Rotator cuff surgery

Learn about the surgical procedure, costs and recovery for rotator cuff surgery.

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What is rotator cuff surgery?1

The rotator cuff is a group of muscles and tendons that attach your arm to your shoulder blade.

Rotator cuff surgery is a surgical procedure that can repair the two most common types of rotator cuff injury:

  • Rotator cuff tear — often caused by lifting heavy objects or falling.
  • Rotator cuff degeneration — caused by age, wear and tear, and genetic factors.

This surgery is performed in hospital under general anaesthetic (you’ll be asleep) and takes 45 minutes to an hour.

The surgery can reduce pain and improve shoulder movement – but it’s usually only considered if other treatments are not helping.

Rotator cuff surgery is performed by an orthopaedic surgeon.

Medical terms for this procedure include ‘rotator cuff surgery’ or ‘rotator cuff repair’.

Woman with signs that she may need rotator cuff surgery

Signs you might need rotator cuff surgery2

Rotator cuff surgery is usually only considered if lifestyle changes, medicines and other treatments like physiotherapy are not helping.

Here are some signs that you may need rotator cuff surgery:

  • Pain and tenderness at rest and at night, particularly if lying on the affected shoulder.
  • Pain or weakness when lifting and lowering your arm or with specific movements.
  • A crackling sensation when moving your shoulder in certain positions.

Shoulder pain can be caused by many different things, so you should see a doctor and get a proper examination before assuming you have a rotator cuff injury.3

Alternatives to rotator cuff surgery2

  • Physiotherapy
  • Rest
  • Limiting overhead activities
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Strengthening exercises
  • Steroid injection
A woman getting physio treatment as an alternative to rotator cuff surgery
A man recovering from rotator cuff surgery who is playing tennis

Rotator cuff surgery recovery1

Most patients leave hospital one day after rotator cuff surgery, but it can take up to a year to regain the strength to use your shoulder normally again.

Here are some things to keep in mind during your recovery:

  • Seeing a physiotherapist and doing the recommended rehabilitation exercises can help speed up recovery.
  • Regular exercise can help you to return to normal activities as soon as possible.
  • You may not get back the same strength that you had before you damaged your shoulder.

Getting rotator cuff surgery at a public vs private hospital

It’s important to understand how getting your procedure in a public or private hospital differs.

Question
Public system (Without health insurance)
Private system (With health insurance)

Will I avoid public hospital waiting lists?

  • No.
  • Yes.

Will I be able to choose my hospital?

  • No.
  • Yes.

Will I be able to choose my doctor or surgeon?

  • No.
  • Yes.

Will I have out-of-pocket costs?

  • No.
  • Yes.

What is the cost of rotator cuff surgery?

In a public hospital

In a public hospital, rotator cuff surgery is covered by Medicare for eligible residents.

Once you are discharged from hospital, you may still need to pay out-of-pocket for things like medicines and health services (like physiotherapy or occupational therapy).

In a private hospital, using health insurance

In a private hospital, private health insurance can cover some costs of rotator cuff surgery.

You may have an out-of-pocket cost if you use private hospital cover when you get treatment. You can minimise some of these costs by choosing a hospital and specialist that have agreements with your health insurer.

If you have an excess on your cover, you will have to pay for that out of pocket.

What is hospital excess?

What is an out-of-pocket cost?

How to find health cover for rotator cuff surgery

Minimise your costs

Ask your GP for an open referral

Your GP is the one who’ll most likely refer you to a specialist – but you may want the option to choose your own specialist.

Asking for an open referral can let you:

  • Choose your own specialist.
  • Find a specialist with good availability who can perform treatment at the hospital you prefer.
  • Find a specialist that you trust to perform your surgery.
  • Find a specialist with minimum out-of-pocket expenses for you.

Find a surgeon with minimum out-of-pocket costs

To find orthopaedic surgeons who have an agreement with HBF, just search for ‘orthopaedic surgeon’ in our find a provider tool.

  • Look for the “Full Cover” tick mark or “Access Gap Cover” tick mark.
  • These specialists will help minimise your out-of-pocket cost.

Find a Provider

If you’ve already started working with a specialist

If you’ve already got a specialist, ask them these questions:

  • Do you have a Full Cover or No Gap agreement with HBF?
    If they don’t, you may need to consider if their fees work with your budget.
  • What hospital(s) do you operate in?
    You can then check if the hospital has a Full Cover or No Gap agreement with HBF.
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