Cost of Orthopedic Hardware

[VictorSuvorov 0]

Looking to establish a benchmark of what is directionally "reasonable" for simple othopedic harware : screws, bolts, rods, plates.

What is the range of prices (medical chardes) ?

[freeatlast 0]

Hi Mate

I hope you haven't had to buy too much of that hardware ...

[philly51 0]

2 steel bars and 4 screws spanning L3- L6 cost only
$125,000.

Life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, Shouting "...holy shit...what a ride!"

[VideoFly 0]

My C5-C7 plate and screws cost about $150.00. Installation cost over $40,000.00.

[boyfalldown 0]

$2900 installed. At least thats what my insurance company paid, plus my $100 deductable.

[GLIDEANGLE 1]

There is no "simple" hardware. This material is very expensive for a number of very good reasons. What you feel is reasonable probably isn't. Note that you typically have to pay the hospital for the hardware... they typically mark up the (already expensive) hardware a lot.

Yes, you may be being charged too much, but the market/usual and customary rate is probably WAY more than you expect.

The choices we make have consequences, for us & for others!

[VictorSuvorov 0]

If you have a better definition than "very expensive", "very good reasons" and "a lot" than your expert opinion will be a valuable contribution to the discussion and will be much appreciated.

[VictorSuvorov 0]

No not a lot, just a rod and a couple of screws. Just for the hadware:

1 rod - $9,520
2 crews - $1,320 each


it took me exactly 3 month to get back to jumping - first jump was a tandem recurrency :). i am trying to get back to my running routine.

[buff 0]

Quote

If you have a better definition than "very expensive", "very good reasons" and "a lot" than your expert opinion will be a valuable contribution to the discussion and will be much appreciated.

Okay I'll bite and try to help you with why Ortho is so expensive and the expense is not in the implant hardware. If there are any Orthopods lurking, feel free to correct or clairify.

Typically the hospital owns the sets/trays of instruments used in the OR for implantation of a certain system (read manufacturer) of ortho hardware. There are many manufacturers and each intrument set contains "tools" that work with that system. Think of all the "special" tools required by an auto shop to work on the different makes of autos. All of these "tools" are very expensive just as equiping your tool shed is to you. You may only require one set of socket wrenches but the OR may require 3 sets for multiple procedures. Think of a large place that does level 1 trauma and a multiple victim 3 car accident. You need a lot of tool sets just to handle that one incident.

Now you have a set of instruments that can put in a femoral rod. There are screw drivers, pneumatic drills, hammers, reamers, and the requisite clamps, hemostats, retractors, etc. All made out of metals that can be stearilized repeated under high pressure steam. Tools wear out and need to be replaced also.

So the hospital has a capital outlay of lets say 35K for just one set of instruments to handle your femoral rodding. Now they have to pay for the implants (rods, plates, screws). The implants are usually consigned and paid for at time of use. So your stainless steel rod costs 385.00 and is marked up to help defray the cost of that very expensive set of instruments. Depending on the ortho volume, the set of instruments may not be paid for in 5 years or may be paid off in 6 months.

Now you go and totally fuck yourself up by catching your leg on the bank of the swoop pond and then flip thru your risers and faceplant into mother earch. Now you require a maxilliofacial tray with a whole set of very tiny plates and screws and drill bits etc. to put your smile back in the game. Add another 30K to the "tool" chest.

And if you broke your hip, that's another tray that has pneumatic saws, jigs, etc. It adds up.

A large facility can easily have a million or two tied up in ortho instrumentation of various manufacturer systems depending on their surgeons, prefrences, and training. Just as a TI is trained on a Strong or UPT system, so is an orthopod trained on an implant system. He/she may only use Zimmer and Synthes and not Smith & Nephew implants because he does not have training on that system. Some trauma stuff may only be used once or twice a fiscal year but the capital cost is still there.

It's much like a rigger who outlays the cost of his training and tools. If he buys a sewing machine or two but only uses them for a repair once in awhile, he's going to have to recover that cost by increasing his repacks a bit.

So that's the layman condensed version of why your implant costs as much as it does.

It's called the Hillbilly Hop N Pop dude.
If you're gonna be stupid, you better be tough.
That's fucked up. Watermelons do not grow on trees! ~Skymama

[wmw999 2,116]

Something to add to that explanation is that anything that is man-rated (i.e. people's lives depend on it) will have a rafterload more of inspections and development costs. Because it probably has to be certified.

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[VictorSuvorov 0]

That was very educational. Thank you
I understand the concept of amortizing the capital expenditures and the inventory carriyng costs to a unit of production quite well. When I examined my hospital bill, I found several line items for tools, so charges for those were captured separately. I do not believe per unit costs I quoted included any allocation for the tools used.

[kallend 1,621]

OK, but how does that account for the $35 for two aspirins?

...

The only sure way to survive a canopy collision is not to have one.

[wmw999 2,116]

They're very special hospital grade aspirin

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[jbh186 0]

My rod in my femur from knee to hip, 4 screws, a rod on each side of my spine from L3-L9 (or something like that), some cage thingy and 14 more screws ran $112,000 plus installation.

It was an expensive landing.

Cost to me, $250.00 plus Dr. copays and prescriptions.

[NovaTTT 1]

Quote

OK, but how does that account for the $35 for two aspirins?

It's a simple clerical error.



They normally charge $35 PER.

"Even in a world where perfection is unattainable, there's still a difference between excellence and mediocrity." Gary73

[buff 0]

The instruments that you were billed are probably one-time use or disposable instruments. There are laproscopic instruments like that and some other types that can't be stearilized again.

Some places bill out a sterilization fee and some don't.

Asprin or meds -- cost more because of nursing and PharmD salaries. The realistic way to bill would be one nurse at X hrs of care but you're not allowed to do that so nursing and pharmacist salaries are covered by cost of drugs and rooms.

And the hospital pharmacists are not the same as the grocery store folks. I checked that a couple weeks ago when I was at a party with four pharmacy grads. They all work for a grocery chain pharmacy and they said they are not Clinical PharmD.

I might change that line to - If you're gonna be stupid, you better be tough and have a good medical plan

It's called the Hillbilly Hop N Pop dude.
If you're gonna be stupid, you better be tough.
That's fucked up. Watermelons do not grow on trees! ~Skymama

[DSE 3]

Bolt in pelvis-300.00
Plate/screws- 450.00
Rod spanning L's-175.00
Installation-just over 200.000.00

Stupid hurts and it's expensive.

[R1DOC 0]

I am an orthopaedic surgeon. Buff is on track with how the costs work. I guess this is a plug for Blue Skies Mag., but I will be doing an article on the 10 most expensive orthopedic injuries in skydiving and base jumping. I'm aiming for June/July issue at this point.