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You generally cannot replace a 10-inch rough-in toilet with a 12-inch model without making significant plumbing updates. A 12-inch rough-in toilet will not fit a 10-inch rough-in space because the floor drain is in the wrong position. To accommodate the larger toilet, you would need to move the drainpipe, which could cost between $0.75 and $30 per linear foot, plus labor. In most cases, it is more cost-effective and simpler to purchase a new 10-inch rough-in toilet. However, it is possible to install a 10-inch rough-in toilet in a 12-inch space by using a longer connector.

Some of the problems with in-wall toilets include the complex installation, which might need extra framing. It is also more difficult to access the toilet tank for maintenance or troubleshooting because it’s behind the flush button panel and in the wall. Over time, you’ll spend more on maintenance because you’ll need a plumber to work on hidden plumbing.

If you experience the telltale sign of wax ring failure, which is leaking water, replacing the faulty ring takes one to three hours, depending on accessibility. This is an exacting and time-consuming job, as several components must be removed for the plumber to access the ring. Once replaced, however, wax rings require little to no maintenance and last 30 years or longer.

The cost of making a bathroom accessible can be $3,000 to $25,000, but you could spend as much as $50,000 building a brand-new ADA-compliant bathroom. Some bathroom accessibility upgrades to consider include:

• Installing grab bars: $100–$500 

• Lowering cabinets and vanities: $1,200–$2,500

• Installing modified doors: $700–$1,500

• Installing a modified toilet: $400–$1,000

• Installing an accessible sink and faucet: $100–$1,000

• Adding a walk-in tub: $1,100–$17,000

• Converting a bathtub into a walk-in tub: $350–$1,000

• Installing a wheelchair-accessible shower: $2,000–$7,500

• Installing a shower ramp: $16–$300