Bariatric surgery costs range from $10,000 to $35,000 depending on the type of procedure. Gastric bypass is at the higher end (around $30,000) while gastric banding is at the lower end (around $20,000 on average). Patients with insurance may pay just a few hundred dollars or a few thousand depending on the copays or deductible outlined in their health plan. Individuals who are covered by Medicare or Medicaid may have only a minimal copay for their surgery. However, they may need to meet stricter requirements to qualify for the procedure compared to other insured patients.
What’s Covered by Bariatric Surgery Prices?
There are a number of fees typically associated with weight-loss surgery. These include:
- Lab fees for blood work, x-rays and other pre-operative tests
- Surgeon’s fee
- Anesthesiologist’s fee
- Hospital facility fee (for use of the facility during the operation)
- Additional days of hospital/recovery center stay
- Follow-up care (first 90 days)
Surgical fees vary substantially based on geographic location and the surgeon’s level of experience. The most invasive form of weight-loss surgery (open gastric bypass) may require a three-day hospital stay or longer. In contrast, a gastric banding patient might be discharged the same day or just stay overnight. Patients who do not have a support system in place at home might need to spend a much longer time in a recovery center. This can substantially increase the cost of the procedure.
Additional Bariatric Surgery Costs
Here are costs that may be incurred above and beyond those for the actual operation:
Medically-supervised weight loss: This may be a requirement imposed by the bariatric surgeon or the insurance company prior to approving a patient for surgery. This weight-loss attempt may go on for several months or up to a year. It may involve special foods or other supplies in addition to nutritional counseling.
Psychological evaluation: This may not be mandatory, but it is usually advisable to have some form of professional evaluation prior to bariatric surgery. This might be a single evaluation session or ongoing therapy and behavioral modification to address issues such as binge eating or anxiety, which may interfere with post-operative lifestyle changes.
Pain medications, wound care and recovery supplies: Pain killers, antibiotics, bandages and other items may be provided at the time of surgery. However, some items may need to be purchased in advance to prepare for recovery at home.
Fill/adjustment of gastric band: The LAP-BAND® and REALIZE® both require ongoing maintenance. This may involve simply adjusting the amount of saline in the band (at a cost of $100-300 per visit) or correcting other device problems (several hundred to a thousand dollars). Or, the band may need to be removed or replaced if there is a device failure.
Treatment for complications: Bariatric surgery costs may include hospitalization for life-threatening side effects or revision surgery. Outpatient treatment may also be required for moderate-to-serious side effects. These medically necessary visits are typically covered by insurance. However, patients paying out of pocket should be aware that repairing damage to the gastrointestinal system may cost more than the original surgery depending on the degree and location of complications.
Nutritional monitoring, supplementation and counseling: Bariatric surgery patients typically face a lifelong challenge to get sufficient nutrition. They may also have a higher rate of side effects if they do not adhere strictly to the recommended post-op diet. Long-term followup includes daily supplementation, frequent lab tests and nutritionist and fitness counseling as needed. This may cost several thousand dollars per year.
Plastic surgery: Bariatric surgery prices are only half the picture. The operations used to remove excess skin and re-contour the body after extreme weight loss can cost tens of thousands of dollars. These are considered cosmetic procedures and are not covered by insurance.
When Does Insurance Cover Bariatric Surgery Costs?
The qualification process is different for every plan. Here are some general guidelines:
- The patient must have a BMI of 40 or more
- Patients with a BMI of 35-40 (or 30-40 for gastric banding) must have at least one significant medical condition related to being overweight (high blood pressure, diabetes, etc.)
- The patient must have a history of long-term weight loss attempts under medical supervision
- High body weight must have been a problem for several years
- Surgeon, anesthesiologist and facility must be in-network
Patients who expect to have their surgery covered by insurance must go through a pre-approval process first. Otherwise, they may be stuck with the bill for the entire procedure. Most bariatric surgery centers will assist patients with navigating this process to ensure maximum coverage. Patients who do not have insurance or who do not qualify under their existing insurance plan may choose financing such as a revolving line of credit to cover their bariatric surgery costs.