DEXA Scan in Germany: What It Costs, When Insurance Pays and Where to Get One

Short answer: a DEXA bone density measurement costs about 40 to 70 euros without insurance ^[4]. The whole-body scan for body composition (fat mass, muscle mass, visceral fat) mostly costs 50 to 200 euros per measurement, going by the prices providers publish in 2026. Radiology practices are often at the lower end, specialised sports and longevity providers with a results consultation at the upper end.

Why the range is so wide: for bone density there is the official fee schedule for private billing (GOÄ), which caps the price. For body composition there is no fixed code. The price depends on whether you only get the printout or half an hour of discussion on top. Both can be sensible. You should just know what you are paying for.

Scan	What is measured	Self-pay (typical)	Statutory insurance
Bone density (osteodensitometry)	T-score at lumbar spine and hip	approx. 40 to 70 euros [4]	Yes, but only with a concrete osteoporosis indication [3]
Whole-body composition	Fat mass, lean mass, visceral fat, ALMI	approx. 50 to 200 euros	No, always self-pay

Both measurements run on the same machine. Some practices therefore offer a package of bone density plus body composition that is cheaper than two separate appointments. Asking pays off.

Privately insured? Then it depends on your plan. Bone density measurement is usually reimbursed when there is a medical question. The pure body fat measurement without a diagnosis is usually not a reimbursable service with private insurers either. If you are spending the money yourself anyway, read our self-pay guide, which covers what is worth paying for at all in Germany, Austria and Switzerland.

DEXA (also written DXA) stands for dual-energy X-ray absorptiometry. The machine sends X-rays at two different energies through your body. Because bone, fat and lean tissue absorb the two energies to different degrees, the software can split your body into three compartments: bone mineral, fat mass and lean soft tissue ^[7]. That is the whole trick. And from it come two different examinations.

Scan 1: bone density measurement. Measured usually at the lumbar spine and both hips (femoral neck and total femur), as the DVO guideline specifies ^[1]. The result is the T-score: how many standard deviations your bone density sits above or below the average of young healthy adults. From minus 2.5 it is called osteoporosis. Between minus 1 and minus 2.5 it is osteopenia, a pre-stage with below-normal bone density ^[2]. In practices this examination is often simply called Knochendichtemessung or osteodensitometry and takes a few minutes.

Scan 2: the whole-body scan for body composition. Here you lie completely under the scanner for about five to ten minutes. You get a printout with:

• fat mass in kilograms and percent
• lean mass, often split into arms, legs and trunk
• an estimate of visceral fat (the fat around your abdominal organs)
• ALMI, the appendicular lean mass index: the muscle mass of your arms and legs divided by your height squared ^[7]

This is the scan that strength athletes, people on weight-loss injections and longevity-minded people mean when they search for a DEXA scan.

The difference matters because it determines everything else: the cost, the insurance question and where you have to go. If you ask a radiology practice for a DEXA scan, you get scan 1 by default. If you want to see fat and muscle, you have to ask explicitly for body composition (Körperzusammensetzung). Not every practice that measures bone density has this software enabled.

Short answer: statutory insurance pays for bone density measurement when there is a concrete medical reason. It never pays for body composition. Here is the rule in detail.

The rule comes from the G-BA, the Federal Joint Committee that decides what statutory insurance pays for. Since its decision of February 2013, insurance covers the bone density scan when concrete findings from your history and examination mean your doctor intends to treat osteoporosis specifically with medication ^[3]. The classic example is a vertebral or hip fracture without adequate trauma, meaning a fracture from a fall from standing height or from lifting a shopping bag. But a fracture is no longer a requirement. Anyone who takes cortisone long-term, for example, or has other tangible risk factors can get the measurement at insurance expense. Insurance pays for a repeat measurement no earlier than five years later, unless special findings make an earlier one necessary ^[15].

Who should be measured at all according to the guideline? The 2023 DVO guideline says that after every fracture from age 50 your fracture risk should be assessed promptly. If the fracture looks like a fragility fracture, meaning a break from very little force, the full workup with DXA should follow promptly. From age 70 this workup should be offered to everyone. In postmenopausal women and men from 50 it depends on the individual risk constellation, such as cortisone therapy, rheumatism, diabetes, falls or a hip fracture in mother or father ^[1]. The European guideline by Kanis and colleagues argues similarly: measure when the fracture risk would influence the decision, not as a screening for everyone ^[2].

And if you are healthy, 45 and simply want to know how your bones are doing? Then bone density measurement is an IGeL, a self-pay service. The practice has to tell you this beforehand and give you the expected costs in writing before the scan. At 40 to 70 euros that is no drama, but you should know that the guidelines see no proven benefit for this case ^{[1, 2]}.

Body composition is a different chapter. There is no billing code for it in the statutory fee schedule (EBM). No insurer covers it, not even with obesity or suspected sarcopenia (age-related loss of muscle mass and strength). Some insurers subsidise health checks through bonus programmes, but the DEXA body fat scan practically never belongs to them. Count firmly on the full price.

In Austria? There the insurer pays for a bone density measurement when a doctor refers you and the scan is done at a contracted institute (Vertragsinstitut) ^[20]. In Switzerland, ask your basic insurer before you book.

Before the addresses: a DEXA scan is an X-ray exam, and that changes how you get one. Under section 83 of the German Radiation Protection Act, every application of ionising radiation to humans requires a justifying indication, issued by a doctor with radiation protection qualification. The benefit must outweigh the radiation risk ^[5]. A pure lifestyle measurement along the lines of "I want to know my body fat percentage" strictly speaking does not meet that. This is why the body composition scan is much harder to get in Germany than in the USA, where DEXA studios sit on every corner. Reputable providers in Germany solve this by having a doctor document a medical question: suspected sarcopenia, follow-up under obesity therapy or a weight-loss injection, sports medicine diagnostics. If someone sells you the scan without any medical contact at all, that is a warning sign, not a convenience feature.

Where you will find one, in descending order of frequency:

• Radiology practices. Almost every larger practice has a DEXA machine for bone density. Whether the whole-body software is enabled is usually stated on the website under Körperfettmessung or Körperzusammensetzung. Cheapest in price.
• Osteology centres and endocrinologists. Specialised in bone, often with better quality control of the machine. First choice if osteoporosis is your concern.
• Sports medicine institutes and university sports science. Some universities and Olympic training centres measure body composition for external clients too, sometimes at research rates. Worth a call.
• Commercial body composition and longevity studios. Usually with medical affiliation, detailed evaluation and the highest price.

For the five big cities, our community has collected local experience. In the chapter groups of Berlin, Munich, Hamburg, Frankfurt and Cologne, the fastest way is to ask who got measured where and whether the results consultation was worth the money.

Three questions to ask when you book:

• Which machine? The big makers are Hologic and GE Lunar. Their values are not directly comparable, so stay with the same machine for follow-up scans ^{[7, 12]}.
• Full report? You want regional values and visceral fat, not just a percentage.
• Doctor's interpretation included? A printout alone helps you little.

The report comes as a multi-page printout with colour graphics and lots of numbers. Five of them count.

T-score (bone density only). Comparison with young healthy adults of the same sex:

• minus 1.0 or higher: normal
• between minus 1.0 and minus 2.5: osteopenia
• minus 2.5 or lower: osteoporosis ^[2]

Important: according to the DVO guideline, the treatment decision does not hang on the T-score alone but on the absolute fracture risk, calculated from age, sex, T-score and risk factors ^[1]. A T-score of minus 2.0 can require treatment in a 75-year-old with a previous fracture and not in a 52-year-old without risk factors.

Z-score (if you are under 50). Your report also shows a Z-score: your value compared with people of your own age and sex. For women before menopause and men under 50, this is the number to read, not the T-score ^[13]. A Z-score of minus 2.0 or lower means below the expected range for your age ^[13]. That is worth a talk with your doctor, but it is not an osteoporosis diagnosis on its own.

Body fat percentage. DEXA values come out higher than what you know from callipers or fitness apps, because DEXA really captures all fat, including that in organs and muscles. In reference data from NHANES, a large US national health survey, the median for 25-year-old men was around 24 percent and for women around 38 percent. It rises with age ^[11]. There is no proven longevity threshold. People who train usually sit well below the median. So compare your value not with Instagram but with your own value from last year.

Visceral fat (VAT, visceral adipose tissue). The fat between the abdominal organs, given in grams or square centimetres. DEXA estimates it from the abdominal region of the scan. The estimate agrees well with CT measurement, which is considered the gold standard ^[10]. Visceral fat is more closely linked to insulin resistance and cardiovascular risk than total fat percentage. If you only want to watch one number, watch this one.

ALMI (appendicular lean mass index). The lean mass of your arms and legs in kilograms, divided by height in metres squared. This is the number sarcopenia is pinned to. The European sarcopenia consensus group EWGSOP2 sets the cut-off at below 7.0 kg/m² for men and below 5.5 kg/m² for women ^[6]. But careful, the order matters: EWGSOP2 diagnoses sarcopenia first via muscle strength, specifically grip strength below 27 kg (men) or 16 kg (women). Only when strength is low does the low ALMI confirm the diagnosis ^[6]. Little muscle mass with good strength is not yet sarcopenia. You can place your grip strength against German reference values with our grip strength calculator before spending money on the scan.

DEXA versus InBody and body fat scales. InBody, Tanita and the scale in your bathroom all use bioelectrical impedance analysis (BIA): a weak current runs through your body. From the resistance, a formula estimates your body water and from that fat and muscle. The word estimate is to be taken literally here. The value depends on how much you have drunk, whether you have trained, when you last went to the toilet and which formula the manufacturer built in. A French analysis of 3,655 measurements compared the two directly. From normal weight up to a BMI of 40, BIA overestimated lean mass by about 3 to 8 kilos compared with DEXA. Only in very underweight people (BMI below 16) did it underestimate it. And for any single person the two numbers often disagreed widely, whatever their BMI ^[8]. For a rough direction the scale is enough. For the question of whether you lost two kilos of muscle in six months on a weight-loss injection, it is not. DEXA measures directly and repeats to within one to two percent. It also gives you regional values and visceral fat, which BIA can only model ^[7].

The radiation. DEXA works with a very low X-ray dose. Damilakis and colleagues report about 4 to 8 µSv for a whole-body scan and roughly 20 µSv for a spine plus hip bone density measurement, depending on the machine ^[9]. For comparison: natural background radiation in Germany averages 2.1 millisieverts per year, about 6 µSv per day ^[14]. A transatlantic flight gives you several dozen microsieverts. A body composition scan therefore equals about one day of normal life, a bone density measurement a few days. Low is still not zero, which is why the law ties every scan to a medical indication ^[5]. It is no reason to be afraid of the scan. Exception: no scanning during pregnancy.

How often? For bone density: the interval depends on how far your T-score is from the treatment threshold ^[1]. Statutory insurance pays for a repeat no earlier than five years later, sooner only with special findings ^[15]. For body composition the question is different: each measurement has a precision of about one to two percent. The ISCD (International Society for Clinical Densitometry) recommends measuring again only when the expected change is larger than this least significant change ^{[12, 19]}. In practice that means every 6 to 12 months if you are following a strength, muscle-building or weight-loss programme. Every few years is enough if you only want to know whether anything is shifting. Anyone losing weight on semaglutide or tirzepatide should keep an eye on muscle share; more on that in our guide to preserving muscle on GLP-1. Monthly scans are a waste of money because the change disappears in the measurement noise.

Short answer: for four groups yes, for most others not for now.

Yes, if you are over 50 and have a fracture risk. The DVO guideline provides the measurement for exactly these cases ^[1]: a fracture from an everyday fall, cortisone for months, rheumatism, early menopause, a hip fracture in one of your parents, or simply being 70 or older. Here bone density is not a longevity extra but standard medicine. In many of these cases insurance pays ^[3]. Raise it with your GP.

Yes, if you are on a weight-loss injection. On GLP-1 medication, part of the weight you lose is lean mass, which includes muscle. In the large semaglutide trial this happened even with diet and exercise counselling ^[18]. Training and protein reduce the loss. A scan before starting and one after six to twelve months shows you in black and white whether you lost fat or muscle. The scale cannot do that.

Yes, if you train seriously for strength. Anyone who has been at the barbell for years and wants to know whether the last 3 kilos were fat or muscle gets an answer from DEXA that no other affordable method delivers. Once a year, same machine, same time of day.

Yes, with suspected sarcopenia. If your grip strength is below the EWGSOP2 cut-offs (27 kg men, 16 kg women) or you only get up from a chair with momentum, the ALMI confirms the diagnosis ^[6]. That is then also a medical question that justifies the scan.

When you can save the money. Under 50, no risk factors, just curious? Then three free checks tell you almost the same:

• the grip strength test for muscle function
• a tape measure around your waist at navel height for visceral fat (waist divided by height should be below 0.5)
• a photo every three months in the same light

Grip strength predicts mortality well for such a simple test: in the PURE study, every 5 kg less grip strength went with a 16 percent higher risk of death ^[16]. Waist to height beats BMI as a screen for heart and metabolic risk ^[17]. The photo does not predict anything, but it shows you the trend. And if the result does worry you, at least you know which of the two scans to book.

No test extends your life. The DEXA scan is a measuring instrument that shows whether what you are doing works. If you are not doing anything yet, the money is better spent at the gym than at the radiologist.