Sleeve gastrectomy is billed under CPT 43775, which CMS describes plainly as partial removal of the stomach for weight loss using a laparoscope. It is the most commonly performed bariatric operation in the United States, and it is also the cheapest of the major ones, for a reason that shows up directly in the price: it is a shorter procedure with no rerouting of the intestine, and many patients go home the same day.
That makes the gastric sleeve unusually easy to shop, because a same-day operation with a fixed team and no hospital admission is exactly the kind of care a center can quote as one number in advance. Several do, publicly, on their own websites. This guide uses those published 2026 prices plus 2024 CMS data to show what the number covers and why identical operations are quoted $6,500 apart.
What Does a Gastric Sleeve Cost Without Insurance?
A published all-in cash bundle runs $9,995 to $16,496 as of September 2026. The marketplace range is wider because it includes hospital-based outpatient prices.
| Price you might be quoted | Low | Typical | High |
|---|---|---|---|
| Surgeon fee only, Medicare-allowed (CPT 43775) | n/a | $710 | n/a |
| Surgeon fee only, average billed charge | n/a | $4,752 | n/a |
| All-in cash bundle, published center prices | $9,995 | $10,500 | $16,496 |
| Cash bundle including up to two hospital nights | n/a | $12,650 | n/a |
| MDsave marketplace, gastric sleeve (outpatient) | $10,298 | $16,484 | $26,877 |
| MDsave’s estimated national average benchmark | n/a | $34,547 | n/a |
| Financing at an advertised $238 per month for 60 months | n/a | $14,280 | n/a |
The four published bundles come from centers that post their self-pay rates openly. Alabama Surgical Associates in Huntsville lists $9,995, covering the surgeon’s professional fees, anesthesia and facility fees. The Nicholson Clinic in Dallas lists $10,500, adding pre-op labs and an EKG done in its own office, a pre-op dietitian visit, and office visits before and after surgery for life. North Mississippi Medical Center in Tupelo lists $12,650, which includes a hospital stay of up to two nights. Michigan Surgery in West Bloomfield lists $16,496, which includes preadmission testing and a one to two day hospital stay.
The surgeon-fee figures come from the CMS Medicare Physician and Other Practitioners dataset for the 2024 data year, released in May 2026. Nationally, 2,023 providers billed CPT 43775 in a facility setting across 4,926 services, submitting an average charge of $4,752 and being allowed an average of $710 by Medicare. That is the professional fee and nothing else, which is why a quote near it is never the whole cost of the surgery.
Where the Sleeve Price Actually Goes
The surgeon’s fee. The professional charge for performing the operation and the routine post-operative care attached to it. At Michigan Surgery that fee explicitly covers the pre-operative office visit, the surgery, and the first 90 days of post-op care.
The facility fee. The operating suite, recovery room and supplies. This is the line that separates a $9,995 same-day sleeve from a $16,496 sleeve with a hospital admission, and it is the single biggest reason two quotes diverge.
Anesthesia. Billed by a separate group in most hospital settings, which is how patients end up with an unexpected second envelope. Every package above folds it in.
The hospital nights. North Mississippi’s price covers up to two nights including nursing care, lab work, X-rays, medications and an in-hospital dietary consult. Michigan Surgery’s covers one to two days and charges separately for anything beyond that.
The follow-up window. This varies more than anything else and is easy to miss when comparing headline numbers. Nicholson includes office visits for life. Michigan Surgery includes 90 days, then charges $65 per office visit. North Mississippi includes follow-up exams at two, six and twelve weeks, dietitian visits at two and six weeks, and eight weeks of wellness center membership. Alabama Surgical’s sleeve price lists no follow-up at all, which is part of why it is the cheapest on the list.
What Drives the Price
Whether you are admitted
This is the dominant variable. Nicholson notes that the majority of its sleeve patients have surgery at a surgery center and go home the same day, with a small additional fee if a medical condition requires a hospital setting or an overnight stay. Every package on this page that includes hospital nights costs more than every package that does not.
The rule that shapes the whole market
Here is something almost no price guide mentions. In CMS’s July 2026 ASC addenda, CPT 43775 appears on Addendum EE, the list of surgical procedures excluded from payment in ambulatory surgery centers for calendar year 2026. It also carries status indicator C in the July 2026 OPPS Addendum B, meaning it is not paid under the hospital outpatient system either. By contrast, the laparoscopic gastric band code sits on Addendum AA with an ASC payment rate of $6,487.74 and an outpatient rate of $10,860.07.
The practical translation for you as a cash payer: the low-overhead surgery-center route that makes a $9,995 sleeve possible exists mostly outside the Medicare payment system. That is a pricing opportunity, not a warning, but it does mean you cannot use a Medicare facility rate to sanity-check a surgery-center sleeve quote. Compare against other published cash bundles instead, or run the number through our fair price checker.
Accreditation and center type
North Mississippi’s bariatric center is accredited as a Comprehensive Center under the MBSAQIP program and is designated a Cigna Center of Excellence and part of the Optum Bariatric Centers of Excellence Network. Accredited hospital-based programs are not usually the cheapest option on a price list, but they are the ones most likely to be in network if you later obtain coverage, and they carry the resources a complicated case needs.
What is deliberately outside the number
Michigan Surgery states that its package does not cover additional operating room time, an extended hospital stay, an additional surgery such as a hernia repair performed at the same time, professional fees for a radiologist or pathologist, or additional care for complications. Nicholson excludes post-operative blood work and prescriptions. The psychological clearance most programs require before scheduling is generally a separate expense, as is the pre-operative upper endoscopy many surgeons order, which our endoscopy cost guide prices.
Cash Price vs. Insurance
For the sleeve specifically, paying cash is often the faster road rather than only the cheaper one. Insurers typically require documented participation in a weight loss program, documented failure of conservative therapy, and medical and mental health clearances, which takes months to assemble. A self-pay patient at Michigan Surgery needs a signed medical clearance from a primary care physician with an EKG and blood work, a psychological clearance, and payment in full at least ten days before surgery.
The trade you are making is real, though. Michigan Surgery states plainly that if an insurer did not authorize and pay for the surgery, it will usually not pay for routine post-operative care related to it, and that a new insurer is unlikely to pay later either, because you did not obtain prior authorization with the plan in force at the time. Budget for years of follow-up out of pocket, not just the operation.
If the surgery happens at a hospital, the machine-readable price file is worth opening before you accept a quote. Our guide to hospital price transparency explains how to find CPT 43775 inside one and compare the posted discounted cash price against the package you were offered.
How to Pay Less
Ask whether your case can be done same-day at a surgery center. This is a medical question for your surgeon, not a preference you can choose, but it is the single largest price lever on this page. If the answer is yes, the same-day bundles are the ones to price.
Get the exclusions in writing and compare follow-up windows, not just headline prices. A $10,500 package with office visits for life and a $9,995 package with no follow-up attached are not the same purchase. Ask each center for its written list of what happens if you stay an extra night or need an unplanned procedure.
Price at least one center outside your metro. These bundles are prepaid and portable, and the published spread on this page is $6,501 for the same operation. Travel costs are small against that.
Apply for financial assistance before surgery if a nonprofit hospital is involved. Bariatric surgery for a qualifying patient is medically necessary care, not cosmetic, so it is generally eligible. Screen yourself with our charity care checker and follow the steps in our hospital charity care guide.
Audit any bill that arrives after a package price. If you were quoted a flat number and then billed separately, the itemized statement is where you find out why. Our itemized hospital bill guide walks through requesting and reading one.
Do the financing arithmetic before you sign. Alabama Surgical’s advertised $238 a month applies to a 60-month term with qualifying credit and excludes interest, which is $14,280 in payments against a $9,995 price.
The Bottom Line
Budget $10,000 to $16,500 for a gastric sleeve paid in cash as of September 2026, and treat any figure in the low four figures as the surgeon’s fee alone. The published spread is almost entirely about hospital nights and follow-up, not about surgical quality, so ask both questions before you compare two numbers.
If you are still deciding between operations, our bariatric surgery cost guide prices the whole category side by side, and our gastric bypass cost guide covers the Roux-en-Y, which prices higher at every center that publishes both. If you are weighing surgery against medication, start with our GLP-1 cost guide.