New Medicare Rule Could Make Your Surgery Cost More Than Usual

A new Medicare rule may cost Medicare patients big-time when it comes to certain surgeries. The rule cuts payments to hospitals for certain shoulder, spine, and other musculoskeletal surgeries, according to Kaiser Health News.

For many years, there were 1,740 risky surgeries on the “inpatient-only” list for Medicare. 

Patients can now only have some of these surgeries on an outpatient basis, which means that they might have to pay more.

Why the new rule?

Dr. James Hiddleston of the Stanford University Medical Center said, “The impetus for this is for Medicare to save money. The oldest trick in the book is to say the patients don’t need to be cared for in an expensive hospital setting.”

Judith Stein of the Center for Medicare Advocacy stated that these new Medicare billing practices will “further confuse hospital patients.”

As outpatient procedures, many of these surgeries could cause health risks and complications, especially in those with chronic conditions. 

Medicare costs: inpatient vs. outpatient

Under Medicare Part A, a patient pays the deductible of $1,484 for a hospital stay of up to 60 days (a benefit period), plus 20 percent of the doctor’s charges.    

But outpatient procedures fall under Medicare Part B, in which the beneficiary pays 20 percent of the cost of each service rendered, including doctor’s charges, a facility fee, drug costs, and excess charges.

Have you experienced high medical bills after a routine surgery? Follow us on Facebook and let us know. 

Up Next...

blog image

Medicare World Blog

CA Residents: Privacy Notice for California Residents |