Time to read : 5 Minutes
Australia's Most Expensive Surgeries
It’s a sad fact of life that the longer you live, the more maintenance your body generally needs - and planning for these costs can be challenging.
When you think about the most expensive surgeries in Australia, you probably think of severe medical issues like heart transplants etc., but what's more surprising is that some of the most common surgeries that many Australians need as we get older are right up on that list when it comes to high costs.
Hip replacements for example, are one of the most common surgeries performed in our hospitals. According to the Australian National Joint Replacement Registry, 51,894 hip replacements were performed in 2022, which is 95% higher than a decade prior.
In order of overall price tag, our top 10 are:
1. Transplants: $40,000-$150,000 No matter the organ involved, transplants rank as the most expensive surgeries, with costs ranging from $40,000 for a kidney to close to $150,000 for a heart or liver. Public hospital waiting list: Liver or heart: 9+ months; kidney 5-7 years. Note that the surgeries are often performed rapidly once a suitable transplant becomes available.
2. Coronary Artery Bypass Graft: $44,000 This invasive procedure, aimed at improving heart blood flow, involves grafting a healthy vein or artery to bypass blockages. Public hospital waiting list:18 days.
3. Spinal Fusion: $42,000 Spinal fusion, addressing chronic lower back pain from degenerated discs, entails surgically joining two or more spine bones. Public hospital waiting list: 12-18 months.
4. Hip Replacement: $25,000 Common among older individuals, hip replacement, costing $25,000, alleviates pain and improves mobility by replacing a worn-out hip with an artificial one. Public hospital waiting list: 120 days.
5. Colorectal Surgery: $25,000 Involving the removal of part or all of the colon or rectum, this surgery, priced at $25,000, is prompted by conditions like cancer or Crohn's disease. Public hospital waiting list: 15 days
6. Knee Replacement: $23,000 Similar to hip replacement, knee replacement at $23,000 aims to relieve pain and enhance mobility, especially for arthritis sufferers. Public hospital waiting list: 223 days.
7. Gallbladder Surgery: $17,000 Addressing gallbladder issues through a small keyhole incision costs $17,000. Public hospital waiting list: 30-90 days
8. Pacemaker Insertion: $16,000 A pacemaker, regulating heart rhythm through electrical impulses, costs $16,000. Public hospital waiting list: 30-90 days
9. Angioplasty and Stent Insertion: $16,000 Both procedures, increasing blood flow in veins and arteries, cost $16,000. Public hospital waiting list: 30 days
10. Prostatectomy: $16,000 Removal of the prostate, addressing conditions like prostatitis or prostate cancer, costs $16,000. Public hospital waiting list: 44 days.
Note: Waiting times are based on the longest median waiting times for elective surgeries in public hospitals across the country for 2019-20. This varies by state, and also depends on whether your surgery is classified as ‘urgent’ or ‘elective’.
And the cost?
When it comes to medically necessary elective or semi-elective surgeries, your overall cost varies based on your individual surgeons' fees and specific medical requirements (such as allergies to certain medications, etc.). If you have private health insurance, some of the costs can also be determined by your insurer.
Can Medicare help? What about private health insurance?
Medicare covers some of the above treatments for public patients in a public hospital, as long as they’re deemed medically necessary. Medicare's cover includes your:
operating theatre fees,
necessary surgical consultations,
medically necessary surgeries.
Medicare doesn't cover all of your hospital accommodation costs for non-essential surgery - and that’s the a big part of your surgery bill. The remainder gets paid either by your private health insurer, or by you.
Some insurers offer a "medical gap scheme" to assist with any additional costs, with your private health insurance covering some or all of the gap, depending on your procedure. Your actual out-of-pocket expenses for your specific surgery will vary based on your individual needs.
If you're a public patient in hospital, Medicare only covers all your medical expenses if your surgery is medically necessary. If you're a private patient in a public hospital, Medicare subsidises your doctor's fees.
If you’re not covered, you’re going to foot the bill for any part of your hospital visit that isn’t covered by Medicare.
The bottom line:
Some of the most common medical procedures are also the most expensive, like hip and knee replacements.
Medicare might cover some of your costs, but it won’t cover all of your hospital stay. That’s on your private health insurer if you're covered, and on you if you're not.
Your private health insurance can combine with Medicare to cover up to 100% of the Medicare Benefits Schedule (MBS) for your surgical costs in a hospital. Check with your insurer if your policy includes gap cover.
