Robotic Surgery

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DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 4/18/2009 8:15 PM (GMT -6)   
I'm not sure I'm reading correct information. One article said this was a lot more expensive than a standard operation. Could someone please give me a guesstimate on the total cost of the robotic surgery, including hospital stay charges and everything? Thanks again for the help!
 
Dana

ups4
Regular Member


Date Joined Nov 2008
Total Posts : 20
   Posted 4/18/2009 8:20 PM (GMT -6)   
My total bill was in the neighborhood of $67K. This was just for the surgery and hospital stay.
By comparison when I had pneumonia and was in the hospital for about 2 weeks, that bill was around $84K.

Thank goodness for insurance.

Paul
Paul in Sunrise, FL
Diagnosed 7/07 age 52, 53 now.
PSA 2.5-3.5 at diagnosis.
Biopsy proved positive.
Davinci surgery 10/07.
All nerve bundles/lymph nodes spared.
Continence returned by 12/07.
ED getting better everyday w/Viagra.
PSA's post surgery all <.01.
Dr. Daniel Ead, Urologist in Plantation FL
Latest PSA results from 1/12/09=.01


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 4/18/2009 8:34 PM (GMT -6)   
Mine was about the same cost as ups4. What's interesting is the billed charges (hospital about $33K and doctor about $25K) compared to the allowed or contracted amount through my insurance. The hospital was paid about $2,500 and the doctor about the same. I don't mean to imply that I was stuck paying the balance either. I only paid my deductible. No idea what one would have to pay if insurance was not available. Would the hospital and doctor still bill the same or do they give you a big "discount"?
Age 51, (50 at DX)
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00
Second post op PSA 2/10/09, 0.00


califguy
Regular Member


Date Joined Sep 2008
Total Posts : 72
   Posted 4/18/2009 8:42 PM (GMT -6)   
My bill was about 62,000. When it looked liked insurance wouldn't cover, the hospital said we could pay about 1/2 of that. Insurance covered and guess what? They paid the hospital about 30k in the end so it would have been basically the same.

Don't get discouraged!!
CalifGuy
 
Diagnosed Feb 2008  54 years old
3+4=7 gleason
7.5 PSA
4 out of 20 biopsies were cancerous
daVinci Robotic surgery July 24, 2008  Univ of Calif San Francisco Med Center  Dr Peter Carroll
In hospital 2 nights altho I had option of leaving the next day but stayed due to distance home.
Contained in prostate, not spread
Six weeks post surgery PSA less than .01
Five month PSA less than 0.1  Lab did wrong type of PSA test so this test was not as accurate.
Eight Month PSA less than .01  Yeah!!!!1


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 4/18/2009 8:50 PM (GMT -6)   
I'm on medicare and medicare supplement> Medicare allows a fixed rate for the surgery and the hospital and pays a percentage of what the allow. My supplemental insurance pays the percentage that medicare doesn't pay. It cost me zero. The robotic surgery will have lower hospital stay. I was there for only one night while the standard opn surgery may require 4-5 days in the hospital.
Age: 67
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09
Surgeon: Dr. Randy Fagin, Austin TX.
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Bilateral 10-20% involved
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
seminal vesicles clean
Lymph nodes: not dissected
1st PSA test 4/7/09 result <0.1


DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 4/19/2009 7:56 AM (GMT -6)   
Eeks-looks like I was way off. I read somewhere the surgery costs around $15,000. I told me boyfriend (he has insurance) I thought the out-of-pocket costs would come to around $5,000. I was way off huh? I REALLYappreciate the replies-sending my healing thoughts out to you all.
 
Dana

TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 4/19/2009 11:06 AM (GMT -6)   

Good morning,

My doc does both laproscopic and robotic procedures and I asked about the cost difference. He told me that the robotic procedure was $3000 more due to paying for the robot which is owned by the med center.


NRC
New Member


Date Joined Jun 2008
Total Posts : 3
   Posted 4/21/2009 11:19 PM (GMT -6)   
I can't speak to the costs for the robotic surgery, but I had the open procedure at Johns Hopkins last fall and the total was in the neighborhood of $20,000 for everything. Surgeon's fees were about $6,500, hospital about $8-9,000, with pathology and anesthesiologist fees making up most of the rest. I checked in on a Tuesday morning, had the surgery around noon and was discharged late afternoon on Thursday. The procedure itself lasted about 90 minutes, or so they tell me. Three or four of the surgeons there do not participate in Blue Cross/Blue Shield, so if you're not a member of one of the plans that they do participate in you'll need to pay the surgeon's fee in advance.

Neil

Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 4/22/2009 5:41 AM (GMT -6)   
Mine at MT. Sinai, NYC was 40K total.
Paul
46 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6 (Biopsy 3/07 just suspicious)
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
PSA 0 at nine months.
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - Took 100mg viagra every night. for several months
Totally usable erections at 10 weeks, which disappeared over the course of a month or two.
ED bounce is what they call it. Now, at one year, ED is fine with viagra.
One year PSA - undectable!


jrponalameda
Regular Member


Date Joined Dec 2007
Total Posts : 56
   Posted 4/22/2009 5:49 AM (GMT -6)   
DanaA said...
Eeks-looks like I was way off. I read somewhere the surgery costs around $15,000. I told me boyfriend (he has insurance) I thought the out-of-pocket costs would come to around $5,000. I was way off huh? I REALLYappreciate the replies-sending my healing thoughts out to you all.
 
Dana
I think there's substantial variation. I saw the bills for my DaVinci surgery and associated expenses as sent to my HMO, and they totalled around $38,000. I'm pretty sure my HMO paid less than that. I had some copays to cover, probably around $1000 total. The out-of-pocket costs will depend on the insurance. I think the robotic is somewhat more expensive, but the difference might not be that significant with insurance.
 
John
Diagnosed Sep 2007 Age 54 Gleason 6 (3+3)
DaVinci Surgery 11/8/07 University of Minnesota
2/22/08, 8/15/08 PSA Undetectable


webstergl
Regular Member


Date Joined Mar 2009
Total Posts : 25
   Posted 4/22/2009 6:53 AM (GMT -6)   
I had the robotic surgery at Baylor in Plano texas and total cost was 78.000 total paid by my insurance. Whe I was deciding whether to have open or robotic my urologist explained to me that the cost is pretty much the same for either procedure

Age 54 (Dx age 52)

11/06 severe prostate infection PSA was at 52

2/07  4th PSA still at 6.2

3/07 Biopsy

4/07 5 of 12 core samples positive with Gleason at 6 -7

6/07 Robotic Radical Prostatectomy

Pathology showed Cancer was organ contained

Last 3 PSA’s 0

11/08 Dx with BNC (Bladder Neck Contracture) due to scare tissue

3/08 Scheduled for TUI, as well either an AUS or Male sling not sure at this point which one


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 4/22/2009 8:40 AM (GMT -6)   
DanaA

It all depends on whether your boyfriend has insurance or not. Most all hospitals and surgeons are part of the Network Contracted Providers to Medicare or the Health Plans. Then there is a HUGE discount offered by the medical providers to Medicare or the Health Plans.

My total was $38K of Charges but the health plan paid around $12K all together. I had deductibles and co-insurance but it wasn't much. However that depends on each person's plan.

Anymore, I don't think there is much of a difference in cost between the two surgery options.
Age 60
PSA 2007 4.1
PSA 2008 10.0
Diagnosed April 2008
Biopsy: 6 of 12 cores positive
Gleason 4 + 5 = 9
CT and Bone Scan negative
Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared
Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th
pT2c
lymph nodes negative
PSA Sept 28, 2008 0.00
PSA Jan 22, 2009 0.00


alex1
Regular Member


Date Joined May 2008
Total Posts : 29
   Posted 4/22/2009 9:26 AM (GMT -6)   
Dana:

I had the robotic surgery in Atlanta at Northside Hospital in Feb 2008 with a very good surgeon who does about 300 per year. Mostly due to low insurance reimbursement numbers, he didn't do insurance at all - his fee was $8500 in cash up front, and his schedule stays full. Insurance in my case took care of Hospital costs at a very good hospital and virtually everything else - it was only a 24 hour stay. From what I could tell, you're probably right on with a number in the $15,000-$20,000 range unless you're in a high cost area, or have complications that increase the hospital stay. If his insurance is good, the out of pocket should be pretty reasonable. My overall experience would cause me to highly recommend both my doctor and hospital if asked, both as to standard of care and costs.
58-year old attorney, no family history of PCa
Biopsy 12/29/2007 with 1 of thirteen samples positive; estimated 5% involvement
3+3=6 Gleason
TR2C Stage
RRLP on 2/21/2008 with excellent prognosis (no evidence;margins and other tissue clear) on cancer clearance and sparing of both nerve bundles
Post-OP:Actual involvement 15%, one lobe only; PCa fully contained in prostate-no involvement with other tissues and margins clear
Catheter out on 3/2/2008; fully continent by 3/31/2008
Undetectable PSA on 3/31/2008
Working on ED: 20MG Levitra every other day; Vacuum pump almost daily; some improvement, but not there yet. Started using MUSE with some success, 11/1/2008
2d undectable PSA on 7/21/2008
3d undectable PSA on 10/30/2008


beachbum50
Regular Member


Date Joined Sep 2007
Total Posts : 292
   Posted 4/22/2009 11:15 AM (GMT -6)   

I had the Di Venci procedure in October of 08 in Norfolk Virginia, the bill from the hospital and 28 hours of care was $35,000, but I'm sure the Blue Cross paid half of that, my fantastic surgeon charged $4,500 and was paid $3,000 by Blue Cross.

Beachbum turn

After having prostate cancer, mu outlook on life is "Every day is a holiday, and every meal is a banquet!"


Beachbum
 
PSA 10 June 2007
Biopsy July 2, 15 of 16 samples positive
T2C
3+3=6
prostate weighed 40 grams
Di Vinci 10/09/07, four hours on table, 3 in recovery
Total time in Hospital: 29 hours
Record for Dr. Lance, 70% of prostate had cancer, but NO spread, clean margins,Clean nodes,
First PSA at 5 weeks, UNDETECTABLE!
Catheter out at seven days, dry from hour one!
Second PSA 19 weeks post op, UNDETECTABLE 2/11/2008
Third PSA 5/12/08, six months post op, UNDETECTABLE
Fourth PSA 8/21/08, nine months post op, UNDETECTABLE
One Year visit in December 2008, UNDETECTABLE, now go visit every six months!
The Lord has truly Blessed me.


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 4/22/2009 4:41 PM (GMT -6)   
Greetings, Dana.  I had open surgery, not robotic so can't speak to that cost.  I have good insurance (Cigna) and was in the hospital from Monday morning to Wednesday morning.  Surgeon obviously knew what insurance would pay because he billed about $2100 and was paid $1975.  The hospital bill for 2 days was $25,000 and they were paid about $8,000.  I had some lab bills and other services that billed about $5,000 and were paid about $1,000.  My total cost was a $250 copay.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 4/22/2009 9:27 PM (GMT -6)   
Hi, Dana
Ihad my surgery at Shawnee Mission Medical Center in Overland Park, KS in January. All the bills are in and my out of pocket cost is less than 2K. Humana insurance covered the rest, after discounts. I had to stay an extra week due to a bad reaction to the anesthetic and the total bill came to about 68K, and that was with a private room for the last two days. Glad I had the insurance, as some poor fellows do not. My insurance is coming up for renewal in June and I expect it will go up at least 15% due to the history. My total output in premiums this last year was way below what I ran up in usage...so I'll have to bit the bullet to keep the coverage. Well worth it.

Bob
 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 Fully continent...ED progressing as expected.


DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 4/23/2009 10:53 AM (GMT -6)   
Thank you to everyone for the feedback and sharing! I talked to Cleveland Clinic today and they said without insurance the cost would be $47K. He thought with insurance the cost would probably be double that. Reading all these different costs and the spread between them is, frankly, appalling. He's been trying to get through to his insurance company for days and they won't answer or return calls. I told him to look for a patient advocate number online. Anyone have suggestions for threats or other tactics to get these people to return his call? Having money really does matter when it comes to access to the health or legal system.
 
Dana

sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 4/23/2009 1:55 PM (GMT -6)   
So far about $58,000 for my insurance company Dana. That was with only one night in the hospital. I have no complaints, was well taken care of round the clock by about 16 different people after getting to my room. Thank goodness for insurance though.

In dealing with the insurance companies, keep trying every number you have for them and search for more. His urology clinic or primary care physician should have someone who deals directly with the insurance people. He has to be cerified for surgery before the hospital will even admit him and that is obtained for you by the doctors office.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
Fully continent on 4-09-09, no more pads
First Post-op PSA 2-17-09   0.00


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 4/24/2009 3:44 PM (GMT -6)   
DanaA, Sorry your health plan is not being responsive. Is your husband's health plan through an employer group? If so, ask the employer to contact the Sales and service rep for the plan. If the plan was sold through a broker, he or she can help get an answer to you. If none of the above, contact your state insurance commissioner. The insurance plan will respond.
Age 51, (50 at DX)
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00
Second post op PSA 2/10/09, 0.00

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