On average, gallbladder surgery can cost between $3,044 and $6,321. However, several factors affect the final cost of the surgery and the out-of-pocket costs a person must pay.
There are multiple types of gallbladder surgery.
A cholecystectomy involves surgically removing a person’s gallbladder.
Most surgeons perform a laparoscopic cholecystectomy. This minimally invasive procedure is
A surgeon may also use cholangiography or perform common bile duct exploration along with the laparoscopic cholecystectomy.
These procedures help the surgeon find any additional stones and blockages in the gallbladder and common bile duct. They also increase gallbladder surgery costs.
This article outlines average gallbladder surgery costs, insurance coverage options, and questions to ask doctors and insurance representatives.
These estimates include facility and doctor fees, but Medicare notes that a person may incur additional costs.
Gallbladder surgery is likely to be a medically necessary procedure. This means most major private insurance companies will cover the cost.
Private insurance companies may have their own definition of what makes a procedure medically necessary, but in general, major insurance policies may explain a medically necessary service as one that:
- is necessary for diagnosing, treating, curing, or relieving a health condition, disease, illness, or injury
- is not merely for the convenience of the person, their family, or the doctor
- falls within the generally accepted standards of medical care
Private health insurance policies vary by company and even from policyholder to policyholder. It is important for someone considering gallbladder surgery to consult their policy and an agent on factors such as pre-approval processes, percentage coverages, and copay requirements.
Medicare Part B is the section of Medicare that covers medically necessary services.
Once a person has met their annual deductible for Medicare Part B-covered services, they are usually responsible for 20% of the Medicare-approved amount. Medicare pays the remaining 80% of the approved amount.
It is advisable for someone who needs gallbladder surgery to speak with both the surgeon and a Medicare representative for a clearer understanding of the Medicare-approved amount.
What can a person expect to pay out of pocket?
Medicare explains that the gallbladder surgery cost a person can expect to pay out of pocket depends on the specific procedure and where the surgery takes place:
|Ambulatory surgical center (ASC)||Hospital-based outpatient department (HOPD)|
|Laparoscopic cholecystectomy with cholangiography||$620||$1,181|
|Laparoscopic cholecystectomy with exploration of common duct||$702||$1,263|
An ASC is a non-hospital facility where people who will not need more than 24 hours of care may access surgical services. An HOPD is part of a hospital that provides outpatient services and can include a surgery center.
Surgery cost breakdown with Medicare
Medicare provides the following gallbladder surgery cost breakdowns.
Medicare breaks down the cost for laparoscopic cholecystectomy:
Laparoscopic cholecystectomy with cholangiography
Medicare breaks down the cost for laparoscopic cholecystectomy with cholangiography:
Laparoscopic cholecystectomy with exploration of common duct
Medicare breaks down the cost for laparoscopic cholecystectomy with exploration of common duct:
Medicaid might be an option for those without insurance. Medicaid is a federally- and state-funded health insurance program for people with limited resources and income.
Each state establishes its own Medicare program according to federal policy guidelines. Depending on the state, Medicaid may cover some or all of a person’s gallbladder surgery cost.
Someone interested in applying for coverage can visit Medicaid’s State Profile for information about eligibility, coverage, enrollment, and more.
The average cost range for gallbladder surgery varies depending on:
- type of gallbladder surgery
- geographic location
- type of facility
- additional doctor fees
- any necessary additional procedures
- X-rays and lab testing
- the person’s insurance policy
- prescription medications
- follow-up appointments
Below are a few programs that provide financial help to people who have qualifying medical conditions and meet eligibility requirements:
Additionally, a person may find financial assistance by asking about the facility’s payment plans or receiving care from private, not-for-profit medical teams.
Those who do not have insurance and are not eligible for Medicare or Medicaid may have other options.
For example, veterans may apply for healthcare benefits through the U.S. Department of Veterans Affairs, which offers coverage for inpatient and outpatient surgical procedures.
Alternatively, a person may apply for coverage via HealthCare.gov.
Even outside the open enrollment period, a person may be eligible for coverage through the Affordable Care Act when they have recently experienced a qualifying life change.
For example, if someone who needs gallbladder surgery also recently lost their health insurance, had a change in their household size, or had a qualifying residence or income change, they may be eligible for coverage.
To best understand the gallbladder surgery cost they may face, a person can consider talking with their insurance provider before scheduling the procedure.
Some questions to ask include:
- Does the policyholder have to get a second opinion?
- What percentage of coverage does the policy handle?
- Does coverage change if the policyholder needs additional procedures?
- What deductible does the policyholder have to meet?
- Is the policyholder responsible for copayment or coinsurance?
- What kind of out-of-pocket expenses can the policyholder expect?
- What is the policy’s out-of-pocket maximum?
- Does the policy cover any pre- or postsurgical care?
- Are all medical team members (e.g., surgeons, anesthesiologists) in-network?
- Does the policy cover care at the surgical center or hospital outpatient department?
- Are there any medications or related procedures the policy does not cover?
The cost of gallbladder surgery varies depending on a number of factors. However, in general, a person may expect their gallbladder surgery cost to be anywhere from $3,044 to $6,321.
A person’s doctor — and their insurance provider, if they have one — can provide a more detailed estimate based on their specific situation. Often, some type of financial assistance for gallbladder surgery is available.