Most insurers will deeply discount the second procedure performed in a single operative session. This is because the payment for every surgical procedure include pre- and post-operative management.
Typical discount for the second procedure is 50%.
So, for example. Let's say the insurer pays $1,000 for augmentation on one breast (making the math simple). If you are augmenting both breasts in the same operative session, they will discount the second breast augmentation by 50% ... i.e. they will pay only $500 for the second procedure, for a total payment of $1,500 (not $2,000).
You can do the same thing in setting up your cosmetic self-pay fees. If the fee for one breast is $2,000 you can state that the fee for bilateral procedure (done at the same operative session) is $3,000.
A healthcare attorney is the best source for competent answers about what it is legal to do or not do.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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