For many women, the weight and size of their breasts can cause significant discomfort. For them, getting breast reduction surgery can dramatically improve their health and quality of life. Some women postpone surgery because they are afraid of how much this procedure could cost.
While the cost of this surgery can initially be a significant concern, understanding the breast reduction surgery cost with insurance in NY and the steps required to maximize your coverage to get the procedure covered or out-of-pocket expenses minimized can help you make the best choice for your health, happiness, and wallet.
Typical Breast Reduction Surgery Costs
The total out-of-pocket costs of breast reduction surgery will vary widely depending on factors such as your plastic surgeon’s expertise, hospital fees, required anesthesia, preoperative tests, and postoperative care. In New York, the average cost of this procedure typically ranges between $8,000 and $15,000 without insurance, but for many women, insurance will cover the majority of the cost of surgery.
Basic Costs Associated with Breast Reduction Surgery | |
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Cost Breakdown | *Estimated Range (USD) |
Surgeon’s Fee | $5,000 – $8,000 |
Anesthesia Fees | $1,000 – $2,000 |
Facility Fees (hospital/clinic) | $2,000 – $5,000 |
Postoperative Care | $500 – $1,000 |
Additional Costs (e.g., garments, medication) | $500 – $1,000 |
*While these numbers provide a general estimate, the actual cost will vary based on your specific circumstances, insurance coverage, and surgery complexity.
Insurance Coverage for Breast Reduction Surgery
Unlike purely cosmetic surgeries, breast reduction surgery is often deemed medically necessary for women experiencing physical discomfort. Symptoms like chronic back, neck, and shoulder pain, skin irritation, or posture issues can make your surgical intervention eligible for insurance coverage or reimbursement. However, securing coverage requires meeting the specific criteria set by your insurance provider.
Common Insurance Requirements for Breast Reduction Coverage | |
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Documentation of Medical Necessity | Women need to provide evidence that their symptoms significantly impact their quality of life and cannot be alleviated by non-surgical methods. |
Non-Surgical Treatment Failure | Insurers often require proof that patients have attempted alternative treatments, such as physical therapy, pain medication, more supportive bras, or chiropractic care. |
Predetermined Minimum Amount of Tissue Removed | Many insurance plans specify a minimum amount of breast tissue in grams that must be removed for the surgery to qualify as medically necessary. |
Referral and Preauthorization | Typically, women need a referral from a primary care physician or specialist and preauthorization from the insurance company before surgery will be covered. |
Steps to Maximize Insurance Coverage
Navigating insurance coverage for breast reduction surgery in New York can be complex, but working with a skilled and supportive office can make the process easier, smoother, and less worrisome. Here are our recommended steps to get the most from your insurance coverage:
![]() | Consult with a Plastic Surgeon: Start by finding a board-certified plastic surgeon who is experienced in insurance-covered procedures. They can assess whether you meet the criteria for medical necessity and provide the required documentation. |
![]() | Work with Your Primary Care Physician: Your primary care doctor can document medical issues you have experienced that were caused by your overly large breasts and make an official recommendation for surgery. |
![]() | Gather Evidence: Compile your records from any non-surgical treatments you’ve attempted, photos demonstrating your physical issues (e.g., shoulder grooves from bra straps), and notes from any specialists you’ve seen. |
![]() | Submit a Detailed Preauthorization Request: Include all supporting documents in the preauthorization request to the insurance company. This process often determines whether the surgery will be covered. |
![]() | Appeal if Denied: You have the right to appeal if the insurance company denies your coverage. Working with an experienced surgeon or insurance advocate who has dealt with submissions and appeals before can improve the chances of getting your surgery approved. |
Even with insurance, patients in New York may face out-of-pocket expenses. These include deductibles, copayments, and coinsurance, which vary based on the patient’s insurance plan.
Tips for Successful Insurance Approval
Working with an office that has an insurance liaison who understands the intricacies of the process, can prevent you from facing additional challenges getting your surgery covered or dealing with insurance denials due to insufficient documentation or disagreements over the necessity of the surgery. Our insurance liaison suggests the following tips:
- Choose the Right Surgeon: Work with a surgeon familiar with the insurance process and documentation requirements.
- Stay Persistent: Insurance approval may take time and multiple submissions. You will need to be patient during the process but also persistent to ensure you meet deadlines and respond to questions.
- Understand Your Plan: Read your insurance policy thoroughly to ensure you understand the specific coverage details and any potential exclusions that could prevent you from having your surgery covered, or when you would need to cover costs up front and have your insurance company reimburse you.
Harris Plastic Surgery: Your Partner in Breast Reduction Advocates
Breast reduction surgery can improve the quality of life for women struggling with physical discomfort due to large breasts. In New York, the financial strains of paying for this procedure out-of-pocket can be reduced by using insurance to cover some of the expenses. By understanding the costs, your specific insurance requirements, and strategies for approval, you can navigate the process more easily and focus on your health and well-being.
Harris Plastic Surgery - Your Breast Reconstruction Experts
To learn more about the breast reduction surgery cost with insurance in NY or start the process to improve your quality of life, schedule your consultation today. Or contact us online or by phone/text if you have any additional questions for our team.

Joanne Parrinello, Practice Manager
Joanne Parrinello is an expert patient care coordinator, with two decades of experience navigating the complex financial side of medically necessary breast reduction and reconstruction surgery. She acts as a guide to patients, helping them understand their options and their expected out-of-pocket expense. The insurance industry can be complex and filled with jargon that makes you feel like you need a translator. At Harris Plastic Surgery, Joanne is that translator.