232 for inpatient surgery. The average coinsurance rate is 17%-18%.
Related articles: Physical Therapy, Knee Replacement, Health Insurance
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What should be included: | - According to the American Academy of Orthopaedic Surgeons[6] , patients who seek care for a torn meniscus must first be evaluated by a doctor to determine the extent of the damage. The doctor may check for tenderness around the meniscus and bend, straighten, and rotate the knee. If there is a tear, these motions will cause a clicking sound. The doctor may also order imaging tests.
- If the tear is small and on the outer portion of the meniscus, it may be enough to simply rest, ice, bandage, and elevate the knee. Non-steroidal anti-inflammatory medicines can curb swelling and pain.
- Otherwise, a doctor may recommend arthroscopic surgery, in which instruments are inserted into a tiny incision in the knee. According to the Mayo Clinic[7] patients can often go home the same day as the surgery.
Additional costs: | - Physical therapy following surgery can help to improve the knee'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.
- Doctors may recommend using crutches to take pressure off the knee. For example, aluminum crutches[8] from CVS cost $32. Most health insurers will cover mobility aids if they are deemed medically necessary, approved suppliers are used and patients meet certain guidelines.
Discounts: | - Many hospitals offer discounts of 30% of more to self-pay patients. At St. Joseph Hospital[9] 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. However, according to a 2007 analysis[10] of hospital pricing trends published in the journal Health Affairs, some facilities put the onus on the patient to request discounts in advance and be declared eligible by the hospital, so it would be wise to ask about a particular hospital's policies up front.
Shopping for torn meniscus treatment: | - The American Academy of Orthopaedic Surgeons features a orthopedic surgeon finder[11] .
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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 |
| Posted by: The German Patient in Berlin, Other. | Posted: October 2nd, 2020 10:10AM |
| Insurance Carrier: Techniker Sickness Fund | Inpatient or Outpatient: Outpatient |
| Provider: Gruenau Hospital Berlin |
Paid $6 for Diclofenac. Surgery covered by German healthcare system. Brought own crutches (would have been same amount). |
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| Posted by: Stuy in Philadelphia, PA. | Posted: August 19th, 2019 06:08PM |
| Insurance Carrier: 33,000 | Inpatient or Outpatient: Outpatient |
| Provider: Blue Cross Blue Shield TX |
Torn meniscus (medial) Edge of meniscus was cut. Surgeon remarked it was the simplest and easiest kind of repair to do on the meniscus. No complications.
Range of prices for this kind of repair is very large depending on the intensity of the surgery and if the repair is a cut or sewing back together. ACL and knee reconstruction is much more expensive. |
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| Posted by: Bill R. in LINCOLNTON, NC. | Posted: August 7th, 2019 09:08AM |
| Insurance Carrier: BSBS | Inpatient or Outpatient: Outpatient |
| Provider: Atrium Health |
The Hospital charged $ 26K to use their facility for two hours, the doctors charged another $ 12K for their valuable time and the MRI was $ 2K so total cost for this little clean up job was $ 40K. Not sure where the numbers above come from but they are not real. |
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| Posted by: Gerald M Scholder in Merritt Island, FL. | Posted: January 30th, 2019 09:01AM |
| Insurance Carrier: Blue Cross Blue Shield | Inpatient or Outpatient: Outpatient |
| Provider: Merritt Island Surgery Center |
Physicians/Surgeons from Space Coast Orthopedics perform operations at this outpatient Center. The Dr. charges were $2,285 and the "facility" charges were $13,000+. Total bill $15,900. I had a 25% co-pay of approved charges, $2800. I was told I would get local anesthesia but got General or "Sedation" Anesthesia. I was out. |
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| Posted by: TORN MENISCU in montague, NJ. | Posted: February 10th, 2015 05:02PM |
I recently had surgery on my right knee, torn meniscus on my inner knee. After suffering for 6 months, decided to visit my doctor who then recommended an orthopedic surgeon. Ran the normal visits; x-rays, MRI, etc - got to the point where I couldn't sleep, limping all the time, and nothing took care of the pain. When surgery was a definite and a date set, I asked several times for an "estimate", which no one could give me. I figured it would be around $5,000-8,000 - just received the estimated bill (THIS IS NOT A BILL) - it was $20,000, with about $6,000 "in question" - granted, I am not in pain anymore, but $20,000????? I really had no idea .... my friend just had sciatica surgery - that was $8,000 ... who knew???? |
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| Posted by: a user in Franconia, NH. | Posted: July 8th, 2013 01:07PM |
| Insurance Carrier: Harvard Pilgrim | Inpatient or Outpatient: outpatient |
| Provider: Alpine Clinic |
I foolishly jumped into surgery not knowing the changes my employer made to our insurance policy just prior to the surgery. my deductible was 4000 plus I had to pay $50 for each doctor visit, prior and follow up, and $25 copay for each PT appointment. It has been 20 months and I can still not walk. looking at partial knee replacement now but with different surgeon. |
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External Resources: | - my.clevelandclinic.org/orthopaedics-rheumatology/diseases-conditions/meniscal-tear...
- orthoinfo.aaos.org/topic.cfm?topic=a00109
- www.hcup-us.ahrq.gov/reports/statbriefs/sb86.jsp
- www.palimomi.org/my-hospital-bill/uninsured-calculator.aspx
- kff.org/health-costs/report/employer-health-benefits-2012-annual-survey/
- orthoinfo.aaos.org/topic.cfm?topic=A00358
- www.mayoclinic.com/health/torn-meniscus/DS00932/DSECTION=treatments-and-drugs
- www.cvs.com/shop/Home-Medical/Walkers-Wheelchairs-&-Canes/Canes-&-Crutches/_/N-3uZ...
- www.sjo.org/For-Patients/Your-Hospital-Bill/Self-Pay-Discount-Program.aspx
- content.healthaffairs.org/content/26/3/780.full?ijkey=L6moAROSh5koY&keytype=ref&si...
- www7.aaos.org/member/directory/directory.aspx
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