OBJECTIVES:  Many health care systems are evolving to different payment models where they want to include the whole patient treatment in an episode payment. In order to achieve this goal, it is important to know not only procedure costs, but also patient complications and resources consumption costs in a certain period of time. Our main goal was to estimate the costs and resources utilization of bariatric surgery in the perioperative time and two years after the procedure in the Brazilian private health care system reality. METHODS:  A longitudinal analysis was performed (2013-2015), using hospitalization records and outpatient information from private payers (Orizon). RESULTS: Records from 300 hundred patients were analyzed. Patients had 36 years old on average and 80% were female. The average length of stay was 2.25 days. 2.3% of the patients were readmitted in less than 30 days. 15% of the patients visited ER (1.5 visits on average) in the first 30 days post-surgery. 4% of the hospitalizations required ICU. The average patient cost of surgery plus two years follow up was USD 10,000 distributed: USD 7,541 (75%) in the perioperative time and USD 2,459 (25%)in the following two years after surgery. Variability in the post-surgery expenses ranged from USD 100 to USD 63,012. CONCLUSIONS:  Payment models are moving towards a continuum of care payment where payers are looking for Bundle Payments. Costs variability in two years post-surgery after a bariatric procedure is huge, but on average consumes 25% of the total treatment cost. Payers and hospitals should be careful in order to consider what to include in a bundle payment to keep both financially sustainable. Studies considering more patients are needed to give a broader perspective.