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The Cost of Common Surgeries: 9 Procedures Compared

cost of surgery
Georgia Carter
Georgia Carter Updated: 15 September 2021
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Many people will opt for surgery as a last resort to treat their condition, but it can be worth considering for those who want the quickest recovery time and least amount of pain. There are many types of surgeries that can be done depending on the severity and type of problem. However, private surgery costs in Australia are not cheap. 

This article compares the costs of 9 common medical procedures in order to help you determine which one is best for your needs, as well as the costs involved for each surgery. Compare the costs of each to determine whether you have adequate health cover in place should you need to undergo one of these procedures.

Key facts

  • Medicare covers specific surgeries if they are listed on the Medicare Benefits Scheme
  • Transplant surgery is the most expensive surgery you can receive in Australia
  • Health insurance can cover 100% of your surgery costs, not including hospital overnight stays.
  • You can purchase medical gap schemes that can help cover the costs of in-hospital services.

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How do surgery costs work?

Types of surgeries are differentiated through three different catalogues. Surgery is either urgent, elective, or cosmetic. Medicare is Australia’s universal healthcare system that covers Australian citizens. Surgery costs from the hospital can be partially or fully covered by Medicare in public hospitals. Medicare may cover up to 75% of the costs in private hospitals if the procedure is listed on the Medicare Benefits Scheme. 

You will have to pay the rest yourself unless you have private health insurance and your level of coverage includes the surgery you are undertaking

Medicare

Although the public hospital’s responsibility is to provide you with medically necessary surgeries, Medicare will cover these costs. MBS covers medically necessary elective and semi-elective procedures; urgent/emergency treatments at a public hospital may also be reimbursed so long as they are deemed appropriate treatment for your condition. Services covered by Medicare include:

Private Health Insurance

Private health insurance can help pay up to 100% of the Medicare Benefits Schedule (MBS) for medical costs in a hospital. However, as a private patient, specialists will typically charge added fees, and your insurer may only cover some or all these extra costs through its ‘medical gap scheme’. Benefits of private health insurance include:

Compare the costs of common surgeries in Australia

Surgery typeTotal out-of-pocket cost insuredTotal out-of-pocket cost uninsured
Hernia$370$1065
Cataracts$400$770
Prostatectomy$480$3150
Coronary artery bypass graft$390$3750
Knee replacement$570$5200
Angioplasty and stent insertion$10$4350
Hip replacement$590$5725
Pacemaker insertion$50$4775
Gallbladder surgery$350$1425

Source: Medical Tools Costs Finder (Australian Government, Deparment of Health, September 2021)

surgery

Transplants cost

When it comes to transplants, few options compare. Transplants are a fairly new procedure, but in just about any case, they’re the best option for patients looking to extend their life expectancy and fix failing organs with improved anaesthesia and fewer chances of rejection. Today, costs range from $50,000 to $150,000 depending on which organ is purchased with an indefinite lifespan expected post-surgery without major health complications or risks involved compared to other traditional treatment methods available today.

Colorectal surgery cost

Colon and rectal surgeries are used to treat symptoms, remove abnormal areas of tissue, or help prevent more serious problems. Abnormal conditions such as cancer can be treated with colorectal surgery. A cost of $25,000 is associated with it, which may increase if additional costs like post-procedure medications arise along with other treatment expenses for the coexisting condition(s).

Prostatectomy cost

There is a wide range of treatments that can help to resolve prostatitis and prostate cancer. Many individuals opt for the removal of their respective organs, called a prostatectomy. The procedure aims at negating any existing conditions by removing one’s organ from their body completely. The average cost of this surgery is $16,000.

Coronary artery bypass graft cost

The coronary artery bypass graft is a medical procedure conducted by surgeons and requires general anesthesia. It lasts 2-4 hours in an operating room under sterile conditions. Using surgical tools, the surgeon will remove plaque from your blocked arteries to attach them with veins or other parts of your body that originate somewhere else. This surgery can be used for people suffering from heart disease as it restores blood flow through healthy vessels into the harder working portions of their hearts called myocardiums. The coronary artery bypass graft is $44,000.

Knee replacement cost

The technology of knee replacement surgery in Australia has given rise to a new way of living for the people there. It provides relief from arthritis and joint pain that would have otherwise made it difficult to walk without any limp at all, with help costing $23,000 per procedure..

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Angioplasty and stent insertion cost

Angioplasty or a stent insertion is used to increase blood flow through your veins and arteries. Angioplasty uses a small balloon inserted in the vein or artery, which opens up these vessels, whereas, for stents, they are installed inside them. Hence, ensure it stays open, just like how balloons inflate when you blow air into them. Stenting costs around $16,000 on average.

Hip replacement cost

Despite its popularity, hip replacement surgery is not cheap. The price tag for the procedure can be as much as $25,000, which makes it more prohibitive to those who need this treatment but cannot afford it.

The cost of hip replacements in Australia is increasing due to an aging population and their demand for health care services such as hospitalisation or surgeries. Hip replacement surgery costs about $25,000, so many Australians cannot get these procedures done because they cannot afford them despite how popular the service has become amongst middle-aged and elderly citizens.

Spinal fusion cost

Spine fusion is an expensive surgery that joins two or more bones in your spine to treat chronic lower back pain from degenerated discs. The average cost of this intensive procedure is $42,000.

Pacemaker insertion cost

Your heart is equipped to pump blood through your body, but its efficiency can be affected by problems like high BP. The pacemaker regulates the timing of a person’s heartbeat. It ensures that oxygenated blood gets sent where it needs to go, so you do not have any health complications due to an irregular rate or rhythm in your contractions. A pacemaker costs around $16,000 which could save money on medical expenses if one has issues with their pulse instead of buying medication etc.

Gallbladder surgery cost

The gallbladder is a small organ in your abdomen that helps you digest fatty foods. If it becomes blocked by stones or an abscess, indigestion and discomfort will occur until surgery to remove the blockage. Gallbladder surgery is a non-invasive surgical procedure where your gallbladder, stones and the connecting tract to your liver are removed through an incision in the abdomen. The cost of this type of surgery ranges from $17,000-$25,000, with most patients able to leave after one night at the hospital.

How private health insurance can help me cover the cost of my surgery.

When you go for surgery in a hospital, private health insurance can cover up to 100% of the Medicare Benefits Schedule (MBS) for your medical costs. But as a private patient, specialists may charge added fees and then only provide between 75-85% of those extra costs using Medicare; however, some insurers have “medical gap schemes” that help meet any additional expenses through co-payments during treatment. Private health insurance will typically cover these gaps depending on the procedure at hand, with each insurer’s terms & conditions applying when choosing one plan over another.

Frequently asked questions and answers.

  • How much does a normal surgery cost?

    While it depends on what is considered a normal surgery, on average, surgery typically costs between $16,000 and $20,000. This cost can be partially or fully covered by Medicare, depending on the type of surgery, or be covered in part if you have private health insurance. Your level of coverage includes the surgery you are undertaking.
  • What is the most expensive surgery in Australia?

    If you’re looking to get a heart or liver transplant, it’s going to cost. Costs for transplants can range anywhere from $150,000 up into the millions depending on your needs and where in the world you are getting your procedure done.
  • Does Medicare pay for surgery?

    Medicare will cover the cost of medically necessary surgeries for public patients in public hospitals. However, Medicare only provides between 75% and 85% of the costs charged to you as a private patient if surgery is performed at that time by another doctor who isn’t working with your surgeon.
  • Does Medicare require pre-authorisation for surgery?

    Medicare’s Prior Authorization system is an important step in combatting Medicare fraud. Requiring a pre-approval for certain services lessens the chance that health care providers will bill Medicare without providing necessary medical treatment or submitting false claims to obtain payment from taxpayers’ money. Prior authorisation is a requirement for health care to obtain approval from Medicare. It’s not completely necessary, but it ensures the doctor isn’t wasting your money on unnecessary treatments or procedures. Prior Authorization saves costs and helps ensure that you’ll get more bang out of your medical coverage buck!
  • What percentage does Medicare pay for surgery?

    Medicare will cover 75-85% of the costs for medically necessary surgeries performed on public patients in public hospitals, but this covers only a fraction of what you have to pay as a private patient.

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