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. 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 navigate the financial side of ACL surgery, balancing coverage, deductibles, and planning for the full cost of recovery. The good news is that understanding these costs upfront gives patients the clarity to make decisions with confidence.

In this guide, we break 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. The goal is to demystify the process so 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, and the cost reflects multiple components. Understanding what patients are paying for helps clarify where differences in price come from and why some practices charge more or less than others.

Facility fees. This is typically the largest component of ACL surgery cost. Facility fees cover operating room time, nursing staff, equipment sterilization, anesthesia support, and post-operative monitoring. Where surgery takes place matters: hospital-based surgery generally carries higher facility fees than outpatient surgical centers. However, quality and accreditation should always be the priority over price. At a major health system like Ochsner, facility fees reflect the resources, safety infrastructure, and staffing that support excellent surgical outcomes.

Surgeon fees. Contrary to what many patients expect, surgeon fees are typically the smallest component of the total cost of ACL reconstruction. Surgeon reimbursement rates are largely standardized and set by insurance companies and CMS (Centers for Medicare and Medicaid Services). They do not vary significantly based on a surgeon’s experience, fellowship training, or outcomes. A fellowship-trained ACL specialist with decades of experience and a documented track record of superior outcomes is reimbursed at essentially the same rate as a general orthopedic surgeon doing occasional ACL cases. This is one of the realities of the current healthcare system. The value of choosing the right surgeon shows up not in the surgeon’s fee, but 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 and is safer and more effective for pain control than general anesthesia alone. These fees are separate from surgeon and facility costs.

Graft materials. The graft choice (autograft using the patient’s own patellar tendon, hamstring, quadriceps tendon, or donated allograft tissue) impacts cost. Allograft tissues come from a tissue bank and include tissue processing, testing, and sterilization costs. Autografts avoid these tissue bank fees but may increase operative time or require additional imaging. Learn more about graft options and outcomes in ACL reconstruction techniques.

Imaging and diagnostics. MRI scans to confirm the tear, X-rays, and sometimes CT scans if patients have complex anatomy or are undergoing revision surgery are billed separately. Some of these costs may be incurred before surgery as part of the 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 an independent therapist. This is often the largest out-of-pocket component for patients, even with insurance. For more on ACL surgery and what to expect, see ACL reconstruction and ACL surgery.

Average Cost Ranges

ACL surgery costs vary significantly by region, facility type, surgeon experience, and insurance coverage. Rather than citing specific dollar amounts that may be outdated, this guide offers a realistic framework for understanding the ballpark figures patients typically encounter.

Without insurance. The total cost of ACL reconstruction, including facility fees, surgeon fees, anesthesia, and graft materials, typically ranges from moderate to substantial depending on whether surgery is at an outpatient surgical center or a hospital-based facility. Facility fees represent the largest portion of the total, while surgeon fees, which are standardized by insurance and CMS, make up the smallest share.

With insurance. If patients have commercial insurance, out-of-pocket cost depends entirely on the plan’s deductible, copay structure, and whether the facility and surgeon are in-network. Most patients with good insurance plans pay their deductible (usually $500-$2,500) plus any copays for PT and follow-up visits. The insurance company then covers the majority of the remaining costs at negotiated rates.

Louisiana and Baton Rouge context. Healthcare costs in Louisiana and the Baton Rouge area are generally in line with the national average, sometimes slightly lower than in major metropolitan areas. Ochsner Health, as a large regional health system, often 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, it is essential to check with the 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 is a critical point: unlike cosmetic procedures, most commercial insurance plans, Medicare, and Medicaid recognize ACL reconstruction as essential treatment, not elective surgery. This means 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 handles this process. They submit imaging, surgical notes, and medical justification to the insurance company, and the insurer approves the procedure before the patient comes in. This protects patients from surprise denials and gives confidence that insurance is committed to covering the cost.

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

Deductibles and copays. The insurance plan specifies a deductible (the amount patients pay 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 may have separate deductibles for professional services vs. 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 may require pre-authorization. High-deductible plans may require patients to meet their deductible for PT as well, meaning the first PT 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 is what to budget for:

Physical therapy copays. At 16-24 weeks of PT with 2-3 visits per week, patients could 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 patients face. Ask the insurance company about visit limits and whether they cap PT deductibles separately from medical deductibles.

Bracing and support equipment. A custom or functional knee brace post-operatively ($300-$800) is often recommended during the first few months and then during return to sport. Some insurance plans cover this if the brace is prescribed as medically necessary; others do not. 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 (often $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, but 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 does not cover lost income, it is part of overall financial planning.

Does Graft Choice Affect Cost?

Yes, graft choice does impact the overall cost, but it should not be the primary factor in the decision. Here is the breakdown:

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

Allograft (donated tissue). Allograft tissue is processed, tested for disease, and sterilized by a tissue bank. These costs are passed on to patients, typically adding $2,000-$5,000 to the total procedure cost. However, 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 option that is 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 because there are no additional tissue bank fees. Increasingly, academic orthopedic programs are developing standardized rehabilitation protocols for quadriceps tendon grafts to optimize recovery.

The right graft is the one that best matches the patient’s anatomy, activity level, and any prior surgeries. Cost should be one factor, but not the decision-maker. Insurance usually covers all graft options at the same benefit level, so the cost difference is often not as large as patients might think once insurance negotiation is applied.

How to Prepare Financially

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

2. Understand deductible status. Check how much of the deductible has already been met this year. If it is early in the calendar year and the deductible has not been met, consider timing surgery to maximize benefits across two calendar years (e.g., December surgery carries deductible into January). Conversely, if the deductible has already been met, timing surgery soon maximizes insurance coverage.

3. Ask about payment plans. Most surgical facilities and independent PT practices offer payment plans for out-of-pocket costs. Do not hesitate to ask. Many accept CareCredit or similar healthcare financing options that allow spreading costs over months.

4. Get a pre-operative cost estimate. Dr. Burnham’s office can provide a detailed breakdown of what the surgeon, facility, and anesthesia typically cost. Combined with insurance verification, this gives a realistic total-cost estimate.

5. Plan for lost income if self-employed. If patients are an athlete, self-employed, or independent contractor, 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 the 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, but it is 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 compared to those who have surgery elsewhere. That superior outcome translates to fewer complications, shorter recovery time, and a better chance of getting back to the activities patients love without restrictions.

From a financial perspective, choosing the right surgeon and facility makes a significant difference in long-term costs, even though surgeon fees themselves are standardized. Better surgical technique means fewer revisions, shorter rehabilitation, and less time away from work or competition. Long-term studies have demonstrated that the quality of the surgical procedure significantly influences outcomes at 20+ years post-operatively, particularly when factors like pre-operative knee extension and meniscus status are optimized.

At Ochsner-Andrews Sports Medicine Institute, Dr. Burnham believes in transparency. He works with insurance to maximize coverage, provides detailed cost estimates upfront, and does not rush patients through recovery to cut costs. The investment in ACL reconstruction is also an investment in future athleticism and quality of life.

If patients have questions about cost, insurance, or financial planning for ACL surgery, Dr. Burnham’s office is here to help. The team can verify coverage, provide estimates, and discuss 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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