Question 1

Does Medicare cover gallbladder removal surgery?

Accepted Answer

Yes. Medicare covers laparoscopic cholecystectomy (CPT 47562) when medically necessary — typically for symptomatic gallstones, acute cholecystitis, or biliary colic. Medicare pays 80% of the approved amount under Part B (outpatient) or Part A (inpatient). Most uncomplicated cholecystectomies are performed as same-day outpatient procedures. Complicated or emergency cases (acute cholecystitis with perforation) typically require inpatient admission.

Question 2

Is cholecystectomy inpatient or outpatient with Medicare?

Accepted Answer

Uncomplicated laparoscopic cholecystectomy is most commonly performed as an outpatient (same-day surgery) at either an HOPD or ASC. The ASC facility fee is approximately $3,400 vs $5,200 at an HOPD. Acute, complicated, or emergency cholecystectomies are performed inpatient with DRG 418 billing ($10,109 Medicare pays to the hospital). If your surgery is planned and non-emergency, ask your surgeon about outpatient ASC scheduling to minimize costs.

Question 3

What is the Medicare out-of-pocket cost for gallbladder surgery?

Accepted Answer

In 2026, the surgeon fee for laparoscopic cholecystectomy (CPT 47562) is approximately $394 nationally (your 20%: $79). The HOPD facility fee is approximately $5,200 (your 20%: $1,040); the ASC facility fee is approximately $3,400 (your 20%: $680). Anesthesia adds $400–$800 (your 20%: $80–$160). Total out-of-pocket at an ASC without Medigap: approximately $840–$920. With Medigap Plan G, cost is $0 after the $283 annual deductible.

Question 4

Why does this calculator show a different amount than Medicare.gov's cost estimate?

Accepted Answer

This calculator may show a higher number than Medicare.gov's "Patient Pays (average)" for several reasons: (1) Deductible timing — this calculator applies the $283 Part B annual deductible if it has not yet been met; Medicare.gov's average assumes many patients have already satisfied theirs. (2) Anesthesia — Medicare.gov's estimate covers the facility fee and surgeon only; anesthesia is billed separately and is included in this calculator. (3) Location adjustment — surgeon fees are adjusted by your region's Geographic Practice Cost Index (GPCI); in high-cost cities like Seattle or New York, surgeon fees run 30–50% above the national rate. Facility fees (HOPD and ASC) are nationally fixed by CMS and should match Medicare.gov exactly. (4) Patient mix — Medicare.gov's "Patient Pays" average includes Medigap enrollees who pay $0 coinsurance, which pulls the reported average below what uninsured Original Medicare patients typically pay.

Cost Component	Medicare-Approved Amount	Your Share (20%)
Surgeon Fee — Cholecystectomy (CPT 47562)	$631	$126
Hospital Outpatient (HOPD) Facility Fee	$6,176	$1,235
Ambulatory Surgery Center (ASC) Facility Fee	$3,030	$606
Inpatient Hospital (DRG 419) — Medicare Pays	$9,939	$1,736 Part A deductible
Anesthesia (estimated)	$400–$800	20% of approved

Medicare Cholecystectomy Cost 2026 | Out-of-Pocket Estimator

2026 Medicare Cost Summary — Cholecystectomy (CPT 47562)

What Medicare Pays

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