One in five medically necessary breast reductions gets denied, and the number doing the denying is the Schnur scale. Here’s how each payer sets the bar.

CPT 17110 covers up to 14 benign lesions in one unit, not one per lesion. Bill it per lesion and the payer strips the overage before it pays.

Running plastic surgery billing in-house isn’t one hire — it’s a full revenue-cycle system. Here’s the whole machine, end to end.

In-house or outsourced plastic surgery billing — the real trade isn’t cost. It’s who owns your AR, your follow-up, and your denials.

Outsourced or in-house billing for your dermatology practice? The real cost, where revenue leaks, and five questions to answer before you switch.

On January 1, 2026, Medicare cut skin substitute pay ~90% to a flat $127.14/cm². What survives for plastic surgery and dermatology — and what doesn’t.

The Core Problem: One Code, Many Techniques The technique changes depending on the patient. The CPT code doesn’t. For top surgery — augmentation, reduction, mastectomy with nipple reconstruction — reimbursement is tied to the standard diagnosis for that procedure type. A reduction for macromasty and a reduction for masculinization carry the same code, same reimbursement, […]

What Is a Good Clean Claim Rate? Ninety-five percent. That’s the floor. The reciprocal is a 5% denial rate — which sounds manageable until you see how many follow-up hours that 5% generates downstream. Most practices below 95% aren’t losing to payer behavior. They’re losing to their own intake process. Three variables move this number […]

In plastic surgery billing, accounts receivable, often referred to as AR, rarely deteriorates overnight. More often, AR slowly drifts. Denials increase, aging stretches out, cash flow tightens, and leadership assumes it is a payer issue. AR is a slow burn… once you notice a fire is it often too late or at least you’ve lost […]

The Future of Medical Billing Technology Is Already Here Remember when “AI” sounded like something from a sci-fi movie? Yeah, same. Now it’s sitting in your billing software, quietly doing more in five seconds than a human could in five hours — without the caffeine dependency. Artificial Intelligence (AI) and Machine Learning (ML) are no […]