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Centers for Medicare & Medicaid Services

National Coverage Determination (NCD) for Gastric Bypass Surgery for Obesity (100.1)

Benefit Category
Physicians' Services

Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

Gastric bypass surgery, which is a variation of the gastrojejunostomy, is performed for patients with extreme obesity.

Indications and Limitations of Coverage

Gastric bypass surgery for extreme obesity is covered under the program if (1) it is medically appropriate for the individual to have such surgery; and (2) the surgery is to correct an illness which caused the obesity or was aggravated by the obesity.

Cross Reference
See ยงยง40.5 and 100.8 of the NCD Manual.
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