How We Calculate Surgery Costs

SurgeryCostGuide provides cost estimates for 62 procedures, plus real hospital charges by state where CMS Medicare data exists. This page explains exactly where our data comes from, when we do and do not publish a state-level figure, and what the numbers on each page mean.

Data Sources

We combine three independent data sources to build our cost estimates:

1. CMS Medicare Provider Data

The Centers for Medicare & Medicaid Services publishes facility-level data for every hospital and ambulatory surgery center (ASC) that accepts Medicare. This includes the number of cases performed, billed charges, negotiated payment rates, and Medicare reimbursements. We use this for our facility cost tables — the "Negotiated Rate" column shows what insurers actually pay, not the inflated list price.

2. ASPS Annual Statistics

The American Society of Plastic Surgeons publishes annual benchmarks for surgeon fees across cosmetic and reconstructive procedures. These cover the surgeon's portion of the bill only — facility and anesthesia fees are separate.

3. Fair Health Consumer Data

Fair Health provides benchmark pricing for medical and dental procedures by geographic area. We use this to validate and cross-reference our cost ranges, particularly for dental and diagnostic procedures.

State-Level Figures

We publish a state-level price only where real hospital data supports one. For procedures that appear in the CMS Medicare facility data in enough volume (for example knee and hip replacement, heart bypass, pacemaker, gallbladder, hernia, and cataract surgery), the state figure is the median billed charge among the hospitals in that state that report to CMS, shown next to the number of reporting hospitals. States with fewer than five reporting hospitals are marked with an asterisk because the median is less reliable.

For everything else — cosmetic, dental, and most outpatient procedures, which Medicare data does not cover — we publish a national typical range only. There is no public hospital-level dataset to ground a state-by-state price for those procedures, so we do not show one.

Change log

October 2026: We withdrew the state-by-state estimates that were previously calculated by scaling each national average by the Bureau of Economic Analysis Regional Price Parity (a cost-of-living index), along with the "cheapest states" and "most expensive states" rankings built on them. When we compared those estimates with real CMS hospital charges, they did not hold up — in some states the direction was wrong. State figures on this site now come only from CMS hospital data.

What the Numbers Mean

Cost Range (Low / Mid / High)

The "typical range" on each page represents the 25th to 75th percentile of reported costs. The middle figure is the median. Roughly half of patients pay within this range. Outliers — unusually complex cases, premium surgeons, or deeply discounted cash-pay rates — fall outside this band.

Negotiated Rate vs. Billed Charges

Hospital "chargemaster" prices (list prices) are often 2-5x what's actually paid. Our facility tables show the negotiated rate — the amount insurers have agreed to pay after discounts. This is a much more accurate reflection of real costs.

Volume

The case volume column in our facility tables shows how many times a facility performed that procedure in the reporting period. Higher volume generally correlates with more experience and better outcomes.

Limitations & Disclaimer

All cost data on SurgeryCostGuide is for informational and educational purposes only. Important caveats:

For a binding price on your specific case, request an itemized written estimate from the facility before scheduling — federal price-transparency rules (CMS, 2021) require hospitals to provide one on request. Our figures are for budgeting and comparison; they are not a quote.