How Much Does Gastric Sleeve Surgery Cost? 2026 U.S. Prices, Insurance and by State

How much gastric sleeve surgery costs in the U.S.

Gastric sleeve surgery, or laparoscopic sleeve gastrectomy (LSG), removes about 80% of the stomach through small cuts in the belly and leaves a narrow, banana-shaped "sleeve." It is permanent. CareCredit's weight-loss surgery cost table puts the national average at $19,459 (CareCredit). Synchrony's 2026 cost study of practices, run in all 50 states and D.C., found a lower average of $10,681, with prices from $7,269 to $18,483 (CareCredit).

A newer, non-surgical option is endoscopic sleeve gastroplasty (ESG). The doctor stitches the stomach smaller from the inside with a thin scope passed through the mouth, and it can be reversed. It averages $11,131, from $7,572 to $19,485. ESG usually leads to less weight loss: 12% to 20% of body weight in a year, versus 40% to 50% within a year or two after a surgical sleeve (CareCredit).

The price you are quoted depends on the surgeon's experience, facility fees, anesthesia, appointments before surgery, care after surgery and where you live (CareCredit).

What hospitals spend on a sleeve

A large study of 687,866 U.S. patients (2016 to 2019) found that the median hospital cost of a sleeve gastrectomy was $10,900, with the middle half of hospitals between $8,600 and $14,000. A gastric bypass cost more: $13,600. The hospital itself explained about 37% of the difference in cost between patients, and hospitals in the top third by sleeve volume spent about $1,500 less per operation (Ng et al., The American Surgeon, 2023). These are costs to the hospital, not bills, and they do not include the surgeon's fee, but they show how much the choice of hospital matters.

Gastric sleeve cost by state

The table above lists Synchrony's average sleeve price for every state. The most expensive are California ($12,995), Washington, D.C. ($12,700), Hawaii ($12,269) and New York ($12,163). The cheapest are Arkansas ($9,208), Mississippi ($9,285) and Alabama ($9,381). Texas averages $10,543 and Florida $10,512 (CareCredit). That means the same operation can cost nearly $3,800 more depending on the state, before any extras.

What a sleeve quote should include

A low headline price can leave out large parts of the bill. Before you compare, ask whether each quote includes:

• The surgeon's fee and the anesthesia fee.
• The hospital or surgery center, including the overnight stay. After a laparoscopic sleeve, patients stay in the hospital for up to three days (CareCredit).
• Tests and visits before surgery, such as lab work, a pre-surgery diet and nutrition visits.
• Follow-up visits after surgery and a plan for the vitamins and supplements you will need to take (CareCredit).

Does insurance cover gastric sleeve surgery?

Sometimes. Some health plans exclude weight-loss surgery entirely, while others pay for all or part of it. Most plans want proof that your weight is causing health problems, such as sleep apnea or heart disease, and that diet and exercise have not worked. Some require a set number of documented weight-management visits first. Even when the operation is not covered, a plan may still pay for related lab work and exams (CareCredit). With coverage, you still owe your deductible, coinsurance and copays.

BMI requirements

Under the 2022 guidelines of the American Society for Metabolic and Bariatric Surgery, surgery is recommended for adults with a BMI of 35 or more, with or without other health problems, and for people with type 2 diabetes and a BMI of 30 or more. It should be considered at a BMI of 30 to 34.9 when other methods have not worked (ASMBS). Insurers often use stricter rules: CareCredit notes that a BMI of 40 or higher, or a lower BMI with conditions such as sleep apnea, high blood pressure or type 2 diabetes, is the usual starting point (CareCredit). Check your number with our BMI calculator for weight-loss surgery and read more in BMI requirements for gastric sleeve.

Medicare and Medicaid

Medicare's national coverage rule allows the regional Medicare contractors to cover a laparoscopic sleeve when you have a BMI of 35 or more, at least one health problem related to obesity, and earlier medical treatment for obesity did not work (CMS). Medicare does not pay for travel to the surgery center (Medicare.gov). Medicaid coverage varies by state (CareCredit).

Paying yourself: HSA, FSA and financing

The IRS lets you count weight-loss costs as medical expenses when they treat a disease a doctor has diagnosed, such as obesity, high blood pressure or heart disease (IRS Publication 502). That is why sleeve surgery and related costs can often be paid from a health savings account (HSA) or flexible spending account (FSA); confirm with your plan administrator before you pay. Some surgeons and hospitals offer payment plans, and medical credit cards such as CareCredit are another option (CareCredit). Read the interest terms of any card before you sign.

It can also help to look beyond the first bill. In a study presented at the ASMBS 2026 meeting, two-year total health costs for patients with obesity and type 2 diabetes were about $41,400 after a sleeve, compared with $58,600 for patients on GLP-1 drugs (ASMBS).

What changes if you have your sleeve abroad

If you are thinking about a sleeve abroad, the table above shows what clinics listed on xcuro quote. The surgery is the same, but the plan around it changes:

• Flying home. Flying after surgery raises the risk of blood clots, and the CDC suggests waiting 10 to 14 days after major surgery before air travel (CDC).
• Follow-up at home. A sleeve needs lifelong follow-up: diet stages, vitamin checks and lab work. Line up a U.S. doctor or bariatric program before you go. Treating complications back home can be expensive and might not be covered by your insurance (CDC).
• Records and insurance. Bring your medical records, get copies of everything from the hospital before you leave, and consider travel health insurance that covers medical evacuation (CDC).

See our gastric sleeve in Mexico guide, compare all-inclusive gastric sleeve packages, and read is gastric sleeve in Mexico safe?. Still choosing a procedure? See gastric sleeve vs. gastric bypass.

How to compare gastric sleeve quotes

1. Check that every quote is for the same procedure: a surgical sleeve (LSG) or an endoscopic sleeve (ESG).
2. Ask for the total price: surgeon, anesthesia, hospital nights, tests and follow-up.
3. Ask your insurer for the written requirements (BMI, health conditions, supervised diet visits) before you pay anything yourself.
4. Ask how many sleeves the surgeon and hospital do each year; busier hospitals had lower costs in the study above.
5. Ask what happens, and who pays, if there is a leak, bleeding or a readmission.
6. Check whether your HSA or FSA can pay, and read the terms of any financing.