Insurance is often unwilling to pay oral surgeon because they are considered dentist, not doctor -- If med insurance is the problem then get primary doc to recommend ENT doc who will do biopsy.

Many of these oral lesions, precancerous, cancerous or whatever, do not hurt which is why some get as far as they do without detection -- Two of my three were painless, but luckily the third wasn't, because that's how I found it.

Depending on the circumstances, they numb the area, cut some pieces away (or the whole thing if it is small) and then put in sutures -- They should give you a prescription for pain meds for when the numbing agent wears off (Ask before hand about that; otherwise you may forget) -- I find the sutures to be the most annoying part.