Fair Square Medicare Wordmark

Does Medicare Cover SI Joint Fusion?

Caucasian nurse holding spine model against the patients backs. Clinic interior. stock photo
By Daniel Petkevich
Nov 28, 2022

Medicare has your back

Your sacroiliac joint, or SI Joint, is one of the more overlooked parts of the body that can cause unexpected pain. If you are experiencing pain, an SI joint fusion is one of the more popular new procedures in relieving this pain. The good news is you'll have Medicare coverage if you need it.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

What is sacroiliac joint dysfunction?

Sacroiliac joint dysfunction is an issue caused by a misalignment of the sacroiliac joints in your lower back. These joints connect your spine and pelvis together, and when they become inflamed or irritated, it can cause pain, stiffness and limited mobility.

What is SI joint fusion surgery?

SI joint fusion is a surgery used to treat chronic pain caused by sacroiliac joint dysfunction. The aim of the surgery is to eliminate movement in the area and provide long-term pain relief. During SI joint fusion, the surgeon will remove damaged bone from the affected area and replace it with a grafting material, such as metal implants or donor bone. In some cases, screws and rods may be used to hold the bones in place.

What are the risks and benefits of SI joint fusion surgery?

SI joint fusion surgery carries some risks, including infection, nerve injury and blood clots. Patients should discuss the risks with their doctor before undergoing this procedure to make sure they understand what they are getting into.
The benefits of SI joint fusion surgery include long-term relief from chronic pain and improved mobility in the area. Many patients who undergo SI joint fusion report a marked improvement in their quality of life.

How does Medicare cover SI joint fusion surgery cost?

Medicare covers SI joint fusion in certain circumstances. Generally speaking, Medicare Part B will provide coverage for SI joint fusion if it is deemed medically necessary by your doctor and is performed by an approved healthcare provider. Medicare will pay 80% of the fee if it's done in an outpatient facility. On average, you can expect to pay $1,728 in out-of-pocket costs,

according to Medicare.gov

. You could get more coverage on out-of-pocket costs if you have a

Medicare Supplement Plan G

.

How to know if you need SI joint fusion surgery?

The best way to know if you need SI joint fusion surgery is to consult with your doctor. Your doctor can help you determine whether or not this procedure is the right option for you and discuss any other treatment options that might be available.

What happens after surgery?

After SI joint fusion surgery, your doctor will likely recommend a period of rest and physical therapy. It may take some time for the area to heal fully; however, many patients report improved mobility and pain relief after undergoing this procedure.

Alternatives to SI joint fusion surgery

SI joint fusion surgery isn't the only option for treating sacroiliac joint dysfunction. Other treatment options may include physical therapy, medications, and lifestyle changes such as diet and exercise. In some cases, these non-surgical treatments can provide significant relief.

Takeaway

SI joint fusion is a surgery used to treat chronic pain caused by sacroiliac joint dysfunction. Medicare Part B typically covers this procedure when it is deemed medically necessary. Before undergoing SI joint fusion, you should talk to your doctor about the risks and benefits of the procedure to see if it's right for you. This content is for informational purposes only. If you have any questions about your Medicare plan, give us a call to speak with a Medicare expert today.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Abortion stock image
Does Medicare Cover Abortion Services?
Dec 13, 2022
Happy senior man and dentist assistant talking during appointment at dental clinic. stock photo
Finding the Best Dental Plans for Seniors
Jan 4, 2023
Closeup of a male Doctor or physiotherapist doing stretching for a patient in the clinic for examining treating injured of back stock photo
Does Medicare Cover Chiropractic Visits?
Dec 22, 2022
wart on the sole of a white man's foot stock photo
Does Medicare Cover Wart Removal?
Jan 17, 2023
Diagnosis incontinence stock image
Does Medicare Cover Incontinence Supplies?
Dec 22, 2022
senior man holding up his medicare card stock photo
Everything About Your Medicare Card + Medicare Number
May 12, 2022
senior gentleman wearing a suit working on his laptop outside of his office stock photo
How Your Employer Insurance and Medicare Work Together
Sep 27, 2022
Cover image
Medicare Deductibles Resetting in 2024
Jan 18, 2024
Human hands holding healthy lung shape made from paper on light blue background. stock photo
How Much Does Trelegy Cost with Medicare?
Jan 24, 2023
plastic surgeons standing over a patient stock image
Does Medicare Cover Cosmetic Surgery?
Nov 28, 2022
Senior couple going over their finances in front of a computer stock image
How Much Does Medicare Part B Cost in 2023?
Dec 27, 2022
Doctor demonstrating upper cervical spine anatomy stock photo
Does Medicare Cover Cervical Disc Replacement?
Jan 20, 2023
Orthopaedist at work treating a bunion, stock photo
Does Medicare Pay for Bunion Surgery?
Nov 29, 2022
Cover image
Health Savings Accounts (HSAs) and Medicare
Jan 24, 2024
elderly woman with glasses having difficulty reading her phone stock image
Is Vitrectomy Surgery Covered by Medicare?
Dec 2, 2022
Sinusitis. stock illustration
Is Balloon Sinuplasty Covered by Medicare?
Dec 1, 2022
SIBO (small intestinal bacterial overgrowth) symptoms stock photo
Does Medicare Cover SIBO Testing?
Dec 1, 2022
woman sitting on sofa feeling pain in her foot at home stock photo
Does Medicare Cover Qutenza?
Jan 13, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Indianapolis

13 Best Ways for Seniors to Stay Active in Philadelphia

13 Best Ways for Seniors to Stay Active in Phoenix

2024 "Donut Hole" Updates

Are Medicare Advantage Plans Bad?

Building the Future of Senior Healthcare

Can I Change Medicare Advantage Plans Any Time? | Medicare Plans

Can I Change My Primary Care Provider with an Advantage Plan?

Can I Choose Marketplace Coverage Instead of Medicare?

Can I Laminate My Medicare Card?

Costco Pharmacy Partners with Fair Square

Do I Need Medicare If My Spouse Has Insurance?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover Boniva?

Does Medicare Cover Cala Trio?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover COVID Tests?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Flu Shots?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hoarding Cleanup?

Does Medicare Cover Ilumya?

Does Medicare Cover Inqovi?

Does Medicare Cover Jakafi?

Does Medicare Cover Ketamine Infusion for Depression?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Nuedexta?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Ozempic?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover Physicals & Blood Work?

Does Medicare Cover PTNS?

Does Medicare Cover Scleral Lenses?

Does Medicare Cover the Urolift Procedure?

Does Medicare Cover Vitamins?

Does Your Plan Include A Free Gym Membership?

Explaining IRMAA on Medicare

Explaining the Different Enrollment Periods for Medicare

Fair Square Bulletin: We're Revolutionizing Medicare

Fair Square Client Newsletter: AEP Edition

Finding the Best Vision Plans for Seniors

How Are Medicare Star Ratings Determined?

How Much Does a Pacemaker Cost with Medicare?

How Much Does Xeljanz Cost with Medicare?

How to Become a Medicare Agent

How to Deduct Medicare Expenses from Your Taxes

How to Enroll in Social Security

Is Displacement Affecting Your Medicare Coverage?

Is Gainswave Covered by Medicare?

Is HIFU Covered by Medicare?

Is PAE Covered by Medicare?

Medicare Advantage MSA Plans

Medicare Supplement Plans for Low-Income Seniors

Medigap vs. Medicare Advantage

Saving Money with Alternative Pharmacies & Discount Programs

The Fair Square Bulletin: August 2023

The Fair Square Bulletin: January 2024

The Fair Square Bulletin: July 2023

The Fair Square Bulletin: June 2023

The Fair Square Bulletin: October 2023

The Fair Square Bulletin: September 2023

What Happens to Unused Medicare Set-Aside Funds?

What If I Don't Like My Plan?

What is a Medicare Beneficiary Ombudsman?

What People Don't Realize About Medicare

What to Do When Your Doctor Doesn't Take Medicare

What's the Deal with Flex Cards?

What's the Difference Between HMO and PPO Plans?

When to Choose Medicare Advantage over Medicare Supplement

Will Medicare Cover it?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2024

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2024 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M