How much do common surgeries cost?

We’ve compiled a list of 30 hospital surgeries in private hospital using the government’s new tool to show you the median cost (the middle) that health funds covered in 2018-19. After all, a lot of the value you get is what folks like us pay when you need to use your cover.

The figures in the shaded column are what you’d pay if you didn’t have hospital cover and you wanted to enter private hospital as a self-funded patient (spoiler: not fun for your pocket!).

Remember that half the surgeries cost more than the figures quoted. Hospital doesn’t come cheaply!

Surgery type         Health fund
  No gap % Patient out-of-pocket costs Specialist fees Medicare specialist benefit Specialist benefit Accomm, theatre and device benefit Total health fund payment
Cataract  $54   $400   $2,000   $750   $770   $2,300   $3,070 
Colonoscopy  $80   $150   $1,300   $590   $490   $700   $1,190 
Gall bladder  $31   $360   $2,700   $1,100   $1,100   $4,600   $5,700 
Heart surgery
(Coronary artery bypass graft)
 $21   $340   $15,000   $7,400   $6,700   $31,000   $37,700 
Heart surgery
(Stenting blocked heart surgery)
 $30   $30   $3,100   $1,600   $1,400   $15,000   $16,400 
Heart valve replacement  $22   $300   $14,000   $7,000   $6,500   $39,000   $45,500 
Pacemaker procedure  $42   $50   $2,600   $1,300   $1,100   $18,000   $19,100 
Varicose veins  $35   $330   $1,900   $740   $710   $3,000   $3,710 
Hernia (inguinal or femoral)  $42   $360   $1,800   $660   $640   $3,500   $4,140 
Thyroid tumour removal  $26   $680   $3,700   $1,500   $1,100   $4,900   $6,000 
ACL repair  $20   $700   $3,900   $1,400   $1,400   $4,500   $5,900 
Single hip replacement  $20   $550   $5,000   $1,900   $1,900   $21,000   $22,900 
Double hip replacement  $11   $3,300   $8,600   $3,100   $2,400   $34,000   $36,400 
Knee replacement  $24   $550   $4,700   $1,800   $1,800   $19,000   $20,800 
Shoulder replacement  $25   $570   $5,600   $2,100   $2,100   $19,000   $21,100 
Bladder tumour removal  $49   $280   $1,600   $660   $560   $1,500   $2,060 
Kidney stone removal  $35   $320   $3,000   $1,300   $1,300   $2,200   $3,500 
Prostate removal (endoscopic)  $35   $460   $3,000   $1,200   $1,100   $4,500   $5,600 
Radical prostate removal  $10   $4,700   $8,800   $2,600   $1,600   $12,000   $13,600 
Caesarean: major complexity  $40   $420   $4,400   $2,000   $1,900   $8,600   $10,500 
Caesarean: minor/intermediate complexity  $44   $420   $3,700   $1,600   $1,800   $7,800   $9,600 
Vaginal delivery major complexity  $65   $300   $3,000   $840   $1,700   $5,800   $7,500 
Vaginal delivery minor/intermediate complexity  $71   $350   $2,800   $800   $1,600   $5,900   $7,500 
Adenoids  $29   $350   $1,200   $350   $400   $1,200   $1,600 
Grommets  $28   $360   $1,300   $420   $490   $1,200   $1,690 
Tonsil removal  $22   $500   $1,400   $400   $470   $2,100   $2,570 
Apronectomy (removal of excess abdominal skin and fat)  $10   $5,000   $7,000   $1,300   $700   $7,500   $8,200 
Gastric band  $34   $750   $3,600   $1,100   $1,000   $8,800   $9,800 
Gastric bypass  $22   $560   $4,400   $1,600   $1,400   $9,500   $10,900 
Sleeve gastrectomy (partial stomach removal)  $28   $850   $3,500   $1,200   $1,000   $9,500   $10,500 

*All Australia, median data 2019 FY 

These figures come directly from the Australian Government Department of Health and reflect health funds overall, not just Peoplecare.

Want more help with your planned surgery?

You can get a much more accurate estimate of planned surgery costs (if any) by asking your specialist for an itemised quote called Informed Financial Consent.

After more info? Check out our Going to Hospital Guide.

 

All articles