Hospital Cost with Hernia Repair and Tummy tuck (revised question) see Questions Details

Question

I'm sorry I wasn't as clear last post. My insurance is covering my hernia repair which will require hospital stay, I am also getting a abdominoplasty at the same time which I will be paying for out of pocket. My Question is if the insurance is paying for hospital stay due to hernia repair, will the hospital charge me separate out of pocket cost for the abdominoplasty if the procedure is preformed at the same time?

Mokhtar Asaadi, MD, FACS · Answer

Thank you for your question. Insurance may cover hernias at the time of tummy tuck, like umbilical hernia. If you have a large apron of redundant skin that causes irritation of skin, they might cover it.Therefore, I would recommend double checking but from my experience, this is usually the case.

Andrew T. Cohen, MD, FACS · Answer

Yes.  You have to pay for the cosmetic time of the tummy tuck in the operating room plus the anesthesiologist and the surgeon fee for the plastic surgeon.  That's how it works.

Curtis Wong, MD · Answer

you can expect to be charged for the time and anesthesia used in the portion considered cosmetic by your surgeons.  The overnight stay should be covered by the insurance for recovery from your hernia repair.

Robert M. Grenley, MD (retired) · Answer

To answer your question, if an insurance-covered procedure (in your case hernia repair) is performed in a hospital at the same time as a cosmetic procedure (in your case abdominoplasty), the hospital nurses will keep track of how much time is spent on the hernia repair (which is a short procedure) and how much time is spent on the abdominoplasty (a much longer procedure), and you will be billed at hospital rates for the out-of-pocket cost for the abdominoplasty. At our hospital here in Seattle, they charge the patient about $5,000 per hour for a cosmetic procedure...needless to say, as a result cosmetic procedures are essentially never performed there. Fortunately, we have a general surgeon who comes to our office when an abdominoplasty patient needs a hernia repair, so we expose the area as part of the tummy tuck, the general surgeon repairs the hernia, and we proceed to complete the abdominoplasty. The general surgeon charges insurance for his surgeon's fee, and there is a small charge by our office facility to insurance to cover the cost of the mesh used in the hernia repair if any. Our normal OR charge for the cosmetic abdominoplasty which the patient pays, is a fraction of the cost of one hour of OR time at the hospital. The only exception to this would be a very massive abdominal wall hernia that the general surgeon feels he needs to perform at the hospital as an inpatient...but this is rare, and out of many, many patients I can only recall this happening on one occasion.

Ronald V. DeMars, MD (Retired) · Answer

Yes, in most cases the hospital will decide which portion of time is considered the cosmetic surgery and will charge you for that time as will the anesthesiologist. Best to determine the exact cast preoperatively or you may be in for a sad surprise. Hospital bills are notoriously high, inaccurate, and never in the patient's favor. You can probably establish the fees you will be responsible for now, in fact most plastic surgeons offices will do this for you, so you are prepared for the bad news.

Hospital Cost with Hernia Repair and Tummy tuck (revised question) see Questions Details

Answers (5)

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