My suggestion to you is to go to an orthopedist, tell him your situation, tell him you will pay the best you can. He will still be required to bill you, but if you have a prior agreement he will give you latitude. The real problem for your situation is being admitted to the hospital for elective surgery. I do not know what their position would be.
That is exactly what happened to my mom who was on Medicare. After 2 years of having breast cancer and knowing it but not seeking treatment she told me. She was living on SS and had nothing but Meducare and thought she couldn’t afford treatment.
I called our local cancer center and talked to the Doctor who owns/runs it’s nurse. Explained the situation and she said she would talk to doctor and call me back. She did and made an appointment with the doctor for the next day.
At the appointment he told Mom they would take whatever Medicare paid. He said......if you receive a bill throw it in the garbage. They treated her for 6 years until she finally passed from a brain tumor. After she died the gal from accounting called me with a final bill, which was huge, for my mom. I told her what the doc had told us and I never heard from them again.
Thank God for doctors who truly care about people.