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 when you pay yourself ^[4]. The whole-body scan for body composition, meaning fat mass, muscle mass and visceral fat, sits mostly between 50 and 200 euros per measurement at 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 a fee schedule (GOÄ) that 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

A detail many people do not know: 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: your bone mineral content compared with young healthy adults. From minus 2.5 it is called osteoporosis, between minus 1 and minus 2.5 osteopenia ^[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. The result is a printout with fat mass in kilograms and percent, lean mass, often broken down by arms, legs and trunk, plus an estimate of visceral fat (the fat around your abdominal organs) and the appendicular lean mass index ALMI, meaning 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.

Since the G-BA decision of February 2013, osteodensitometry has been covered when, based on concrete history and clinical findings, there is an intention 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. As a follow-up under therapy, a repeat is planned no earlier than after five years, sooner only with special findings ^[3].

Who should be measured at all according to the guideline? The 2023 DVO guideline recommends baseline diagnostics with DXA after every fracture from age 50, especially with signs of a fragility fracture. From age 70 it 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 beforehand and offer a written treatment contract. 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 EBM billing code for it. No insurer covers it, not even with obesity or suspected sarcopenia. 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.

First the uncomfortable truth, then the addresses. A DEXA scan is an X-ray application. 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.

What to pay attention to when booking: ask about the machine manufacturer (the big ones are Hologic and GE Lunar; values from the two systems are not directly comparable, so stay with the same machine for follow-up measurements ^{[7, 12]}). Ask whether you get the full report with regional values and visceral fat, not just a percentage. And ask whether a medical interpretation is included. A printout alone helps you little.

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

T-score (bone density only). Comparison with young healthy adults of the same sex. Down to minus 1.0 normal, minus 1.0 to minus 2.5 osteopenia, from minus 2.5 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.

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 the US reference data from NHANES, 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). 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 showed that agreement between BIA and DEXA depends strongly on BMI: with overweight, BIA systematically overestimates lean mass, with underweight it underestimates it ^[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, is reproducible to within one to two percent and additionally delivers 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 put the effective dose at a few microsieverts depending on machine and mode, roughly in the range of 1 to 10 µSv ^[9]. For comparison: natural background radiation in Germany is around 2 millisieverts per year, about 6 µSv per day. A transatlantic flight gives you several dozen microsieverts. A DEXA scan therefore corresponds roughly to one day of normal life or less. That is why the legislator still ties the application to a medical indication, but not a 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]. Insurance plans five years as the follow-up interval ^[3]. For body composition the question is different: each measurement has a precision of about one to two percent. The ISCD recommends measuring again only when the expected change is larger than this least significant change ^[12]. 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. A fracture from an everyday fall, cortisone for months, rheumatism, early menopause, a hip fracture in your parents or simply age from 70: these are the constellations for which the DVO guideline provides the measurement ^[1]. 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, a relevant part of the lost weight goes as muscle if training and protein are not right. 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. If you are under 50, have no risk factors and are simply curious, three things tell you almost the same for zero euros: the grip strength test for muscle function, a tape measure around the waist at navel height for visceral fat (waist to height should be below 0.5) and a photo every three months in the same light. All three markers have more evidence for their link to mortality than body fat percentage. And if the result does worry you, at least you know which of the two scans to book.

An honest caveat to close. 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.