Payment & Insurance
Will the surgery be covered by my insurance?
It depends. First, ask your insurance provider if morbid obesity is covered under your policy. Give them the ICD10 Code of E66.01. If it is covered, check that the operative procedure you are considering also is covered. You will need to supply these CPT codes:
- For the Roux-en-Y procedure, give them the CPT Code of 43644.
- For the Lap-Band procedure, give them the CPT Code of 43770 (many insurance companies do not approve the Lap-Band procedure, so check thoroughly with your insurance company).
- For the sleeve gastrectomy procedure, give them the CPT Code of 43775.
Finally, ask if UF Health Shands Hospital is an approved facility under your insurance provider. We use the tax I.D. of 591943502. Giving this number to your insurance company may facilitate a faster response to your query.
If your policy does not cover the diagnosis of morbid obesity or the operative procedure itself, you still have a few options:
- You could obtain another insurance carrier, but you need to be sure the new policy covers morbid obesity and the surgical procedure before making this decision.
- You may continue to participate in alternate medical programs designed to lose and maintain weight loss.
- In selected cases, we will consider performing the surgery if you elect to self-pay. The hospital requires a considerable deposit, and you must fully understand all risks of the financial burden. We will review this major decision with you extensively and will help in any way we can.
If you are interested in self-pay options for bariatric surgery, call Ethan Haselmayer at 352.594.4702 to make arrangements. Full payment must be received 10 days prior to surgery.
Following are the costs for each type of surgery:
- Lap gastric banding (includes five fills): $15,348
- Gastric bypass: $18,348
- Sleeve gastrectomy: $16,348
The estimates listed above cover the cost of physician, anesthesia and facility fees for the procedure only. These costs do not cover fees associated with a consultation, pre-operative appointments, testing, nutritional counseling, protein supplements, vitamins or any additional services while inpatient.
Please note that certain insurance companies require supervised weight loss. You can download our supervised weight loss form (PDF) here.
To qualify for Medicaid coverage of bariatric surgery, patients must meet the following criteria:
Presence of Morbid Obesity:
- 100 pounds overweight
- Body Mass Index (BMI) greater than or equal to 35 with co-morbid conditions (cardiopulmonary problems, obesity related cardiomyopathy, severe diabetes mellitus, hypertension, sleep apnea, or arthritis)
- Or BMI of 40 without comorbidity
- There is no treatable metabolic cause for the obesity, such as adrenal or thyroid disorders
- The patient is an adult (at least 18 years of age)
Before we can schedule any appointments, we must have a referral from a primary care provider and the information listed below.
- Letter of medical necessity from PCP for a referral to a bariatric surgeon
- Medical records documenting diagnoses and appropriate treatments of co-morbid conditions
- Current weight and height
- Plans for participation in a postoperative multidisciplinary program that includes guidance on diet, physical activity, behavior management and social support
- History of participation in a three-month, physician supervised multidisciplinary weight loss program within the past six months that included:
- Dietary therapy
- Physical activity (moderate levels of activity for 30 – 45 min., 3-5 x/wk)
- Behavior-management support
If you are interested in finding out more about obesity, treatments for severe and morbid obesity and the outcomes of surgical treatment, please watch our online seminar. All potential bariatric surgery patients must complete this seminar prior to their first consultation with a UF Health bariatric surgeon.