Orthopedic Surgery FAQs | ATX Orthopedics Austin, TX
1. Does my insurance pay for out-of-network surgery in Texas?
Answer: Under the Texas No Surprises Act and HB 3359, many state-regulated health plans (look for the “TDI” or “DOI” logo on your card) are required to apply your out-of-network cost-sharing directly toward your in-network deductible and out-of-pocket maximum. This means you can choose a specialist at ATX Orthopedics without being penalized by a separate, higher deductible. We provide a Good Faith Estimate before every procedure to ensure total pricing transparency.
“Check your card for the TDI logo.” > If you see “TDI” (Texas Department of Insurance) or “DOI” (Department of Insurance) printed on your card, your plan is state-regulated. This means you are protected by Texas laws that require your insurance company to apply out-of-network surgery payments toward your in-network deductible.
2. Can I have a total knee or hip replacement and go home the same day?
Answer: Yes. Dr. Sean Gallagher specializes in outpatient total joint replacement. By using minimally invasive techniques—such as the SuperPATH hip approach and quad-sparing subvastus knee approach—we avoid cutting major muscles and tendons. This “muscle-sparing” philosophy allows most healthy patients to recover comfortably at home rather than in a hospital, significantly reducing the risk of infection and speeding up mobility.
3. What makes the “SuperPATH” hip replacement different?
Answer: The SuperPATH technique is a tissue-sparing approach that allows the surgeon to perform a hip replacement without ever dislocating the hip or cutting the supporting muscles and tendons. Unlike traditional surgery, there are typically no “hip precautions” or activity restrictions after surgery. This results in a more natural-feeling hip and a faster return to daily activities for our Austin patients.
4. What hand and nerve conditions does Dr. Benjamin Amis treat?
Answer:Dr. Benjamin Amis is a fellowship-trained specialist in hand and upper extremity surgery. He provides advanced treatment for carpal tunnel syndrome, trigger finger, tennis elbow, and cubital tunnel syndrome. Using microsurgical and minimally invasive techniques, he focuses on relieving nerve compression (such as the median and ulnar nerves) to restore grip strength and eliminate numbness.
5. Do I need surgery for my knee or shoulder pain?
Answer: Surgery is always our last resort. At ATX Orthopedics, we provide a comprehensive range of non-surgical treatments including regenerative medicine injections, physical therapy coordination, and customized bracing. We use advanced imaging to determine if your injury—such as a meniscus tear or rotator cuff strain—can be managed biologically without an operation.
6. How much does knee replacement surgery cost in Austin, TX?
Answer: At ATX Orthopedics, the all-inclusive self-pay price for a total knee replacement in Austin is $21,500 — bundled to include the surgeon fee, Pinnacle Surgery Center facility fee, implants, anesthesiologist, and 90 days of post-operative care. For patients using insurance, we can provide a Good Faith Estimate before your procedure so you know your out-of-pocket cost in advance. View our full surgical bundle pricing or contact us to discuss your insurance benefits.
7. How much does ACL surgery cost in Austin, TX?
Answer: Our self-pay bundle for ACL reconstruction (allograft) in Austin is $15,500 — all-inclusive covering surgeon, surgery center, implant, anesthesia, and 90 days of follow-up care. Patients using insurance with out-of-network benefits may have this applied toward their in-network deductible under Texas law. Dr. Sean Gallagher performs outpatient ACL surgery at Pinnacle Surgery Center of Austin, typically allowing same-day discharge. See all procedure pricing.
8. Is self-pay cheaper than using insurance for orthopedic surgery in Austin?
Answer: For many patients, especially those with high-deductible health plans, self-pay can actually be less expensive than going through insurance. When you use insurance at an in-network hospital system, you may still owe your full deductible — often $3,000–$7,000 — plus facility and anesthesia co-insurance charges added on top. Our all-in surgical bundles include every fee upfront with no surprise bills. We recommend comparing your estimated out-of-pocket cost through insurance against our self-pay bundle price before deciding.
9. Can I use my insurance at ATX Orthopedics even if you are out-of-network?
Answer: Yes. ATX Orthopedics accepts Aetna, Anthem BCBS, Cigna, UnitedHealthcare, and Medicare (non-participating), among others. For plans where we are out-of-network, many Texas-regulated plans (those with a TDI or DOI logo on your card) are required under HB 3359 to apply your out-of-network payments toward your in-network deductible. We provide a Good Faith Estimate before every procedure and can help you understand your benefits before scheduling. Contact our office with questions about your specific plan.
10. Why choose ATX Orthopedics over a large hospital system in Austin?
Answer: Large hospital systems in Austin — like Ascension or Seton — employ mid-level providers (nurse practitioners and physician assistants) who often handle the majority of patient visits and surgical decisions. At ATX Orthopedics, every visit, every surgical decision, and every procedure is performed directly by your board-certified surgeon. You will never be handed off to a PA or NP. Our Austin surgery center scheduling is also significantly faster — most patients are seen and scheduled within weeks, not months. We provide transparent pricing before surgery, shorter recovery times with minimally invasive techniques, and direct access to your surgeon throughout recovery.
