Hi Everyone,
I went to see an ENT earlier this week about a sensitive 1cm lesion on the underside of my tongue (have had it for 8 months). My father (a family doctor) numbed and removed it in December and has since grown back to 1cm. The ENT suspected it is just a granuloma but wants to get it removed and sent to pathology to make sure (my father was concerned it could be a papiloma or something else involving HPV). The lesion is easily accessible (just on the underside of my tongue), so I thought it would be a simple procedure to biopsy. The ENT wanted to schedule me to an ambulatory surgery center and put me under general anesthesia to perform the surgery. I was expecting local anesthesia and a few incisions, plus maybe a stitch or two. Does this seem unnecessary? The finance department called today and said the cost of the procedure was $15,000! What have other people paid for tongue biopsies? Luckily I have good insurance (will pay ~$2000 out of pocket), but I'm a student, so thats a good deal of money to me. Is it worth getting a second opinion to see if someone can do the biopsy in house under local anesthesia? Other people on this forum have quoted biopsies for less that $500 (http://oralcancersupport.org/forums/ubbthreads.php?ubb=showflat&Number=124535 is an example). Is that out of pocket or total cost? I realize that good health is worth the money, but I also need to be financially smart at this point in my life. Thanks to all for your opinions.

Welcome. You get always get a 2nd opinion for many reasons. Most insurances have the best rate available than one would generally be charged by themselves, so what the hospital says may be different than what your insurer is billed, but individuals paying on their own can possibly work the payments out. I believe most hospitals may only charge what is the current Medicare rate, if a medicare participant, but not sure. There are many medical care professionals involved in a surgery, and an anesthesiaologist charges several thousand dollars, then the pathologist for the pathology of the biopsy, plus many more. For sure the surgery will be over $2,000

If a biopsy can be done in an office setting, that still may come to over $1,000 having had two myself, but I have insurance, and believe the pathology was close to $800. The other thing is, the ENT may do an triple scope, pendascopy, of the esphogus during surgery to check for other lesions, which can occurr.

You can always call your insurer, and see what the charges would be. My thought for myself is, money can always be found, but don't short change on your health. I hope this helps.

Good luck with everything.

Scott, please get this taken care of. Any sore that has been there for 2 weeks or longer needs to get checked by a professional.

When the growth was removed what happened to the tissue? Wasnt it sent to a lab for testing?

There are all kinds of things it could be. But knowing that it has been there for 8 months then returned when it was removed means it really should be checked out.

Sorry the cost is something very hard to determine, it can vary greatly depending upon many factors. The post you referenced is over 2 years old so its probably a different charge now. Most members have medical insurance so will not be able to give you the costs for having a biopsy preformed.

When having a biopsy done it could be done 3 ways. First is what I myself prefer, to have a tiny piece of tissue removed without anything at all right in the ENTs office. Next would be a local and third would be what your doc explained to you under anesthesia. Both the second and third options can still be done in office depending upon the set up your oral surgeon or ENT has. Most will be set up to do this if they are dealing with alot of oral cancer patients. You will want to have someone who is qualified doing the biopsy. When it comes to your health, spare no expense and take care of things the right way.

Good luck!!!

You may require full anesthesia because the lesion is in a tricky location for the surgeon to remove completely and ensure clear margins while you are awake. That was true for my husband; the oral surgeon's initial biopsy of a small bit of his leukoplakia -- which, like your sore, was on the underside of his mobile tongue -- was done under local anesthesia in the office, but when it came time for the ENT's excisional biopsy, which removed the whole thing along with margins, they wanted him knocked out at the hospital surgicenter.

Hi everyone,

First of all thanks for all the quick replies and support. To answer some questions - unfortunately no we did not send it off for pathology the first time it was removed (my father literally brought the novacaine and knife with him on a family trip, so we didnt really have the means to send it off). My father diagnosed it as a papilloma (though he is a family doctor, not an ENT). Now the ENT thinks its a benign granuloma, but wants to run pathology to be sure. Im going to get a second opinion, then will get it removed. I'll post an updated when I know more...