How Varied Are Facility and Anesthesia Fees in Plastic Surgery?

Question

Do facility fees and anesthesia fees vary as much as surgeon fees?

	I understand that surgeon fees vary widely, based on locality and stature (or perceived stature) of the surgeon.

	I am wondering if facility and anesthesia fees vary as much. In Los Angeles, for a Facelift with no eye or brow work other than 'eye suture elevation' and with some added facial fat injections, I was quoted $3,325 for the facility fee and $2,275 for the anesthesia fee (general anesthesia by a physician).

	Not trying to price shop my facelift, just trying to understand all these various fees.

Philip S. Schoenfeld, MD, FACS · Answer

Fees will vary, but, they should fall within a range.  The things that you should look for in your care are the competency of your anesthesiologist or anesthetist and whether the center the surgeon practices out of is an accredited one.  
Patients spend significant amount of time researching their surgeon and should spend some time asking about the support staff of the surgeon during their surgical procedure.  
You will not pay more because the anesthesiologist is board certified or the surgical center is an accredited one, but, you will definitely be better served and a lot safer.

Jed H. Horowitz, MD, FACS · Answer

Because blepharoplasty is such a varied procedure, the cost also varies. Factors which contribute to the cost of eyelid surgery include:Type and extent of surgerySurgeon’s feeFacility feeAnesthesia feeMedicationYes , the facility fees can vary very widelyFor approximate costs by location , search Real Self, American Society of Plastic Surgeons, or American Society of Aesthetic Plastic Surgery and Oculoplastic surgery websites.

Larry S. Nichter, MD, MS, FACS · Answer

The Facility fee sounds high. Here are some of the reasons for price to vary:

	1. Location - Will it be performed in a hospital with an overnight stay, an independent accredited out- patient facility or a doctors office? In general hospitals always charge the most
	
	2. Type of Anesthesia - local, IV sedation or General Anesthesia? Will a board certified anesthesiologist, a nurse anesthetist,  be used, or a RN?
	     
	3. Length and Complexity of Surgery - how much will be removed, how many areas, how long, etc

Otto Joseph Placik, MD · Answer

Anesthesia and facility fees vary widely according to location (hospital vs surgicenter vs office) as well as practitioner (physician-surgeon vs physician-anesthesiologist vs nurse anesthetist). So ask what you are being charged for and compare apples to apples.

Kenneth D. Steinsapir, MD · Answer

Dear Doberman
Even for Los Angeles and Beverly Hills, these anesthesia and facility fees are high.  Yet if you are set on your surgeon, you really have little choice but to pay the fees charged by the surgery center they wan to use. I operate at UCLA. There the facility fee for a facelift and upper eyelid surgery would be $2200.  The anesthesia service charges by the hour at the rate of $300 per hour.  So a facelift and eyelid surgery at the outside might run 5 hours and cost $1500 and that is UCLA.  
If there is a medical issue, you are not is a private operatiing room with a single anesthesiologist or a nurse anesthetist. You are at a center with a dozen anesthesia personel. So fees higher than this are hard to justify. However, many of the private surgery centers are co-owned by the surgeons who operate their. Essentially they get a split of the case at the surgery centers they own.  If you are not happy with the fees, see some additional surgeons. The town is filled with plastic surgeons. You have choices.

Scott C. Sattler, MD, FACS · Answer

There is broad variability in the facility fee for cosmetic procedures.
If your surgeon owns his/her own certified ambulatory surgery center (ASC), the surgeon will have control over the facility fee. You may find that such a practice offers very reasonable facility fees.
For other surgeons do not own their own certified ASC, the only other options are to have the procedure done at an ASC owned by a separate entity (local hospital or multi-specialty group). In this case, your surgeon will not have control over facility fee costs. Hospitals tend to charge very high facility fees for elective cosmetic surgery in hospital-based operating rooms.
Fees for anesthesia are set by the hour. Your anesthesia provider may be a MD or a CRNA (certified registered nurse anesthetist). For outpatient cosmetic surgery, both types of providers are well qualified. The hourly rate for each type of provider may vary.

Michael Law, MD · Answer

The fees for anesthesia and facilities probably vary as much as the anesthesia provider and facilities vary.  In my surgical suite a board-certified anesthesiologist remains at the bedside of my patient throughout the surgery.  This is not the cheapest way to have surgery performed. But it is what I would want for myself or my family. So, it's what I do for my patients. One way to cut corners in pricing is with anesthesia care and facilities that may be less than pristine and state-of-the-art.  I have worked with very capable and talented CRNAs over the years. But, only with direct supervision of a board-certified anesthesiologist. Clearly, MD anesthesia will be more costly than a CRNA, or even no anesthesia provider at all.  As the owner of a surgical facility with Joint Commission and AAAASF accreditation, I can tell you that providing the highest level of care is expensive. But I treat my patients the way  Safety is not the place to cut corners.

David Finkle, MD · Answer

This is a great question and should be answered at the time of the initial consultation with an estimate in writing from the surgeon's office.  Make sure you have the TOTAL fee, not just the surgeons fee.  Here is a sample of the fees you could be looking at:Surgeon's feeFacility feeAnesthesia feeImplant feeGarment feeLab work feeMammogram fee

Raj S. Ambay, MD · Answer

Anesthesia fees do vary but not wildly. It is a function of the amount of time that the surgeon has booked for surgery and the level of experience of the provider (Nurse Anesthetist vs Anesthesiologist).

Kris M. Reddy, MD, FACS · Answer

Each facility has a different pricing structure. It is generally more cost effective for both the surgeon and patient if the surgeon owns his own surgical facility. We own our own AAAASF nationally accredited surgical facility.

How Varied Are Facility and Anesthesia Fees in Plastic Surgery?

Answers (20)

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