Medicare Part B covers Hysterectomy at 80% after the Part B deductible. Here's the full cost-sharing breakdown, admission status rules, and Medicare Advantage differences.
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Does Medicare Cover Hysterectomy? (2026)
Yes. Medicare covers medically necessary hysterectomy: Part A if admitted inpatient, or Part B if performed as an outpatient procedure. Prior authorization is not required under Original Medicare but is commonly required under Medicare Advantage.
Quick answer:
- Inpatient hysterectomy: Part A — $1,676 hospital deductible (2026), then $0 days 1–60
- Outpatient hysterectomy (HOPD or ASC): Part B — 80% after $257 deductible
- Prior authorization: Not required under Original Medicare; required under many Medicare Advantage plans
Part A vs. Part B
Part A (inpatient):
Medical bills contain errors in roughly 80% of cases. Most go uncontested.
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- Formal inpatient admission order
- $1,676 deductible covers days 1–60
- Used for complex cases, expected complications, or longer recovery
Part B (outpatient):
- Laparoscopic and robotic hysterectomies increasingly done outpatient
- 20% coinsurance on facility, surgeon, anesthesiologist, and pathology separately
What Medicare Covers
- The hysterectomy procedure (various CPT codes depending on approach: vaginal, abdominal, laparoscopic)
- Anesthesia (billed separately, 80% under Part B)
- Pathology of removed tissue (billed separately by lab)
- One pathologist's interpretation (professional component, 80% under Part B)
Medicare Advantage Considerations
MA plans require prior authorization for hysterectomy in most cases. Required documentation typically mirrors commercial plans: indication documentation, prior non-surgical treatment records, and sometimes a second opinion requirement.
Related Cost Information
Related: Is a hysterectomy covered by insurance? → · Hysterectomy billing surprises →
Medical bills contain errors in roughly 80% of cases. Most go uncontested.
The free Dispute Kit gives you the exact letter templates, billing-error checklist, and the specific language that gets charges reviewed — the same process that's recovered thousands of dollars for patients who used it.
We'll email it to you immediately. No account required, no spam.
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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