OBJECTIVES: Bariatric surgical procedure volumes have increased as more hospitals offer the service. Strictures following bariatric surgery using circular staplers are a common complication. The objective was to assess the cost of gastrointestinal strictures following laparoscopic bariatric surgery that employed circular surgical staplers in the index procedure. METHODS: Laparoscopic bariatric surgery inpatient discharges (ICD-9-CM:44.31, 44.39) with mention of circular staplers were identified in the Premier Perspective® Database for CY2008 and CY2009. Esophageal balloon dilation procedure codes (CPT:43235, 43245; ICD-9-CM:44.22) for inpatient and  outpatient discharges were used to identify single or multiple strictures within 6 months following bariatric surgery. Groups were propensity score matched (1:1) on age, gender, race, region, hospital teaching status and APR-DRG severity. The initial bariatric surgery costs, hospital length of stay (LOS) and operating room (OR) time between the stricture and no-stricture groups were compared between the matched groups. The cost of strictures was assessed for patients in the stricture group.  RESULTS: A total of 4,731 laparoscopic bariatric surgery discharges utilizing circular staplers were identified. 201(4.3%) of these had a mention of at least one balloon dilation procedure within 6 months of the index procedure. 170 (84.6%) and 31(15.4%) were performed in outpatient and inpatient settings, respectively. 200 patients were propensity matched between the stricture and no-stricture groups. There were no significant differences in initial bariatric surgery costs, LOS and OR time between groups .For the outpatient setting; mean total costs of 1st (N=169), 2nd (N=29), 3rd (N=7) and the 4th stricture (N=3) were $1251, $1025, $1603 and $1610 respectively. One patient had more than 4 strictures. For the inpatient setting, mean total cost was $7110 for the 1st (N=31) stricture. CONCLUSIONS: Post surgical strictures can increase treatment costs for laparoscopic bariatric surgery patients utilizing circular staplers.