A double lung transplant is the most expensive single-organ transplant performed in the United States, ahead of heart and ahead of liver, and the number that gets quoted for it is a billed charge rather than a payment. Almost nobody in the system pays a billed charge, and no lung transplant program sells the procedure at a cash price the way a surgery center sells a knee scope.
The reason to look at the number anyway is that it shows you the shape of the bill. This is not a single-day event; it is a nine-month episode covering the workup before listing, procurement, an admission that can run more than five weeks, six months of intensive follow-up, and then medication for life. This guide covers what each piece billed and what was actually paid as of September 2026, using 2024 Medicare claims, Milliman’s national estimates, and one large transplant center’s published contract rates.
What Does a Lung Transplant Cost Without Insurance?
Milliman estimates total billed charges across the whole episode and splits single from double. CMS claims data covers the admission itself and shows both what hospitals submitted and what changed hands.
The low and high columns below run from single lung to double lung wherever Milliman splits them.
| Service / Phase | Low | Average | High |
|---|---|---|---|
| 30 days pre-transplant workup and evaluation (billed) | $72,100 | n/a | $93,600 |
| Organ procurement | $240,300 | n/a | $257,700 |
| Hospital admission for the transplant | $1,039,700 | n/a | $1,403,800 |
| Physician services during the admission | $108,200 | n/a | $140,400 |
| 180 days of post-transplant care after discharge | $297,500 | n/a | $386,100 |
| Immunosuppressants and other outpatient drugs, first 180 days | $52,900 | n/a | $64,900 |
| Total estimated billed charges for the episode (Milliman 2025) | $1,810,700 | n/a | $2,346,500 |
| Average hospital length of stay | 25.7 days | n/a | 38.2 days |
| Hospital submitted charge, MS-DRG 007 (2024 Medicare claims) | n/a | $1,053,162 | n/a |
| Average total payment made on those same stays | n/a | $186,440 | n/a |
| Surgeon fee, CPT 32851 and 32853 (submitted charge) | $17,613 | n/a | $21,233 |
| Medicare allowed amount for that surgeon fee | $2,859 | n/a | $3,324 |
| Commercial negotiated rate, MS-DRG 007 (one center’s posted contracts) | $106,717 | n/a | $533,584 |
Sources: Milliman’s 2025 U.S. organ and tissue transplant report; CMS Medicare Inpatient Hospitals by Geography and Service for MS-DRG 007 (2024 claims released April 2026); CMS Medicare Physician & Other Practitioners by Geography and Service for CPT 32851 and 32853 (2024 claims released May 2026); Houston Methodist’s standard charges file updated April 1, 2026. MS-DRG 007 does not separate single from double lung, so the CMS rows apply to both.
What the payment side looks like
Across 639 lung transplant discharges nationally in 2024, hospitals submitted an average charge of $1,053,161.93 and average total payment was $186,440.33, of which Medicare paid $140,680.41. That is roughly 18% of the billed amount. The gap is not a discount you can request, but it is the honest context for any statement that a lung transplant “costs” $2.3 million.
Commercial rates land higher and swing enormously by plan. Houston Methodist’s published file lists negotiated dollar amounts on MS-DRG 007 from $106,717 to $533,584, and reported median allowed amounts across individual payer plans that range from $10,906 to $2,020,315, a spread wide enough that no single median is meaningful. The same file shows a national insurer’s transplant product paying a lung transplant case rate of $120,000, with charges above a threshold of $266,667 paid at 45% of billed charges. The case rate is the most interpretable of those figures because it is a stated contract term rather than an average of past claims.
The surgeon’s fee is a rounding error by comparison. Across 314 services nationally in 2024, surgeons submitted an average charge of $21,233.27 for CPT 32853, transplantation of two lungs, and Medicare allowed $3,323.51.
What Drives the Price
One lung or two
The single biggest variable. Milliman estimates $1,810,700 for a single lung transplant against $2,346,500 for a double, a difference of about $536,000 in billed charges, driven mostly by the admission ($1,039,700 versus $1,403,800) and by length of stay (25.7 days versus 38.2). Double lung is also the more common operation: Milliman projected 2,398 double lung transplants against 909 single for 2025.
The admission and the ICU
The hospital admission is about 60% of the billed total for both procedures. A 38-day average stay with a substantial critical-care component is what produces a seven-figure charge, and it is driven by clinical factors nobody chooses. Our guides to ICU cost per day and hospital stay cost per day show how those days price out individually.
Organ procurement, billed separately
Procurement is a distinct line of $240,300 for a single lung and $257,700 for a double. It covers recovery of the donor lungs, preservation, transport, and acquisition overhead, and it is billed apart from the surgery. It is also one of the charges most often mistaken for a billing error on an itemized statement. It is not one.
Where you get listed, and how long you have to stay there
The OPTN/SRTR 2024 Annual Data Report records 3,404 lung transplants in the United States in 2024, a record, with 3,375 in adults and 29 in children. Those are done at a limited number of programs, and lung transplant candidates are often required to relocate near the center before and after surgery. Medicare explicitly does not pay for transportation to a transplant facility, so travel, lodging, and a caregiver’s lost wages are real out-of-pocket costs that no billed-charge figure captures.
Lifelong immunosuppression and follow-up
The 180 days after discharge add $297,500 to $386,100 in billed charges plus $52,900 to $64,900 for outpatient drugs, and lung recipients typically carry the heaviest long-term monitoring burden of any solid-organ group. The immunosuppressants themselves are inexpensive generics at wholesale; see our guides to tacrolimus cost and mycophenolate cost for what they run at retail.
Cash Price vs. Insurance
There is no cash price here, and that is a finding rather than a gap in our research. Across the hospital price transparency files we pulled in September 2026, none published a discounted cash price for MS-DRG 007. Houston Methodist posts self-pay prices on nearly 15,000 other line items and leaves the transplant DRGs blank; WVU Medicine does the same. The transaction is not structured as a retail purchase, so no retail price exists.
What exists instead is coverage plus assistance. Medicare Part A covers lung transplants and the cost of finding the proper organ, Part B covers the physician services and immunosuppressive drugs in certain circumstances, and the transplant must happen at a Medicare-approved facility. After the Part B deductible the standard patient share is 20% of the Medicare-approved amount for Part B services, and Medicare-certified laboratory tests carry no cost to you. Medicaid covers transplants in every state under program-specific rules. Commercial plans route transplants through contracted centers of excellence, and going out of network is the most common way an insured family ends up with a catastrophic balance.
If you are uninsured today and a lung transplant is on the table, the first move is not price shopping. It is a transplant financial coordinator, a coverage determination, and a hospital financial assistance application running in parallel. See our hospital charity care guide for what nonprofit hospitals are required to offer.
How to Pay Less
- Start with the transplant financial coordinator. Every approved program has one. They run insurance verification, prior authorization, and the financial evaluation that determines whether you can be listed, and they know which nonprofit grants and travel-assistance programs move fastest.
- Budget the non-medical costs early, because they are the ones nobody covers. Help Hope Live lists the expenses centers expect candidates to have funded: premiums, deductibles and copays, pre-transplant medications, medical travel and temporary lodging both while listed and after transplant, relocation, mileage and parking, and caregiver lost wages. For a lung transplant these can run for months.
- Apply for hospital financial assistance in writing, early. Nonprofit hospitals must maintain and publicize a financial assistance policy, and an approved applicant cannot be charged more than Amounts Generally Billed for medically necessary care. Our charity care checker will tell you whether you are likely to qualify.
- Get the bill itemized, especially procurement and the critical care days. A $1.05 million submitted charge contains thousands of lines. Our itemized hospital bill guide covers what to request and how to read it.
- Negotiate any residual balance against what was actually paid. Average total payment on these stays was about 18% of submitted charges in 2024 Medicare data, and one large center’s published commercial case rate for a lung transplant is $120,000. Our medical bill negotiation guide has the approach and our negotiation script tool drafts the ask. You can sanity-check individual line items with our fair price checker.
- Treat fundraising as a normal step. Nonprofits including Help Hope Live exist specifically to run transplant fundraising campaigns, hold the money so it does not disqualify you from need-based benefits, and make donations tax-deductible. Centers frequently expect it.
- Do not let anything slide into collections while coverage is pending. Transplant billing is slow and involves multiple parties. Our guide to medical bills in collections covers what to do if a balance was sold before the coverage question was settled.
Bottom Line
A lung transplant bills at roughly $1,053,000 to $2,346,500 and is paid at about $186,000 in 2024 Medicare data, with commercial negotiated rates at one large center running from $106,717 to $533,584 and one insurer’s case rate at $120,000. A double lung transplant is the most expensive single-organ transplant in American medicine, and the hospital admission alone accounts for roughly 60% of it.
The number that actually determines a family’s outcome is none of those. It is whether coverage is in place at a Medicare-approved or in-network center before listing, whether the months of travel and lodging near the center are funded, and whether lifelong medication has a plan behind it. For the rest of this cluster, see our guides to heart transplant cost, liver transplant cost, and cornea transplant cost.