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Does Medicare Cover Robotic Surgery


Medicare covers medically necessary services, robotic surgery is no exception. Since the FDA approves robotics, coverage may be available for some robotic surgery procedures. In some situations, the use of newer technology improved the patient’s overall outcomes following a surgical procedure. Including cases of robotic cardiac surgery, according to reports by The National Library of Medicine.

Surgeons often perform minimally invasive surgeries known as laparoscopic surgery. Other common robot-assisted surgeries include several procedures. Such as, colectomies made up 15%, hysterectomies at 90%, and 20% of prostate removal surgeries are performed robotically.

Is Robotic Prostate Surgery Covered by Medicare?

The Centers for Medicare and Medicaid Services (CMS) doesn’t have a policy for the national coverage on radical prostatectomy. Procedures to remove the prostate may be open, laparoscopic, or robot-assisted surgery. Local coverage is a little different. As it stands, robot surgery for prostate cancer is a service Medicare covers. Additionally, reimbursement for providers is the same as the compensation for traditional (laparoscopic) prostatectomy.

Is the Da Vinci Robotic Hysterectomy Covered by Medicare?

Medical procedures like hysterectomies are often a medically necessary form of treatment, so Medicare benefits pick up the coverage. For patients having a voluntary hysterectomy (non-medically necessary) such as for sterilization, then Medicare won’t cover the costs.

The da Vinci Robotic hysterectomy cost and coverage depend on if the procedure is done at an inpatient or outpatient facility. Part A benefits cover patients who have a hysterectomy in an inpatient hospital setting. Part B pays for outpatient services and hysterectomies.

Both Parts may have deductible amounts that must be met before Medicare will cover costs for any procedure. After the deductible is met, either Part covers 80% of the Medicare-approved expenses. Beneficiaries are responsible for the remaining 20% of the bill.

Does Medicare Advantage Cover Robot Surgery?

Medicare Advantage plans are required to cover the same inpatient and outpatient services that Original Medicare covers. The difference is how much they will cover for that service. While Part B would cover 80% of outpatient services, Medicare Advantage may not cover that much. These plans also leave you with much higher cost-sharing. While Advantage plans are better to have than no supplemental coverage at all if you can afford a Medigap plan, that will leave you with less out-of-pocket costs than Medicare Advantage.

Do Medicare Supplements Cover Robot Surgery?

Medicare Supplements must cover anything that Medicare covers. So, if you know your Medicare approves the surgery, then your Medicare Supplement will fill in the gaps that Medicare doesn’t cover. Depending on what letter plan you choose, you could end up having zero out of pocket costs.

How to Get Supplemental Coverage for Robotic Surgery with Medicare

If you have questions about coverage or plan options, give us a call. Our team of Medicare agents can answer any healthcare coverage questions you may have. Understanding your plan and what options you have is important for your finances. We can compare all supplemental Medicare options in your area, including Medigap, Medicare Advantage, and Part D. You can also use our compare rates form to see options in your area now.

Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

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