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 final 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