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Financial Information

These notes are to give you as much information as possible about any potential expenses you could incur. If you have further questions please ask.

There is universal health cover in Australia from Medicare. This means that all Australian residents are covered by the Public Health system.

The Private Health system offers the advantage of choosing your surgeon, reduced waiting periods and access to a better choice of surgery that may not be available in the public sector. The disadvantage is the financial costs associated with the surgery.

Most doctors’ costs are paid for by Medicare and Health Insurance companies supplement a little to this. In fact most of your Health Insurance goes into paying for your hospital stay and not the doctor’s costs.

There are several costs when seeing a Specialist Surgeon, mine are:

  • Initial Consultation Fee
  • Review Consultation Fee
  • Cost of Surgery – guided by the AMA (Australian Medical Association) fee schedule.

All orthopaedic surgeries are covered by Medicare item numbers. These numbers have an associated rebate. The government determines these rebates and the private health insurance companies supplement these rebates. The amount of rebate varies with each insurance company.

There are several costs to surgery. Most patients believe the bills they are paying are for the surgeons. In reality there are multiple providers who are sending out bills to the patients and the health insurance company:

Surgeon’s Fee

This is the fee payable to the surgeon who performs your operation. This may vary according to your insurer, your operation and personal circumstances.

Assistant’s Fee

Most orthopaedic operations require an assistant. It is commonly set at 20% of the surgeon’s fee. The assistant fee may include a gap.

Anaesthetist’s Fee

Again, this may attract no gap, a known gap or be a set fee. This is dependent upon your personal circumstances, past medical history and the experience of the anaesthetist.

I and my team will explain the fees to you at the time of booking of your surgery.

Hospital Fees

Theatre usage and Bed Fees
These are usually covered by your insurance cover but some levels of cover are different from others. Always confirm your level of cover with your insurer.

Pathology and Radiology Fees
These are performed before, during and after your surgery and may incur additional fees. Check with your insurer.

Implant Costs
These are the bits of metal and plastic that are used to replace joints, fix fractures etc. These are usually covered by your insurer, but please check.

Other expenses that may be incurred include:

Physician/GP

Depending on the nature and type of your procedure, your own health a physician may be invoiced. In this case this would attract a separate account.

Physiotherapy

Depending on the type of Health Insurance you hold, you may receive a separate account for physiotherapy

Pharmacy

Medications that are prescribed for you to take home on discharge will attract a separate fee.

Complications

Much as we would like for this never to happen, all surgery carries the risk of complications. If these occur, it may require re-admission to hospital and even potentially further procedures that will involve additional costs.

For your convenience we accept payment in the rooms, by post and online:

  • Credit Card: VISA, Mastercard and Amex
  • Cheque
  • Cash
  • Electronic – EFTPOS, BPay

Uninsured Patients

Will require a quote from the hospital and the prosthesis companies. Once again, the surgeon’s fees are mainly rebated by Medicare and therefore the patient will not have to pay much out of pocket for their surgeon.

If you have any questions regarding payment or would like further information regarding billing etc please do not hesitate to contact us on

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  • The Mater Hospital, Sydney, North Sydney
  • Shellharbour Private Hospital
  • Nowra Private Hospital
  • Shoalhaven District Memorial Hospital
  • The Royal College of Surgeons
  • Royal College of Surgeons of Edinburgh
  • Royal Australasian College of Surgeons (RACS)
  • Australian Orthopaedic Association (AOA)
  • American Academy of Orthopaedic Surgeons (AAOS)
  • Medical Board of Australia
  • General Medical Council (GMC)
  • Oxford University Hospitals NHS Foundation Trust
  • Shoalhaven Medical Association