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Spinal Cord Stimulator Cost


Factors that determine spinal cord stimulator cost

Chronic back pain affects millions of people and is a leading cause of missed work, strained relationships and an inability to enjoy basic activities and hobbies. If you’ve been diagnosed with a spine condition as the source of your chronic back pain and conservative treatment options have been unable to provide lasting relief, a spinal cord stimulator may be able to help. This is an implanted device consisting of a small power pack, similar to a pacemaker, and two small electrodes that attach to the area near the spinal cord.

Spinal cord stimulators work by sending a gentle current to the spinal cord, which basically works to distract the brain from interpreting pain signals. For people considering a procedure to implant this device, a very essential concern is spinal cord stimulator cost. While costs vary from patient to patient, there are a number of important considerations to understand that help answer this question.

By having a better understanding of what these factors are and how they help determine spinal cord stimulator cost, you can make a more informed decision about care. For people dealing with back pain and other debilitating symptoms related to a spine condition, lasting relief is possible and educating yourself is a key first step on that journey.

Spinal cord stimulator cost considerations include insurance, procedure type and device type

Patients who are recommended for spinal cord stimulator surgery have typically fully explored conservative treatment options including medication, physical therapy and steroid injections without finding the relief necessary for a good quality of life. In many cases, spinal cord stimulators are recommended for back pain sufferers who have had previous spine surgery and do not want to undergo another procedure.

Spinal cord stimulator costs can vary widely, from little-or-no out-of-pocket cost for insured patients, to costs in the tens of thousands of dollars for self-pay. If you are considering a spinal cord stimulator procedure and want to better understand how the cost of the procedure is calculated, learning about these factors can help.

Insurance type and spinal cord stimulator cost

Whether it is an employee-sponsored insurance plan, private insurance or Medicare, most patients use some form of health insurance to pay for surgical procedures such as a spinal cord stimulator. In these situations, the insurance carrier, or payer, will negotiate the cost of the procedure with the provider. One of the biggest factors that can affect the cost of the procedure is whether or not the provider is in network with the payer. In-network providers may have a more significant discount for procedures, resulting in a lower spinal cord stimulator cost.

Another consideration is the nature of the individual’s insurance plan. For example, plans with a high deductible will often result in the patient paying more out of pocket than those with a lower deductible or no deductible.

The procedure itself must also be covered and approved by the payer. Fortunately, spinal cord stimulators are often covered by insurance providers, including Medicare, if they are deemed a necessary part of treatment.

While patients without insurance who are self-payers will generally experience higher costs for spinal cord stimulator procedures, discounts can sometimes be negotiated with providers.

How does the type of spinal cord stimulator procedure affect the cost? 

Like other surgical procedures for back pain, there are a range of approaches that a surgeon can take to install the implanted device. This can have a significant effect on cost.

For example, spinal cord stimulator procedures can be performed on an outpatient basis thanks to the development of minimally invasive procedures. This can help reduce hospital-associated costs. In determining the cost of the procedure, providers will generally divide costs by the surgeon’s fee, facility fee and cost of the device.

If a patient can avoid a lengthy hospital stay and have a quicker recovery time, it can result in reduced spinal cord stimulator cost. Additionally, even if the procedure is an outpatient surgery performed in a hospital, the facility fees can potentially be higher than if the procedure was performed in an ambulatory surgery center.

Cost considerations for spinal cord stimulator devices

There are a number of different types of spinal cord stimulator devices that help modify pain signals in different ways. There are also a number of different manufacturers. Prices can vary for both categories and have a significant impact on the overall cost of the procedure.

Types of devices include:

  • Conventional implantable pulse generator — The most common type of device, runs on batteries.
  • Rechargeable implantable pulse generator — Newer devices that allow the battery to be recharged without the need for an additional surgery. 
  • Radiofrequency stimulator — This type of device has a battery pack outside the body, used less often due to technological developments. 

While the type of device can affect cost, surgeons will generally select the device that is best for a patient’s individual health needs.

Other cost factors for spinal cord stimulators

When considering a spinal cord stimulator, patients should also think about recovery time, the need for physical therapy, prescription medications and other associated costs of rehabilitation.

It is also extremely important to think about the costs that can develop as a result of not undergoing a procedure, including reduced quality of life, missed work and the need for more extensive treatment down the road.

Spinal cord stimulator procedures at USA Spine Care

At USA Spine Care, our spinal cord stimulator procedures are performed on an outpatient basis at a state-of-the-art ambulatory surgery center, helping to reduce hospital-associated costs. We work with most major insurances, including private insurance, Medicare, workers’ compensation claims and personal injury cases. To learn more about spinal cord stimulator cost, contact one of our friendly and caring representatives today. We’ll help you get the answers you need so you can start your journey to relief.

Call toll free 1-866-249-1627.

Spinal Cord Stimulator - People Also Ask

Spinal cord stimulator implants are covered by Medicare and are billed under:

  • Percutaneous Leads and Extensions
    63650 Percutaneous implantation of neurostimulator electrode array, epidural
    63661 Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
    63663 Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
  • Paddle Leads
    63655 Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural
    63662 Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
    63664 Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
  • Stimulators
    63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
    63688 Revision or removal of implanted spinal neurostimulator pulse generator or receiver
  • Analysis and Programming
    CPT codes 95970–95973 are used to report electronic analysis services. These are not considered medically necessary when provided at a frequency more often than once every 30 days. More frequent analysis may be necessary in the first month after implantation.

Published studies of spinal cord stimulation show good to excellent long-term relief in 50 to 80% of patients suffering from chronic pain. One study reports that 24% of patients improved sufficiently to return to gainful employment or housework with stimulation alone or with the addition of occasional oral pain medication.

Unlike a spinal fusion, a spinal cord stimulator surgery is reversible. If a patient decides at any time to discontinue, the electrode wires and generator can all be removed.

Spinal Cord Stimulation is an option for those suffering from chronic, intractable pain of lower back and/or limbs including unilateral or bilateral pain associated with the following conditions:

  • Failed Back Surgery Syndrome (FBSS)
  • Radicular pain
  • Post-laminectomy pain
  • Multiple back surgeries resulting in continued or worsening pain
  • Unsuccessful vertebral disk surgery
  • Degenerative Disk Disease
  • Peripheral causalgia
  • Epidural fibrosis
  • Arachnoiditis
  • Complex Regional Pain Syndrome (CRPS)
  • Causalgia

No surgery is without risks. General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. Specific complications related to SCS may include:

  • Undesirable changes in stimulation (can possibly be related to cellular changes in tissue around electrodes, changes in electrode position, loose electrical connections, and/or lead failure)
  • Epidural hemorrhage, hematoma, infection, spinal cord compression, and/or paralysis (can be caused by placing a lead in the epidural space during a surgical procedure)
  • Battery failure and/or battery leakage
  • Cerebrospinal fluid leak
  • Persistent pain at the electrode or stimulator site
  • A pocket of clear fluid (seroma) at the implant site. Seromas usually disappear by themselves but may require a drain.
  • Lead migration, which can result in changes in stimulation and reduction in pain relief
  • Allergic response to implant materials
  • Generator migration and/or local skin erosion
  • Paralysis, weakness, clumsiness, numbness, or pain below the level of implantation

In a spinal cord stimulator trial, temporary electrodes are placed and then the patient uses an external device to generate electrical current. The electrodes are placed under x-ray guidance with the patient lying on his belly. A local anesthetic is used to numb the skin and deeper tissues. The electrical wire or lead contains a series of four to eight evenly spaced electrodes that can be programmed to generate an electrical field. A spinal cord stimulator trial period is at least 5 to 7 days. This gives you time to test the device and evaluate its effectiveness managing your pain at rest and during activity

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