Fees

We understand that medical costs for seeing a specialist and surgery can be a concern for many patients. You always have the right to ask your doctor about their fees.

In Australia we are fortunate to have universal health care provided through Medicare. This means that all Australian citizens and residents are covered by the public health system, though this may include surgery performed by surgeons-in-training while under the supervision of a qualified surgeon.

In the private health system, you are offered the advantage of choosing your surgeon, seeing an experienced specialist rather than a surgeon-in-training, and accessing a shorter waiting period in exchange for the financial costs associated with seeing a specialist. Most doctors receive payment from Medicare as well as a supplement from the health insurance companies, but most of your health insurance goes into paying for the hospital stay, and the prosthesis involved in your operation.

Relevant Links:

Guide for Patients on How the Health Care System Funds Medical Care - The Australian Medical Association (AMA)Summary Guide for Patients - The Australian Medical Association (AMA)

Costs of Surgery

There are several costs to surgery, each with pricing dependent on factors such as your procedure, your private health insurance company, and the level of cover you might have. While most patients believe they are paying bills for only the surgeon, there are actually multiple providers and professionals who are billing Medicare, the Health Insurance Provider, and occasionally directly to you for a procedure.

Potential fees include:

Surgeon's Fees - dependent on the procedure.
Anaesthetist's Fees - The specialist who provides the anaesthetic and pain relief. Most Anaesthetists charge gaps between $250-1000. Your Anaesthetist will always contact you prior to surgery to obtain informed financial consent.
Surgical Assistant's Fee - The doctor who assists the surgeon. Most assistants will charge a gap between $100-300.
Hospital bed and Theatre Costs - If you have private health insurance then this is usually covered in your "Hospital Excess".
Prosthesis and Implants - This can sometimes be the most expensive part ranging from $1,000 to $100,000. If you have private health insurance and coverage for the procedure, then this is usually covered in your "Hospital Excess" but it is important you check with your insurance prior to surgery.
Blood Tests and Scans - This is for blood tests and x-rays or imaging taken during your inpatient stay and sometimes incurs additional costs.

How are fees calculated?

All orthopaedic surgeries are covered by a Medicare item number. These numbers have an associated rebate. The government (Medicare) determines this rebate, and the private health insurance companies supplement these rebates.

Recently Medicare rebates have not increased in line with indexation, and there is a discrepancy between the rate recommended from the Australian Medical Association (AMA) and each private health insurance. The AMA is the national medical association that analyses the current costs for running safe private practice indexed to the consumer price index with fair and reasonable fees for surgeons. Typically, Dr Eardley-Harris charges a percentage of the recommended AMA fee depending on the procedure

This does mean that even if you have top hospital private health insurance, only part of the surgical fee is covered by Medicare and your Private Health Fund. The remainder of the fee is the out-of-pocket cost or "gap". The out-of-pocket gap can be vastly different depending on your choice of private health fund and level of cover. There are many health insurance "junk policies" that allow tax avoidance for the user but only cover restricted in-patient services and may have "exclusions" for certain surgeries. The most common exclusion is joint replacement due to the large cost of the prosthesis for the health insurance company.

See the links on this page for more information.

Informed financial consent

After booking your surgical procedure, you will be given an informed financial consent.

The financial consent documentation will issue full transparency of the surgical fee and expected out of pocket costs. This will be available for you pre-surgery in the case of planned surgery, allowing you to check you are covered for the procedure from your private health provider. Please note that this does not include the fees for the other health professionals involved in your care who will set their own fee, for example anaesthetist fees for anaesthetic, hospital fees for prosthesis/inpatient care, or assistant surgeon fees for surgical assistance.

Self-funded patients

Patients without insurance are still able to select their surgeon and have surgery performed in a private hospital by Dr Eardley-Harris, however the costs that would normally be covered by the health insurance company are instead covered by the patient, including the prosthesis and implants used. This requires a quote from the hospital and the prosthesis companies for the expected surgery. The surgeon's fee is the same whether you are insured or not and is still rebated by Medicare.

Costs of Surgery

Let's discuss your personalised treatment plan