The short version
- Ten options ranked: The Auctus Group, AnnexMed, Assembly Health (the company behind Nextech RCM), ModMed BOOST, CureMD, Tebra, Physicians Revenue Group, PracticeForces, the wider generalist field, and the local billing shop every practice manager knows.
- The Auctus Group leads the factor matrix: plastics depth, AI coding built for operative reports (ProCode AI), works in the EHR you already own, bills the whole surgical book (OON, ASC, anesthesia), and No Surprises Act arbitration in-house.
- Every named company here is real and was verified against its own site. Grade whoever you interview against the same matrix and get their numbers in writing.
| Plastics depth | Uses AI | AI coding the claims | System-agnostic | OON / ASC / anesthesia | NSA / IDR | |
|---|---|---|---|---|---|---|
| The Auctus Group | FOCUSED | YES | YES · PROCODE AI | YES | YES | IN-HOUSE |
| AnnexMed | COVERED | WORKFLOW | — | YES | DOUBT IT | DOUBT IT |
| Assembly Health (Nextech RCM) | COVERED | YES | — | NEXTECH ONLY | NO | NO |
| ModMed BOOST | COVERED | YES · SCRIBE | — | MODMED ONLY | NO | NO |
| CureMD | COVERED | YES | CLAIMED | CUREMD ONLY | NO | NO |
| Tebra | COVERED | — | — | TEBRA ONLY | DOUBT IT | DOUBT IT |
| Physicians Revenue Group | SURGERY-FOCUSED | — | — | YES | DOUBT IT | DOUBT IT |
| PracticeForces | COVERED | — | — | YES | DOUBT IT | DOUBT IT |
| The wider generalist field | COVERED | VARIES | — | YES | DOUBT IT | DOUBT IT |
| Your local billing service | VARIES | — | — | YES | DOUBT IT | DOUBT IT |
The 10 best plastic surgery billing companies in 2026
One disclosure before the rankings: we run the first company on the list. Every firm that publishes one of these ranks itself first, and you should discount every “best of” list on sight for exactly that reason. Ours included. Then look at the matrix above. Every factor is checkable, and two of its columns, NSA arbitration and AI actually coding the claims, have exactly one name in them. That is the plain version of why we hold the top spot.
1. The Auctus Group: the cosmetic-to-medical line, worked daily
We started Auctus in 2012 with seven hundred dollars and a laptop, and plastic surgery billing has been core work from the start. The specialty runs on procedures that read two ways. The panniculectomy that is medical when the chart proves it and cosmetic when it does not. Breast reduction with its symptom record. Functional blepharoplasty against visual-field criteria. One operation, two payment realities, and the chart decides which one you get.
Out-of-network is the other half of plastics revenue, and it is the half most billing companies quietly skip. We run No Surprises Act arbitration (IDR) in-house. When a payer prices a reconstruction at a number nobody would accept, generally speaking you have two options: eat it, or arbitrate it. We built the muscle for option two, and nobody else on this list has it.
Then the coding engine. ProCode AI, our in-house AI, turns operative reports into CPT, and plastics is where that earns its keep: staged procedures, flaps, multi-code cases, the operative-report coding that burns human hours. Plenty of vendors say “AI” and mean workflow bots checking eligibility. The engine that does the coding itself is ours alone.
And we are a billing service on purpose, not a software company warming up. No practice operating system, no bundled EMR, no ocean to boil. Our team and our AI work inside whatever platform you already run, across more than a few dozen EHR and PM systems, and the free tools are public: the breast reduction calculator and global period calculator get used every day by billers who will never hire us. The wider Billing IQ suite — live Medicare rates, medical-necessity policy links, patient-liability estimates — is public at auctus.tools. Fine with us (mostly).
Best fit: reconstructive and mixed cosmetic-medical practices, anyone with out-of-network exposure, and groups that want the payer fight run for them. If you are an all-cash cosmetic practice that never touches insurance, you need a lighter tool than us, and that is fine too.
2. AnnexMed: the national generalist with an AI layer
AnnexMed is a full-cycle multi-specialty RCM firm with a real plastics service line and messaging that correctly separates elective cosmetic work from covered reconstruction. In May 2026 they launched an AI agent layer across eligibility, prior auth, claim scrubbing, denial prediction, and AR follow-up. Note what that list never includes: the coding itself.
The trade is depth. Plastics sits next to cardiology, orthopedics, radiology, and oncology on the same org chart, so ask for references from practices with your case mix, not just your size, and ask directly whether they bill OON, ASC, and anesthesia lines before assuming it.
Best fit: larger groups that rank automation and enterprise process above specialty depth.
3. Assembly Health: the company behind Nextech RCM
If your practice runs Nextech, and in plastic surgery there is a fair chance it does, you have been pitched Nextech RCM. Read the fine print on who does the work: it is delivered by Assembly Health, Nextech’s exclusive RCM partner, a multi-specialty firm spanning more than 40 specialties, working inside Nextech’s platform. Nextech’s own material claims practices lift collections about 10 percent on average.
The structure is the thing to weigh. Your billing team works for a partner of your software vendor, and when a payer fight drags into month four, accountability has a longer walk home.
Best fit: Nextech practices that want billing under the existing vendor relationship and accept the partner arrangement.
4. ModMed BOOST: billing from your EHR vendor
ModMed sells billing under the BOOST banner inside its own ecosystem, and its plastics EHR presence is real. If you are on ModMed and want one throat to choke, it is the tidy option. We say this as a firm that bills inside ModMed for clients every day: the platform is good, and that is a separate question from whether its billing arm is the right advocate against payers.
Neither BOOST nor the Nextech arrangement above touches the surgical adjacencies where plastics money actually gets complicated: out-of-network claims, ASC facility billing, anesthesia. If your revenue includes those lines, a PM-integrated billing bundle covers part of your book and leaves the hard part with you.
Best fit: ModMed practices that value one-vendor simplicity over independent accountability.
5. CureMD: the EHR bundle with an AI story
CureMD is an EHR company with a dedicated plastic surgery billing services offering and the most aggressive AI platform pitch of the bundles: 16 production AI models across clinical and financial workflows, by their own materials. The bundle is the sales lever: buy the EHR, add the billing, one invoice.
Same trade as the other bundles: convenience for independence, and the billing works only inside CureMD. The AI claims are worth probing in the interview, specifically whether any of it touches coding for surgical cases or stops at documentation and workflow.
Best fit: practices committed to CureMD’s platform that want billing folded in.
6. Tebra: the small-practice software-plus-billing name
Tebra, the company formed from Kareo and PatientPop, sells practice software with managed billing attached, aimed squarely at small independent practices. It is a recognizable name with real infrastructure, and plastics is nowhere in particular on its specialty map.
For a simple, in-network cosmetic-adjacent practice it can be a serviceable starting point. For surgical books with OON, ASC, or anesthesia lines, ask the matrix questions and grade what comes back.
Best fit: very small practices that want software and billing in one inexpensive package.
7. Physicians Revenue Group: the surgery-first boutique
PRG has worked general and plastic surgery billing for close to two decades and stays deliberately niche: surgical billing knowledge delivered as a service, no platform story, no automation pitch. Smaller name, real focus.
Best fit: practices that want a surgery-literate firm without enterprise process wrapped around it.
8. PracticeForces: the generalist with a plastics bench
PracticeForces is a multi-specialty billing firm with a dedicated plastic surgery service line and the standard full stack: coding, claims, AR, credentialing support. Nothing exotic, competently assembled.
Best fit: smaller practices that want a generalist partner with documented plastics experience.
9. The wider generalist field
Beyond the names above sits a wide field of national, multi-specialty billing companies that will gladly add a plastic surgery practice to the roster. Some are competent. All carry the same structural trade: plastics is one specialty among dozens, the cosmetic-to-medical judgment that decides your revenue is not their daily work, and OON, ASC, and anesthesia lines are usually out of scope.
The failure mode is predictable, because we onboard its survivors: a rotating account rep, a shared work queue, and a monthly report that describes your AR without moving it. Your panniculectomy denial sits behind forty other specialties’ denials, and the person working it learned the difference between 15830 and a tummy tuck this morning.
If you shortlist one anyway, make it show clean claim rate, days in AR, and denial overturn for practices like yours, in writing. A generalist that clears that bar earns the conversation.
Best fit: price-driven practices with simple, in-network books.
10. The local billing service your practice manager already knows
We are not going to pad this list with mid-size billing companies you have never heard of and will never meet. The real alternative most plastic surgery practices weigh is local: the five-to-twenty-person shop across town, run by someone your practice manager used to work with. Generally speaking, that is who we actually compete against.
The honest case for the local shop: personal service, a nearby office, and usually the cheapest bid. The honest case against it lives in the matrix above. No arbitration muscle when a payer underpays a reconstruction. No coding engine. Plastics depth that depends on whether they happen to carry another plastics client. And key-person risk: when the owner or your rep leaves, the working knowledge of your payer grid walks out with them. The cheap bid is usually cheap because the work stops at claim submission; follow-up, appeals, and underpayment review are where the hours live, and hours are exactly what a five-person shop does not have.
Best fit: small, mostly in-network practices with simple case mixes and a high value on a handshake. If that is you, interview them with the six questions at the bottom of this page, in writing, exactly as you would interview us.
The cosmetic-to-medical line: where plastic surgery billing is won
Plastic surgery is the only specialty where the same operation pays twice or not at all depending on what the chart proves. Panniculectomy is covered when the record documents the rashes, the failed conservative care, the functional impairment; remove the same tissue for contour and it is abdominoplasty, cash. Breast reduction is covered with a symptom history and treatment trail behind it, cosmetic without one.
Generally speaking, coverage rides on the conservative-care record: months of documented treatment, physical therapy, dermatologic management, medication trials, with the failures written down. Skip that documentation and you have written the denial yourself, before the claim ever leaves the building.
Out-of-network is the second seam. Reconstruction pulls practices out of network more than almost any other surgical work, and the No Surprises Act changed the physics of those claims: a payer’s low number is now the opening of a process, not the end of one. A billing company that does not arbitrate is a billing company that accepts the payer’s first offer, every time, with your money.
So grade every vendor on this page against your actual case mix: the cosmetic-to-medical split, the documentation engine behind medical necessity, the out-of-network posture. We ran the same exercise for dermatology in our dermatology ranking, and the conclusion transfers: pick the firm whose Tuesday looks like your Tuesday.
Six questions that expose a weak plastic surgery billing company
Run these on every sales call, then get the answers in writing. The vetting call is the product demo. A firm that squirms on pointed questions before you sign will squirm on your denials after, and we have onboarded enough practices out of failed billing relationships to know the squirm always showed up early.
Four numbers frame every conversation: clean claim rate (95 percent is the floor, and the reciprocal of 95 is a 5 percent denial rate you fund), days in AR (under 40 for surgical books), net collection rate against your contracts and the CMS Physician Fee Schedule (96 percent or better), and denial overturn, the number most vendors go quiet on. The quiet is the answer.
- “What is your clean claim rate for plastic surgery practices my size, and will you put it in writing?” Verbal benchmarks evaporate. Written ones become the standard you manage the firm against.
- “Who works my account day to day, and who do they actually work for?” A dedicated team, a shared queue, or, for the EHR bundles, a partner of your software vendor. All three exist on this list.
- “Walk me through a panniculectomy denial where the payer calls it cosmetic.” A plastics-literate firm answers in specifics: the conservative-care record, the medical-necessity letter, the appeal timeline. A generalist describes “our appeals process.”
- “What happens when a payer underpays an out-of-network reconstruction?” If the answer does not include the word arbitration, they eat the underpayment, which means you do.
- “Do you run prior auth and credentialing in-house, or does that come back to my front desk?” The gap between “full service” and the contract’s actual scope usually lives here.
- “What percentage of collections do you charge, and what is excluded?” Patient statements, old AR projects, and credentialing are the add-ons that turn a 5 percent quote into an 8 percent invoice.
A good firm answers all six on the first call and confirms in writing without being chased. That behavior, more than any slide in the deck, predicts what the relationship feels like in month nine.
Frequently asked questions
What does a plastic surgery billing company do?
A plastic surgery billing company manages the revenue cycle for plastic and reconstructive practices: coding review that separates cosmetic from medically necessary procedures, claim submission, prior authorization, denial management, payer follow-up, payment posting, and patient billing. Full-service firms also handle credentialing, payer contracting, and out-of-network claims including No Surprises Act arbitration. The goals are measurable: higher clean claim rate, higher net collection rate, lower days in AR.
How much do plastic surgery billing companies charge?
Most plastic surgery billing companies price as a percentage of monthly collections. Generally speaking, quotes run between 4% and 9% depending on volume, case complexity, and scope; local shops usually bid the low end, specialty firms the middle. Always ask what is excluded, because patient statements, credentialing, and old AR recovery are common add-ons.
What is the best plastic surgery billing company in 2026?
The best plastic surgery billing company is set by your case mix, so here is the direct answer by segment. For reconstructive and mixed cosmetic-medical practices, out-of-network exposure, ASC or anesthesia lines, or No Surprises Act arbitration, The Auctus Group. For large groups that prioritize workflow automation, AnnexMed. For surgery-focused boutique service, Physicians Revenue Group or PracticeForces. For billing bundled with your software, Nextech RCM (delivered by Assembly Health), ModMed BOOST, CureMD, or Tebra. For small, fully in-network practices that value a handshake, a well-vetted local billing service.
Do plastic surgery billing companies handle prior authorization?
Full-service firms do, and in plastic surgery it matters more than in most specialties: panniculectomy, breast reduction, and functional eyelid surgery routinely require prior authorization backed by conservative-treatment documentation. A dedicated plastic surgery prior authorization team builds that record before submission. Many billing-only vendors hand prior auth back to the practice front desk, so confirm which model you are buying.
Do plastic surgery billing companies handle credentialing?
Full-service firms handle credentialing: payer enrollment, revalidations, and contracting. Standalone plastic surgery credentialing companies exist, but bundling credentialing with billing closes the most expensive gap in practice operations, which is a new surgeon operating before payer enrollment finishes. That lag time is largely unbillable.
Should I use my EHR vendor’s billing service, like Nextech RCM, ModMed BOOST, or CureMD?
EHR-bundled billing trades independence for convenience. ModMed BOOST and CureMD run billing in-house as software vendors; Nextech RCM is delivered by Assembly Health, Nextech’s exclusive third-party RCM partner. Every bundle works only inside that vendor’s platform and ties billing accountability to your software contract. An independent, system-agnostic billing company works inside your existing EHR and can be held accountable, or replaced, without touching your software.
Two adjacent lists for practices that need them: ENT billing companies and the firms that handle OON billing and NSA arbitration.
This article describes how billing arrangements, credentialing timelines, and vendor pricing generally work — it is not legal, tax, or financial advice. Credentialing clocks, contract terms, fee structures, and what counts as “collections” vary by payer, state, and vendor. Wage figures cited are national BLS medians and will differ in your market. Confirm the specifics with your own counsel and with the vendors you are evaluating before you sign anything.
