Understanding Costs in Plastic Surgery

A guide for patients

Plastic and reconstructive surgery costs in Australia can vary depending on several factors, including the type of procedure, hospital and anaesthetic fees, and whether any part of the surgery is medically indicated or purely cosmetic.

1. Components of Surgical Costs

Each procedure generally includes:

• Surgeon’s fee – for the operation, pre- and post-operative care.
• Anaesthetist’s fee – charged separately by the anaesthetist.
• Hospital or facility fee – for use of the operating theatre, recovery, and any inpatient stay.
• Implants, garments or dressings – where relevant.

For purely cosmetic (non-medically necessary) procedures, these costs are not covered by Medicare or private health insurance, and all expenses are paid by the patient.

2. When Medicare and Private Health Insurance Apply

Some reconstructive or functional procedures attract a Medicare Benefits Schedule (MBS) item number, which means:

• Medicare will contribute a rebate toward part of the surgeon’s fee.
• If you have appropriate private health insurance, your insurer may cover hospital and theatre costs for the MBS-approved procedure.

Examples of procedures that may have an MBS code include:

• Breast reduction or reconstruction
• Abdominoplasty after significant weight loss or pregnancy (if functional criteria are met)
• Skin cancer excision and reconstruction
  
  

3. Private Health Insurance

Having private health insurance with hospital cover is important if your procedure has an eligible MBS code.

• It allows you to have surgery in a private hospital, usually with no waiting period (if you’ve served your waiting times).
• Depending on your level of cover, you may have an excess.
• I do not participate in no-gap or known-gap schemes. I charge a private surgical fee, for which there is generally a modest rebate available from Medicare and/or your private health insurer (if applicable).

 

4. Superannuation Access for Surgery

In limited circumstances, you may be able to access your superannuation early on compassionate grounds to help pay for surgery that addresses a medical condition or alleviates chronic pain or psychological distress.

Conditions include:

• The procedure must be recommended by your treating specialist and a registered medical practitioner.
• The surgery must not be primarily cosmetic.
• An application must be made to the Australian Taxation Office (ATO), including supporting medical reports and cost estimates.
  
  

5. Cost Estimates and Transparency

Before proceeding, you will receive:

• A written quotation outlining all expected costs
• Information about applicable MBS item numbers (if any)
• Guidance on rebates available through Medicare or your insurer

We aim to ensure all patients have a clear understanding of potential out-of-pocket expenses before surgery.