• OASIS Orthopaedics
  • OASIS Orthopaedics
  • OASIS Orthopaedics

Surgery Fees

This information sheet has been designed to provide you with some general information about fees and expenses related to your admission to hospital. This information should be used as a guide to answer most of your questions. Further detailed information regarding finances should be discussed with your surgeon’s secretary as well as your hospital accounts department.

Out of pocket expenses


It is difficult to determine your individual exact out of pocket expenses, as there are many factors that affect the final account. For example, if you have private health insurance, there are differing levels of cover within the insurance funds. Health insurance funds also only cover medical fees up to certain levels. Most surgeons charge fees above what is covered, and almost all patients should anticipate an out of pocket expense. You should check the level of cover that you have and provide this to your surgeon’s secretary to obtain a more reliable estimate. Sports insurance policies are even more variable. Most of these policies require you to pay your accounts first and then send the receipts to the insurance company for reimbursement. This usually means that you will be asked to pay your hospital account on the day of admission. If you are not covered by private health insurance, Workcover or TAC, then the out of pocket expenses may be even higher, despite being able to claim some funds back from Medicare.

You will receive an informed financial consent form regarding the overall costs and out of pocket expenses for the surgeon’s fee when you make your booking for surgery. The surgical fee includes initial follow up visits known as “aftercare”. However, later consultations (generally those more than six to twelve weeks after surgery) usually attract a separate charge.

An estimate of the actual hospital expenses can be obtained prior to surgery by speaking to the accounts department of your hospital and quoting a Commonwealth Medical Benefits Schedule (CMBS) item number as well as the expected length of admission, which can be obtained from your surgeon’s rooms. An estimate of the hospital expenses is just that, and only includes the cost of the hospital bed and theatre fee. Other expenses may be incurred and the final CMBS item numbers may vary depending on the findings at surgery.

You can expect a separate fee for the anaesthetist, for which there may be an out of pocket expense as well. Likewise, it is routine for the surgeon to use an assistant. They will usually introduce themselves to you prior to surgery. Assistants’ fees are billed at a rate of 20% of the surgeon’s fee and some may have an out of pocket expense as well.

Other Expenses


Physiotherapy
Depending on your health insurance cover, you may receive a separate account for physiotherapy.

Radiology
If X-ray is used during or following your operation, you may receive a separate account from radiology. Your health insurance may cover the cost of this.

Pharmacy
Medications that are prescribed for you to take home attract a separate fee.

Pathology
Blood tests and other pathology investigations are frequently requested. You may receive a separate account for these, or it may be covered by your private health insurance.

Implants
Many operations involve the use of implants or fixation devices (eg plates and screws). These are usually covered by private health insurance. Self-insured patients and those patients covered by sports insurance can expect a separate account for these implants. The cost of these implants can be very expensive.

Physician
A physician may also be involved in your care, in which case you will usually receive a separate account from the physician, which is also refundable through Medicare and your private health insurance.

Complications
All surgery carries the risk of complications. Should complications occur, it may require readmission to hospital, which would involve additional costs.