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location: Transition > Bottom Surgery > Costs
Letters
I received my first recommendation letter for bottom surgery from the director of the Counseling Center of the graduate school I was attending so I did not have to pay for it. For the second letter, I am seeing a licensed Social Worker, and each visit is partially paid for by my health insurance (the portion insurance paid is listed in green, and the out of pocket portion, usually my copay, is listed in red).
| Date |
Costs |
Item |
| 12/9/06 |
$110.00 |
$15.00 |
Visit #1 |
| 1/6/07 |
110.00 |
15.00 |
Visit #2 |
| 1/25/07 |
110.00 |
15.00 |
Visit #3 |
| 2/10/07 |
110.00 |
15.00 |
Visit #4 |
| 2/27/07 |
110.00 |
15.00 |
Visit #5 |
| 3/15/07 |
110.00 |
15.00 |
Visit #6 |
| 4/14/07 |
110.00 |
15.00 |
Visit #7 - last visit |
| |
$770.00 |
$105.00 |
TOTALS |
| |
$875.00 |
GRAND TOTAL |
Surgeon Consultations
In January 2007, I had a consultation with Dr. Djordjevic in Maryland. Because this is necessary to have before the surgery, I will share the expenses of that trip. Since this was all paid out of pocket, they are all listed in red. We did not have any lodging expenses, because we stayed with my girlfriend's family in the Baltimore area.
| Cost |
Item |
| $237.20 |
2 round-trip flights |
| 68.00 |
Car rental |
| 9.90 |
Gas for rental car |
| 48.25 |
Airport parking |
| 90.00 |
Pump and T cream from Miro |
$453.15 |
TOTAL |
Also in January 2007, I had a consultation with Dr. Meltzer after he presented at the First Event 2007 conference in Burlington, MA. He did not charge for the consult; and technically I did not have to register and attend the conference in order to have the consult so that visit was essentially free.
Belgrade, Serbia Surgery
The following is a breakdown of the costs associated with my surgery in Belgrade, Serbia (metoidioplasty, urethroplasty, scrotoplasty with testicular implants, and vaginectomy) in June 2007. When applicable, the portion paid for by insurance (potentially bloodwork, but not the surgery itself) is listed in green. Since most of these expenses are out of pocket, they are listed in red. I have also tried to include the Euro or Serbian Dinar amounts, depending on the currency we used to pay the expense, and their USD equivalents when known, as determined by the exchange rate at the time of payment.
| Date |
Cost
(Euro) |
Cost
(Dinar) |
Costs (USD) |
Item |
| 2/2/07 |
1780 |
|
0.00 |
$2,195.21 |
1,000 Euros deposit plus 780 Euros for testicular implants |
| 2/25/07 |
|
|
0.00 |
1,350.45 |
My round trip flight to/from Belgrade on AirFrance |
| 2/25/07 |
|
|
0.00 |
1,350.45 |
Molly's round trip flight to/from Belgrade on AirFrance |
| 2/25/07 |
|
|
0.00 |
213.00 |
My mother's round trip flight to/from Boston |
| 2/25/07 |
|
|
0.00 |
1,178.45 |
My mother's round trip flight to/from Belgrade on AirFrance |
| 5/23/07 |
|
|
$236.00 |
15.00 |
Pre-operative physical exam |
| 5/23/07 |
|
|
434.61 |
0.00 |
Pre-operative bloodwork, chest x-ray, and EKG |
| 5/25/07 |
9000 |
|
0.00 |
12,150.00 |
Remainder for surgery |
| 6/17/07 |
798 |
|
0.00 |
1,174.00 |
Apartment in Serbia (50 Euros/night = 700 Euros, plus 14% tax) |
| 6/17/07 |
30 |
|
0.00 |
45.00 |
Food in Paris airport |
| 6/29/07 |
|
5000 |
0.00 |
80.00 |
6-hour tour of Belgrade (by car, from Miroslav the taxi driver) |
| 6/30/07 |
|
20,916 |
0.00 |
354.00 |
Other expenses (groceries, taxi rides to and from the clinic) |
| |
|
|
$670.61 |
$20,105.56 |
TOTALS |
| |
|
|
$20,776.17 |
GRAND TOTAL |
Post-operative Care
In mid-March 2007 (before surgery), I saw a local pediatric urologist who agreed to manage my care post-surgically. He bills my insurance for "hypospadias," since that is essentially what is produced by metoidioplasty with urethral lengthening. In addition, the most common complications associated with metoidioplasty with urethral lengthening (stricture and/or fistula) are also common complications of hypospadias repair - so if he were to perform any procedures on me to fix these complications, that would still be an accurate diagnosis. The portion paid for by insurance is listed in green, and the out of pocket portion, usually my copay, is listed in red.
| Date |
Costs |
Item |
| 3/21/07 |
728.00 |
$20.00 |
Pre-operative consultation |
| 7/18/07 |
$1,486.00 |
0.00 |
Voiding cystourethrogram (#1) |
| 7/18/07 |
700.00 |
0.00 |
Ultrasound |
| 7/18/07 |
234.00 |
20.00 |
Doctor's appointment |
| 8/24/07 |
1,435.00 |
0.00 |
Voiding cystourethrogram (#2) |
| 8/24/07 |
234.00 |
20.00 |
Doctor's appointment |
| 9/20/07 |
1,435.00 |
0.00 |
Voiding cystourethrogram (#3) |
| 9/20/07 |
271.00 |
20.00 |
Doctor's appointment |
| 12/20/07 |
1,299.00 |
0.00 |
Retrograde urethrogram (#4) / Attempted fistulogram |
| 12/20/07 |
432.00 |
20.00 |
Doctor's appointment |
| |
$8,254.00 |
$100.00 |
TOTALS |
| |
$8,354.00 |
GRAND TOTAL |
1st Revision Surgery
Based on the findings from my post-operative imaging tests, my local pediatric urologist wanted to perform a revison surgery to fix the urethral fistula and remove the "pocket" seen on the VCUGs, which was suspected (and subseuqently found to be) a remnant of the vagina that should have been removed during the original vaginectomy. The official diagnosis and surgery plan was "s/p excision perineal urethrocutaneous fistula repair, cystoscopy, excision of penile shaft skin tags". I received a pre-operative clearance for surgery by my insurance company - the portion paid for by insurance is listed in green, and the out of pocket portion is listed in red.
| Date |
Costs |
Item |
| 3/4/08 |
$1,063.00 |
0.00 |
Pre-operative appointment |
| 3/10/08 |
7,007.00 |
0.00 |
Surgeon's fee - Urologist |
| 3/10/08 |
11,760.00 |
0.00 |
Surgeon's fee - Plastic Surgeon *includes simultaneous minor chest revision* |
| 3/10/08 |
5,202.00 |
0.00 |
Anesthesia (approx. 8 hours) |
| 3/10/08 |
39,350.07 |
$250.00 |
2-night in-patient hospital stay |
| 3/10/08 |
251.00 |
0.00 |
Pathology |
| 3/19/08 |
1,608.00 |
0.00 |
Voiding cystourethrogram (#5) |
| 3/19/08 |
0.00 |
0.00 |
Doctor's appointment (free for 90 days post-surgery) |
| 4/4/08 |
2,907.00 |
0.00 |
Retrograde urethrogram (#6) / Voiding cystourethrogram (#7) |
| 8/11/08 |
325.00 |
20.00 |
Doctor's appointment - Urologist |
| 10/28/08 |
473.00 |
20.00 |
Doctor's appointment - Plastic Surgeon |
| 11/17/08 |
473.00 |
20.00 |
Doctor's appointment - Urologist |
| 1/22/09 |
2,979.00 |
0.00 |
Retrograde urethrogram (#8) / Voiding cystourethrogram (#9) |
| 1/22/09 |
316.00 |
20.00 |
Doctor's appointment - Urologist |
| 1/22/09 |
263.00 |
20.00 |
Doctor's appointment - Plastic Surgeon |
| |
$73,977.07 |
$350.00 |
TOTALS |
| |
$74,327.07 |
GRAND TOTAL |
2nd and 3rd Revision Surgeries
I developed a spontaneous external urethral fistula that needed to be corrected surgically. Also, because my testicular implants never "dropped" properly, I chose to have them replaced with tissue expanders (2nd revision surgery, February 2009), which were expanded over a number of weeks, then replaced with new testicular implants (3rd revision surgery, April 2009). I received a pre-operative clearance for both of these surgeries by my insurance company - the portion paid for by insurance is listed in green, and the out of pocket portion is listed in red.
2nd Revision Surgery
| Date |
Costs |
Item |
| 1/26/09 |
1,004.00 |
20.00 |
Pre-operative appointment |
| 2/4/09 |
3,081.00 |
0.00 |
Surgeon's fee - Urologist |
| 2/4/09 |
$13,925.00 |
0.00 |
Surgeon's fee - Plastic Surgeon *includes simultaneous minor chest revision* |
| 2/4/09 |
3,097.00 |
0.00 |
Anesthesia (approx. 4 hours) |
| 2/4/09 |
22,559.05 |
$250.00 |
1-night in-patient hospital stay |
| 2/4/09 |
229.00 |
0.00 |
Pathology |
| 2/6/09 |
2,891.78 |
25.00 |
Emergency Room Visit |
| 2/6/09 |
86.00 |
0.00 |
Emergency Room Radiographs |
| 2/10/09 |
59.00 |
0.00 |
Doctor's appointment - Plastic Surgeon |
| 2/10/09 |
39.00 |
0.00 |
Doctor's appointment - Urologist |
| 2/17/09 |
0.00 |
0.00 |
Doctor's appointment - Expansion #1 |
| 2/24/09 |
0.00 |
0.00 |
Doctor's appointment - Expansion #2 |
| 3/3/09 |
0.00 |
0.00 |
Doctor's appointment - Expansion #3 |
| 3/10/09 |
0.00 |
0.00 |
Doctor's appointment - Expansion #4 |
| 3/17/09 |
0.00 |
0.00 |
Doctor's appointment - Expansion #5 |
| 3/27/09 |
0.00 |
0.00 |
Doctor's appointment - Expansion #6 |
| |
$46,970.83 |
$295.00 |
TOTALS |
| |
$47,265.83 |
GRAND TOTAL |
3rd Revision Surgery
| Date |
Costs |
Item |
| 4/6/09 |
$17,013.00 |
0.00 |
Surgeon's fee - Plastic Surgeon |
| 4/6/09 |
1,956.00 |
0.00 |
Anesthesia (approx. 3 hours) |
| 4/6/09 |
14,963.17 |
$250.00 |
Outpatient procedure |
| 4/16/09 |
0.00 |
0.00 |
Doctor's appointment (free for 90 days post-surgery) |
| 5/14/09 |
0.00 |
0.00 |
Doctor's appointment (free for 90 days post-surgery) |
| 9/10/09 |
316.00 |
20.00 |
Doctor's appointment |
| |
$34,248.17 |
$270.00 |
TOTALS |
| |
$34,518.17 |
GRAND TOTAL |
SUPER GRAND TOTAL (2nd and 3rd bottom surgery revisions): $81,784.00
|
4th and 5th Revision Surgeries
Despite previously using tissue expanders, the right implant was still sitting way too high (almost over my pubic bone). I decided to try the process again, replacing the current testicular implants with tissue expanders (4th revision surgery, March 1, 2010), expanding them over a number of weeks, then replacing the expanders with new implants (summer 2010). This time I am doing all but the first expansions myself at home instead of going to the office every week. Insurance pre-approved these procedures - the portion paid for by insurance is listed in green, and the out of pocket portion is listed in red.
4th Revision Surgery
| Date |
Costs |
Item |
| 1/19/10 |
485.00 |
20.00 |
Surgeon's fee - Plastic Surgeon |
| 3/1/10 |
$13,302.00 |
0.00 |
Surgeon's fee - Plastic Surgeon |
| 3/1/10 |
1,956.00 |
0.00 |
Anesthesia (approx. 3 hours) |
| 3/1/10 |
14,963.00 |
$500.00 |
Outpatient procedure |
| 3/1/10 |
23.00 |
0.00 |
Pathology |
| 3/16/10 |
0.00 |
0.00 |
Doctor's appointment - Expansion #1 (free for 90 days post-surgery) |
| 3/17/10 |
49.50 |
0.00 |
Sterile saline syringes and needles for home expansion |
| |
$30,800.31 |
$520.00 |
TOTALS |
| |
$31,320.31 |
GRAND TOTAL |
5th Revision Surgery
| Date |
Costs |
Item |
| 6/1/10 |
320.00 |
20.00 |
Pre-op consultation / In-office expansion #11 |
| 6/7/10 |
8,722.00 |
20.00 |
Surgeon's fee - Plastic Surgeon |
| 6/7/10 |
1,494.00 |
0.00 |
Anesthesia (approx. 2 hours) |
| 6/7/10 |
$10,075.00 |
$500.00 |
Outpatient procedure |
| 6/22/10 |
0.00 |
0.00 |
Doctor's appointment (free for 90 days post-surgery) |
| |
$20,611.00 |
$520.00 |
TOTALS |
| |
$21,131.00 |
GRAND TOTAL |
SUPER GRAND TOTAL (4th and 5th bottom surgery revisions): $52,451.31
|
ULTRA GRAND TOTAL (all bottom surgery costs on this page): $239,020.90
- $216,301.99 paid for by insurance
- $22,718.91 paid out of pocket
|
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