Excess Fees Paid for Surgery or Childbirth in Private Hospitals Can Be Recovered

You had a surgery or gave birth in a private hospital; when you looked at your invoice, you saw that the amount you paid was much higher than you expected. When you queried your SGK (Social Security Institution) treatment information via e-Devlet, you realized that the amount SGK paid to the hospital for the same procedure was extremely small compared to what was taken from you. This difference is not a coincidence and is most likely unlawful.

Under Turkish law, the maximum supplementary fee that private hospitals contracted with SGK can request from the patient is limited by the Health Implementation Communiqué (SUT). Any amount collected above this limit can be reclaimed through legal channels. On the other hand — this point is very frequently misunderstood — there is no obligation to apply to the hospital beforehand in order to request a fee refund. It is possible to apply directly to the Consumer Arbitration Committee, mediator, court, or enforcement proceedings.

What is a Supplementary Fee? What is its Legal Basis?

Private hospitals contracted with SGK can collect fees from both SGK and the patient for the health services they provide. This additional amount taken from the patient is called the supplementary fee (ilave ücret).

The legal framework of the supplementary fee is regulated in two main sources:

• Social Insurance and General Health Insurance Law No. 5510, Article 73
• Health Implementation Communiqué (SUT), Section 1.9

SUT has determined a maximum supplementary fee rate separately for each type of healthcare provider and each procedure code. The critical point is this: the supplementary fee calculation is made separately for each service item according to the procedure code in SUT and the multiplier rate determined by its price. A calculation cannot be made over a single general rate or a lump-sum package price.

Why is Package Pricing Prohibited?

Private hospitals present the services they provide by pricing them with a single fee under names such as "maternity package", "surgery package", or "pregnancy tracking package". This practice is directly contrary in terms of SGK legislation.

In the Consumer Arbitration Committee and court processes, the experts calculate each procedure separately with its SUT code, regardless of the "package contract" offered by the hospital, and determine the total maximum supplementary fee based on this calculation.

How is the Maximum Supplementary Fee Limit Calculated?

According to SUT, the general supplementary fee rate for private hospitals contracted with SGK works as follows:

Concrete example: If SGK pays the hospital 4,513.65 TL for a cesarean section surgery, the maximum supplementary fee the hospital can request from the patient is 4,513.65 × 2 = 9,027.30 TL. You can see the full version of this table in the expert calculation section below.

Supplementary Fees in Accommodation (Hotel) Services

SUT has determined a separate pricing procedure for hotel services (room, meals, companion, etc.). For these services, the standard bed tariff (SUT code 510.010) is taken as a basis, and different multipliers are applied depending on the room type:

Services Exempt from Supplementary Fees (SUT Art. 1.9.3)

For the following health services, the private hospital cannot request a supplementary fee from the patient, even if it is contracted with SGK:

• Emergency room services (provided due to an emergency condition)
• Intensive care services
• Health services provided to the newborn — this is an item whose violation is frequently encountered in maternity invoices
• Burn treatments
• Cancer treatments (radiotherapy, chemotherapy, immunotherapy)
• Organ, tissue, and stem cell transplants
• Surgical procedures for congenital anomalies
• Hemodialysis treatments

How Does the Expert Calculate? — A Real Example

In special hospital fee disputes heard before the Consumer Arbitration Committee or the Consumer Court, an expert is appointed. The expert does not take into account the package contract or general information documents offered by the hospital, but calculates each service separately over its own SUT code and SUT price.

The table below concretizes the calculation method in an actually issued expert report. The report examined a dispute involving a cesarean delivery and 9 months of pregnancy tracking, for which 60,000 TL was collected from the hospital. The expert evaluated each procedure one by one according to SUT and calculated the maximum legal supplementary fee total:

This example clearly shows how precise and itemized the expert's calculation is. The hospital put forward the defense that "prior information was given within the scope of the package"; however, the expert rejected this defense on the grounds that "it was not concretely demonstrated which services the total collected amount corresponded to, and how the procedures within the scope of SUT and those outside the scope were separated."

How Do You Know if You Overpaid?

Query SGK Treatment Information from e-Devlet

By logging into e-Devlet, you can access the SGK records belonging to the relevant procedure from the "SGK Sağlık Hizmetleri Sorgulama" (SGK Health Services Inquiry) section. By seeing the amounts SGK paid to the hospital and multiplying them by the SUT rates, you can calculate the legal ceiling yourself.

Use the SGK Supplementary Fee Calculation System

You can query the legal maximum amount the hospital can charge for that service by entering the hospital name, branch, and procedure code into the supplementary fee calculation tool at gss.sgk.gov.tr.

Request a Detailed Invoice

Request an invoice from the hospital containing an item-by-item breakdown of the amount you paid on a procedure code basis. The hospital is obliged to provide this document. Compare each item on the invoice with the SGK inquiry screen.

Pre-Application Checklist

Practical advice: Make your payment by credit card as much as possible. A card statement is a direct means of proof; in cash payments, the burden of proof becomes significantly heavier.

Legal Ways for Fee Refund

There are four independent ways in Turkish law to recover excess surgery or maternity fees. In order to apply for any of these ways, there is no obligation to file a complaint with the hospital beforehand or receive a written response. The consumer can directly and independently choose the path they wish; when deemed appropriate, they can conduct multiple paths simultaneously.

1. Consumer Arbitration Committee (THH)

According to the monetary limits valid for 2026, if the dispute amount is below 186,000 TL, the application is made to the THH; if it is above this amount, mediation is mandatory before filing a lawsuit in the Consumer Court.

Online applications can be made to the THH via e-Devlet: turkiye.gov.tr → Tüketici Başvuruları (Consumer Applications). The decision is made within 6 months at the latest. The THH decision is in the nature of a court writ (ilam) and makes it possible to apply for enforcement proceedings. The THH, when necessary, appoints an expert to calculate the maximum supplementary fee within the scope of SUT.

2. Complaint Application to SGK

Complaining to SGK is an independent path; it can be used simultaneously with other paths. SGK can audit the hospital that illegally collects fees, apply administrative sanctions, and issue an official letter identifying the excess collection. This determination document serves as strong evidence in the THH or court process. Application channels: SABİM 184, ALO 182 Health Line, CİMER.

3. Mediation (Pre-Litigation)

If the dispute exceeds the THH limit, the mandatory mediation process must be completed before filing a lawsuit in the Consumer Court. If an agreement is reached in mediation, the process ends without going to court; if no agreement is reached, a lawsuit is filed with the drawn-up report.

4. Lawsuit in the Consumer Court

If the dispute amount exceeds the THH limit or the THH decision is appealed, the lawsuit is heard in the Consumer Court. The court appoints an expert to calculate the maximum supplementary fee within the scope of SUT; if the lawsuit is found justified, litigation expenses and attorney's fees are charged to the opposing party.

Collection via Enforcement Proceedings

Since the excess fee taken from the private hospital has the nature of a certain and due money receivable, it can be subject to enforcement proceedings directly through general attachment without judgment (ilamsız icra). Without waiting for the THH decision, an application can be made to the enforcement office based on the invoice and SGK data.

I Signed a Contract — Did I Lose My Right?

No. If the hospital made you sign a contract or consent form prior to surgery and this document states that you "accepted" the high amount, this situation does not eliminate your legal right.

There are three main legal grounds for this:

• Writing an unlawful price into a contract does not make that contract provision valid (Turkish Code of Obligations Art. 27).
• Before surgery or birth, the patient is under duress/necessity (müzayaka) (economic obligation/pressure state); this situation prevents speaking of consent given with free will.
• Unfair terms in consumer contracts are not binding on the consumer (Consumer Protection Law Art. 5).

Statute of Limitations

Frequently Asked Questions