Sinus surgery is a very common procedure that often changes a patient’s life with respect to his or her ability to breathe. In preparing for the procedure, your doctor should give you a full breakdown of the costs involved. Normally, these costs fall into three categories: (1) surgeon’s fees (2) anesthesia fee and (3) hospital or ambulatory surgery center fee. Read below for a more in-depth explanation of these fees and what they entail, in addition to important information about the role that insurance coverage plays in cost determination.
Sinus surgery can improve your quality of life.
Cost No. 1: Sinus Surgeon Fees
The first and largest fee involved in a sinus surgery procedure is the doctor’s fee. The exact amount varies from surgeon to surgeon, and is often indicative of the doctor’s level of experience. Several other factors besides skill level also influence cost including location and whether the surgery is currently high in demand.
Your surgeon will discuss this fee with you during your consultation. Be advised that it is important to make sure that the surgeon is a good fit, and that you feel completely comfortable moving forward with the surgery.
You shouldn’t select a surgeon simply on cost alone. You should evaluate your surgeon’s ability to give you to results. A great place to start is by reading on-line reviews on the doctor. To be valuable, reviews should be found on several different sites and be more than a couple or words. You are right to question search results showing hundreds of reviews on one site and maybe a couple on another site. In selecting your surgeon, consider whether the surgeon is board certified, has additional fellowship training, and whether you feel safe and confident under his or her medical care. If you have had sinus surgery before, consider a second opinion before using the same surgeon.
Cost No. 2: Anesthesia Fees
Be prepared for your surgeon to explain that anesthesia fees are also included in the total cost of a sinus surgery procedure. The amount of the anesthesia fee depends on the answers to the following three questions:
(1) Who is the anesthesia provider?
(2) How long is the surgery expected to last?
(3) Will the anesthesia be local or general?
Note that the length of the procedure depends on the severity of your sinus issues and varies from patient to patient. Surgery duration also depends on how thorough your surgeon is in removing obstructive sinus tissue. Again, you can get an idea of this by looking for patients reviews who have had a similar surgery to the one you will have and have improved symptoms.
Also note that most sinus surgeries require general anesthesia. As a result, anesthesia fees will be larger than if you were undergoing a procedure that calls only for local anesthesia.
On average, anesthesia costs range between $100 and $5,000 per case. Insurance may cover some or all of this cost.
Cost No. 3: Facilities Fees
A facility fee is the final cost included in a sinus surgery procedure. Your surgeon chooses whether to perform the procedure at either (1) a hospital, (2) the office, (3) or a private surgery center.
Costs vary depending upon the location and philosophy of where you have your procedure performed. However, facility fees are typically less expensive for operations taking place in a private facility, versus those performed in a hospital. Dr. Bennett is aware of this cost difference, as well as patient priority in minimizing unnecessary costs. As a result, he performs almost all sinus surgeries at a private, state-of-the-art surgery facility.
Waiting room of the Midtown Surgery Center.
A facility fee is often made up of five separate costs, including:
Operating room expenses
Recovery room expenses
Surgical staff, technicians and nurses
Miscellaneous medical equipment and supplies.
Depending upon the location, a facility fee will generally range from between $1,000 and $5,000. Similar to anesthesia fees, remember that longer and more complicated procedures often equate to a higher cost. Insurance may cover some or all of this cost.
Cost No. 4: Miscellaneous Expenses
There are other expenses to consider when calculating the cost of a procedure:
Medication: pain medication and antibiotics may be needed after surgery.
Physical exam: a physical with lab testing is required before anesthesia.
Hotel room: you should plan on staying in Manhattan after your procedure for one night.
Transportation: travel and parking expenses.
Missed work: priceless.
Sinus Surgery & Health Insurance
The principle goal of a sinus surgery procedure is to correct breathing problems. Unlike rhinoplasty, sinus surgery is not considered a cosmetically elective procedure, but rather, a surgery required to maintain your health.
Generally, most insurance policies cover the costs of sinus surgery. Dr. Bennett and his office staff will check your plan before you meet to find out the extent of your coverage so there are no surprises. However, sometimes dealing with insurance companies can be headache-inducing and confusing. Policies can also change without your knowledge, due to the for-profit nature of most insurance companies.
Dr. Bennett and his staff give you a full breakdown of your coverage and make sure you receive the full benefits of your policy.
Dr. Bennett understands this, which is why his experienced staff will your benefits for you. During your consultation, his staff will contact your insurance company and get all of the pertinent information regarding coverage for the procedure. After you finish your meeting with Dr. Bennett, a member of his staff will sit down with you and explain your policy in detail, and answer any questions you may have. Dr. Bennett realizes that his patients work extremely hard to be able to afford health insurance premiums, so he deems it critical that you receive the benefits you deserve. Dr. Bennett realizes that not everyone can afford elite insurance packages and will work with patients to find a payment solution for your sinus surgery without financial hardship.
Dr. Bennett has put together this Insurance Guide to Nose Surgery to answer some of your questions and give your specifics on the major insurance carriers.
Scheduling Sinus Surgery
Sinus surgery can seem like an incredibly invasive procedure that forces you to put your life on hold in order to recover. However, the time spent recovering from the procedure is minimal in comparison to the lifelong benefits of being able to breathe normally without constant congestion and sinus pain.
After sinus surgery, you will need to take about a week off from work to get plenty of bed rest and help the healing process. You will also be responsible for carefully cleaning and caring for your new-and-improved nose. Although a minor inconvenience, remember the dramatic changes that sinus surgery can have on your respiratory system and to your level of general well-being.
Talk to your doctor about the best time to schedule the procedure, making sure you give yourself adequate time to recover peacefully and without disturbance.