INSURANCE & BILLING
Dr. Russo participates as an “in-network” provider for most all commercial insurance plans. As an “in-network provider” the cost of Dr. Russo’s care is dictated by the terms of your plan’s in-network benefits. Please check with your insurance carrier to determine coverage.
Effective January 1, 2025, Dr. Russo will no longer participate with Medicare and Medicare Advantage Plans. Thankfully, Medicare will continue to pay for other aspects of your care based on your benefits as dictated by your plan, however the professional fee will not be covered as dictated by the fee schedule below. Medicare also specifies that each patient seen by Dr. Russo will be asked to sign this contract to acknowledge that Dr. Russo is an opted out provider.
While this change may raise some concerns, Dr. Russo would like to reassure his patients that he remains committed to providing exceptional care at a minimal cost burden. Therefore, he has decided to provide consultation services at no cost for new and follow-up visits in the clinic. Medicare patients are also welcome to continue using their Medicare insurance within OrthoArizona for all other related services such as X-rays, durable medical equipment, injections, advanced imaging (MRI or CT), and physical therapy. In addition, if surgery is recommended during the visit, Medicare will also continue to cover the hospital or surgery center fees, anesthesia services, and implant costs associated with surgery.
By focusing on fewer administrative burdens associated with Medicare, Dr. Russo will be able to spend more time with each patient, reduce wait times for consultations and surgeries, and provide more timely and comprehensive care. To support this, Dr. Russo has expanded his staff to offer enhanced concierge-level services, greater responsiveness to patient questions and concerns both before and after surgery, and improved scheduling efficiency for appointments.
WHY DR. RUSSO IS OPTING OUT OF MEDICARE
Dr. Russo is committed to treating his patients as family members, providing the highest quality and skilled care with an empathetic and patient-focused approach to joint replacement. This commitment has become more difficult as healthcare in this country rewards volume over quality care by decreasing reimbursement every year for the same services. Many surgeons have responded by increasing volume to make up for lost revenue, allowing less time per patient. While this shift is not new, the last 6 years have seen significantly higher reimbursement cuts most pronounced for hip and knee replacement. For the 5th year in a row, despite inflation and rising cost of providing care, Medicare has announced yet another 3% decrease in payment to total joint surgeons.
Dr. Russo is unwilling to make sacrifices to the level of care he provides to make up for lost revenue. It is not acceptable nor sustainable to continue earning less income every year despite working longer hours and performing more surgery year after year on increasingly complex patients. Dr. Russo recognizes that his patients already wait several months to be seen in clinic, as well as surgical wait times that often exceed 6 months. With increasing payment cuts, those wait times will only get worse if a change is not made.
Dr. Russo’s decision to opt out of Medicare allows for more time to spend with patients both in the operating room and in the office. It allows the focus to be placed back on quality over quantity and improves timely access to care including surgery, patient questions and concerns. Dr. Russo remains committed to serving his patients as he would his own family and believes this change is necessary to continue to do so.
DR. RUSSO OFFERS AFFORDABLE FINANCING FOR YOUR SURGERY
Many patients ask about the available Financing Options for their procedure. Financing allows you to enjoy your procedure now and pay for it with convenient monthly payments over time.
Dr. Russo and OrthoArizona work with CareCredit offering a variety of payment plans, to give you options for surgery financing. CareCredit® is a medical credit card. Once approved, you may use your line of credit for additional medical treatments like cosmetic procedures, dentistry, LASIK surgery, eyeglasses, hearing aids, pet care, and more, without the need to reapply.
The financing option makes it easier for you, our patient, to get the medical procedures you want- when you want them. CareCredit®, the leader in patient financing, has a payment plan for everybody. You can conveniently pay over time with a ‘No Interest’ or ‘Low Interest Payment Plan’ that fits comfortably into your lifestyle and budget.
Click on the banner below for links to CareCredit®. You may apply directly online or call us for assistance.
MEDICARE FEE SCHEDULE
| PROCEDURE | ESTIMATED CASH PRICE |
| In Office Consultation | $0 |
| Annual/Routine followup & Post-op Visits | $0 |
| Primary Total Hip Replacement | $6,500 |
| Primary Total Knee Replacement | $6,500 |
| Primary Partial Knee Replacement | $6,500 |
| Conversion of prior surgery to Total Hip or Knee Replacement | $7,000 – $9,000 |
| Revision Total Hip or Knee Replacement | $10,000 |
**This fee schedule contains estimates and is being provided for educational purposes only. Prices may vary. Prices may change over time or may increase due to the complexity of your case. We may provide a more detailed and personalized estimate upon request. This fee schedule does not supersede any agreements you may be asked to sign.