Dr Scott-Young’s consultation fee depends on whether you have an initial or follow-up appointment. His consultation fees are paid on the day of your consultation. Dr Scott-Young discounts his fees for aged and disability pensioners. A valid referral is required to obtain a Medicare rebate.
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How much does spine surgery cost with Prof Scott-Young?
The fact is that most of our patients don’t end up needing surgery. For those patients who do, the exact type of procedure will depend on their individual diagnosis and circumstances. Even two patients with the same problem might need two different operations. There is no one-size-fits-all remedy with spine surgery.
Dr Scott-Young understands that deciding to proceed with elective spine surgery can be a big step and considering the cost of the surgery will be an important part of your decision. Prior to proceeding, we do our best to ensure our patients understand the costs of surgery, including what is covered by Medicare and their private health fund and what financial contribution they need to make. This process is called Informed financial consent. While we do our best to tell our patients about the likely costs of their hospital stay, you may have to pay additional expenses.
When surgery is recommended, our patients are provided with a detailed estimate of professional fees, so they can make an informed decision. We also ensure that there is a cooling off period so that patients have time to consider whether they wish to undergo the recommended surgery and if they are financially prepared to do so.
Our estimates include information about:
- The surgeon’s fees & Medicare item numbers
- The assisting doctor’s fees & Medicare item numbers
- How much of these fees are covered by Medicare & your private health fund
- Your out of pocket expense
- The cost of your physiotherapist-supervised rehabilitation program
If you have private health insurance, most of the costs relating to your stay in hospital should be covered by your health fund. However, there will be other costs associated with a hospital admission for spinal surgery that may not be covered by your insurance, including:
- Your private health insurance excess
- Other doctors that are asked to assist with your admission to hospital
- Other miscellaneous costs
You will need to carefully check your private health insurance policy to see what you will be covered for.
When creating an estimate, we approximate how much you will get back from Medicare and your private health fund, based on Medicare item numbers that apply to the surgery that has been recommended. These item numbers are combined in different ways, depending on the exact procedure required. Because of the number of possible procedures and combinations of item numbers, it is not possible to show you the cost of every procedure that Prof Scott-Young performs. Please also read the Price Disclaimer for a better understanding of the nature of the costs involved.
The image below is interactive and is designed to give you some examples of Prof Scott-Young’s fees that he charges for the surgery he performs. It also demonstrates that higher fees apply to more complex surgery. The fees shown are only for Prof Scott-Young’s role in the surgery and do not include the other costs relating to the surgery and hospital admission.
There are some FAQs below that will answer some of your other questions about fees for surgery. We also recommend you have a look through our What To Expect pages to gain a better understanding about the steps involved in having spine surgery under the care of Dr Scott-Young.
Prof Scott-Young’s Surgery Fees
C5-6 Total Disc Replacement
Item numbers: 51131, 51011
L4-5 Total Disc Replacement & L5-S1 Anterior Lumbar Interbody Fusion
Item numbers: 51130, 51021, 51041, 51165
C4 C5 Vertebrectomy
Item numbers: 51055, 51023, 51013
Level 5 Scoliosis Correction – Both Anterior and Posterior Procedures
Item numbers: 51064, 51015, 51165
The prices listed in the diagram above only cover Prof Scott-Young’s estimated fees for his role in the procedures listed. Please note:
- The prices do not include any other costs relating to the surgery and hospital admission, such as costs of the hospital stay, assisting doctor’s fees, anaesthetist’s fees, radiology fees, physiotherapist-supervised rehabilitation program and any other unexpected costs.
- Expenses or fees for the provision of medical services arising from adverse events or complications during your admission for surgery or after discharge from the hospital are not included.
- It is important to be aware that prices will vary for each individual patient and we cannot guarantee the prices listed above.
- The prices listed above are examples only of Prof Scott-Young’s estimated fees for the procedures identified. They do not represent the highest or lowest fees he charges.
- It is impossible to provide exact prices even for the same type of procedure because a lot depends on the patient’s individual diagnosis and circumstances.
- There are over 70 Medicare item numbers for spinal surgery and hundreds of possible combinations of those item numbers that depend on the exact surgery that is performed.
- When spine surgery is performed, during the procedure different or extra steps may need to be taken to ensure you receive the best treatment for your condition. This may change the final Medicare item numbers, total fees, and out-of-pocket expense associated with your surgery.
- We will do our best to give you an accurate estimate before you proceed with surgery.
Frequently Asked Questions
The ‘gap’ or ‘out of pocket expense’ is what you personally pay towards the cost of your surgery (after any rebates are taken into account). It is the amount that you do not get back from Medicare or your private health insurer.
Prof Scott-Young does not participate in any gap cover arrangements. A gap cover arrangement is an agreement between your treating doctor and your health fund on the basis that your doctor will bill the health fund direct at a rate set by the health fund. Each health fund sets its own fee level it is prepared to pay for your surgery.
Prof Scott-Young discounts his surgery fees for aged and disability pensioners. The size of the discount depends on the type of procedure he recommends. The discount will be clearly set out in the surgical estimate.
Your surgeon does their best to decide what surgery you need before they operate. But sometimes the type of operation needed changes based on what your surgeon finds during the surgery. This means that the final Medicare item numbers may be different, and the surgeon’s fee may then change.
When all your investigations have been completed and you and your surgeon agree that spine surgery may be an option for your spinal condition, they will discuss their recommendations with you and provide you information about the type of surgery. At that time, you will be provided with an estimate outlining the costs of the procedure. We recommend that you look through our patient journeys to see how this works.
When surgery is elective it means that it is not required to save your life or to prevent permanent impairment or disability. With most spine surgery, the patient can choose whether to undergo the surgical procedure (and accept the risks associated with the surgery) or to continue to manage their symptoms without surgery. It is the patient who elects to have surgery or not.
Unfortunately, it’s not that simple. We recommend that you look through our patient journeys to gain an understanding of how surgeons determine what surgery is appropriate for a patient.
Because most spine surgery is elective, your surgeon believes it is important for you to take time to consider their recommendations before proceeding. We will provide you with an estimate and then you are able to consider those costs (together with the other information you have been given about the procedure) and come to a decision about whether to proceed. There is a lot to consider before making such an important decision and we want to ensure you take the time to consider things carefully before proceeding. You may wish to consult your local GP about your decision. You may also ask your GP to refer you for a second opinion from another surgeon.
Once you have decided to proceed with surgery, and you have a surgery date, payment of the total amount estimated is required 10 business days prior to your surgery. After your surgery, we will assist you in making a claim to receive your rebates from Medicare and your private health insurer. The hospital will require payment of your excess (if any) on the day of your admission.
The surgeon’s fees are just a small part of the cost of a hospital admission. The cost of the hospital stay and the expense of going to the operating theatre are high. Also, spine surgery usually involves expensive implants. These large costs are covered by private health insurance. Medicare does not pay for any part of the hospital costs. Sometimes, unexpected costs can also arise. For example, you may need to stay longer in hospital after your surgery than originally expected. And, if an adverse event occurs, you may need to go back to theatre. A hospital stay can quickly go from being something you can afford to something that causes financial stress. Health insurance works like other insurance – it protects you against the cost of the unexpected.
Surgery is very expensive and health funds generally make you wait one year before having elective surgery for a pre-existing condition. We recommend that you join a fund before you see your surgeon as it will make the wait shorter if he recommends surgery.
The Australian government has introduced legislation to simplify private health insurance policies. When choosing health cover, you need to ensure that you are covered for spinal conditions and surgery. Under the new system, your cover needs to include the Clinical Category: back, neck and spinal conditions. You can check this cover with your insurer or on your online account with your insurer. You do not need MBS item number to check your cover. Just ask, “am I covered for back, neck and spinal conditions?”
The surgical fees charged for spinal surgery includes all the usual post-operative appointments you need with your treating surgeon after the procedure. Medicare calls this aftercare. No consultation fee is charged during the normal aftercare period. The length of the aftercare period depends on the nature of the procedure. For most of our spine surgery, the aftercare period is 12 months. Aftercare does not apply if you see your surgeon for a different problem. For example, if you had lower back surgery but returned to see the surgeon about your neck. Prof Scott-Young’s policy is to bulk bill Medicare (no out of pocket cost) for any future appointments, once the aftercare period is over.
Disclosure of Financial Interests
The development of new technologies and treatments for diseases of the spine are often developed through collaborations between commercial organisations and specialists who work in the field. These collaborative relationships are important for advancing and improving patient care. This is recognised by the Australian Orthopaedic Association (AOA) in its Code of Conduct and its Position Statement on Interaction with Medical Industry 2020.
Dr Matthew Scott-Young is often at the forefront of innovation in patient care, research and medical devices. He contributes his expert knowledge to the development of spine care technologies and treatments either freely or is compensated through commercial arrangements with the medical industry. Dr Scott-Young has invented spinal implants for use in both the lumbar and cervical spine. Dr Scott-Young only participates in arrangements that are conducted in accordance with the AOA’s Code of Conduct.
Dr Scott-Young ensures that his patients are aware of his financial interests by posting this information on his website and in discussions about surgery he recommends.