What is the Typical Surgeon's Fee for Immediate Reconstruction with Tissue Expanders?

I had a bilateral mastectomy with tissue expanders this fall. When I asked my plastic surgeon's office manager how much my out-of-pocket cost would be, she replied, "We'll work with your insurance." Now, months later, the billing department is threatening to charge me $25,000 (this is just the surgeon's fee) for the implant exchange surgery because my insurance only paid $10,000 of the $35,000 they submitted. And the initial tissue expanders submission was for $67,000 for which only $11,000.

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5 Doctor Answers | Asked by Shan in nyc in New York, NY

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Unpaid fees for immediate reconstruction with tissue expanders

Thank you for your questions. There is not set fee for reconstruction with tissue expanders. What portion of the bill you are responsible for depends on many things....whether the procedure was a covered benefit under your specific plan, whether your surgeon/hospital was in-Network or out-of-Network, whether you had met your deductible, etc.... I suggest you speak with the physician's office and hospital directly. Also consider the advice of legal counsel,... more

Breast Reconstruction Costs

If your surgeon is out-of-network, then they have the right to charge you the difference from what your insurance carrier did not cover. If they are in-network, then they cannot charge you anymore then your insurance company says that they can. It does not matter what the office says if they are in-network with your insurance company. In that instance, they can only charge you what the insurance company deems that they can. I would discuss this... more

Fees for breast reconstruction

Sorry about your problem, but questions regarding fees shoudl have been discussed up front inlcuding yoru responsibilty and the approximate cost. Discuss this with the doctor's office.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Insurance and Financial Disagreements in Plastic Surgery

There is no one set price applicable across this country for any surgical procedure. As a rule, the larger and more expensive the city, EVERYTHING there becomes expensive (parking rates, restaurants, all services, contractors and medical charges). Sincde it is very expensived for a Plastic surgeon to have an office in New York (insurance, rent, high cost of staffing, taxes etc) these costs are passed on to the patients just as every other business would do. Plastic surgeons EITHER... more

Breast reconstruction cost

There is no typical fee as you can find widely different ranges. Medicare, HMO's, and insurance plans have their own fees determined by political and business factors. Individual surgeons have their own fees determined by market forces, reputation, and experience. The fee should be discussed upfront and specifically. "Working with your insurance plan" is not very clear or legally binding I would guess, but the paperwork and consent you signed might be. i would suggest speaking... more