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How Much Does Heart Surgery Cost in Australia?
How Much Does Heart Surgery Cost in Australia?
Written by
Tina Sendin
Edited by
Ellie Garran
Reviewed by
Andres GutierrezCompare Health Insurance Policies
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What is heart surgery?
Long story short
In the public system, Medicare covers the full cost of heart surgery
But you can’t choose your surgeon and will face a waiting list – occasionally more than 90 days for a bypass.
Going private lets you skip the wait and choose your specialist
While specialist fees are high, Medicare and a hospital insurance policy can cover a portion of them.
Even with private cover, you’ll likely have some out-of-pocket costs
For major heart surgeries, 75–80% of patients pay around $500–$600 for specialist fees, alongside your policy’s excess and any daily co-payments.
To be covered for heart surgery, you’ll likely need at least a silver plus or gold hospital policy
Cardiac rehabilitation is typically a gold service, but is generally available in silver plus policies.
What is heart surgery?
Heart surgery is a broad term for procedures performed to treat cardiac issues. It ranges from minimally invasive procedures to open-heart surgeries (where the surgeon opens your chest to access your heart).
More complex heart surgeries include coronary artery bypass surgery, aortic valve replacement, and angioplasty. These surgical procedures are typically done for patients with coronary heart disease, especially when medication or lifestyle changes just aren’t cutting it. Or worse, when a heart attack strikes.
You might be at higher risk for coronary heart disease if you have high blood pressure, high cholesterol, diabetes, or a family history of heart issues, or if you’re a smoker.
Coronary artery bypass graft
Also called heart bypass surgery, cardiac bypass surgery, or cardiac revascularisation, this procedure treats coronary artery disease (a build-up of plaque inside the arteries).
When arteries supplying blood to your heart become blocked or narrowed by plaque, it can lead to shortness of breath, chest pain (angina), or a heart attack.
The surgery is done under general anaesthetic and typically takes about three hours.
Your surgeon will make an incision down the middle of your chest, through the breastbone. They will also connect you to a heart-lung machine, which keeps your blood flowing while your heart is still and the bypass is being done.
To create the bypass, the surgeon will take part of a blood vessel – often a vein from your leg or an artery from your arm or chest – and use it to reroute blood around the narrowed or blocked arteries, restoring proper blood flow to your heart.
Aortic valve replacement
Aortic valve replacement is a surgery to replace a faulty aortic valve.
The aortic valve is like a one-way door, letting blood flow from your heart to the rest of your body. If it doesn’t open or close properly, your heart needs to work overtime.
The most common reason you’d need an aortic valve replacement is aortic stenosis – when your valve opening narrows down, often due to ageing. But sometimes the heart valves can be faulty from birth, or damaged due to an illness.
When your aortic valve is damaged, you’ll likely experience symptoms like shortness of breath, tiredness, or swelling in your arms and legs. An echocardiogram (heart ultrasound) can confirm whether your valve needs fixing.
There are two ways to replace a faulty valve.
Transcatheter aortic valve implantation
A balloon catheter is inserted into the artery. Once it’s in the right place, the balloon is gently inflated to open the aortic valve. Then, the surgeon puts a new valve in place of the old one.
Open heart technique
The patient goes under general anaesthesia while the surgeon cuts through the breastbone to get to the heart. A machine then takes over to keep the heart and lungs working while the faulty valve gets replaced with a new one – either a biological valve (which could either be from a human or animal tissue) or a mechanical one made of metal.
Angioplasty
Angioplasty is a procedure to improve blood flow through a narrowed blood vessel – usually an artery, which carries blood away from your heart. It helps prevent issues like heart attacks, angina (chest pain), and peripheral vascular disease (when arteries to your legs and feet become narrowed).
With this procedure, the doctor inserts a thin tube (catheter) into the blood vessel, and a small balloon is gently inflated at the blockage point to open it up and restore blood flow.
If there’s a risk the artery might narrow again, the doctor may insert a stent – a tiny metal tube – into the artery to keep it open.
While angioplasty typically lasts from 30 to 60 minutes, you might need to stay in the hospital for the night following the procedure.
How much does heart surgery cost?
The cost of heart surgery in Australia depends on whether you’re going public or private.
Is heart surgery covered by Medicare?
If you have heart surgery as a public patient in a public hospital, Medicare will cover the entire cost. You won’t pay for the surgery, hospital stay, or doctors’ fees.
There’s a trade-off, though. You don’t get to choose your surgeon, and you’ll be placed on a public waiting list.
Is heart surgery covered by private health insurance?
As a private patient, the total costs can be heart-dropping. But this is where private health insurance can help. And as well as helping lighten the financial load, it comes with perks like shorter wait times, choosing your own surgeon, and even recovering in a private room.
Let’s look at the numbers for private patients undergoing cardiac surgery, based on the Australian Government’s Medical Costs Finder.
Aortic valve replacement and coronary bypass surgery costs, 2023–24
| Aortic valve replacement | Coronary bypass surgery | |
| Typical specialist fee | $15,000 | $16,000 |
| Medicare paid | $7,500 | $7,900 |
| Insurer typically paid | $6,500 | $6,900 |
| Typical out-of-pocket cost | $500 | $510 |
| Percentage of patients with an out-of-pocket cost | 76% | 75% |
Source: Medical Costs Finder – Heart valve replacement (not TAVI); Coronary artery bypass graft (CABG)
Note: These are the amounts patients typically paid for these services, rounded to the nearest dollar. They do not include hospital payments such as excesses, co-payments, or other payments. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in these figures. Data retrieved January 2026.
While 70–80% of patients pay anywhere between $500 and $600 out of pocket even with Medicare and private health insurance, it’s still a far cry from the thousands you’d otherwise spend on specialist fees (like for an anaesthetist, surgeon, and surgical assistant). For instance, for a heart bypass surgery, anaesthetist fees alone typically cost $4,000!
Are there other out-of-pocket costs for heart surgery?
Helpful tip
When you’re facing surgery, it’s a good idea to ask your medical team for a full quote (including MBS item numbers) before your procedure. Then, talk to your health fund to understand exactly what they’ll cover and what your final out-of-pocket expenses will be.
Ask your specialist whether they participate in your health fund’s gap cover scheme. It can make a huge difference to your final bill. Don’t be afraid to have that conversation up-front – it’s your money and your peace of mind.
Andres Gutierrez
General Manager – Health
Are there ongoing costs after heart surgery?
Recovery doesn’t end when you leave the hospital, so it’s wise to factor some potential costs into your budget.
- Follow-up appointments: You might need regular check-ups with your GP and cardiologist following your surgery to monitor your recovery and manage your health.
- Medications: If you have aortic valve surgery and you’re given a mechanical valve, you’ll need to take medicine for the rest of your life to stop blood clots. If you’re given a biological valve, you’ll also need to take anti-clotting medicine, but just for a few months post-op. The Pharmaceutical Benefits Scheme (PBS) can help shoulder the cost of these meds.
- Cardiac rehabilitation: Cardiac rehab involves exercise, education, and mental health support to help you recover and return to everyday life. Some of the costs for this may be subsidised and provided at minimal cost. You can also check whether your policy can cover this – you’ll find it under hospital cover for ‘Rehabilitation’.
- Lost income: Full recovery from open aortic valve replacement can take several weeks to months, while recovery from transcatheter aortic valve implantation can be faster. After a heart bypass, recovery usually takes five to seven days. Regardless of the procedure, you’ll need to take some time off work – and potentially lose some income if you run out of leave.
How long will I have to wait for heart surgery?
This is one of the most significant differences between the public and private systems.
Public system
According to 2024–25 data from the Australian Institute of Health and Welfare, 10% of patients admitted for coronary bypass surgery in the public system waited for longer than 90 days, but this can change depending on your state and the urgency of your case.1Australian Institute of Health and Welfare – Waiting times by intended procedure
Private system
As a private patient, you can essentially schedule your surgery as soon as you and your chosen surgeon are ready. This ability to bypass public waiting lists is a major reason people opt for private health cover.
If you’re taking out cover for the first time or upgrading your policy, you’ll need to serve a waiting period. For heart surgery, it’s typically:
- 12 months for any pre-existing conditions
- two months for new conditions that arise after you take out cover, and for rehabilitation.
What level of health insurance do I need to cover heart surgery?
To be covered for heart surgery in a private hospital, you need a hospital insurance policy that includes the ‘heart and vascular system’ clinical category.
Silver and gold policies have this, and in some cases, a plus policy like bronze plus might. If heart issues run in the family, this cover isn’t something you want to skimp on.
Cardiac rehabilitation is also usually taken care of by hospital cover, under ‘Rehabilitation’. This category only has to be covered under a gold policy. In some cases, it could be covered on a plus policy like silver plus, although this may only be on a restricted basis. (That could mean being partially covered for hospital costs as a private patient in a public hospital, but copping it hard in a private room or private hospital.)
It’s always worth checking with your insurer and hospital for the specifics!
Frequently asked questions
Will Medicare pay for heart bypass surgery?
Yes. If you are a public patient in a public hospital, Medicare covers 100% of the cost. But you might have to wait up to three months, and sometimes longer, to get the surgery.
Are there financial assistance programs available for heart bypass surgery?
There’s such a thing as cardiology surgery loan, which is a personal loan specifically meant for heart patients. And yes, bypass surgery could be covered under some of these loans – which can lend you from from $2,000 to $70,000, with flexible repayment options.
Are there low-cost options for heart surgery?
The most cost-effective option is to be treated as a public patient in the public hospital system, where Medicare covers the entire cost. You’ll need to weigh this against the waiting time in the public system, which can occasionally be longer than three months, as well as the benefits of private health insurance, like choosing your own doctor and potentially recovering in a private room.
Don’t skip a beat on your cover
Navigating health insurance options when you’re worried about your heart can be overwhelming. But having adequate cover in place means you can focus on what’s important – your heart’s health and recovery.
With iSelect, you can compare policies from a range of insurers in a snap. Find a policy that gives you confidence and control over your healthcare choices. Try our online comparison tool or give our friendly team a hoy on 1800 784 772.
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