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Thread: How much did your surgery cost?

  1. #26
    Join Date
    Jan 2006
    Location
    Jersey, Channel Islands (British Isles)
    Posts
    1,551

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    My surgeon's fee was 5,286.01 USD, then the other doctors charged on top of that.
    Lithotripsy for kidney stones 8 December 2004.
    Began to feel unwell 19 December 2004, with hindsight, the beginning of endocarditis.
    Stroke 12 March 2005.
    Endocarditis diagnosed 16 March 2005.
    MVR/AVR - ATS 30 June 2005.
    Discharged 10 July 2005, taken ill on journey from hospital.
    Admitted to hospital 14 July 2005, complete heart block.
    Discharged from hospital 22 July 2005.
    Returned to work 9am on 7 November, dismissed 9am 7 November 2005.

  2. #27
    Join Date
    Apr 2006
    Location
    DC
    Posts
    25

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    Quote Originally Posted by MitralMan
    The surgeon's fee was $30K.

    As I understand it, Independence Blue Cross is telling me that the usual and customary surgeon's fee for mitral valve repair is less than $3,000; they're telling me that they'll only cover 60% of that (since it was an out of network surgeon, but that part I understood); and they're saying that my max out of pocket doesn't apply to out of network.
    MitralMan-- Your insurance company is completely out of line. I had the same surgery with the same surgeon for the same sticker price, and my insurance paid $26,311.52, even though it was out of network. I would definitely appeal. Good luck.
    Mitral Valve Repair, 07/2005, NYU Med. Ctr.

  3. #28
    bouteloa Guest

    Default If you can, read the fine print of your health insurance

    I am enrolled in an HMO. Like so many here, I wanted to go to the Cleveland Clinic for my mitral valve surgery but after reading the insurance and consulting with the HMO, they pretty much told me that if I wanted to go out of network, they would pay very little or nothing.

    So I considered, literally, selling my farm to pay to go to Cleveland Clinic but wound up staying in network with a local surgeon, who turned out to be very skilled.

    So I got a good surgery, kept the farm and my HMO paid the total cost of surgery. I had an intensive care coverage with AFLAC who paid me $1900 for my 5 day stay in the hospital.

    So I wound up making money on the deal.

  4. #29
    MitralMan Guest

    Default nearyneary, that's eye-opening.

    Quote Originally Posted by nearyneary
    MitralMan-- Your insurance company is completely out of line. I had the same surgery with the same surgeon for the same sticker price, and my insurance paid $26,311.52, even though it was out of network. I would definitely appeal. Good luck.
    I'm in the middle of the appeal process.

  5. #30
    MitralMan Guest

    Default Bouteloa, I asked Independence Blue Cross in advance...

    Quote Originally Posted by bouteloa
    I am enrolled in an HMO. Like so many here, I wanted to go to the Cleveland Clinic for my mitral valve surgery but after reading the insurance and consulting with the HMO, they pretty much told me that if I wanted to go out of network, they would pay very little or nothing.

    So I considered, literally, selling my farm to pay to go to Cleveland Clinic but wound up staying in network with a local surgeon, who turned out to be very skilled.

    So I got a good surgery, kept the farm and my HMO paid the total cost of surgery. I had an intensive care coverage with AFLAC who paid me $1900 for my 5 day stay in the hospital.

    So I wound up making money on the deal.
    My doctors DID the paperwork. This is pretty fine fine print. But I take your point, and I'm delighted it worked out well for you!

  6. #31
    Join Date
    Jun 2005
    Location
    I live in Denver NC
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    1,136

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    Since it will be 25 years in August since my last OHS (mitral valve replacement), I guess the cost of my surgery would be a little outdated. It seems like I remember the whole thing costing around $35,000. That would include 10 days in the hospital and a couple of days in ICU. I don't remember what the surgeon charged. Just two years ago, I spent three nights in the hospital having my defibrillator implanted, and just the hospital portion was $40,000 for that. I guess everything's relative, right? LINDA

  7. #32
    Join Date
    May 2006
    Location
    Smynra, GA
    Posts
    281

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    85k for everything - 3 days in the hopsital
    Contracual price for BCBS was only 12k for everything!!!!!!!!!
    10k for surgery
    Surgery took 2.5 hours to complete = 4k per hour for surgeon
    This suregon does 5 surgeries a day = 20k per day (ballpark figure) and he deserves every penny of it.
    Insurance paid for private room because that is the only rooms they have available in that ward. Nice big room for my family

    I hope they pay for my cardiac rehab

    Feeling good = priceless!
    Mike

    Tricuspid Valve Repair, June 1984
    [I]Dr. Gordon Danielson, Mayo Clinic[/I]
    Tricuspid Valve Replacement, March 2006
    St. Jude Mechanical Valve
    [I]Dr. Albert Pacifico, University of Alabama, Birmingham[/I]

  8. #33
    Join Date
    Oct 2005
    Location
    Massachusetts
    Posts
    4,341

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    I wouldn't want to be his 'fifth' surgery of the day. Eeeks........

  9. #34
    Join Date
    May 2006
    Location
    Smynra, GA
    Posts
    281

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    Luckily he had just come back from vacation and I was the first surgery of the day

    They way they set up surgery today (I'm guessing) is too prep everybody up beforehand. One surgeon opens you up, one operates on you and one closes you up. By the time the operating surgeon gets there you are ready to be operated on and of course he has his fellows to assist in surgey. I actaully got a bill from 3 different doctors.

    A little off the topic here but if you get a chance read the book "Walk on Water, The Miracle of Saving Childrens Lives" The books deals more with children but you get an idea of what life in the OR is about. It's not pretty. The book takes place in Dr. Roger Mee's OR ( Cleveland Clinic) one of the top Heart Suregons in the world.
    Mike

    Tricuspid Valve Repair, June 1984
    [I]Dr. Gordon Danielson, Mayo Clinic[/I]
    Tricuspid Valve Replacement, March 2006
    St. Jude Mechanical Valve
    [I]Dr. Albert Pacifico, University of Alabama, Birmingham[/I]

  10. #35
    Dave_40 Guest

    Default

    Geez, are you guys quoting the payed out or retail price.

    Hospital alone was $200K payed at 23 cents ea for MV + bypass + icky complication reopen and 4 day ea ICU and ward. I have no idea what the surgeon got as I can't even figure out who paid him. Stupid multiple payer capitated billing.

    St Jude retail price is $10K+
    A T-echo will run $3-5K easy.

    Now I liked rehab, but dont even get me started on cardiac rehab per visit charge, and get this it was paid at retail price. Crazy. For that kind of money they should have included a massage, a new work out outfit per week and a snack.

  11. #36
    Join Date
    May 2006
    Location
    Smynra, GA
    Posts
    281

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    I'm quoting both. On my EOB the BCBS insurance was billed for 85K if you look at the section that states "Not Covered and "Covered". Under the section covered is what the insurance actually paid because of the contracted price they have with the Doctor or Hospital for that procedure. Under that section was 12k total. If I didn't have insurance the price for me would have been 85k. That's they way I understand it. I actually ended up paying $2200 total for everything. I have a $200 deductible and a $2000 maximum out of pocket. I met that easily after surgery. Everything is covered at 100% for the rest of the year excluding copays.
    Mike

    Tricuspid Valve Repair, June 1984
    [I]Dr. Gordon Danielson, Mayo Clinic[/I]
    Tricuspid Valve Replacement, March 2006
    St. Jude Mechanical Valve
    [I]Dr. Albert Pacifico, University of Alabama, Birmingham[/I]

  12. #37
    Join Date
    Apr 2002
    Location
    Pittsburgh, PA
    Posts
    282

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    My wife's mitral valve repair at the Cleveland Clinic was just shy of $80,000. The "negotiated rate" secured by the insurance company was just shy of $50,000. And we paid $0.
    My wife ("jaydee") had her mitral valve repaired on November 1, 2005 at the Cleveland Clinic (Dr. Cosgrove).

  13. #38
    Brad Guest

    Default

    Mine was free! Good ol' British NHS!

  14. #39
    Georgia Guest

    Default

    MM - I understand that you get screwed by going out of network - we've have a few minor battles over this b/c the pcp's office fouled up the paperwork.

    But how on earth have they determined the usual and customary surgeon's fee for a mv repair to be $3,000??? I've heard of insurers doing ballsy things, but this one's nuts. I'd go to the insurance department, make a complaint, and the insurer will have to justify the u&c amount to the dept. It won't cost you anything, and it'll annoy the heck out of your insurer.

    And get a copy of your contract. See if it specifically says that the out of pocket doesn't apply to out of network. They figure they have you over a barrel because you're post surgery and they think you won't be in any condition to fight. At these costs it might behoove you to get a lawyer.

  15. #40
    sfconstrct Guest

    Default sfconstrct cost

    haven't got the surgeon's bill yet, avr and root repair at Cedar Sanai, 174K four day stay. Bill said I owe 400 bucks wrote that check quick. Going on 9 weeks and all else is going well. Good luck. steve in so.ca.

  16. #41
    Join Date
    Oct 2002
    Location
    louisiana
    Posts
    440

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    My first valve surgery cost around 150kMy mechanical valve alone was 40k. since my second surgery I now have2 mechanical valves and with my stroke during the 2nd surgery an 17 days in ICU and then a mnth in rehabI don't want to think about what the 2nd one cost.

    lettitia

  17. #42
    Join Date
    May 2004
    Location
    Oregon
    Posts
    3,623

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    I'm just at 4 weeks out today and have not received any bills. However, my angiogram bill came from the hospital. JUST the hospital bill was 10K !! There will be more from the cardio and anesthesiologist, of course. I have an in network (which I chose) maximum personal payout number. With the breast biopsy in January and the angiogram in March.....I think I'll be home free by the time my AVR bills come in.........am curious at this point.

    Good luck with you insurance company, MM. Go get 'em!!

    Marguerite
    AVR 4/18/06, age 52. Bovine tissue. CE Perimount RSR Model 2800. 23 mm. BAV diagnosed age 27(1981). Moderate stenosis (1.0 cm) 9/03; severe stenosis (.7cm) 12/05, Aortic measure at surgery 4/06, critical (.53 cm)

  18. #43
    Birky Guest

    Default cost of surgery

    Mine was $76,000 for 11 days in the hospital, $6000 for surgeon, $3000 for the assistant plus another trip to the hospital where I live and that was another 5 days. With everything including angiogram, cardio rehab it was $160,000. I had a mitral valve replacement.

  19. #44
    Kathy Canistro Guest

    Default surgery cost

    My first surgery was 20k for the surgeon and 90k for the hospital. (4 days)
    The second surgery was 17k for the surgeon and 238K (4 weeks) for the hospital. We paid $ 20 for the first one and $600 for the second due to co-pays to have the PICC line unclogged.

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