Surgery center or hospital: what the operating room costs in each

The same code is paid very differently in an ambulatory surgery center and in a hospital outpatient department; pick a procedure and a metro to compare.

Operating room for tummy tuck, hospital minus surgery center

$3,936

$2,848 in a surgery center, $6,784 in a hospital outpatient department, at national rates.

Surgery center (ASC)$2,848
Hospital outpatient department$6,784
Hospital as a multiple of the center2.38 x

Medicare 2026 rates for the same codes, adjusted with the wage index of the metro area (50 % of the center rate, 60 % of the hospital rate).

How this is computed

Compiled by Radif Partners · Where each line comes from · CMS 2026 rate files · not a quote

The operating room is the line that changes most with the place of the operation. Medicare publishes two rates for each procedure code: one for an ambulatory surgery center, in Addendum AA, and one for a hospital outpatient department, in Addendum B. For cosmetic operations the hospital rate is always the higher of the two in the October 2026 files, from about 1.9 times the center rate for facelift to 2.6 times for breast augmentation. A tummy tuck room costs $2,848 in a center and $6,784 in a hospital at national rates. The metro adjustment widens the gap in high-wage areas, because 60 % of a hospital rate follows the local wage index against 50 % of a center rate. Private facilities set their own prices, but the direction is usually the same.

Two payment systems

Surgery centers and hospitals are paid under different Medicare systems. A center receives the rate of Addendum AA, based on the hospital relative weights, as the file's payment indicators state, but multiplied by its own conversion factor of $56.32 in 2026. A hospital receives the rate of the payment group of the code in Addendum B; when the code has status J1, the payment is comprehensive and packages everything else done that day. That is why combined operations cost little more in a hospital: the second procedure is often packaged.

National Medicare rates, October 2026; sorted by the dollar gap.
ProcedureSurgery centerHospitalHospital statusRatio
Breast augmentation$3,172$8,350J12.63 x
Tummy tuck$2,848$6,784J12.38 x
Breast lift$2,848$6,784J12.38 x
Rhinoplasty$3,026$6,048J12 x
Chin implant$3,026$6,048J12 x
Brazilian butt lift$2,911$5,431T + T1.87 x
Gynecomastia surgery$1,603$4,000J12.5 x
Otoplasty$1,481$3,387J12.29 x
Arm lift$1,248$2,968J12.38 x
Thigh lift$1,248$2,968J12.38 x
Liposuction$1,941$3,620T1.87 x
Facelift$1,941$3,620T1.87 x
Brow lift$1,088$2,429J12.23 x
Upper eyelid surgery$1,129$2,108T1.87 x
Lower eyelid surgery$1,129$2,108T1.87 x

The wage index

Both rates are adjusted to the place with the FY 2026 wage index of its area, as the final rule for 2026 sets out. Surgery centers use the index before the rural floor and reclassification, hospitals the final index. In Los Angeles the center index is 1.2139 and the hospital index 1.4315, so a tummy tuck room there is $3,153 in a center and $8,540 in a hospital. The metro comparison shows every area.

Center or hospital for your procedure

Operating room for rhinoplasty, hospital minus surgery center

$3,321

Surgery center (ASC)$3,023
Hospital outpatient department$6,344
Hospital as a multiple of the center2.1 x
Open the full calculator →

Office operating rooms

Some plastic surgeons operate in an operating room inside their own office. Medicare publishes no facility rate for such a room for the codes priced here, which its surgery center file lists as procedures for centers and hospitals, so the practice sets the fee itself. A quote that names an office suite can be compared with the surgery center benchmark, which is the closer of the two. The choice between an office, a center and a hospital also depends on your health and the length of the operation, which the surgeon and anesthesia team weigh. The quote page explains what to ask.

What readers ask about this bill

Is plastic surgery cheaper in a surgery center than a hospital?

At Medicare rates, yes, for every cosmetic procedure priced here. The October 2026 hospital outpatient rate runs from 1.9 to 2.6 times the surgery center rate for the same code. A tummy tuck room is $2,848 in a center and $6,784 in a hospital at national rates.

Why does the hospital charge more for the same operation?

Hospitals and surgery centers are paid under different Medicare systems. Hospital rates are built from hospital costs, and many cosmetic codes are paid there as comprehensive packages for the whole day. Surgery center rates use the same relative weights as the hospital system but a lower conversion factor, so they come out lower.

What is an office operating room?

An operating room inside a surgeon’s practice, which may be accredited by a private body. Medicare publishes no facility rate for the cosmetic codes done there, so the practice sets the price. The surgery center benchmark on this site is the closest public reference to compare such a facility fee with.

Next line to check

Anesthesia fee

Base units, time units and the local conversion factor: how an anesthesia bill is built.

Combined procedures

What a second or third procedure in the same session saves on the room and the anesthesia.

Reading a quote

Take an all-inclusive price apart: what the room and anesthesia take at public rates, and what is left for the surgeon.

Cost by city

The same procedure in 26 metro areas: what the wage index and anesthesia factors change, and what they do not.

Rate files and documents behind this page

Compiled by

Independent publisher of cosmetic surgery cost breakdowns built from public Medicare rate files

Rates and sources checked on · Editorial policy · Contact

These figures are benchmarks: public Medicare rates for the operating room and anesthesia of the same codes; the surgeon's fee, which no public file publishes, counts only from your own quote. A practice sets its own prices, often above Medicare rates, and only a surgeon who has examined you can say what you need. The site describes bills, never whether a procedure suits you, and earns nothing from any surgeon, clinic, drug maker or lender.

Rates of 2026, files last read on