How Much Does Surgery Cost With Medicare? A Cost Breakdown by Procedure

Surgery is one of the most expensive kinds of medical care you can receive. Whether you know well in advance you’ll need a procedure or it’s emergent, it’s rarely a planned expense. Read on to find out how different Medicare plans pay for surgery and what you could expect to pay for some common procedures.

What determines how much you’ll pay for surgery with Medicare?

If your doctor has told you that you need surgery, the amount you’ll pay depends on a handful of factors including:

• Where you have surgery – Some facilities, even in the same area, charge dramatically different prices for a procedure.
• The kind of surgery – More complicated surgeries, like a cardiac bypass, are going to cost more than others, like a breast biopsy.
• Whether the procedure is inpatient or outpatient surgery – Part A pays for hospital stays and Part B pays for outpatient care, so you may have different deductibles and copays, depending on your status.
• Your Medicare plan – some Medicare Supplement plans cover more, or all of, your out-of-pocket costs once you pay your Part B deductible, while others, like Medicare Advantage plans, have additional costs.
• How long you stay in the hospital – After you pay your Part A deductible, Medicare pays for most of your hospital stay costs if your hospital stay is 60 days or fewer.

If you are having inpatient surgery, Medicare Part A pays for most of the costs. You could be responsible for some charges, depending on the type of Medicare coverage you have and how long you are in the hospital.

Inpatient vs. outpatient Medicare surgery costs: What changes?

The way Medicare covers your surgery depends on whether it’s inpatient or outpatient. Medicare Part A covers most of the costs of inpatient care, and Medicare Part B covers outpatient services.

An outpatient surgery is one that typically gets you in and out of a hospital or surgery center in a day. These include:

• Cataract surgery,
• Knee arthroscopy,
• Colonoscopy,
• Vasectomies.

Inpatient procedures are generally more involved and require monitoring for at least one overnight stay in a hospital. These may include:

• Gastric bypass surgery,
• Coronary artery bypass,
• Kidney or other organ transplants.

Medicare Part A surgery costs: Deductible, coinsurance, and lifetime reserve days

When you have inpatient surgery (where a doctor formally admits you to the hospital), it’s covered by Medicare Part A. Following are the costs for inpatient surgery with Original Medicare (both Part A and Part B).

Medicare Part A deductible – For each benefit period (the time you are admitted to the hospital until 60 days after you’ve had no care related to the visit), you’ll be responsible for your Part A deductible, which is $1,736 in 2026.

Most of the time, that’s all you’ll owe for surgery. But if you have a long hospital stay – 61 days or more – you would pay the daily fee ascribed by Medicare. (This doesn’t happen often; the average hospital stay in the United States is about five days.)

Days 61-90 – If you’re in the hospital this long, you’ll pay $434 daily in 2026.

Days 91-150 – These are known as lifetime reserve days, which you would typically only need if you have major complications. During this time, you’ll pay $868 per day.

Days 151 and beyond – If you remain in the hospital for one benefit period this long, you’re responsible for all your hospital costs.

Medicare Part B surgery costs: Deductible and 20% coinsurance

For these procedures, you’re responsible for your Part B deductible ($283 in 2026) if you haven’t already paid it. Medicare then covers 80% of the costs, and you pay 20% of the remaining charges, including doctor and facility fees. You can request an estimate of all these costs prior to the surgery to get an idea of the total amount you’ll owe.

Does Medicare Advantage or Medigap cost less for surgery?

What you will pay for surgery is very different depending on what type of Medicare plan you have. Medicare Supplement (Medigap) and Medicare Advantage cover costs differently, and various plans within each coverage type will pay more or less for the procedure. But understanding the basics of both types of coverage can help you decide which could save you the most money when you have to have surgery.

Medicare Advantage: Copays, out-of-pocket maximums, and network limits

Medicare Advantage plans are an alternative option to Original Medicare, so they have their own cost structure. With Medicare Advantage, you’re responsible for copays for doctor’s visits and rehabilitation as well as coinsurance for each day you spend in the hospital. For an inpatient surgery that requires rehabilitation after, your costs could look something like this with a typical Medicare Advantage plan:

• Copay for your specialist visit to be diagnosed: $25
• Amount billed per day in the hospital for surgery at $350 per day (for days 1 through 5): Four days is $1,500
• Rehabilitation copay of $25 per visit: Eight therapy sessions are $200

Total costs for the surgery would be = $1,750

Other considerations:

• Medicare Advantage plans have doctor and hospital networks, so to save money, you’ll need to have the surgery performed at an in-network facility.
• You’ll also need to make sure you have any prior authorization approved by your insurance company.
• Though you’re responsible for more of the costs of care, many Medicare Advantage plans have low – often $0 – monthly premiums. This could save you $1,500 to $2,000 in premiums when compared to Medigap plans.
• If you have other healthcare expenses during the year, you’ll continue to pay copays for doctor visits and other care.

With Medicare Advantage, you have some protection from high-cost care with the annual Maximum Out-of-Pocket limit, which is $9,250 for in-network services in 2026. That is the limit the government sets, but many plans set their own limit; in 2026, the average amount across Medicare Advantage plans is $5,421. To guard against high costs, look for a plan with the lowest out-of-pocket maximum for the year.

Medigap: Predictable costs and no network restrictions

Medigap is meant to cover the costs for services that Original Medicare doesn’t. And it does this if you have inpatient surgery. Here’s what the costs for the inpatient procedure from above could look like with Medigap Plan G, one of the most robust types of Medicare Supplement coverage:

• Your Part B deductible for the office visit to get a diagnosis: $283
• Medigap Plan G pays for your Part A deductible of $1,736 (in 2026) for four days in the hospital: $0
• Rehabilitation copay is paid at 80% by Original Medicare; Plan G covers the remaining 20%: $0

Total costs for the surgery would be = $283

Estimated annual costs for monthly premiums of $150 for Plan G = $1,800

Other considerations:

• Medigap plans typically don’t require prior authorizations for most procedures, so your doctor – not your insurer – decides when you need medically necessary care.
• You’ll also be able to get treatment from any doctor or facility that accepts Medicare assignment; Medigap doesn’t have provider networks.
• Your expenses for the procedure may be low, but you also need to consider monthly premiums, which are higher for Medigap plans compared to Medicare Advantage plans.
• Once you’ve paid your Part B deductible, most other healthcare expenses you incur will be covered for the year.

Does knowing I have surgery coming up change which plan I choose?

If you know you have a surgery that is scheduled, or has been recommended by your doctor, it may impact the kind of plan you choose for the upcoming year. Here are some scenarios based on United Medicare Advisors’ internal data.

What if you need knee surgery and you’re choosing between Plan G and Plan N? – You would have your surgery and physical therapy and pay the $283 deductible and be done for the year with Plan G. With Plan N, you would pay the deductible, and each of your rehabilitation visits would also include a small $25 copay, as would any other doctor’s visits you have throughout the year.

What if you’re on a fixed budget with no savings, planning surgery, and choosing between Plan G and Plan N? — Plan N offers lower premiums than Plan G ($150 for Plan G and $108 for Plan N on average in 2026). Knowing how much you’ll pay every month may be more important than having medical bills spread over the year.

What if you’re on Medicare Advantage and you have a surgery scheduled? – You would likely need to wait until the surgery, physical therapy, and follow-up visits were finished before applying for a Medigap plan. Unless you live in a state with guaranteed issue, you would have to go through medical underwriting. Because you already have surgery planned, you would likely be denied or have higher premiums.

What if you’re on Medicare Advantage and you may have to have surgery? – As long as you live in a state with guaranteed issue rights, or can otherwise pass underwriting, you should be OK to switch to a Medigap plan. If there is no treatment pending or on the books, you’ll likely be able to change.

How much does surgery cost with Medicare, by procedure?

Even with cost estimator tools available, it can be difficult to understand what you would have to pay for surgery. Below, we’ve provided an estimate of the cost if you have Original Medicare based on the Medicare Price Lookup tool, which offers national average prices for outpatient procedures.

All these outpatient procedures would be covered under Medicare Part B. The charts below assume you have already paid your Part B deductible, which was $283 in 2026. You would then just be responsible for your 20% coinsurance.

Notes:

• For any surgeries that require rehabilitation or durable medical equipment (like walkers or crutches), you are responsible for 20% coinsurance.
• If medication is prescribed, your Part B plan typically covers drugs given in the hospital. If you have medications that need to be taken at home later, these will likely be covered by your Part D plan.
• Surgery costs are often lower in ambulatory surgery centers than in hospital outpatient departments. But you would sometimes pay less at when getting procedures at a hospital because Original Medicare caps your copayments at these facilities at $1,676.

Cataract surgery cost with Medicare

Your cataract surgery out-of-pocket costs for 2026 include the surgeon and care facility where you have the procedure completed.

	Ambulatory Surgical Center	Hospital Outpatient Facility
National Average Cost:	$1,885	$2,987
Medicare 80% Coverage:	$1,508	$2,390
Your 20% Coinsurance:	$377	$597

Medicare doesn’t cover technology upgrades like laser surgery, which can be $1,000 to $2,500 per eye. It also doesn’t pay for special lenses, which can add more than $1,300 per eye out of pocket.

Knee and hip replacement cost with Medicare

Knee replacement

	Ambulatory Surgical Center	Hospital Outpatient Facility
National Average Cost:	$10,552	$14,275
Medicare 80% Coverage:	$8,441	$12,307
Your 20% Coinsurance:	$2,109	$1,967

Hip replacement

	Ambulatory Surgical Center	Hospital Outpatient Facility
National Average Cost:	$10,776	$14,278
Medicare 80% Coverage:	$8,620	$12,309
Your 20% Coinsurance:	$2,154	$1,968

Bariatric surgery cost with Medicare

	Ambulatory Surgical Center	Hospital Outpatient Facility
National Average Cost:	$1,485	$2,117
Medicare 80% Coverage:	$1,188	$1,693
Your 20% Coinsurance:	$296	$423

Hernia and rotator cuff surgery cost with Medicare

Hernia surgery

	Ambulatory Surgical Center	Hospital Outpatient Facility
National Average Cost:	$3,454	$6,600
Medicare 80% Coverage:	$2,763	$5,280
Your 20% Coinsurance:	$690	$1,319

Rotator cuff surgery

	Ambulatory Surgical Center	Hospital Outpatient Facility
National Average Cost:	$4,671	$8,389
Medicare 80% Coverage:	$3,737	$6,711
Your 20% Coinsurance:	$934	$1,677

Cardiac bypass surgery cost with Medicare

Cardiac bypass surgery, unlike the others above, is an inpatient procedure, so the payment structure would be slightly different.

Medicare Part A covers the hospital portion of the fees. Assuming there are no complications and you have a short stay, you would pay the per-day hospital fee until you meet your deductible for that benefit period, which is $1,736 in 2026.

Medicare Part B pays for 80% of the physician and surgeon fees after you pay your deductible, which is $283 in 2026. You are responsible for 20% of any remaining costs. Physician fees can be at least $5,000, meaning you could pay $1,226 ($283 + $943 (20% of the total after the deductible).

Medicare Part B will also pay 80% for cardiac rehabilitation after surgery; you’ll be responsible for the other 20% of those costs. Medicare pays for 36 sessions.

Your total costs could look like this:

• Your Part A deductible: $1,736
• Physician fees: $1,226
• Rehabilitation of 36 sessions at 20% of $150 per visit: $1,080

Total: $4,042

Medicare Part D covers prescription drugs you may need, like blood thinners, after surgery. You’ll be responsible for any copays for these medications.

Surgeries Medicare doesn’t cover

Medicare doesn’t cover surgeries that aren’t medically necessary (sometimes called elective surgeries), like cosmetic procedures, unless they serve a medical purpose. For example, Medicare will cover an eye lift if the droopy lids impact your vision.

Some surgeries that aren’t covered by Medicare include:

• LASIK and other nonmedically necessary vision-correction surgeries,
• Routine cosmetic work,
• Most elective weight-loss procedures (unless your doctor documents a medical justification),
• Surgeries that Medicare deems experimental or lack broad clinical trial approval,
• Elective birth control like a vasectomy.

How to estimate your Medicare surgery costs before you schedule

You can get an estimate of what your potential costs will be for surgery by contacting your doctor or hospital before the procedure. You can also reach out to your plan carrier, who can help with cost estimates. If you are getting an outpatient procedure, you can look up the average national costs online using Medicare’s own Outpatient Procedure Price Lookup tool.

Compare your Medicare costs before surgery

If you know you have surgery coming up, it may be time to consider a new Medicare plan that will cover a majority of your healthcare costs. To compare plan coverage and prices before your procedure, reach out to a licensed United Medicare Advisors agent.