Just got the bill for my 52 minutes in the Cath Lab 3 weeks ago for the angioplasty procedure on my right leg.
The bill was $25,506.37. This is the number you are familiar with under the pre-age-65, unlimited price gouging model for healthcare.
Medicare Reimbursement cut that to $7,072.36
My piece of it was $1,414.48 – just 5.5% of $25,506 that was billed. And note that all the work was done as an outpatient under Medicare Part B. My out of pocket would have been much lower if I was admitted to a hospital and most of the charges fell under Part A.
I feel fine. But my ability to walk pain free has only increased to about 800 ft, up from 200 ft just prior to the angioplasty procedure.
I’ve measured out a 200 ft track adjacent to my home and I walk that 4 or 5 times a day to the point where I can’t tolerate the pain (currently about 1,300 ft.) Then I return home and elevate the leg for 10 or 15 minutes to relieve the pressure.
I don’t have any problem walking around the house or up and down stairs. It just looks like it’s going to take a while before I return to walking 5 or 6 miles/day.
True…but something of a moot point in that there was presumably no actual reason for a hospital admission. Free to you…but much higher bills, and ultimately with a much higher write-off to the hospital. Which then causes one to ponder how long before hospitals begin to withdraw from participating in traditional Medicare as is happening with Medicare Advantage
Yes, I’ve been wearing compression stockings on my right leg since 2020 when my doctors were thinking the problem was superficial venous insufficiency (i.e., varicose veins.)
Unfortunately, compression stockings aren’t a cure for a “decades old calcified aneurysm” in the popliteal artery.
That depends. The vascular specialist is still evaluating whether there is less risk in leaving the calcified aneurysm in my leg, or whether to remove it – there is still a risk it could leak or burst along the margin where the calcified mass meets healthy arterial tissue.
An open leg surgery would mean 2 or 3 days in the hospital.
It’s also interesting to note that this is a physician-owned outpatient facility where Portland Hospital is cut out of the action and they keep all the revenue in house. They have 5 offices in the more rural areas of Oregon where Medicare Reimbursement rates are higher. Since this office was a 34 mile drive from my home, I suspect it is located just outside the urban boundary where the higher reimbursement rates apply.
Went to see vascular specialist today for 1-month check up on the angioplasty procedure of my right leg.
I’ve been disappointed in the pace of my recovery (at best I can only walk about 500 ft pain-free with a normal gait), and in the past week I been waking up with a slight discomfort in the right foot, indicating that blood flow is becoming compromised. I can still get relief from the pain by elevating the leg for 5 or 10 minutes, so it’s not an emergency.
The ultrasound imaging they did today revealed that the 1" diameter calcified aneurysm just above my knee had prolapsed (i.e., shifted position) and was again pressing on the artery restricting blood flow. The doctor hadn’t yet seen the ultrasound but his nurse practitioner told me that I’d likely need a second intervention either a stent angioplasty or an open leg surgery to repair the aneurysm. I’ll do a video call with the surgeon later on in the week to discuss options.
From what I’ve read today, neither is a particularly good choice. A stent can buckle or wear out with the flexing of the knee, that’s the reason they first try the balloon angioplasty in the hope that they can solve the problem without a stent. And there is risk in doing an open surgery on a limb with compromised blood flow since that makes healing and recovery from the surgery problematic.
Yes for the artery they’re doing the repair on, but my leg has been suffering from compromised circulation for 25 years. The surgery would have a better chance of success if the whole leg was healthy.
It takes a while for new pathways of blood flow to emerge after an angioplasty. The 3 arteries they ballooned just below the knee are in good shape and the color of my right foot has improved. (It was deep purple in the days before the angioplasty.) Maybe the solution is to do the stent, hope it lasts for 6 months or a year, and bet that the blood flow along the whole leg improves enough to reduce the risk of the open leg surgery?
I guess I’ll have the recommendation by week’s end.
