ACL Surgery Cost Guide: What to Expect and How to Prepare

When a patient tears their ACL, one of the first questions after “Will I play again?” is usually “How much will this cost?” Dr. Jeremy Burnham understands this concern. ACL reconstruction is a significant investment—both medically and financially. Over the past 15+ years at Ochsner-Andrews Sports Medicine Institute, Dr. Burnham and his team have worked with hundreds of patients to address the financial side of ACL surgery. They help patients understand coverage, deductibles, and the full cost of recovery. The clarity that comes from understanding these costs upfront allows patients to make decisions with confidence.

This guide breaks down what goes into the price tag of ACL surgery, what insurance typically covers, and how to prepare financially for reconstruction and the recovery ahead. Understanding the process means patients can focus on what matters most: getting back to the activities they love.

What Determines the Cost of ACL Surgery?

ACL reconstruction is a major surgical procedure with costs tied to multiple components. Understanding each piece explains why prices vary between practices and what patients are actually paying for.

Facility fees. This is typically the largest component. Facility fees cover operating room time, nursing staff, equipment sterilization, anesthesia support, and post-operative monitoring. Hospital-based surgery generally carries higher facility fees than outpatient surgical centers. Quality and accreditation should always come first. At Ochsner, facility fees reflect the resources, safety infrastructure, and staffing necessary for excellent surgical outcomes.

Surgeon fees. Here’s what many patients don’t realize: surgeon fees are typically the smallest component of the total cost. Surgeon reimbursement rates are standardized and set by insurance companies and CMS (Centers for Medicare and Medicaid Services). They don’t vary based on a surgeon’s experience, fellowship training, or outcomes. A fellowship-trained ACL specialist with decades of experience and documented superior outcomes receives essentially the same reimbursement as a general orthopedic surgeon doing occasional ACL cases. That’s a reality of the current healthcare system. The real value of choosing the right surgeon shows up in better outcomes, fewer revisions, and faster return to sport.

Anesthesia fees. An anesthesiologist manages patient care during surgery. Regional anesthesia (a nerve block) is common for ACL surgery—it’s safer and more effective for pain control than general anesthesia alone. These fees are separate from surgeon and facility costs.

Graft materials. Graft choice impacts cost. Autografts using the patient’s own tissue (patellar tendon, hamstring, quadriceps tendon) avoid tissue bank fees. Allograft tissues come from a tissue bank and include processing, testing, and sterilization costs. Autografts may increase operative time or require additional imaging. For details on graft options and outcomes, see ACL reconstruction techniques.

Imaging and diagnostics. MRI scans to confirm the tear, X-rays, and sometimes CT scans for complex anatomy or revision cases are billed separately. Some costs may be incurred before surgery as part of diagnosis.

Physical therapy. Post-operative rehabilitation is essential and typically begins 1-2 weeks after surgery. PT costs depend on insurance coverage, number of sessions needed (usually 16-24 weeks for return to sport), and whether patients use an in-house facility or independent therapist. This is often the largest out-of-pocket component, even with insurance. See ACL reconstruction and ACL surgery for more on what to expect.

Average Cost Ranges

ACL surgery costs vary significantly by region, facility type, and insurance coverage. Rather than citing specific dollar amounts that become outdated, this guide offers a realistic framework for understanding typical cost ballpark figures.

Without insurance. The total cost of ACL reconstruction—including facility fees, surgeon fees, anesthesia, and graft materials—ranges from moderate to substantial. Facility fees represent the largest portion. Surgeon fees, standardized by insurance and CMS, make up the smallest share.

With insurance. Out-of-pocket cost depends entirely on the plan’s deductible, copay structure, and in-network status. Most patients with good insurance pay their deductible (usually $500–$2,500) plus copays for PT and follow-up visits. Insurance then covers the majority of remaining costs at negotiated rates.

Louisiana and Baton Rouge context. Healthcare costs in Louisiana and the Baton Rouge area align with the national average, sometimes slightly lower than major metropolitan areas. Ochsner Health, as a large regional health system, negotiates favorable rates with major insurers, which can reduce overall costs compared to standalone surgical centers or out-of-state facilities.

For the most accurate estimate, patients should check with their specific insurance provider and the surgical facility before the procedure. Dr. Burnham’s office helps facilitate these conversations so patients know exactly what to expect.

What Insurance Typically Covers

ACL reconstruction is considered medically necessary. This matters: unlike cosmetic procedures, most commercial insurance plans, Medicare, and Medicaid recognize ACL reconstruction as essential treatment. Insurance should cover the bulk of the cost, subject to the plan’s terms.

Pre-authorization. Many insurers require pre-authorization before scheduling surgery. Dr. Burnham’s office staff handle this process. They submit imaging, surgical notes, and medical justification to the insurance company. The insurer approves the procedure before the patient comes in, protecting patients from surprise denials and confirming insurance commitment to covering the cost.

In-network vs. out-of-network. Always verify that the surgeon and facility are in-network. Out-of-network rates can be 2–3 times higher, and patients may be responsible for the difference. Ochsner Health is in-network with most major Louisiana insurers—Aetna, BCBS, Humana, and UnitedHealth—but it’s worth confirming the specific plan.

Deductibles and copays. The insurance plan specifies a deductible (amount paid before insurance kicks in) and copay or coinsurance amounts for different services. For ACL surgery, the surgeon, facility, and anesthesia are usually covered at the same benefit level. Some plans have a single surgical deductible; others separate deductibles for professional services and facility services.

Physical therapy coverage. This varies by plan. Most plans cover PT visits at a copay (typically $30–$75 per visit), but some have annual visit limits or require pre-authorization. High-deductible plans may require patients to meet their deductible for PT, meaning the first visits are out-of-pocket.

Out-of-Pocket Costs to Plan For

Even with good insurance, ACL reconstruction involves out-of-pocket costs beyond the deductible. Here’s what to budget for:

Physical therapy copays. At 16–24 weeks of PT with 2–3 visits per week, patients typically have 32–72 PT visits. At $30–$75 per copay, this adds up to $960–$5,400 in PT costs alone. This is often the largest out-of-pocket expense. Ask the insurance company about visit limits and whether PT has a separate deductible.

Bracing and support equipment. A custom or functional knee brace post-operatively costs $300–$800 and is often recommended during the first few months and during return to sport. Some insurance plans cover this if prescribed as medically necessary; others don’t. Compression sleeves, ice packs, and supportive footwear are usually out-of-pocket.

Follow-up office visits. Patients have several post-operative visits (2 weeks, 6 weeks, 12 weeks, 6 months, 1 year). These are typically covered at the copay or coinsurance rate ($0–$50 per visit depending on the plan).

Imaging and diagnostics. Follow-up X-rays or MRIs may be needed during recovery. These usually count toward the deductible or require a copay. If the deductible has already been met, they may be fully covered.

Lost wages consideration. This is not a direct medical cost, but it is real. Most patients take 2–4 weeks off work after ACL surgery and are restricted from heavy lifting or standing for 6–12 weeks. High-level athletes lose training time and potential competition earnings. While insurance doesn’t cover lost income, it’s part of overall financial planning.

Does Graft Choice Affect Cost?

Yes. Graft choice impacts overall cost, but it shouldn’t be the primary decision factor. Here’s the breakdown:

Autograft (patient’s own tissue). Using the patient’s patellar tendon, hamstring, or quadriceps tendon costs less upfront—no tissue bank fees. Harvesting tissue requires additional operative time and may require extra imaging or larger incisions, which can offset the savings. Research shows that long-term outcomes with patellar tendon autografts are excellent, with studies documenting good functional results at 20+ years post-operatively. See quadriceps tendon grafts and the future of ACL reconstruction for the latest in graft selection.

Allograft (donated tissue). Allograft tissue is processed, tested for disease, and sterilized by a tissue bank. These costs add $2,000–$5,000 to the total procedure cost. Allograft avoids morbidity at the harvest site and may allow for less operative time in revision or complex cases.

Quadriceps tendon (patient’s own tissue). The quadriceps tendon is an autograft gaining popularity because of excellent biomechanical properties and lower morbidity compared to patellar tendon. It typically costs the same or less than patellar tendon autograft since there are no tissue bank fees. Academic orthopedic programs increasingly develop standardized rehabilitation protocols for quadriceps tendon grafts to optimize recovery.

The right graft matches the patient’s anatomy, activity level, and prior surgeries. Cost should be one factor, not the decision-maker. Insurance usually covers all graft options at the same benefit level, so cost differences are often smaller than expected once insurance negotiation is applied.

How to Prepare Financially

1. Verify insurance coverage. Call the insurance company or have Dr. Burnham’s office do it. Ask about deductible, copay structure, PT coverage, and in-network status. Request a pre-authorization estimate if available.

2. Understand deductible status. Check how much of the deductible has been met this year. If it’s early in the calendar year and the deductible is unmet, consider timing surgery to maximize benefits. December surgery carries the deductible into January; if the deductible is already met, schedule surgery soon to maximize insurance coverage.

3. Ask about payment plans. Most surgical facilities and independent PT practices offer payment plans for out-of-pocket costs. Many accept CareCredit or similar healthcare financing options that spread costs over months.

4. Get a pre-operative cost estimate. Dr. Burnham’s office provides a detailed breakdown of typical surgeon, facility, and anesthesia costs. Combined with insurance verification, this gives a realistic total-cost estimate.

5. Plan for lost income if self-employed. Athletes, self-employed workers, and independent contractors should factor in lost earnings during the immediate post-operative period (typically 2–4 weeks unable to work) and the restricted-duty period (6–12 weeks with limitations). Some disability insurance or workers’ compensation may apply depending on the situation.

6. Budget for ongoing costs. Beyond immediate surgery and PT, plan for bracing ($300–$800), supplements or anti-inflammatories, and any additional PT sessions once insurance visits are exhausted. Some athletes continue private coaching or training with a sports performance specialist during return to sport, which is out-of-pocket.

The Bottom Line

ACL reconstruction is a significant financial investment. It’s also one of the most cost-effective surgical treatments in orthopedics when considering long-term outcomes. Patients who undergo surgery by an experienced ACL specialist have better functional outcomes, lower revision rates, and faster return to sport. That superior outcome translates to fewer complications, shorter recovery time, and a better chance of returning to the activities they love without restrictions.

Surgeon fees are standardized. The difference isn’t in the surgeon’s bill—it’s in the quality of the surgical technique, which significantly influences long-term outcomes. Better technique means fewer revisions, shorter rehabilitation, and less time away from work or competition. Studies show that the quality of the surgical procedure significantly influences outcomes at 20+ years post-operatively, particularly when pre-operative knee extension and meniscus status are optimized.

At Ochsner-Andrews Sports Medicine Institute, Dr. Burnham prioritizes transparency. He works with insurance to maximize coverage, provides detailed cost estimates upfront, and focuses on the long term rather than cutting costs in the short term. The investment in ACL reconstruction is also an investment in future athleticism and quality of life.

Patients with questions about cost, insurance, or financial planning for ACL surgery can contact Dr. Burnham’s office. The team verifies coverage, provides estimates, and discusses all options so patients move forward with confidence.

About the Author: Dr. Jeremy Burnham is a board-certified orthopedic surgeon and fellowship-trained sports medicine specialist at Ochsner-Andrews Sports Medicine Institute in Baton Rouge, Louisiana. With over 15 years of experience in ACL reconstruction and complex knee surgery, Dr. Burnham has helped hundreds of athletes from LSU student-athletes to professional competitors return to sport after ACL injury. His research on ACL biomechanics and rotatory knee laxity has been published in leading journals and presented at national conferences. He combines evidence-based surgical technique with a deep understanding of the athlete’s journey to optimize outcomes and minimize complications.

References

1. Shelbourne KD, Benner RW, Gray T. Results of Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autografts: Objective Factors Associated With the Development of Osteoarthritis at 20 to 33 Years After Surgery. Am J Sports Med. 2017. DOI: 10.1177/0363546517718827
2. Slawaska-Eng D, Svendsen C, Zhang E, et al. Substantial variability and inconsistent quality of publicly available rehabilitation protocols after quadriceps tendon anterior cruciate ligament reconstruction: A cross-sectional analysis of academic orthopaedic surgery programmes. J Exp Orthop. 2026. DOI: 10.1002/jeo2.70653
3. Blucher NC, Feller JA, Devitt BM, et al. Is There an Association in Young Patients Between Quadriceps or Hamstring Strength After ACL Reconstruction and Graft Rupture? Orthop J Sports Med. 2022. DOI: 10.1177/23259671221101003

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