If my Insurance Covers Fixing a Deviated Septum How Much More Should I Pay to Make my Nose Smaller?

Some surgeons might throw in a little lowering of your nasal bridge for free, but  I suspect most will not.  The cost really depends on the individual surgeon and how involved the cosmetic work is.  Also consider that there could be additional fees from the anesthesiologist and operating room, particularly if done In a hospital as opposed to the doctors office.

Rhinoplasty and Insurance coverage varies. Your deviated septum payment could be $1000 or $5000 depending on the carrier. It does not pay for hump removal and that is not free and will vary depending on the skill of the surgeon and the amount of other work that needs to be done.

There is tremendous variation in what surgeons charge for rhinoplasty.  Typically, the turbinates and a functional septoplasty do not pay a ton of money from insurance.  And, with that said, the patients do not what to spend more than they have to for the cosmetic portion.  I have seen cosmetic charges for rhinoplasty combined with functional surgery ranging from $1500 to $35,000. Depending on where you are in the country and what you need, this will make all the difference.  Expect $5000 - $10,000 with the tip guys in the country.  

A deviated septum and turbinates surgery is performed for airflow improvement to the nose and is done out of medical necessity.  This is typically billed to the patient’s insurance, but remember you still have co-pays and deductibles to deal with.  These procedures only improve the airflow dynamics through the nose and do not affect the shape of the nose.  A rhinoplasty procedure is performed for cosmetic purposes and patients have to pay that portion themselves.  The fee for the rhinoplasty procedure is approximately $7,012, which includes the operating room, anesthesia, and the facility fee.  The rhinoplasty procedure takes much longer than the functional breathing surgery.  The rhinoplasty procedure would involve narrowing the nasal tip, possibly narrowing the nostrils, and possibly osteotomies depending upon how much of a hump is present.  This is done with general anesthesia through closed rhinoplasty techniques where the incisions are placed inside the nose.  This surgery is performed in our Medicare certified ambulatory surgery center.

Each surgery has their own payment structure. When evaluating the patient for rhinoplasty their are maneuvers that can be performed specifically to improve the function of the nose and their are maneuvers that are performed specifically to improve the appearance of the nose. A septoplasty improves the function of the nose. Putting in spreader grafts to widen the nasal valve on the inside in order to improve breathing improves the function of the nose. Taking down a dorsal hump or changing the appearance of the nasal tip are cosmetic maneuvers. Typically, the office staff will submit the functional aspects of your surgery to your insurance carrier and you will be informed of how much you are responsible for. The surgeon can then estimate the amount of time required to perform the cosmetic portion of the procedure and you will be required to pay cash for that portion. Make sure to get specific numbers on what is covered by insurance and what isn't covered prior to doing the procedure. It is very important to make sure that everybody is on the same page financially.

Insurance won't cover any cosmetic changes to your nose. If you're undergoing a septoplasty and turbinate reduction, your plastic surgeon can perform a cosmetic rhinoplasty at the same time. The costs vary widely by surgeon, region and extent of the cosmetic changes you desire. This might range from $3000-7500. There is unfortunately no way to "game the system" and have your insurance cover the cosmetic portion of the procedure. Trying to do so can backfire and result in a denial of coverage for the entire procedure which would leave you on the hook for a very large medical bill. It's just not worth the risk.Stephen Weber MD, FACS

Insurance companies pay in network doctors in NY about $750 for a deviated septum repair so any cosmetic work is fee for service.  Shaving the nasal bone may sound simple to you but there is much more involved in recreating the nasal pyramid.  This is not free and I don't know why you would think that an additional procedure should be free.  Without an examination, it is impossible to know the type of nasal deformity, the amount of work required and, hence, the fee.  Additionally, if you have surgery in a hospital, please know that the minute the septoplasty ends and the cosmetic work begins, the clock begins to tick. Frequently, combination surgeries cost more because the hospital and anesthesiologist will want to be paid at full price, than when you have a cosmetic procedure performed with the anesthesiologist or facility of the surgeon's choice.  GIven the limited amount of in-network reimbursement for this procedure (because insurance companies figured out long ago that patients were trying to game the system and adjusted the allowance for the procedure accordingly), I think you can expect to pay about the same amount as for a same alone cosmetic procedure.

Even if you only do the functional surgery (the septum and turbinates ) insurance will rarely cover the total cost of the operation. After consultation to determine what will be done cosmetically  the office staff will contact your insurance company so you will know the part of the charges that will be your personal responsibility.

While the functional portion of your surgery may be covered by insurance the aesthetic portion will be charged directly by the patient. This varies surgeon to surgeon what the added cost will be. Of course any surgeon has the right to offer this additional portion free as long as the insurance is not billed for the enhanced time. I know this is confusing as it is a commonly asked question. Discuss with your surgeon ahead of time what if any added he will bill so there are no surprises! Best regards!

As a Cosmetic Surgeon, I do not bill insurance.  Patients pay a specific surgical fee and then I perform the contracted work.  If the turbinates & septum need surgery, I include this with the patient's septorhinoplasty surgery.  Hope this helps.