Gastric Bypass Cost

Gastric Bypass Surgery Cost – As Low as $0, But Average Is $3,500

The average cost of gastric bypass surgery is $24,300. That drops to around $3,500 with insurance but could be as low as $0 depending on your specific insurance pan and how much of your deductible and out-of-pocket maximum you’ve already paid this year.

The ultimate out-of-pocket costs depend on:

  • Chosen hospital and surgeon
  • Insurance plan and benefits
  • Special discounts
  • Financing
  • Tax savings

Read and click the sections below for everything you need to know about minimizing your gastric bypass costs.

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01.

Cost of Bypass With Insurance

SECTION SUMMARY:

  • $3,500 average out-of-pocket costs, depending on your insurance plan

1. United States: Covered If Your Plan Includes Bariatric Surgery

In the U.S., gastric bypass is covered under any plan that includes weight loss surgery.

How Do You Know If Your Insurance Includes Weight Loss Surgery?

It varies based on how you get your health insurance:

  • Individual/Family Plans & Small Group Plans (under 50 employees) – Obamacare requires that many states cover weight loss surgery.
  • Large Group Plans (50+ employees) – it is 100% up to the company whether the chosen benefits plan includes bariatric surgery. Ask someone in the HR department or contact your insurance company to see whether it’s covered.
  • Medicare & Medicaid – both of the federally sponsored plans cover gastric bypass surgery, but not all surgeons accept Medicare and Medicaid.
Click Here to Check Your Insurance

If Your Policy Covers It: Ask for a Free Insurance Check

Most surgical practices will check your insurance benefits for free. Importantly, they’ll normally do it quickly since they have a staff experienced in dealing with insurance companies.

Instead of doing your own research, reach out to local surgeon’s office to check your insurance benefits.

Contact a surgeon for a free insurance check.

The below are average out-of-pocket gastric bypass costs if you have insurance:

  • HMO: $1,475
  • PPO: $2,542
  • POS: $2,270
  • High-Deductible Health Plan: $1,901

See below for assumptions:

  • Zero dollars paid towards your calendar year deductible for other services
  • The were calculated with special formulas that are based off of average plan designs from Kaiser Family Foundation’s Annual Employer Health Benefits Survey (1)

If Your Policy Does NOT Cover It: Seek Partial Coverage

You can likely get some of the costs associated with weight loss surgery paid for by insurance even if you have plan exclusion for bariatric surgery. Whether some of the costs are covered turns on how your medical team submits the claims to the insurance company.

For example, there are a lot reasons unrelated to weight loss surgery why your doctor might request:

  • Cardiology exam
  • Lab work
  • Medically supervised diet program
  • Psychological exam
  • Sleep study

Since is possible or likely that the above was ordered for a reason other than weight loss surgery, the costs can be covered by insurance. If your doctor submits one of these claims using a weight loss surgery CPT code (Current Procedural Terminology Code), your insurance is unlikely to cover it. But if your doctor uses a general CPT code, it likely will be covered.

We assure you that the most upstanding doctors do this. It’s an ethical option because these types of tests and can be beneficial to your health whether or not you end up having weight loss surgery.

The U.S. Insurance Approval Process

Getting your insurance company to approve your gastric bypass surgery takes between 1 and 12 months. Below are the steps:

  1. You meet the body mass index (BMI) requirements and that fact is documented by your doctor:
    • BMI of 40+ –OR–
    • BMI above 35 with one or more of:
      • Clinically significant obstructive sleep apnea
      • Coronary heart disease
      • Medically refractory hypertension
      • Type 2 diabetes mellitus
      • Other obesity-related health issues
  2. Complete three to seven months of a medically supervised diet program in succession.
  3. Book an appointment with your chosen weight loss surgeon for a consultation.
  4. Schedule an appointment with your regular doctor (PCP) so you can get a medical clearance letter.
  5. You’ll need to book a psychiatric exam to get a clearance letter for your mental health.
  6. Book an appointment with a Registered Dietitian for your nutritional evaluation.
  7. Your insurance company will have you send them:
    • Everything you received in steps 1 – 6 above
    • A history of health issues that stem from suffering from obesity
    • Additional problems caused by your weight and any treatment attempts
  8. You’ll hear back from your insurance company in less than a month.
  9. Your insurance company will mail you an approval or denial:
    • If it’s a yes, your weight loss surgeon’s office will call you to get you on the schedule
    • If it’s a no, you can try and appeal the denial.

Your chosen surgical practice can do nearly all of this for you. It’s likely that all the required experts are part of the staff (registered dietitian, psychiatrist, bariatric coordinator, etc.).

Click here to access the weight loss surgeon directory to begin.

For more information about gastric bypass insurance, see our Bariatric Surgery Insurance Patient Guide.

If you’re interested in learning about insurance coverage of weight loss surgery outside of the U.S. visit our country specific pages below:

02.

Cost Without Insurance

SECTION SUMMARY:

  • Total Cost: $24,000, on average
  • Loan Payment: $556/month, on average
  • Discounts & Tax Savings: Usually available

The average cost of gastric bypass without insurance is $24,300, although this varies widely by surgeon. If you don’t have insurance and ask a surgeon for a gastric bypass quote, you will get one of 3 responses:

  • No Self-Pay Option – these are few and far between – most surgeons readily accept self-pay patients.
  • Partial Quote – some surgeons will respond with only the fees they directly control: the surgical fees. Due to the fact that they don’t know the exact amount of some fees in advance (such as hospital fees). However, most will furnish you with contact information so you can call the hospital and figure out the total cost of your surgery.
  • All-Inclusive Packages – many surgeons will have an “all-inclusive” cost for to share. This is just what it sounds like: a detailed description of everything covered by the cost-quote the surgeon provides.

1. How to Get Weight Loss Surgery Insurance in the U.S.

If your benefits package doesn’t currently include coverage for gastric bypass surgery there are two ways to get it:

  • You may be able to get covered by a plan that requires weight loss surgery be an included benefit under The Affordable Care Act (“Obamacare”). See the Obamacare page for more information.
  • Request that your place of work add it to the current benefits package. If your current employer has more than 50 employees, the employer gets to make the decision on whether weight loss surgery is covered. It makes good financial sense for the company to include bariatric surgery. You can click here to find specific statistics and information to share with the decision-makers in your Human Resources department.

2. Discounts: 6 Discounts to Ask Your Surgeon About

Ask your surgical center if any of the below are available to you:

  • Self-Pay Discounts. Make sure you ask about a possible discount for cash pay!
  • Other Discounts. If you the cash to pay all of your out-of-pocket costs up front, some surgical offices will provide a discount.
  • Same Surgeon, Different Hospitals. This might surprise you, but the hospital fees are always the largest portion of the bill for weight loss surgery. Like anything, some hospitals charge more than others. Be sure to ask your surgeon if he or she is using the lowest-cost location suitable for their needs.
  • Complications. It’s possible you could experience a complication during your procedure. Ask your doctor who foots the bill if that happens. Look at your cost quote carefully to see whether it falls on the surgeon or on you.
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03.

Cost by Location

SECTION SUMMARY:

  • United States: $24,000 USD
  • Canada: $20,125 CAD
  • Australia: $4,500 AUD
  • United Kingdom: £11,100
  • International (Medical Travel): $4,000 to $24,000 USD

Your total gastric bypass cost depends on where you have the surgery. This varies widely by surgeon and hospital. Different surgeons in the same city can have a price difference of $5,000 to $10,000 or more.

And cost often has nothing to do with the quality of the surgeon or hospital. Instead, cost is driven by:

  • The general costs of living in your geographic region
  • The competition amongst providers in your area can drive costs down
  • If number of people covered by Medicare and Medicaid where you live
  • If the hospital used has for-profit or non-profit status

This section shares average costs by location.

For a specific price in your location, click here to contact a surgeon and ask for a free quote.

1. United States: $24,300

The average cost of gastric bypass surgery in the United States is about $24,300. But there is a big cost difference between states. Costs range from $15,300 in Arkansas to $57,500 in Alaska.

2. Canada: $20,427 CAD

Quebec is the only province in Canada with enough “self pay” surgeons to calculate an average.

Average gastric bypass costs in Quebec are $20,427 CAD.

For an exact quote, click here to find and contact a surgeon

3. Australia: $4,568 AUD

For state and territory averages, tap to through the chart below. These cost averages (listed in Australian dollars) assume that you have insurance.

For an exact quote, click here to find and contact a surgeon

Tap here to see average costs by territory

RegionAverage Cost
NEW SOUTH WALES$4,568
NEW SOUTH WALES surgeons surveyed are located in Sydney
QUEENSLAND$5,325
QUEENSLAND surgeons surveyed are located in Brisbane and Gold Coast
SOUTH AUSTRALIA$3,299
SOUTH AUSTRALIA surgeons surveyed are located in Adelaide and Barossa Valley
TASMANIA surgeons surveyed are located in Hobart
VICTORIA$5,237
VICTORIA surgeons surveyed are located in Melbourne
WESTERN AUSTRALIA surgeons surveyed are located in Perth

4. United Kingdom: £11,233

For an exact quote, click here to find and contact a surgeon

5. International (Medical Travel): $4,352 to $24,300 USD

Following are averages by country (in U.S. Dollars for comparison purposes):

  • Australia – $16,192
  • Canada – $16,192
  • Costa Rica – $12,650
  • Egypt – $4,352
  • India – $10,525
  • Mexico – $7,489
  • Thailand – $10,626
  • United Kingdom – $14,370
  • United States – $24,300

Click here for an in-depth review of medical travel for gastric bypass surgery.

04.

Cost Vs. Remaining Obese

SECTION SUMMARY:

  • The average patient saves $11,000 per year after year 2, post-surgery

$24,300 (the average cost of gastric bypass surgery without insurance) is a lot of money, but it’s a small number when compared to the lifelong medical costs of remaining obese.

Beginning in Month-13 post-surgery, people that paid for bariatric surgery out-of-pocket (i.e., insurance didn’t cover anything) save about $900 a month when compared to the average cost of remaining obese (2). Said another way, it’s about $11,000 you’ll “save” every year. Just reducing the number of prescription drugs you’ll take saves, on average, $3,000 or more each year (3).

Stated simply, approximately 21 months after you have surgery you will “break even” and be able to spend $11,000 less on your healthcare expenses each year.

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05.

Cost Breakdown

SECTION SUMMARY:

  • Pre-Op (before surgery)
  • Standard costs during surgery
  • Non-standard costs during surgery
  • Post-Op (after surgery)

The following sections break down when you’ll incur certain costs.

Pre-Op (costs before surgery)

  • There are costs associated with the insurance required physician-monitored weight loss program
  • Consultations with the nutritionist and/or dietitian
  • Associated psychological visits for your required mental health clearance
  • Cardiologist (heart health clearance)
  • Labwork, echocardiogram (AKA an “ECG” or “EKG”) and/or costs for X-Rays
  • Your surgeon may charge a fee for your initial consultation
  • You might have to undergo a sleep study

Standard costs during surgery

These are exactly what you would assume: the costs associated with the hospital stay, surgical fees, anesthesia, operating room, and any necessary assistant staff that will be present during your procedure.

Non-Standard Costs During Surgery

If the need arises during surgery for a pathologist to review biopsies or a radiologist to review x-rays, you could have additional costs.

Post-Op (costs after surgery)

  • Reviewing surgical complications, if necessary
  • Visits to your doctor
  • Any necessary vitamins
  • Additional spending on food since healthy food is often more expensive
  • Gym or personal training fees
  • A new wardrobe (you should allow yourself to hit your projected plateau weight first)
  • Surgical procedure to get rid of sagging skin (see more in the Downsides section below)
06.

Financing Options

SECTION SUMMARY:

  • 7 ways to make surgery more affordable

Gastric bypass financing is fairly common. You can use it for:

  • Covering the expense of the actual surgery
  • Anything your benefits plan doesn’t pay for (e.g., copays, deductibles, or co-insurance)

The below options for financing gastric bypass surgery can be used (click a link to read a more detailed explanation of each):

  1. Payment Plan Through a Qualified Surgeon
  2. Brokers, Direct Lenders, and Credit Cards (Unsecured Medical Loans)
  3. Friends & Family
  4. Secured Medical Loans
  5. Retirement Plan Loans
  6. Permanent Life Insurance Loans
  7. Medical travel – having surgery in a location that is less expensive than where you live
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07.

Cost Vs. Other Procedures

SECTION SUMMARY:

  • With Insurance: Tied for Lowest Cost
  • Without Insurance: 6th Lowest cost out of 7

Gastric bypass is tied for the lowest-cost procedure if you have insurance that covers bariatric surgery. Without insurance, it has the 6th lowest average total cost.

Click Here to Compare the Cost of Gastric Bypass
08.

Tax Considerations

SECTION SUMMARY:

  • Your gastric bypass surgery may be tax deductible
  • Tax-favored savings accounts help offset costs

Click your country below to find out if tax savings are available:

1. United States: Might Be Deductible, Special Tax-Favored Accounts Available

Gastric bypass surgery is tax deductible, which can major implications in lowering the overall costs of your surgery.

So long as the costs are greater than 10% of your adjusted gross income, you can categorize the cost of your surgery as a deduction.

You’ll have to submit Schedule A of the IRS Form 1040 to receive the deduction. Retain your medical bills and the paid invoices for proof.

Cash held in certain types of savings accounts (including your IRA) can be a way to pay for a portion of your gastric bypass tax-free:

Health Savings Account (HSA)

You can open an HSA alongside a “qualified high deductible” health plan. You can use money from the HSA to cover certain medical expenses. An HSA receives the best tax treatment possible. It’s even possible to transfer money from your IRA money to your HSA. Visit the IRS’s Site for additional information.

Archer Medical Savings Account (Archer MSA)

An HSA for people that are self-employed or small businesses is called an Archer MSA. Click here for additional information.

Health Reimbursement Account (HRA)

If your employer offers an HRA, you’ll need to know whether the plan allows for use of HRA moneys to pay for “all qualified medical expenses.” Click here for more information.

Flexible Spending Account (FSA)

Employees and employers may contribute funds to an FSA, sometimes referred to by its IRS code, “Section 125”. FSA dollars can be used for qualified medical expenses tax free. Click here to read the specifics from the IRS.

If you’re interested in the tax information for countries outside of the U.S. visit our country specific pages below:

09.

Free Insurance Check & Cost Quote

SECTION SUMMARY:

  • You can find a top weight loss surgeon
  • You can contact a local surgeon and ask for a free insurance check or cost quote

Most surgeons offer a free gastric bypass cost quote and a free insurance check. Most also offer a free in-person seminar, free webinar, or free initial consultation.

Surgical centers, hospitals, and their associated staff are experts in all steps of this process. Instead of trying to navigate this all by yourself, leverage their collective knowledge by contacting someone in your area today.

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