If you or someone you love has been diagnosed with kidney failure, you’ve likely already faced some difficult decisions. Choosing between dialysis and transplantation isn’t just a medical decision—it’s also a financial one.

A kidney transplant offers freedom from dialysis, better long-term outcomes, and an improved quality of life. But it comes with a steep price tag.

According to Milliman Research (2020), the average cost of a kidney transplant in the United States is about $442,500 in the first year alone. This includes evaluation, surgery, hospital stay, and follow-up care—but not long-term medications or potential complications.

Understanding the full financial picture can help you prepare, access the right resources, and avoid unnecessary surprises.

What’s included in the cost of a kidney transplant

A kidney transplant isn’t a one-time charge. The total cost includes multiple stages of care. Here's what that looks like:

Pre-transplant evaluation

Before you’re placed on a transplant list, you’ll undergo a detailed evaluation process. This may include:

• Lab and blood work

• Imaging (like CT scans or ultrasounds)

• Cardiac testing

• Consultations with specialists

According to the United Network for Organ Sharing (UNOS, 2023), this step can cost between $5,000 and $15,000 depending on your health needs and location.

Understanding creatinine levels can give insight into kidney function during evaluation.

Organ procurement and matching

Finding a donor match involves both medical testing and administrative work. Even if you have a living donor, costs are still significant.

Medicare data (CMS, 2023) shows that organ procurement often makes up 30% of the total transplant cost, averaging $70,000 to $100,000.

Surgery and hospital stay

This is the single largest component of the transplant bill. It includes:

• Surgical fees
  

• Hospital room and ICU care
  

• Anesthesia
  

• Imaging and lab work post-surgery
  

According to Global Perspective on Kidney Transplantation (2020), transplant surgery and hospitalization typically cost more than $150,000.

Urine protein test strips can also help track early signs of kidney stress post-operation.

Recovery and medications

After surgery, you’ll need lifelong anti-rejection medication to keep your new kidney functioning. Common medications include tacrolimus, mycophenolate, and steroids.

The United States Renal Data System (USRDS, 2024) estimates annual medication costs to be around $24,000.

You’ll also need:

• Frequent bloodwork

• Routine imaging

• Ongoing doctor visits
  

Complications and graft failure

Unfortunately, not all transplants succeed. If your new kidney fails, you may need to return to dialysis or undergo another transplant.

The National Kidney Registry (2024) estimates that graft failure adds an extra $95,000 to $150,000 to total care costs.

Monitoring for white blood cells in urine is one way to detect early signs of infection or inflammation post-transplant.

How much is a kidney transplant without insurance?

If you don’t have insurance, the financial burden can be overwhelming.

According to Milliman Research (2020), the billed cost for a transplant admission alone is around $414,800. This doesn't include follow-up care, medications, or related costs like transportation and time off work.

In total, the first-year cost for an uninsured person can exceed $500,000.

What insurance covers for a kidney transplant

Medicare

Medicare covers kidney transplants for people with end-stage renal disease (ESRD), regardless of age. It pays for:

• 80% of the transplant costs

• Hospital and doctor visits

• 36 months of immunosuppressant drugs (extended coverage available as of 2023)
  
  

According to the Centers for Medicare & Medicaid Services (2023), Medicare is the primary payer for over 60% of U.S. kidney transplant recipients.

Medicaid

Medicaid coverage varies by state but often includes:

• Evaluation and surgery

• Hospital stays

• Post-operative care and medication

If you qualify for Medicaid, it may cover 100% of the cost with little to no out-of-pocket expenses.

Private insurance

Most private insurance plans cover kidney transplants but may include:

• Deductibles

• Coinsurance

• Prior authorization requirements

The National Kidney Foundation (2024) notes that private insurance patients may still pay between $5,000 and $15,000 out of pocket.

Employer group health plans

These plans can offer more comprehensive transplant coverage, but you'll still want to verify what’s included, especially for medications and living donor costs.

Kidney transplant cost by country

Kidney transplant pricing can vary significantly depending on where you live:

Unexpected costs people often overlook

Even with great insurance, some costs may still surprise you:

• Travel and lodging if your transplant center is far

• Lost income during recovery

• Home health needs (e.g., equipment or caregiver support)

• Donor-related expenses like travel, meals, or childcare

According to the Cato Institute (2024), families often face $10,000 to $20,000 in uncovered costs.

Financial help is available

If you're feeling overwhelmed by the numbers, you're not alone. Here are a few places to turn:

• National Living Donor Assistance Center (NLDAC): Helps with travel and lodging for donors

• American Kidney Fund (AKF): Offers grants for medical bills and insurance premiums

• GoFundMe / Help Hope Live: Crowdfunding platforms used by transplant recipients

• Manufacturer savings programs: Drugmakers often provide discounts or free meds for low-income patients

Is a kidney transplant cheaper than dialysis?

Yes—over time, a transplant can actually save money.

According to USRDS (2024), dialysis costs about $90,000 per year. Over 10 years, that’s $900,000.

By contrast, a kidney transplant (including follow-up) might cost $250,000 to $500,000 over the same period.

The National Kidney Registry (2024) estimates that a transplant saves Medicare $215,000 to $347,000 per patient over a decade.

Beyond dollars, most people report better energy, fewer dietary restrictions, and greater freedom post-transplant.

Understand this better by reviewing the stages of CKD and symptoms to know when dialysis costs begin adding up.

What to know about living donor transplants

Living donor transplants have several benefits:

• Better outcomes—Graft survival is 90% at five years, compared to 81% with deceased donors (Global Kidney Registry, 2023)

• Shorter wait times

• Lower risk of rejection

According to UNOS (2023), about 7,000 kidney transplants in the U.S. each year involve living donors.

While the recipient’s insurance usually covers the medical costs, donors may still need help with travel and lost income—this is where grants and reimbursement programs can make a difference.

What happens if you delay a transplant?

Delaying a transplant comes with risks:

• Dialysis limits your lifestyle and increases health risks over time

• You may face longer wait times as your condition worsens

• You’re more likely to experience complications from surgery if you're not in optimal health

According to the CDC (2024), more than 13 people die each day while waiting for an organ.

Acting early gives you time to prepare emotionally and financially—and increases your chances of success.

Delays also increase your risk for renal tubular acidosis, a condition that worsens in advanced kidney failure.

5 ways to plan financially for a transplant

Here are a few steps to reduce stress and stay in control:

1. Meet with a transplant financial counselor early in your journey

2. Explore every insurance option, including Medicare, Medicaid, and private plans

3. Track your medical expenses for potential tax deductions

4. Apply for aid programs before your bills pile up

5. Talk to your employer about disability, leave, and benefits

Signs it might be time for a transplant

Your kidneys play a vital role in removing waste, balancing fluids, and supporting blood pressure. When they begin to fail, your body often gives subtle—but important—clues. Recognizing these signs early can help you explore treatment options, including transplant, before complications worsen.

You may need to consider a kidney transplant if you're experiencing:

• Swelling (edema) in your legs, ankles, or around your eyes

• Constant fatigue, weakness, or decreased exercise tolerance

• Shortness of breath, especially with mild activity or at night

• Changes in urination, including dark, foamy, or reduced output

• Loss of appetite, nausea, or vomiting—often due to toxin buildup

• Cognitive changes, such as confusion or difficulty focusing

• Persistent high blood pressure, even with medications

• Metallic taste in the mouth or an ammonia-like breath odor

According to the National Institute of Diabetes and Digestive and Kidney Diseases, many of these symptoms appear in late-stage chronic kidney disease (CKD)—particularly Stage 4 or 5, when kidney function drops below 30%.

Learn more about creatinine levels in stage 3 kidney disease, which often qualifies patients for transplant.

Medical criteria for kidney transplant referral

Transplant centers follow specific medical guidelines to determine if someone is eligible. You may be referred for transplant evaluation if you meet any of these criteria:

• Low eGFR indicating reduced kidney function

• On dialysis or expected to need it within 6–12 months

• Chronic kidney disease from diabetes, hypertension, polycystic kidney disease, or glomerulonephritis

• No active infections or untreated cancers

• Stable heart, lungs, and overall health for surgery and recovery

• Able to follow a medication plan and attend follow-ups

Each transplant center may apply these criteria slightly differently. The decision also considers your age, overall health, and support system.

If you or your doctor think you may be approaching transplant eligibility, ask for a referral to a transplant center. Early evaluation gives you the best chance to find a donor, prepare financially, and stay ahead of complications.

Takeaway

Kidney transplants are expensive—but also life-saving. When you understand how much a kidney transplant costs and where to find help, you take an important step toward recovery.

If you’re ready to take control of your health, it starts with knowledge—and a plan.

Worried about how your kidney or liver is doing?
Ribbon Checkup’s at-home kidney and liver health tests help you monitor vital markers between doctor visits—giving you clarity, control, and peace of mind.

FAQs

Can I get a transplant without insurance?

Yes—through Medicaid or hospital charity programs. But you’ll need to plan carefully and provide documentation.

Will Medicare cover everything?

Medicare covers 80% of transplant costs and, as of 2023, can cover lifelong anti-rejection drugs for eligible patients.

Is there someone to help me with all this?

Yes. Every transplant center has a financial coordinator to walk you through your coverage and connect you to aid.

 

Written by Abel Tamirat, MD
Dr. Abel Tamirat is a licensed General Practitioner and ECFMG-certified international medical graduate with over three years of experience supporting U.S.-based telehealth and primary care practices. As a freelance medical writer and Virtual Clinical Support Specialist, he blends frontline clinical expertise with a passion for health technology and evidence-based content. He is also a contributor to Continuing Medical Education (CME) programs.

Related Resources

• How to Check Kidney Function at Home
   A practical guide to monitoring your kidney health using at-home tests—helpful before and after a transplant.
  

• Understanding Creatinine Levels: A Comprehensive Guide
   Learn how creatinine levels reflect kidney function and why they play a critical role in transplant evaluation.
  

• Chronic Kidney Disease Stages: Know the Symptoms
   Explore how CKD progresses, when a transplant may become necessary, and what symptoms to watch for.
  

References

2025 U.S. organ and tissue transplants: Estimated costs and utilization, emerging issues, and solutions. (2025). Retrieved June 10, 2025, from Milliman.com website: https://www.milliman.com/en/insight/2025-us-organ-and-tissue-transplants-costs-utilization? 

Kidney Disease: Fact Sheet. (2024, December 10). Retrieved June 10, 2025, from National Kidney Foundation website: https://www.kidney.org/about/kidney-disease-fact-sheet 

Preemptive kidney transplant - Type - Mayo Clinic. (2025). Retrieved June 10, 2025, from Mayoclinic.org website: https://www.mayoclinic.org/tests-procedures/preemptive-kidney-transplant/pyc-20384830 

Wang, J. H., & Hart, A. (2021a). Global Perspective on Kidney Transplantation: United States. Kidney360, 2(11), 1836–1839. https://doi.org/10.34067/kid.0002472021 

Wang, J. H., & Hart, A. (2021b). Global Perspective on Kidney Transplantation: United States. Kidney360, 2(11), 1836–1839. https://doi.org/10.34067/kid.0002472021 

Wang, J. H., & Hart, A. (2021c). Global Perspective on Kidney Transplantation: United States. Kidney360, 2(11), 1836–1839. https://doi.org/10.34067/kid.0002472021 

and, D. (2025, June 10). Kidney Transplant. Retrieved June 10, 2025, from National Institute of Diabetes and Digestive and Kidney Diseases website: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/kidney-transplant