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Does Medicare Cover Laser Spine Surgery?

Christian Worstell by Christian Worstell    |    Published Oct 03, 2019    |    Reviewed by John Krahnert

Medicare Part B may cover laser spine surgery if the procedure is ordered by a doctor and considered medically necessary. Learn more about Medicare’s out-of-pocket costs and the limits of when Medicare does cover spinal surgery.

doctor examines x-ray

Medicare Costs

Even if your surgery is considered medically necessary and Medicare does cover back surgery in your case, there are some costs that you’ll likely have to pay out of pocket, including:

  • Medicare Part A deductible ($1,364 per benefit period in 2019)
  • Medicare Part B deductible ($185 per year in 2019)
  • Medicare Part A coinsurance ($341 per day for days 61-90 in a hospital, $682 per each “lifetime reserve day” of each benefit period for days 91 and beyond, and all costs beyond lifetime reserve days in 2018)
  • Medicare Part B coinsurance (typically 20 percent of the Medicare-approved amount of service)

Medicare Supplement Insurance (Medigap) helps cover some of Medicare’s out-of-pocket costs. To find out which Medigap plans are available in your area, speak with a licensed agent at 1-800-995-4219 .

Understanding Laser Spine Surgery

Laser spine surgery is a less invasive alternative to traditional surgery. Surgeons make smaller incisions and use tools to tunnel to the site of pain. Muscles aren’t removed, which means that the damage to nearby tissue is minimal and recovery is quicker.

It’s Not for Everyone

Dr. Michael Steinmetz, the Co-Director of the Cleveland Clinic’s Center for Spine Health, argues that laser spine surgery isn’t for everyone. The surgeon notes that he rarely uses lasers to:1

  • Remove tumors from spines
  • Remove bone or soft tissue near a nerve
  • Shrink disk material near a nerve

Steinmetz notes, too, that in most standard practices, only around a third of cases are right for minimally invasive procedures. Some may actually use a laser, he adds, while others rely on scalpels and microsurgical instruments.

Speak with your doctor to decide if laser spine surgery is the right option for you. Your doctor can also provide specific pricing information regarding your surgery and Medicare. 

Does the Laser Spine Institute Accept Medicare?

The Laser Spine Institute offers services that are partially covered by Medicare. They break their fees up into professional fees and facility fees.

Medicare does cover the costs associated with the professional fees. Their ambulatory surgery center facility fees are not covered by Medicare. 

 

Medicare Supplement Insurance can help cover your out-of-pocket laser spine surgery costs.

Find a plan

Or call 1-800-995-4219 to speak with a licensed insurance agent.

 

1Retrieved from https://health.clevelandclinic.org/2016/04/laser-spine-surgery-may-not

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