Schnur Scale Breast Reduction Calculator
The Schnur Scale Breast Reduction Calculator estimates the Minimum Required Removal for insurance coverage based on height, weight, and planned resection. This tool helps plastic surgeons and patients verify medical necessity status quickly. Whether you're planning a bilateral procedure, checking unilateral eligibility, or documenting for insurance pre-authorization, this resource provides clear, data-driven guidance.
How Medical Necessity Status Is Calculated
Medical Necessity Status is determined by comparing your planned tissue removal against a standard threshold derived from your body size. We first calculate your Body Surface Area (BSA) using the Du Bois & Du Bois formula based on your height and weight. This BSA value is then applied to the Schnur Scale sliding scale to find the specific minimum grams required for coverage.
BSA = 0.007184 × Weight^0.425 × Height^0.725
Where:
- Weight is measured in kilograms (kg)
- Height is measured in centimeters (cm)
Finally, the tool compares your planned removal weight against this minimum to determine if the surgery meets criteria. This method ensures a standardized, objective assessment widely accepted by insurance providers.
What Your Medical Necessity Status Means
Your Medical Necessity Status indicates whether your surgery is likely to be covered by insurance or classified as cosmetic. A "Meets Criteria" result means your planned removal is significantly above the minimum required grams for your body size. For instance, if the minimum threshold is 350g and you plan to remove 500g per breast, you exceed the requirement by over 40%, placing you in the green band with a high approval probability.
If your result shows "Does Not Meet Criteria," your planned removal is below the threshold. However, a "Borderline" result means you are within 10% of the minimum. In this case, you should prepare extensive documentation of physical symptoms, such as chronic back pain or shoulder grooving, to justify the medical need.
Important Note
Ensure you input the planned removal per breast, not the total combined weight, to get an accurate status. Insurance companies typically require the resection weight for each individual breast to match the scale.
This tool is for informational purposes only and is not a substitute for professional medical advice or a guarantee of insurance coverage. Always consult with your plastic surgeon and insurance company to confirm eligibility.
If your results are borderline, consider requesting a letter of medical necessity from your physician to strengthen your case.