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How Much Does Spinal Fusion Surgery Cost in Australia?
How Much Does Spinal Fusion Surgery Cost in Australia?
Written by
Madeline Pettet
Edited by
Ellie Garran
Reviewed by
Andres GutierrezCompare Health Insurance Policies
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What is spinal fusion surgery?
Long story short
Spinal fusion surgery is usually part of a larger back operation to relieve pressure on nerves
It’s often a last resort if other treatments haven’t helped, like seeing a physio or following a pain management plan.
As a public patient, Medicare handles the costs of your spinal fusion surgery
You might have a long wait to be seen, though.
Private health insurance could also help pay your spinal fusion surgery costs
You can also enjoy perks like choosing your doctor, having the possibility of a shorter wait, and potentially getting a private hospital room.
What is spinal fusion surgery?
Your vertebrae gives your back its flexibility. But like pinching your finger in the car door, nerves in your spine can get pinched between your vertebrae. This can be extremely painful and have some major effects on your wellbeing, like leg weakness and trouble with toileting control.
Spinal fusion surgery is a pretty nifty way of helping relieve pressure on nerves in your spine, plus keep your spine a little more stable. Your surgeon – either an orthopaedic specialist or neurosurgeon – will use a bone graft or medical-grade screw or rod to encourage two or more vertebrae in your spine to grow together, becoming a single bone.
Spinal fusion surgery is usually done at the same time as another type of spinal surgery – a decompression surgery – that also helps to free those nerves. For instance, you might have a laminectomy, where your surgeon removes parts of your vertebrae. The laminectomy and spinal fusion give your affected nerves a little more room to breathe, so they hopefully don’t get squished again.
But spinal fusions are hardly a surgeon’s bread and butter. This surgical procedure is reserved for back pain caused by serious conditions like traumatic injuries, infections, or cancer; if your spine is seriously unstable; or if the nerves in your back are so compressed that it’s led to big concerns like problems controlling your bladder. Sometimes, kids with scoliosis who’ve had no luck with other treatments might also have it.
Put simply, surgery is generally a last resort when pain has become chronic and nothing else has helped. In most cases, minimally invasive methods, rather than surgery, can be just what the doctor ordered. Think things like seeing the physio or an exercise physiologist, and/or putting together a pain management plan with your health care team. Sometimes, looking after your physical and mental health can be enough to send back pain packing – and cost a lot less than back surgery.
How much does spinal fusion surgery cost?
The average cost of spinal fusion surgery ranged from $9,717 to $18,736 for private hospital patients in 2023–24, according to the Department of Health, Disability and Ageing. Of course, your spinal fusion costs, including out-of-pocket expenses, all depends on your situation.
Does Medicare cover spinal fusion surgery?
Medicare can cover the cost of your spinal fusion surgery if you use Australia’s public health system. This means you’re a public patient admitted to public hospital.
Does health insurance cover spinal fusion surgery?
In 2023–24, health insurance covered, on average, between $3,150 and $6,722 for private patients’ spinal fusion surgery, according to the Department of Health, Disability and Ageing. How much your insurer covers depends on your policy and your circumstances.
If you’re a private patient, Medicare will pay for some of your surgery costs, specifically 75% of the Medicare Benefits Schedule (MBS) item fee. If you have health insurance, your insurer will pay the remaining 25% of the MBS fee. However, doctors are allowed to charge more than the MBS fee in the private system. This could mean you have out-of-pocket costs for your spine surgery.
Since spinal fusion tends to be part of a bigger surgery and there’s a lot of variation in complexity, it’s hard to say exactly what your out-of-pocket costs could be (or even which MBS item numbers apply). However, the table could give you an idea of what to expect to be covered and what you’ll need to pay based on the average fees in 2023–24. These fees are just for the surgery itself, with hospital fees counted separately – more on that below.
For something more concrete, you’re well within your rights to ask for a quote from your doctor before surgery.
Average intermediate complexity spinal fusion costs for private patients
| Medical fee | $12,016 |
| Medicare paid | $5,208 |
| Insurers paid | $4,056 |
| Patients paid | $3,176 |
Source: Department of Health, Disability and Ageing – Hospital Casemix Protocol Annual Report
Note: These are the amounts patients paid, on average, this service, rounded to the nearest dollars. The paid amounts do not add up to the total average medical fee as dollar amounts are the averages for that dataset only. They do not include hospital payments such as excesses, co-payments, or other payments. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in the relevant figures. Data retrieved January 2026.
To avoid out-of-pocket surgery expenses, you can look for a doctor who has an agreement with your health fund. This means that if your doctor agrees to participate there’ll either be no gap for you to pay or a known gap you can start preparing for before your surgery.
Even with a gap, many people opt to use the private system, since it comes with additional benefits. For instance, you choose your treating doctor. This can help you feel more in control during a difficult time and give you greater confidence in your surgery.
Additionally, you might have a private room as a private patient. Depending on your situation, you might need to stay in hospital for a few days to a week or more. Having a private room could make those initial first days of recovery more comfortable.
Helpful tip
A private room isn’t a guarantee as a private patient. It depends on what’s available at your chosen hospital.
To avoid disappointment, you can ring the hospital ahead of your admission and request one. If one isn’t available, they might have a deal with your insurer for another perk, like some money back on your stay.
Andres Gutierrez
General Manager – Health
Are there other out-of-pocket costs for spinal fusion surgery?
Along with surgical treatment costs, you’ll have hospital costs for your surgery, like for accommodation, medication and dressings, and even the operating theatre your surgery was in. Thankfully, private health insurance can help cover these costs, too.
For people who had an intermediate complexity spinal fusion in 2023–24, the average hospital costs were $39,723, with an average gap of $702.
You can try to minimise this gap by picking a private hospital your health fund has an agreement with – you’ll need to ensure your chosen doctor works there, too!
Even so, you might have a gap written into your health insurance, just under a different name: an excess and/or co-payment.
Your excess is an amount that you agree to pay towards the cost of your hospital treatment in exchange for lower premiums. You usually pay it when you’re admitted as an inpatient to hospital.
You pick your excess when you take out your hospital cover. Don’t worry if your excess amount has slipped your mind; you can refresh your memory by taking a look at your policy documents.
A co-payment is the ‘fun-sized’ version of an excess. It’s a smaller payment you make for each day you’re in hospital. Since it might be a few days before you’re ready to go home after your surgery, you might need to make a few co-payments.
Are there ongoing or additional costs for spinal fusion surgery?
Spinal fusion surgery is an intensive surgery; everyone’s recovery is different, including how successful they find surgery.
If you’re still experiencing pain or have nerve compression issues, you might need a spinal fusion revision. Essentially, your surgeons get back in there and tidy things up further.
Complications like nerve injuries are also a possibility. These, too, could mean revision surgery and another hospital stay.
However, assuming all goes well, a physiotherapist will visit you before you head home. They’ll personalise an exercise program to get you moving safely.
Once you’re back at home, you’ll likely touch base with your physio to keep track of your progress and adjust your physical therapy accordingly. Your private health insurance could help cover these appointments.
If you’re seeing the physio as an outpatient, your hospital insurance might handle the costs. Otherwise, physiotherapy might be included on your extras cover. How much is covered depends on your policy.
Along with catching up with the physiotherapist, you’ll need another check-in with your surgeon, too. Your health insurance can’t help pay for this follow-up appointment, but you can still get a Medicare rebate. Your out-of-pocket cost will be the difference between what Medicare pays and your specialist charges.
How long will I have to wait for spinal fusion surgery?
Like the overall cost of your spinal fusion surgery, your wait depends on your circumstances.
For instance, in the public system, spinal fusion surgery is usually treated as either semi-urgent or non-urgent, depending on your symptoms. Semi-urgent patients are meant to be seen within 90 days, while non-urgent patients need to be seen within 365 days. But your wait can be longer than these guidelines. It depends on the public waitlist and resources available.
However, you might have a much shorter wait as a private patient. The chance of being seen sooner is another perk of going private. Given that chronic back pain can seriously impact your quality of life, from restricting your mobility to nosediving your mood, it’s understandable to want surgery sooner.
You’ll need to keep in mind any waiting periods you have attached to your hospital cover. If it’s your first policy, you’ve gone without cover for a while, or you’ve upgraded recently, you’ll need to hold your policy for a while before you can start claiming. Usually, your waiting period is at most two months. However, if your back problems were around before you got your cover, and therefore a pre-existing condition, your wait might be as long as 12 months.
What level of health insurance covers spinal fusion surgery?
For hospital insurance, the clinical category to look for is back, neck, and spine covers spinal fusion surgery. By default, all silver and gold tier hospital policies include this cover.
You might find it offered on bronze plus policies. It might also be on a basic plus policy, but this cover will come with restrictions.
Where can I find and compare health insurance?
If you’re already feeling stretched thin, adding finding health insurance to your to-do list can feel like the straw that broke the camel’s back. But iSelect can help. Speak with one of our health insurance comparison experts on 1800 784 772 to compare a range of health insurance from different providers. Or you can use our online comparison tool right now.
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