How much does a surgeon get paid from insurance for a TKR in New Jersey?

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My doctor is out of network on my insurance plan and I would like to know how much doctors are being paid for this surgery from insurance companies.

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  • Posted

    Stay with in network. If not you are looking at around 100k plus
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    • Posted

      Wow ! Is that how much your insurance company paid your doctor for your TKR? Where did you come up with this amount if it is not what your insurance company paid? 
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    • Posted

      That is a rough estimate. It all depends on where you have it done. I had my done in pa. Bills totaled around 100k. Now we all know what is billed versus what is paid.
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    • Posted

      Again that is what the bills were, not what I paid. But with,out of network you will pay a pretty pennie. Go on line and look at your insurance info it will tell you what you need to pay out of network. My guess will be if you use an out of network doctor you will need to pay because it was not an emergency.

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  • Posted

    I am on Ohio and had a right knee replacement and all together with hospital stay, pt, meds anesthesia, the actual implant and Surgeon fees and miscellaneous about 50K.
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  • Posted

    I am on Ohio and had a right knee replacement and all together with hospital stay, pt, meds anesthesia, the actual implant and Surgeon fees and miscellaneous about 50K.
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  • Posted

    Reimbursements run differently depending on how the practice is set up. Some are owned by hospitals, some privately. You have to take so many things into consideration......the paid reimubursement in my area where I go is around $12000. However, the Dr gets nowhere near that in his pocket. He is paid a salary and some form of profit split. These things are so structured and planned you see a really good surgeon with tenure will make more than a guy with just a few years in practice. Unless you actually saw a Dr's contract you haven't an idea what he's actually making. Before people become obsessed with Dr's salaries, many of these people come out with school loans of over $100000.

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    • Posted

      As far as I know all Insurance Compaines have to send out an EOB (explination of benifits) which shows the exact amount paid to the doctor. I am not debating or obsessed with how much anyone makes all I was asking was if anyone knows for a fact what their Isurance paid the Doctor for a TKR in New Jersey. Thanks anyway.
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    • Posted

      EOB shows what its paid to the practice, in essence. For example, my wife recently fell and broke a hip. The PHR was done by a Dr in a practice that is owned by a hospital. The billing and payment shows the payment going to the dr when it actually funnels into the hospital and the Dr is paid a base salary. Again, really hard to tell how you could divide everything up to know what the Dr is being paid on an individual basis. About the only way you would ever really know is off The Dr was a lone wolf in a private practice. Not may if any of those left.
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  • Posted

    I often wondered how much my bilateral TKR and 6 day hospital stay would cost if I had to pay. Based on these numbers - OUCH!!! As a Canadian it cost me nothing.
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  • Posted

    I heard $1400.
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    • Posted

      I believe your doctor is correct, I have also been told that is all a Doc gets paid through Medicare. Docs in network do not get a whole lot more from what I have heard. I was hoping that someone would have an EOB where it shows exactly the amount that was paid to the Doc for the surgery in New Jersey. Thanks for the responce. 
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