It does seem that the facility fee is a bit high, even for the Dallas area. It could be that the facility does not have the accreditation which allows for insurance reimbursement. That said, tummy tuck and liposuction are procedures that are not covered by insurance, even just for surgeon fees so I would ask more questions and/or get a second opinion from another area plastic surgeon who can help you understand what you are being quoted.
Insurance does not cover cosmetic tummy tuck and liposuction. If it did, it would potentially be because misleading billing codes were being submitted to game the system. If you are getting a panniculectomy, this is not the same as a cosmetic tummy tuck and it is highly likely you will not be satisfied with your result. Usually this happens when the surgeon owns the facility. I am sure this is not the case, if you are seeing a board-certified Plastic Surgeon.Good luck and remember the adage- you get what you pay for.
Thank you for your question. Yes, that is a very high facility fee. First of all, I am very surprised that your insurance is covering a tummy tuck and lipo. These are typically NEVER approved by insurance as they are considered cosmetic surgery and are contract exclusions. Insurance may cover a panniculectomy for medical necessity, but this is not the same as a tummy tuck and liposuction would be excluded. Also, if the procedure was covered by insurance, you would only be responsible for your deductible and copay, and not the facility fee. (If the insurance approved it, then they approved the facility fee (hospital or surgery center) and surgeons fee in covering the procedure. The market rate for tummy tuck with liposuction in this area is typically between $7500 and 9000 for the entire procedure, anesthesia, surgeons fee, facility fee inclusive. I would ask some more questions.. it sounds a bit strange. Please feel free to call our office with any other questions that you may have. 214-943-9222.Good luck!
I have never had the CPT codes for a tummy tuck with liposuction covered by insurance. Facilities fees can range in price. $ 6,525 is a low price for the surgery in the Dallas area, which may also include your deductible.
I appreciate your question.
Cost varies by geographic location, surgeon expertise, OR time, anesthesia, length of procedure etc. I would recommend that you go to The American Society of Plastic Surgery website and look for a list of board certified plastic surgeons in your area. You can call their offices in advance and ask for quotes prior to scheduling consultations.
The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.
Best of luck!
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
Thanks for your inquiry. When your insurance is involved, usually there is a contracted allowable and you pay for your co-insurance and any deductible you have not met. So it is hard to tell you if this number is fair on not. Hope that helps.
Thanks for your question. If insurance is truly covering your TT/Lipo then it should be done at an accredited surgery center or hospital and you should only be paying your coinsurance/deductible. TT/Lipo however is almost NEVER covered and so this part is confusing and you are likely still getting a very good deal. This type of surgery should only be done by a Board Certified Plastic Surgeon and ideally someone who is an ASAPS member and specializes in cosmetic body contouring. You should have received a quote that told you the surgeon's fee, anesthesia fee and facility fee individually. Does your surgeon own the facility where you are having your procedure? Might be that you need a better explanation. Best of Luck!
I don't know your exact situation, but usually when insurance is paying for a procedure, it is done at a hospital and not a surgery center or in office operating room. The operating room/anesthesia fees in a hospital are usually a lot more expensive. In the Dallas area there is no way that you could get a tummy tuck with liposuction for $6,525, so it sounds like you are still getting a good deal.
Thanks for your question! Yes, that does sound exorbitant for a procedure that is combined with your insurance copay. However, make sure that you get an itemized copy of what's being included: maybe some of that is your deductible going towards the insurance component. I would definitely ask your plastic surgeon: facility fees vary widely from surgeon to surgeon, but anything more than the $2500-3500 range for a facility fee would raise a flag with me. Best of luck!