Deviated Septum Surgery (Septoplasty) Cost and Insurance

What is included in the cost of septoplasty?

Septoplasty is usually performed at an outpatient surgery center or hospital under general anesthesia. The full cost typically includes several separate components:

• Surgeon fee — the ENT's professional fee for the procedure
• Facility fee — the surgery center or hospital's charge for the operating room, equipment, and nursing staff
• Anesthesia fee — usually billed separately by an anesthesiologist or CRNA
• Pre-operative workup — labs, a nasal endoscopy, and CT imaging if not already done
• Post-operative visits — follow-up appointments are typically included or billed separately

When these components are added together, the uninsured cost commonly falls in the $3,000–$8,000 range, though complex cases or high-cost markets can exceed that.

When does insurance cover septoplasty?

Health insurance — including most commercial plans and Medicare — covers septoplasty when the procedure is medically necessary, not purely cosmetic. Insurers generally require documentation of 1Ref 1van Egmond MMHT, Rovers MM, Tillema AHJ, van Neerbeek N (2018).Septoplasty for nasal obstruction due to a deviated nasal septum in adults: a systematic review.Medical necessity criteria for septoplasty; nasal obstruction as primary indication for coverage; need for failed conservative treatment before surgery:

• A significantly deviated septum confirmed on physical exam or imaging (CT scan)
• Functional symptoms such as chronic nasal obstruction, difficulty breathing through the nose, recurrent sinus infections, or sleep-disordered breathing attributable to the obstruction
• A trial of conservative treatment — typically nasal steroid sprays and possibly allergy evaluation — that has not adequately relieved symptoms

The NAIROS randomized controlled trial, which compared septoplasty to medical management in adults with nasal obstruction due to a deviated septum, found that surgery resulted in significantly greater improvement in patient-reported outcomes at 6 months, and that improvement was sustained to 12 months 2Ref 2Carrie S, Fouweather T, Homer T, et al. (2024).Effectiveness of septoplasty compared to medical management in adults with obstruction associated with a deviated nasal septum: the NAIROS RCT.Septoplasty (with or without turbinate reduction) produces significantly greater improvement in patient-reported outcomes at 6 and 12 months compared to nasal steroid and saline spray medical management. This trial provides the most robust evidence to date that septoplasty benefits appropriately selected patients.

Prior authorization is standard for this procedure. Your ENT's office will typically handle the authorization request.

What will I actually pay with insurance?

Your out-of-pocket cost with insurance depends on:

• Whether the surgeon and facility are in-network
• Your annual deductible and how much of it you have already met
• Your coinsurance percentage after the deductible
• Your plan's out-of-pocket maximum

For someone with a $2,000 deductible who has met none of it, the first $2,000 of the procedure's allowed amount is typically the patient's responsibility. After that, coinsurance (often 20–30%) applies to the remainder until the out-of-pocket maximum is reached.

Asking your ENT's billing office for the CPT codes that will be billed — and running them through your insurer's cost estimator — gives a more accurate picture before you schedule.

Does septoplasty require prior authorization?

For most plans, yes. Prior authorization is standard for elective surgical procedures. Your ENT's office handles the authorization request, submitting your CT imaging, clinical notes, and documentation of prior treatment. It is worth confirming authorization has been approved — not just requested — before your surgical date, as a missing authorization can result in the claim being denied.

Who performs septoplasty?

Septoplasty is performed by ENT surgeons (otolaryngologists). Some facial plastic surgeons also perform the procedure, particularly when combined with rhinoplasty. If your primary care provider has documented your nasal obstruction and conservative treatments have not helped, a referral to an ENT for evaluation is the appropriate next step.