How Much Does Appendicitis Surgery Cost?

What is appendicitis? 

Your appendix is a little pouch that is attached to your large intestine. If it becomes inflamed, this is known as appendicitis. 

Appendicitis can happen if food or faecal matter get stuck and block your appendix. This is the perfect opportunity for bacteria to build up and start infecting the appendix.  

If left untreated, your appendix can burst (‘perforate’ is the medical term), sending all that nasty pus and gunk into your abdominal cavity. You could then experience further infection, like peritonitis and sepsis, which can be life-threatening. Scarily, a burst appendix can happen in roughly 36 hours from the time the infection first takes hold. As a result, appendicitis is treated as a serious health emergency. 

Anyone can get appendicitis (assuming you still have an appendix) – in fact, in 2022–23, appendicitis was one of the top three reasons for emergency department admissions that involved surgery.¹Australian Institute of Health and Welfare – Australia’s hospitals at a glance

As a result, it’s probably a good idea for everyone to know what symptoms to look out for (particularly with that clock to complicated infections ticking down). Symptoms can include: 

• dull pain around your bellybutton, moving to sharper pain on your right lower side of your abdomen (this is where the appendix is)
• additional pain in your lower back, legs, and/or backside
• fever
• vomiting
• loss of appetite
• diarrhoea or constipation 

If your appendix has burst, these symptoms may be more severe. You also may collapse. 

Treatment is pretty straightforward, thankfully. You’ll most likely have your appendix surgically removed in what is known as an appendectomy. Appendectomies are usually performed via keyhole or laparoscopic surgery with a few small incisions made. Sometimes, though, a bigger incision may be needed. 

In the case of a burst appendix, your appendicitis surgery will also include draining any pus from your abdominal cavity to hopefully stop infection taking hold there. 

Are there out-of-pocket costs for appendicitis surgery? 

Your out-of-pocket costs may be a result of the gap between what your surgery costs and how much your insurer will cover. Similarly, you might have an excess to pay before your insurer will accept a claim for your surgery. 

Depending on your policy, your out-of-pocket costs could also include co-payments. These are set fees for each day you’re in hospital. For appendicitis surgery, you may need to spend a few days in hospital. As a result, you may have a few co-payments to pay. 

If you want to check what your excess is and if you have a co-payment, you can look at your policy documents or speak with your insurer. 

There also could be a further out-of-pocket cost depending on how you get to hospital for your surgery. Because appendicitis can be an emergency – particularly if your appendix has burst and your symptoms are severe – you may need to take an ambulance. If you don’t have appropriate cover and your state or territory doesn’t cover your ambulance fees, you could have to pay for this service. Depending on where you live and the kind of callout, this could be a thousand dollars or more. 

‘When I was a kid, my dad needed his appendix removed. He went with a surgeon that his doctor recommended. Over the next few years, my sister had appendicitis and then myself. Because we had health insurance, we could use the same surgeon dad did. Knowing the surgeon’s track record with our family gave us peace of mind.’

Madeline Pettet
Digital Writer, iSelect

What about costs after having your appendix removed? 

In the days following your appendectomy, it’s possible for an infection to take hold. If that’s the case for you, you may need to take some antibiotics to handle this. These will likely be covered by the Pharmaceutical Benefits Scheme, so you may have only a small out of pocket cost. 

It’s also possible that after surgery you could develop an abscess in your abdominal cavity. Unfortunately, this requires surgical draining. As a result, you may have further out-of-pocket treatment costs. 

Finally, in some cases, appendicitis may not have been the cause of your symptoms, but your doctors may have still removed your appendix without a complete diagnosis. This is due to the urgency and seriousness of appendicitis being left untreated for the time it takes to do more conclusive tests. However, it can mean that you need to get further medical testing done, along with other treatments. These could carry their own out-of-pocket costs. 

How long will I have to wait for appendicitis surgery? 

Appendicitis is an emergency. When you present to the emergency department with appendicitis symptoms, you might still have to wait to be seen by a healthcare professional, though. How long you’ll wait can depend on a number of factors, including how busy the emergency department is.  

In 2022–23, the emergency department median waiting time was 20 minutes nationally.²Australian Institute of Health and Welfare – Emergency department care 2022–23 data tables You could end up waiting less time or a little longer, though.  

But keep in mind that this was only the waiting time from presenting at the department to clinical care beginning. You will likely need to wait longer for your surgery, as the healthcare team will need to diagnose your condition and organise the surgery. 

If you’re intending to claim your appendicitis surgery with your health insurance, you may need to be mindful of any waiting periods that apply. If you’ve just bought health insurance or upgraded your cover, you may have a two-month waiting period to get through before you can claim. If you’ve had any symptoms before your cover started that could suggest your appendicitis is a pre-existing condition, you will have a waiting period of up to 12 months. 

Clearly, appendicitis isn’t going to wait, and it’s important to seek treatment as soon as possible. Therefore, it might be a good idea to get health insurance sooner rather than later if you’re hoping to use the private system if or when you get appendicitis. 

What level of health insurance do I need to cover appendicitis surgery? 

If you have bronze tier hospital cover, you’ll be covered for appendicitis, along with a range of other conditions. You might even want to opt for a higher hospital cover tier to get coverage for a greater range of other medical needs. 

Where can I find and compare health insurance? 

While your appendix’s function may be a mystery, how to find a health insurance policy that suits your needs is crystal clear. With iSelect, you can compare a range of health insurance options from different providers online. Alternatively, you can call 1800 784 772 and speak with one of our health comparison experts to nail down a policy that works for you. 

Written by

Madeline Pettet

Digital Writer (Health)

Madeline is ready to demystify the technical so customers can save and live their best lives. She’s passionate about sustainability and overall wellbeing. In her spare time, she’s staring adoringly at her cats.

Edited by

Ellie Garran

Digital Editor

As Digital Editor, Ellie is passionate about making our web content clear and simple to save iSelect customers time and effort. They also love knitting and sewing, especially with recycled materials, so you’ll probably find them in the iSelect office wearing a dress made out of a sheet.

Reviewed by

Andres Gutierrez

General Manager – Health

Andres is our General Manager for Health, and he enjoys solving complex problems to make big ideas simple for everyone to understand. He also speaks at least three languages and is currently discovering the joys of being a new parent.