A hysterectomy, the surgical removal of the uterus, is one of the most common major surgeries performed on women in the United States, with more than 500,000 procedures performed annually according to the CDC. Surgeons order a hysterectomy to treat uterine fibroids, endometriosis, abnormal uterine bleeding, uterine prolapse, adenomyosis, and gynecologic cancer. The procedure can be performed through four different surgical approaches: vaginal, laparoscopic, robotic-assisted laparoscopic, or open abdominal. Each approach carries a different price tag, a different hospital-stay length, and a different recovery timeline. Uninsured patients facing a hysterectomy should know that a vaginal or laparoscopic procedure at an ambulatory surgery center can cost a fraction of what the same surgery costs at a hospital with an overnight admission.
The single biggest cost driver for a hysterectomy is the combination of surgical approach and site of service, not the underlying diagnosis. A vaginal or laparoscopic hysterectomy performed at an ambulatory surgery center with same-day discharge can cost $8,500 to $16,000 in 2026. The identical clinical indication treated with an open abdominal hysterectomy requiring a 2 to 3 day inpatient hospital stay can cost $18,000 to $35,000 or more. Robotic-assisted procedures add an equipment and facility premium without changing what Medicare pays the surgeon, since the professional fee is the same regardless of whether a robot assists the laparoscopic technique. Patients who ask their surgeon whether a vaginal or laparoscopic approach is clinically appropriate, and who confirm the facility type before scheduling, retain the most control over the final bill.
The following guide covers what a hysterectomy costs without insurance in 2026, what Medicare pays under the Physician Fee Schedule and the inpatient DRG system, how the No Surprises Act Good Faith Estimate process works for a scheduled hysterectomy, self-pay and financial assistance options, and a federal rule unique to this procedure: Medicaid cannot pay for a hysterectomy performed solely for sterilization, and requires a signed informed-consent acknowledgment for medically necessary hysterectomies under 42 CFR 441.255. Patients comparing a hysterectomy to a fibroid-only alternative should also review the comparison to myomectomy covered in the FAQ section below.
Hysterectomy Cost by Site of Service in 2026
The biggest cost driver of Hysterectomy is the site of service: where the procedure is performed. 2026 CMS price transparency data confirms a 2-3x billing differential between independent centers and hospital outpatient departments.
Hysterectomy prices without insurance vs. 2026 Medicare rates| Site of Service | Range Without Insurance | 2026 Medicare Rate |
|---|
| Ambulatory surgery center (ASC, vaginal or laparoscopic) | $8,500 to $16,000 | ~$4,800 (facility, ASC payment) |
| Hospital outpatient department (same-day discharge) | $12,000 to $22,000 | ~$5,800 (facility, OPPS) |
| Hospital inpatient (abdominal or complex approach) | $18,000 to $35,000 | ~$9,028 (DRG 743, facility) |
| Surgeon professional fee (all settings, billed separately) | $2,500 to $6,000 | ~$950 (2026 PFS, non-facility) |
2026 Medicare rates reflect the CMS Physician Fee Schedule (non-facility), the Hospital Outpatient Prospective Payment System (OPPS), and the average FY 2026 Inpatient Prospective Payment System (IPPS) DRG 743 payment. Without-insurance ranges reflect FAIR Health Consumer data and CMS Hospital Price Transparency files. The surgeon's professional fee (~$950) is billed separately on top of any facility rate.
Source: CMS FY 2026 IPPS Final Rule, CMS 2026 Physician Fee Schedule, CMS 2026 Hospital Outpatient PPS, FAIR Health Consumer
Why the Same Procedure Is So Much More at a Hospital
Hospitals bill an inpatient hysterectomy at facility rates that bundle the operating room, recovery room, nursing staff, anesthesia supplies, and every day of the hospital stay into a single Medicare Severity Diagnosis Related Group (MS-DRG) payment. Ambulatory surgery centers and hospital outpatient departments performing a same-day vaginal or laparoscopic hysterectomy bill under a lower, procedure-specific facility rate instead. Since 2018, CMS has removed most vaginal and laparoscopic hysterectomy codes from the Medicare inpatient-only list, meaning these approaches are increasingly performed and reimbursed as outpatient surgery in 2026, which lowers the facility bill substantially compared to an overnight hospital admission.
The 2026 Medicare payment gap illustrates the spread: the average inpatient DRG 743 facility payment (uterine and adnexa procedures for non-malignancy, without complication or comorbidity) is approximately $9,028, while the outpatient facility payment for a same-day laparoscopic or vaginal hysterectomy is approximately $5,800 under the Hospital Outpatient Prospective Payment System. The surgeon's professional fee, billed separately under the 2026 Physician Fee Schedule, is approximately $950 regardless of site of service. Without insurance, the cash-pay spread is even wider: hospital inpatient admissions for an open abdominal hysterectomy commonly run 2 to 3 times what an ambulatory surgery center charges for a vaginal or laparoscopic hysterectomy.
The practical takeaway: ask your gynecologic surgeon directly whether a vaginal or laparoscopic approach is clinically appropriate for your diagnosis, and whether the procedure can be performed at an ambulatory surgery center or outpatient hospital department instead of requiring an inpatient admission. For patients with large fibroids, significant pelvic adhesions, suspected cancer, or a very large uterus, an open abdominal approach and an inpatient stay may be medically necessary. For most benign indications, however, a same-day outpatient approach is both clinically appropriate and substantially less expensive.
Hysterectomy Cost by Surgical Approach in 2026
The surgical approach a gynecologist chooses depends on the diagnosis, uterine size, prior surgeries, and pelvic anatomy, but it is also the single largest lever on the final bill. A vaginal hysterectomy is generally the least invasive and least expensive. A laparoscopic or robotic-assisted hysterectomy uses small incisions and a camera. An open abdominal hysterectomy involves a larger incision and is reserved for larger uteruses, extensive adhesions, or suspected malignancy. A radical hysterectomy, which also removes surrounding tissue and lymph nodes, is reserved for gynecologic cancer.
Typical cost by variant| Surgical Approach | Cash Range Without Insurance (2026) | Typical Hospital Stay | Typical Recovery Time |
|---|
| Vaginal hysterectomy | $8,500 to $16,000 | Outpatient or 1 night | 2 to 4 weeks |
| Laparoscopic or robotic-assisted hysterectomy | $12,000 to $28,000 | Outpatient or 1 night | 2 to 4 weeks |
| Abdominal (open) hysterectomy | $15,000 to $30,000 | 2 to 3 days | 4 to 6 weeks |
| Radical hysterectomy (gynecologic cancer) | $22,000 to $45,000 | 3 to 5 days | 6 to 8 weeks |
Robotic-assisted surgery typically adds a facility equipment fee of $1,500 to $3,000 without increasing what Medicare pays the surgeon, since the 2026 Physician Fee Schedule reimburses the laparoscopic hysterectomy code at the same rate whether or not a robotic system assists. Radical hysterectomy for cancer is billed and reimbursed differently and often involves additional oncology-related charges not reflected in this table.
Source: FAIR Health Consumer, CMS FY 2026 IPPS Final Rule, CMS 2026 Physician Fee Schedule, ACOG Practice Guidance on Hysterectomy Approach
What Medicare Pays for Hysterectomy
Medicare covers a hysterectomy when a Medicare-enrolled physician determines the surgery is medically necessary, most commonly for symptomatic fibroids, abnormal bleeding, prolapse, or gynecologic cancer. Original Medicare Part A covers the hospital facility fee when the procedure requires an inpatient admission, paying the hospital a fixed amount based on the assigned Medicare Severity Diagnosis Related Group. The 2026 national average payment for DRG 743 (uterine and adnexa procedures for non-malignancy, without complication or comorbidity) is approximately $9,028. The 2026 Part A inpatient deductible is $1,736 per benefit period, after which there is no daily coinsurance for the first 60 hospital days. Medicare Part B covers the surgeon's professional fee under the 2026 Physician Fee Schedule, paying approximately $950 for the global surgical package, which includes routine pre-operative visits and 90 days of routine post-operative follow-up care.
Medicare Advantage plans (Part C) cover the same medically necessary hysterectomy but may apply different cost-sharing, such as a per-day inpatient copay instead of the Part A deductible, and most Medicare Advantage plans require prior authorization before a scheduled hysterectomy. Medigap supplement plans cover the Part A deductible and, depending on the plan letter, some or all of the Part B coinsurance, which is 20 percent of the Medicare-approved amount after the 2026 Part B deductible of $283. Patients on an ACA-compliant plan through the marketplace or an employer face a different structure: hysterectomy is not a preventive service under Affordable Care Act rules, so the plan's deductible and coinsurance apply in full until the patient reaches the 2026 out-of-pocket maximum of $10,600 for an individual or $21,200 for a family.
Medicaid coverage of a hysterectomy carries a federal requirement that does not apply to most other surgeries. Under 42 CFR 441.255, Medicaid cannot pay for a hysterectomy performed solely to render a patient permanently unable to reproduce, and for any medically necessary hysterectomy, the surgeon must inform the patient orally and in writing, before the surgery, that the procedure will cause permanent infertility. The patient or her representative must sign a written acknowledgment of that disclosure, and the hospital must keep the signed form on file. A hysterectomy claim missing this signed acknowledgment can be denied by state Medicaid programs regardless of medical necessity, so Medicaid patients should confirm the consent form was completed and filed before the surgery date.
Under the No Surprises Act, effective January 1, 2022, any patient who is uninsured or paying out of pocket has the legal right to a written Good Faith Estimate from every provider involved in a scheduled hysterectomy before the procedure date. For a hysterectomy scheduled at least 10 business days in advance, the hospital, the surgeon, and the anesthesiologist must each deliver a written Good Faith Estimate at least 3 business days before the scheduled surgery date. For a hysterectomy scheduled 3 to 9 business days out, the estimate must arrive at least 1 business day before the procedure. The federal consumer guidance is published at cms.gov/nosurprisesact.
Requesting a Good Faith Estimate for a hysterectomy in 2026 requires contacting each provider separately. Follow these steps: (1) Call the hospital's patient financial services department and identify yourself as self-pay or uninsured, then request a written Good Faith Estimate itemizing the facility fee, operating room charge, and expected length of stay. (2) Call the gynecologic surgeon's billing office and request a separate written Good Faith Estimate for the global surgical package, confirming whether it covers the specific surgical approach discussed (vaginal, laparoscopic, robotic-assisted, or abdominal). (3) Call the anesthesiology group, which bills separately in most hospitals, and request a written Good Faith Estimate. (4) Provide your ZIP code and confirm whether any additional procedures, such as removal of the ovaries or a bladder repair, are planned, since those change the billing code. (5) Keep every written Good Faith Estimate. If any final bill exceeds the corresponding estimate by $400 or more, you have 120 days from the bill date to file a patient-provider dispute resolution claim at cms.gov/nosurprisesact.
A Good Faith Estimate for a hysterectomy is not a guaranteed final bill. Common reasons the actual charges exceed the estimate include: the surgical approach converts from vaginal or laparoscopic to open abdominal during the operation because of unexpected adhesions or bleeding, a longer-than-expected operating time, an extended hospital stay due to complications or slow recovery, additional pathology fees if a specimen is sent for cancer evaluation, and supplies not included in the original surgical kit. Patients should ask their surgeon in advance how likely a conversion to an open procedure is, since that single change can add $5,000 to $15,000 to the final bill.
What Factors Affect Cost
- Surgical approach: vaginal and laparoscopic hysterectomy ($8,500 to $28,000) cost substantially less than an open abdominal hysterectomy ($15,000 to $35,000) for the same underlying diagnosis. This is the single largest cost driver.
- Site of service: an ambulatory surgery center or hospital outpatient department with same-day discharge costs less than a hospital inpatient admission, since Medicare's 2026 outpatient facility payment (approximately $5,800) is roughly 36 percent below the inpatient DRG payment (approximately $9,028) for a comparable procedure.
- Additional procedures performed at the same time: removal of the ovaries and fallopian tubes (bilateral salpingo-oophorectomy), a bladder or pelvic-floor repair, or lysis of adhesions each add a separate billing code and can add $1,000 to $5,000 to the total.
- Independent surgical center cash bundles: some freestanding surgical centers and physician-owned ambulatory surgery centers publish flat-rate cash bundles for vaginal or laparoscopic hysterectomy that run 30 to 50 percent below hospital chargemaster rates.
- Hospital chargemaster discount ask: most hospitals publish or will disclose a self-pay discount policy of 20 to 50 percent off the chargemaster price. Patients who identify as uninsured at admission or call the hospital's financial counselor before surgery can often access this discounted cash rate.
- Sliding-scale Federally Qualified Health Centers (FQHCs) and hospital financial assistance: FQHCs that provide gynecologic referral services can help uninsured patients access sliding-scale surgical evaluation, and nonprofit hospitals are required under IRS 501(r) rules to maintain a written financial assistance policy, with eligibility often extending to 200 to 400 percent of the 2026 Federal Poverty Level.
- Insurance network status of all three providers: the hospital, the gynecologic surgeon, and the anesthesiologist each bill separately, and an out-of-network anesthesiologist at an in-network hospital is a common surprise-billing scenario covered by the No Surprises Act.
- Prior authorization: most commercial insurers and nearly all Medicare Advantage plans require prior authorization for a scheduled, non-emergency hysterectomy. Confirm authorization at least 2 to 3 weeks before the surgery date to avoid a denied claim.
Common Hysterectomy Billing Errors
Hysterectomy bills are complex because multiple providers bill separately, the surgical approach can change mid-operation, and additional procedures are frequently performed in the same session. Review these errors before paying:
- Anesthesiologist billed out-of-network when the hospital was in-network. Under the No Surprises Act, your cost-sharing should not exceed in-network rates for this scenario. Dispute the excess with your insurer before paying.
- Open abdominal hysterectomy billed when the operative report shows a laparoscopic or vaginal approach was actually completed, or vice versa. Request an itemized bill and compare it to the operative report.
- Bilateral salpingo-oophorectomy (ovary and tube removal) billed when only the uterus was removed. Verify the operative report lists every organ actually removed.
- Duplicate facility charges: both the hospital and an affiliated outpatient surgical center billed for the same procedure. Request an itemized bill and flag duplicate line items.
- Missing Medicaid hysterectomy acknowledgment form causing a full claim denial on an otherwise medically necessary, properly performed surgery. Confirm the signed consent form is on file before the bill is submitted.
- Extended hospital-stay charges billed after the medical record shows the patient was ready for discharge. Ask the hospital's patient advocate for the documented discharge-readiness date.
Frequently Asked Questions
How much does a hysterectomy cost without insurance in 2026?
Without insurance, a hysterectomy costs $8,500 to $35,000 in 2026 depending on the surgical approach and site of service. A vaginal or laparoscopic hysterectomy at an ambulatory surgery center with same-day discharge runs $8,500 to $16,000. An open abdominal hysterectomy requiring a 2 to 3 day inpatient hospital stay runs $18,000 to $35,000 or more. Add the surgeon's professional fee of $2,500 to $6,000, which is billed separately from the facility charge. The national median across all approaches and settings is approximately $16,500. Asking for the ambulatory surgery center cash-pay rate consistently returns the lowest price for eligible candidates.
What does Medicare pay for a hysterectomy in 2026?
In 2026, Medicare pays the surgeon approximately $950 under the Physician Fee Schedule for the global surgical package. The facility fee depends on setting: the average inpatient DRG 743 payment is approximately $9,028, while the outpatient facility payment for a same-day laparoscopic or vaginal hysterectomy is approximately $5,800. Patients owe the 2026 Part A inpatient deductible of $1,736 per benefit period for an inpatient stay, or the 20 percent Part B coinsurance after the $283 2026 Part B deductible for the surgeon's fee and any outpatient facility charge. Medicare Advantage plans may apply different cost-sharing and typically require prior authorization.
How do I request a Good Faith Estimate for a hysterectomy?
Contact each provider separately before your surgery date. Call the hospital's patient financial services department and request a written Good Faith Estimate itemizing the facility fee and expected length of stay. Call your gynecologic surgeon's billing office for a written estimate covering the global surgical package for the specific approach discussed. Call the anesthesiology group for a separate estimate. For a hysterectomy scheduled at least 10 business days out, each provider must supply the estimate at least 3 business days before your surgery date. Keep every written estimate. If any final bill exceeds the Good Faith Estimate by $400 or more, you have 120 days to dispute it through the federal portal at cms.gov/nosurprisesact.
What is the No Surprises Act and does it apply to my hysterectomy?
The No Surprises Act, effective January 1, 2022, protects patients from unexpected out-of-network charges and requires a written Good Faith Estimate for self-pay and uninsured patients. For a hysterectomy, two protections apply directly. First, if you are uninsured or paying out of pocket, the hospital, surgeon, and anesthesiologist must each give you a Good Faith Estimate before the procedure. Second, if you have insurance and use an in-network hospital, an out-of-network provider who treats you there, most commonly the anesthesiologist, cannot charge you more than your in-network cost-sharing rate. The law does not apply to Medicaid, which has its own separate rate protections and consent requirements.
How do I get a written cash-pay quote for a hysterectomy?
Start by checking the hospital's or surgical center's machine-readable price file, required under CMS price transparency rules since 2021, for the self-pay cash price for a hysterectomy admission. Then call the hospital's financial counselor and ask directly: what is your self-pay cash price for a vaginal, laparoscopic, or abdominal hysterectomy, and does that include the facility fee and all inpatient days? Request the quote in writing as a Good Faith Estimate under the No Surprises Act. Get a separate written quote from the surgeon's office and the anesthesiology group, then compare the combined cash price to your insurance plan's cost-sharing before deciding which to use.
Can I negotiate a hysterectomy bill after the fact?
Yes. Hospital bills for a hysterectomy are frequently negotiable, particularly for uninsured patients. Most hospitals apply a self-pay discount of 20 to 50 percent off the chargemaster price when a patient requests it after billing. Paying a lump sum promptly often yields an additional 10 to 20 percent reduction. Patients who received a Good Faith Estimate before surgery and whose final bill exceeds it by $400 or more can file a patient-provider dispute resolution claim within 120 days of the bill date through cms.gov/nosurprisesact. Nonprofit hospitals are also required under IRS 501(r) rules to maintain a written financial assistance policy; ask the billing department for the application.
What's the difference between hospital and ambulatory surgery center hysterectomy cost?
An ambulatory surgery center performing a vaginal or laparoscopic hysterectomy with same-day discharge typically charges $8,500 to $16,000 without insurance, while a hospital inpatient admission for the same or a more complex approach runs $18,000 to $35,000 or more. The 2026 Medicare facility payment illustrates the same gap: approximately $5,800 for an outpatient laparoscopic or vaginal hysterectomy versus approximately $9,028 for the inpatient DRG 743 payment. Ambulatory surgery centers have lower overhead and avoid the multi-day nursing and room charges that drive up an inpatient hospital bill. Not every patient is a candidate for an outpatient approach; large fibroids, extensive adhesions, or suspected cancer often require an inpatient admission.
Will my insurance cover a hysterectomy?
Yes, in most cases, when a physician determines the surgery is medically necessary. Hysterectomy is not a USPSTF preventive service, so it does not receive the 100 percent no-cost coverage that applies to services like a screening colonoscopy or mammogram. ACA-compliant plans and employer coverage apply the plan's standard deductible and coinsurance, up to the 2026 out-of-pocket maximum of $10,600 for an individual or $21,200 for a family. Most commercial insurers and Medicare Advantage plans require prior authorization before a scheduled, non-emergency hysterectomy. Medicaid covers medically necessary hysterectomy but requires a signed informed-consent acknowledgment under federal sterilization rules before the claim can be paid.
What's the difference between a hysterectomy and a myomectomy?
A hysterectomy removes the entire uterus and ends a patient's ability to become pregnant. A myomectomy removes uterine fibroids while leaving the uterus in place, preserving fertility for patients who want to have children in the future. Myomectomy is generally less extensive than an abdominal hysterectomy but can involve similar recovery time depending on the number and size of fibroids removed. Myomectomy costs $10,000 to $25,000 without insurance in 2026, a range that overlaps with hysterectomy pricing. Patients with fibroids who are unsure which option fits their goals should ask their gynecologist directly about the fertility-preservation tradeoffs and the surgical-approach cost differences between the two procedures.
Does Medicaid require special consent before covering a hysterectomy?
Yes. Under federal regulation 42 CFR 441.255, Medicaid cannot pay for a hysterectomy performed solely to make a patient permanently unable to reproduce. For any medically necessary hysterectomy, the surgeon must tell the patient, orally and in writing, before the surgery, that the procedure causes permanent infertility, and the patient or her representative must sign a written acknowledgment of that disclosure. The signed form must be on file before Medicaid will pay the claim. Patients on Medicaid scheduling a hysterectomy should confirm with the hospital or surgeon's office that this consent form has been completed well before the surgery date to avoid a claim denial.
