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Total Shoulder Surgery Now Offered At St. Cloud Surgical Center Under Medicare

A win for us is a win for you! 

2024 marks a big year for total shoulder surgery. It is now covered by Medicare at outpatient facilities like St. Cloud Surgical Center. 

Our center is no stranger to joint replacement surgeries and the role Medicare plays for qualified individuals. We have been performing total joint replacements for decades.  While some patients may be better suited for, or even prefer, an inpatient setting, time and time again, we have seen the good that outpatient facilities can bring. 

To get the scoop on this new change to total shoulder surgery and what it means for our patients, we sat down with resident shoulder expert, Dr. Matthew Hwang. We discussed candidacy for total shoulder surgery, the perks of it being offered in an outpatient setting, and what one might expect when opting into this type of surgery. 

For over 20 years, Dr. Hwang has provided orthopedic services to patients in the St. Cloud Area. While he services all areas including knee, hip, and elbow, he has a special interest in total shoulder and reverse shoulder replacement surgeries. Thanks to a change in Medicare coverage, his practice is about to get a whole lot busier. 

Dr. Hwang approaches total shoulder replacement conservatively. Surgery is not always his go to answer. In fact, he believes most conditions can be treated through activity modification, physical therapy, medications (oral, topical, or injectable), and even non-traditional methods. However, for roughly 50,000 people in the United States each year, conservative methods are not enough and total shoulder surgery is the appropriate path forward.


Candidacy for Surgery

For Dr. Hwang specifically, there are a few elements he looks at when determining someone a good candidate for total shoulder surgery: 

  • Patient is in their mid-60s or older
  • Radiographic evidence of arthritis
  • Pain that is no longer responding to conservative treatments

In most cases, total shoulder surgery is an elective procedure and it is the patient’s decision to move forward with the operation. If a patient feels they have tried reasonably conservative treatment, yet, their shoulder is not getting to where it needs to be, surgery would be the next step. When a patient comes to this decision, Dr. Hwang recommends they prepare themselves by talking with their surgeon, and anyone in their network who has had similar surgery. Preparation is the key to success! 

Speaking of success, the success rate for total shoulder surgery is incredibly high. Dr. Hwang reports that up to 95% of patients will see significant pain improvement after a shoulder replacement, along with improvements in both range of motion and strength. After 2 weeks patients report less pain and by week twelve, there is a clear difference. For many patients, this surgery really does mean the chance at living a better, more healthy life.


Medicare Now Covering Total Shoulder Surgery 

Total shoulder replacements have always been covered by Medicare, however, until recently, they could only be done in a hospital setting. However, with total shoulder replacements becoming more prevalent, there was a need for change. It was no longer sufficient to only offer this procedure for qualified candidates at an inpatient setting. 

Outpatient total shoulder surgery has a number of benefits and is a preferred method for restoring mobility and alleviating pain for qualified candidates with arthritis in their shoulder by many providers. It’s easy to see why outpatient should be considered a standard practice of care for orthopedic surgeries. 

Benefits of Out-Patient Surgery Settings

  • Cost Effective 
  • Case-By-Case Approach
  • One-On-One Care Team
  • Access to Physical Therapy Sooner
  • Faster Recovery Time While At Home

Perhaps, the largest benefit of having your surgery at the St. Cloud Surgical Center is the people, just ask Dr. Hwang. 

“What I enjoy most about working here is the people, they are special. Really unique. No matter the role, everyone helps to make this place run. From the admitting nurses who see the patients to the anesthesiologist who work hard to get the blocks right, they all play a part. All members of our staff are imperative for making a positive patient experience.”

To find out if you qualify for Medicare coverage, contact your provider directly. If you are curious about potential surgery costs under your Medicare plan, you can visit their Procedure Price Lookup site. 

SOURCES:

Physician Focus: Dr. Matthew Hwang MD

CMS ASC Covered Procedures

BeckersAsc.com: Shoulder Replacements Added to ASC Payable List