Fees, Self-Pay
and Insurance

Private surgery in the UK is paid for in three parts: the hospital, the surgeon, and the anaesthetist bill separately. If you are insured, you will need authorisation covering all three — and it is worth confirming specifically that your policy covers a central London hospital. If you are paying for yourself, a written quote covering all three — hospital, surgeon and anaesthetist — is available to any patient on request, usually the same working day, and is agreed with you before you are admitted. This page sets out how it works, what to check, and where the avoidable problems arise.

Last reviewed: August 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382

Three Separate Bills

Hospital, surgeon and anaesthetist invoice independently. Each is authorised or settled on its own. This is standard across UK private practice and surprises most patients the first time.

Check the Hospital, Not Just the Operation

Some policies restrict cover by hospital band or exclude central London. Confirming this at the point of authorisation prevents the most common avoidable problem.

Quotes on Request

A written quote covering all three fees is available to any patient who asks, usually the same working day, and agreed with you before admission.

  1. There are three separate fees, not one.The hospital, the surgeon and the anaesthetist bill separately. Each has to be settled or authorised on its own.
  2. Insurance authorisation covers all three, not just the operation.Authorise the procedure codes, and confirm cover for surgeon, anaesthetist and hospital. The authorisation code goes to Jo Mitchelson and to the hospital.
  3. Check that your policy covers a central London hospital.Some policies restrict cover by hospital band or exclude central London. This is the most common avoidable problem, and it is far easier to resolve before a date is booked.
  4. A written self-pay quote covering all three fees is available on request.Provided to any patient who asks, usually the same working day, and agreed with you before admission.
  5. Know what the quote covers and when it can change.The quote covers all three fees, the operation and the expected stay. It can change if the procedure changes or the stay is longer than anticipated.

What does the first appointment cost?

New appointments, face-to-face or virtual, are £250–£350. Follow-up appointments are £200–£275. Self-referrals are welcome and no GP letter is needed to book.

Surgical fees are separate and are discussed at the consultation itself, once it is clear what operation is actually being considered. That order matters: quoting for an operation before assessing whether it is the right operation puts the cart before the horse. A good proportion of consultations end without surgery being recommended at all.

Why are there three separate fees?

Because private surgery in the UK is delivered by three independent parties, each of which bills you separately. Almost everyone finds this surprising the first time, and it is worth understanding before the invoices arrive rather than after.

The hospital

Operating theatre, your bed and nursing care, scans, medicines, and everything else the hospital provides. This is usually the largest of the three.

The surgeon

The operation itself, and the care of you around it — including seeing you on the ward each day and your follow-up appointment afterwards.

The consultant anaesthetist

The anaesthetic and your pain management afterwards. A separate consultant, working with Dr Okiror, who will meet you before your operation and who invoices independently.

Three invoices, from three organisations. If you are insured, each needs to be authorised. If you are paying for yourself, each needs to be settled. Nothing about this is unusual — it is how every private hospital in the country works — but knowing it in advance removes most of the confusion.

What do I need to do if I have insurance?

Once a date has been agreed, you will be given the procedure codes for your operation. Those codes are what your insurer needs. From there:

1. Obtain authorisation for the procedure codes

Contact your insurer with the codes you have been given and request authorisation. Do not assume that a policy which covers “surgery” in general covers this operation specifically.

2. Confirm cover for the surgeon, the anaesthetist and the hospital

All three, separately. Each is a distinct question for your insurer, and cover for one does not imply cover for the others.

3. Pass the authorisation code on

Your insurer will issue an authorisation code. It needs to go to two places: to Jo Mitchelson on 020 7952 2882 or pa@lungsurgeon.co.uk, and to the hospital when they contact you. Without it, the hospital may not be able to proceed with your admission.

Insurers accepted: BUPA, BUPA International, AXA, AXA Health, Aviva, WPA and Cigna. Policies vary a great deal within each insurer, so please confirm your specific policy and plan with Jo before booking rather than relying on the insurer’s name alone.

Will my policy cover a central London hospital?

Not always — and this is the most common avoidable problem we see. Many policies restrict cover to particular hospital bands, and some exclude central London hospitals altogether. London Bridge Hospital and The Lister Hospital Chelsea both sit in the higher bands with several insurers.

When you contact your insurer for authorisation, ask two questions rather than one: is the procedure covered, and is this hospital covered under my policy? A patient can hold a perfectly valid authorisation for an operation and still find the hospital falls outside their plan.

If your policy does not cover these hospitals, there are usually options — a different site, a shortfall arrangement, or self-funding the difference. All of them are easier to arrange before a date is set. Raise it early and Jo will help you work through it.

How do I get a self-pay quote?

Ask, and we will get you one. A written quote is available to any patient on request — you do not need to have committed to anything, and you do not need to justify asking. Quotes usually come back the same working day.

The quote is agreed with you before your admission. Nothing about the hospital charge should be a surprise on the day you arrive.

The quote covers all three fees — hospital, surgeon and anaesthetist. They are still invoiced separately, by three separate organisations, but you will have the full picture in one written quote before you commit to anything.

Contact Jo Mitchelson on 020 7952 2882 or pa@lungsurgeon.co.uk and say which operation or investigation you have been advised to consider. If you are not yet sure, that is what the consultation is for.

What does the quote cover, and can it change?

The quote covers all three fees — hospital, surgeon and anaesthetist — for the operation and the expected length of stay in hospital. It is built around what is anticipated, not a minimum.

It can change in two situations, and it is better to know about both now than to meet them later:

When payment is due. The hospitals almost always require the full hospital fee to be settled before you are admitted. The surgeon’s and anaesthetist’s fees are invoiced separately; these can sometimes be settled afterwards, but are usually required beforehand. If the timing is difficult, say so early — it is a practical problem with practical solutions, and much easier to address before a date is set.

What if I am being treated on the NHS?

Dr Okiror’s NHS practice is at Guy’s and St Thomas’, and NHS care is free at the point of use. Nothing on this page applies to it.

Having a private consultation, or some of your treatment privately, does not affect your right to NHS care. You do not lose your place, you are not moved down a list, and you are not obliged to continue privately once you have started. This comes up often and the answer is the same every time: the two are separate, and choosing one does not close the other.

All documentation, imaging and test results are shared with your treating NHS team for any ongoing NHS care. Nothing is held back, and nothing has to be repeated because it was done privately. If you decide at any point to continue on the NHS, your records go with you.

Some patients have an initial consultation or a second opinion privately and then continue their treatment on the NHS. That is entirely reasonable, it is discussed openly, and nobody is expected to move to private treatment simply because they started there.

Questions About
Fees and Insurance

Practical questions about how private thoracic surgery is paid for, and what to check before a date is booked.

Request a Quote →

Or call Jo Mitchelson:
020 7952 2882

How much does a consultation cost?
New appointments, whether face-to-face or virtual, are £250–£350. Follow-up appointments are £200–£275. Surgical fees are separate and are discussed at the consultation, once the operation being considered is known. Self-referrals are welcome and no GP letter is needed to book.
Why are there three separate fees?
Private surgery in the UK is billed by three separate parties. The hospital charges for the operating theatre, your bed, nursing care, scans and medicines. The surgeon charges for the operation itself. The consultant anaesthetist charges separately for the anaesthetic and your pain management afterwards. These arrive as three separate invoices, from three separate organisations, and each has to be settled or authorised separately. It surprises most patients the first time, and it is standard practice across every private hospital in the country.
If I have private medical insurance, what do I need to do?
You will be given the procedure codes for your operation. You then contact your insurer and obtain authorisation for those codes, and separately confirm that the surgeon, the anaesthetist and the hospital are all covered under your policy. Your insurer will issue an authorisation code. That code needs to be given both to Jo Mitchelson, Dr Okiror’s PA, and to the hospital when they contact you. Without it, the hospital may not be able to proceed with your admission.
Will my insurance cover a central London hospital?
Not always, and this is the single most common problem we see. Some policies restrict cover to particular hospital bands or exclude central London hospitals altogether. London Bridge Hospital and The Lister Hospital Chelsea both fall into the higher bands with several insurers. Check this specifically with your insurer when you seek authorisation — not just whether the procedure is covered, but whether that hospital is covered under your policy. It is much easier to resolve before a date is booked than afterwards.
Can I get a self-pay quote before deciding?
Yes, and we are always happy to provide one. A written quote covering all three fees — hospital, surgeon and anaesthetist — is available to any patient on request, and usually comes back the same working day. The quote is agreed with you before your admission, so nothing about the cost should come as a surprise on the day.
What does the self-pay quote cover?
The quote covers all three fees — hospital, surgeon and anaesthetist — for the operation and the expected length of stay in hospital. The three are still invoiced separately, but the quote gives you the whole figure in one place. It can change if the details of the procedure change, or if you need to stay in hospital longer than anticipated — both of which are uncommon, but both of which are worth knowing about in advance rather than afterwards.
When do the fees have to be paid?
The hospitals almost always require the full hospital fee to be settled before you are admitted for your operation. The surgeon’s and anaesthetist’s fees are invoiced separately. These can sometimes be settled after the operation, but are usually required beforehand. If the timing of payment is difficult for you, say so early — it is a practical problem with practical solutions, and it is far better raised before a date is set.
Which insurers are accepted?
BUPA, BUPA International, AXA, AXA Health, Aviva, WPA and Cigna. Policies vary considerably within each insurer, so please confirm your specific policy and plan with Jo Mitchelson on 020 7952 2882 before booking rather than relying on the insurer’s name alone.
Does going private affect my NHS care?
No. Having a private consultation, or some of your treatment privately, does not affect your right to NHS care. You do not lose your place, you are not moved down a list, and you are not obliged to continue privately once you have started. All documentation, imaging and test results are shared with your treating NHS team for any ongoing NHS care, so nothing needs to be repeated because it was done privately.
What if I am being treated on the NHS?
NHS care is provided at Guy’s and St Thomas’ and is free at the point of use. Nothing on this page applies to NHS treatment. Some patients choose to have their initial consultation or second opinion privately and then continue their treatment on the NHS, and that is entirely reasonable — it is discussed openly at the consultation, and no one is expected to move to private treatment because they started there.

Ask for a quote.
You are not committing to anything.

Written quotes covering hospital, surgeon and anaesthetist fees are available to any patient on request, usually the same working day. Appointments at London Bridge Hospital and The Lister Hospital Chelsea are typically available within 2–3 working days. Self-referrals welcome.

Request a Quote → Admission & Your Stay

Jo Mitchelson, PA  · 020 7952 2882 · pa@lungsurgeon.co.uk

St Thomas’ Hospital #1 UK · Guy’s Hospital #2 UK · London Bridge Hospital #10 UK · Newsweek World’s Best Hospitals 2026

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