EN
A stomach cancer diagnosis can upend a family’s plans in a day, and the money question follows at once: the honest answer is that the cost of stomach cancer treatment in Germany has no single figure, only a tariff and an estimate for the specific case. It depends on the stage and the treatment: endoscopic removal, surgery with chemotherapy, or drugs. The hospital issues its official estimate (Kostenvoranschlag) only after reviewing the biopsy, histology and imaging.
This page covers which tariffs apply, what the examination costs, what an estimate looks like and who pays whom. The medical side is covered on the page on stomach cancer treatment in Germany.
What the estimate is built from
The estimate rests on two official catalogues: doctors bill appointments and examinations under the GOÄ fee schedule (Gebührenordnung für Ärzte), and the hospital bills the inpatient stay under the DRG system, which prices each case by its group. Citizenship plays no part: anyone paying privately is billed under the GOÄ, and the law requires general hospital services to be charged equally to all. Here is the official GOÄ text in its current version; the general logic of oncology prices is on the page on cancer treatment prices in Germany.
Sums for the same diagnosis can differ several times over, because the work differs: partial and total gastrectomy fall into different DRG groups, drug cycles vary with the regimen and the tumour’s response, complications add days in intensive care, and slides from home are sometimes re-examined. Does the hospital matter? DRG hospitals, university hospitals included, share one national catalogue, but the base rate that multiplies a group’s weight differs by federal state. Elective extras (Wahlleistung), such as treatment by the head of department or a comfort room, are billed on top by written agreement. Choosing a hospital is covered on the stomach cancer treatment page.
Some costs never reach the medical invoice: a relative’s accommodation, transport, translations beyond the programme, a visa extension. They are calculated separately and in advance, so the family sees the whole budget.
| Cost item | What it depends on | Guide |
|---|---|---|
| Examination and consultations | Tests to repeat; endoscopic ultrasound, PET-CT | Consultation €300–€600; examination with endoscopy €700–€2,200; contrast CT from about €550; abdominal MRI €900–€1,000 |
| Endoscopic removal of an early tumour | Tumour size, days in hospital | Per the hospital’s estimate |
| Surgery and inpatient stay: resection or gastrectomy with D2 lymphadenectomy | Extent of surgery, DRG group, days in intensive care | Per the hospital’s estimate |
| Perioperative chemotherapy | Regimen, number of cycles, body weight | Per the hospital’s estimate, including one cycle without targeted agents |
| Targeted drugs and immunotherapy | HER2 status, microsatellite instability, length of course | Per the hospital’s estimate |
| Follow-up after discharge | Check-ups, nutrition advice | Per the hospital’s estimate |
| Accommodation, transport, translations, visa extension | Length of trip, number of companions | Per the provider’s invoice |
What the examination costs
Examination is billed separately from treatment and is where the estimate starts: a consultation with an oncology professor costs €300–€600, and other prices are below. The gastroscopy is usually repeated with expert endoscopic ultrasound, which shows how deep the tumour has grown and whether nearby lymph nodes are involved (see gastroscopy in Germany). Contrast-enhanced CT is added, sometimes PET-CT for a locally advanced tumour, and the tissue is tested for HER2 status and microsatellite instability, which decides whether targeted drugs and immunotherapy are options.
German doctors often repeat tests done at home, and not out of distrust: the extent of surgery, and so the sum, depends on accurate staging. If the images do not show how deep the tumour reaches or whether lymph nodes are affected, nobody can say whether part or all of the stomach will be removed, or price it.
- Initial consultation with a leading oncology professor: €300–€600
- Comprehensive gastroenterological examination and endoscopy: €700–€2,200
- Contrast-enhanced CT scan: starting at about €550
- Abdominal MRI: €900–€1,000
Surgery, drugs and days on the ward
The cost of surgery depends above all on its extent, which sets the DRG group and the length of stay. Visceral surgeon Dr Erich Bielesch performs both subtotal resection and total gastrectomy for tumours, with D2 lymphadenectomy, the removal of lymph nodes around the stomach and its arteries. If the tumour reaches the oesophagus or duodenum, the operation and the estimate grow; see surgery for stomach cancer. An early tumour confined to the mucosa is sometimes removed endoscopically, without opening the abdomen; the estimate then covers that procedure, a short stay and check-up gastroscopies. This is decided after endoscopic ultrasound and histology, and if the tissue shows a deeper tumour, surgery and a new estimate follow.
The drug part is mainly perioperative chemotherapy, given before and after the operation; in advanced disease a targeted drug may be added for a HER2-positive tumour and immunotherapy for one with microsatellite instability. The regimen is approved by a multidisciplinary tumour board of oncologists, surgeons and gastroenterologists, such as Professor Brigitte Mayinger. It depends on histology and the patient’s condition, and its cost on the number of cycles and the dose, calculated from height and weight.
The final invoice itemises medications, procedures and specialist consultations, including monitoring blood tests, infusion sets, anti-sickness medication and, after surgery, days in intensive care. After discharge come separate costs: check-ups, nutrition advice and vitamin B12 monitoring, since without a stomach the body cannot absorb it from food and it is replaced for life. Rehabilitation and life after the operation are covered on the surgery page; the Krebsinformationsdienst of the German Cancer Research Center explains eating after stomach cancer in detail.
When the disease is at stage four
At stage four the estimate changes shape, because the plan is often built around drug treatment and symptom relief rather than surgery. Therapy cycles and the scans that check the regimen become the main item, and there may be no surgical block. Sometimes a procedure to restore passage is added, such as a stent, a thin mesh tube that keeps the channel open.
The estimate then covers a defined number of cycles and is recalculated after a check-up, because whether and how to continue depends on the tumour’s response. It cannot be compared directly with an estimate for surgery: one covers a stage of treatment, the other a whole operation. The medical side is explained in the article on stage four stomach cancer.
Frequently asked questions
How much does stomach cancer surgery cost?
The hospital states the price in its estimate, and it depends above all on the extent of surgery. Endoscopic removal of an early tumour, partial resection and gastrectomy with D2 lymphadenectomy fall into different DRG groups with different lengths of stay. Days in intensive care change the total, and chemotherapy before and after surgery is billed separately. Without the records, there is no honest figure.
Do international patients pay more than local ones?
No: a DRG hospital must by law charge general hospital services equally to all patients, and doctors bill everyone paying privately under the GOÄ. The difference lies elsewhere: an international patient pays a deposit in advance and pays separately for chosen extras, such as treatment by the head of department or a comfort room.
Can I find out the cost before travelling to Germany?
Yes, approximately: the hospital draws up its estimate from records sent in advance, such as the discharge summary, gastroscopy and histology reports and imaging. Examination prices are known at once; surgery and drugs are priced after the doctors review the records. The final sum is known only after discharge.
How AlenMed requests the official estimate
AlenMed requests the estimate from medical records: discharge summaries, gastroscopy and histology reports, sometimes paraffin blocks for re-reading, and DICOM imaging. We translate them for oncologists at partner hospitals; the doctor outlines the tactics and asks the hospital for an official estimate, which also underlies the visa invitation. The deposit goes straight to the hospital’s official account: at Rechts der Isar Hospital (TUM) in Munich, for example, the appointment confirmation for the visa follows once payment arrives. After discharge the hospital reconciles the services delivered, refunds any balance to the patient’s account and, if complications required a long stay in intensive care, may ask for an additional payment.
AlenMed works with 86 partner hospitals in 38 cities and 345 doctors; the company office is in Munich. A coordinator meets the patient, interprets at appointments and collects the discharge report.
This material is for information only. All figures are indicative, are not a binding public offer and are confirmed by the hospital’s individual estimate (Kostenvoranschlag) after the records are reviewed; treatment tactics are set by a doctor at an in-person consultation.