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How Much Does a Mastectomy Surgery Cost in Australia?
How Much Does a Mastectomy Surgery Cost in Australia?
Written by
Tina Sendin
Edited by
Andrew Kemp
Reviewed by
Andres GutierrezCompare Health Insurance Policies
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What is a mastectomy?
Long story short
Public is free, but you might need to wait
Medicare covers 100% of the cost in a public hospital for mastectomy, but you don’t get to choose your surgeon and might face a heaving public waitlist for reconstruction surgery.
Going private could help you skip public waiting times
The main benefits of being a private patient? You can choose your own surgeon, hospital, mastectomy type, and schedule.
You could expect a gap
Even with private health insurance, more than 70% of private patients pay a gap fee. For a standard mastectomy, it’s typically around $550 and $1,500 for a double mastectomy.
Coverage could be different depending on the medical procedure
Medically necessary breast surgery’ is usually on bronze policies, but reconstruction often requires silver.
What is a mastectomy?
A mastectomy is the surgical removal of the entire breast and is used to treat breast cancer, or in some cases prevent breast cancer from developing.
A mastectomy is one of two types of breast cancer surgeries, with the other being a lumpectomy.
Mastectomy
A total mastectomy removes the entire breast, including the tissue, nipple, areola, skin, and sometimes one or more lymph nodes from under the arm. Sometimes the surgeon is able to keep more normal skin (with or without the nipple), performing what is known as ‘skin-sparing’ or ‘nipple-sparing’ mastectomy. In the latter, a biopsy is usually involved – where sample tissue is sent for testing.
In some cases, you might have the option to choose between a single (unilateral) or double (bilateral) mastectomy, like if there’s cancer in only one breast but you think it safer to remove both. This is a complex and personal decision, which you can talk to your medical team about.
A mastectomy could leave a scar across your chest and could also be present in your armpit if your lymph nodes need to be removed.
Lumpectomy
A lumpectomy, or a breast-conserving surgery, aims to preserve most of the breast by only removing the tumour and some tissue around it. The surgery may leave a scar and could change the breast’s size and shape, and possibly the nipple’s position.
Patients also usually undergo radiation therapy as a post-operative procedure to destroy any cancer cells that may be left in surrounding areas like the armpits.
Depending on the result of the pathology tests following the lumpectomy – say if cancer cells are found from the sample tissue – then another surgery might be needed to remove more tissue. In some cases, a mastectomy might then be recommended.
While mastectomy is a common breast cancer treatment, some women and gender-diverse individuals with a high genetic risk may choose to have it preventatively – this is known as a prophylactic mastectomy. This risk is connected to mutations in genes – including BRCA1 and BRCA2.
While there’s also a type of mastectomy to get rid of excess breast tissue in a male (gynecomastia), we’re only looking at mastectomies in terms of a medically necessary breast cancer surgery.
What’s breast reconstruction?
Many patients who have a mastectomy also choose to have breast reconstruction to rebuild the shape of their breast.
There are different types of breast reconstruction. It can be performed at the same time as the mastectomy (immediate reconstruction) or months – if not years – later (delayed reconstruction). It can also involve either implants (silicone or saline) or your own body tissue (flap or autologous reconstruction).
Deciding whether to have breast reconstruction following the surgery – and what type – is a personal choice.
There are alternatives that don’t require surgery, like opting to ‘go flat’ or wear a breast prosthesis that can be attached to the skin with an adhesive or worn in a bra.
In the end, breast reconstruction adds a layer of complexity to your surgery, how and when other breast cancer treatments are given, and the final cost.
What’s the cost of a mastectomy?
The price tag depends entirely on whether you go through the public system or choose private healthcare.
Will health insurance pay for a mastectomy?
Yes. If you have appropriate hospital cover:
- Medicare pays 75% of the Medical Benefits Schedule (MBS) fee.
- Your health fund pays the remaining 25% of the MBS fee, plus hospital fees like accommodation and theatre costs if your hospital is partnered with your health fund.
Going private with health insurance cover means you can choose your oncologist and surgeon and skip the public queue. But this could also mean having to pay for out-of-pocket expenses.
Let’s have a look at 2023–24 data from the Australian Government’s Medical Costs Finder showing how much private patients end up paying out of pocket for mastectomy and breast reconstruction.
Mastectomy costs in Australia
| Total mastectomy (single) | Total mastectomy (double) | Nipple sparing mastectomy and breast reconstruction with prosthesis (single) | Nipple sparing mastectomy and breast reconstruction with prosthesis (double) | |
| Medical Benefits Schedule (MBS) item number | 31519 | 31520 | 31528 | 31529 |
| Typical specialists’ fees | $4,100 | $6,100 | $6,200 | $10,000 |
| Medicare rebates | $1,800 | $2,300 | $2,700 | $3,400 |
| Insurer typically paid | $1,400 | $1,600 | $2,100 | $1,900 |
| Typical out-of-pocket cost | $550 | $1,500 | $600 | $5,200 |
| % of patients with an out-of-pocket cost | 76% | 83% | 90% | 86% |
Source: Medical Costs Finder – Total mastectomy (single); Total mastectomy (double); Nipple sparing mastectomy and breast reconstruction with prosthesis (single); Nipple sparing mastectomy and breast reconstruction with prosthesis (double)
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.
The specialists’ fees in the table refer to what the surgeon, assistant surgeon, and anaesthetist typically charge. However, it’s also possible for them to charge more than 100% of the standard MBS fee. In that case, you might have to shoulder the gap.
It’s worth checking with your insurer if they offer a medical gap scheme and then with and the healthcare professionals involved in your surgery if they are participating in it.
Does Medicare cover mastectomies?
Yes. A medically necessary mastectomy in a public hospital is free. This includes the surgeon and anaesthetist fees, hospital stay, and theatre costs.
Mastectomy is also listed on the MBS. This means that whether you go public or private, the government subsidises a significant portion of the surgeon’s fee. It also means you can claim rebates on follow-up appointments with your specialist.
But there’s a trade-off from going public. You’ll be treated by the doctor on duty (and they can change, say when the shift changes) and cannot choose your surgeon.
If you’re considering a delayed breast reconstruction, it’s worth knowing that you are waiting a long time in the public system.
Are there other out-of-pocket costs for a mastectomy?
Unfortunately, yes. Hospital costs that include your stay and treatment aren’t included in the table above. Here’s what the 2023–24 figures look like based on the type of mastectomy:
Hospital fees for each type of mastectomy in Australia
| Total mastectomy (single) | $7,100 |
| Total mastectomy (double) | $6,900 |
| Nipple sparing mastectomy and breast reconstruction with prosthesis (single) | $9,700 |
| Nipple sparing mastectomy and breast reconstruction with prosthesis (double) | $11,000 |
Source: Medical Costs Finder – Total mastectomy (single); Total mastectomy (double); Nipple sparing mastectomy and breast reconstruction with prosthesis (single); Nipple sparing mastectomy and breast reconstruction with prosthesis (double)
Note: Data retrieved January 2026.
While your health fund might cover all or a portion of these costs, depending on your level of hospital cover, there are other out-of-pocket costs you’ll need to think of.
Are there other costs after a mastectomy?
Recovery is a journey, and costs can trickle in over the weeks and months following the surgery.
- Follow-up appointments: You’ll likely have regular checks with your surgeon and oncologist. Medicare provides a rebate, but you could also expect a gap fee.
- Breast prosthesis: If you decide to skip reconstruction, a breast prosthesis is an option. Medicare’s External Breast Prostheses Reimbursement Program may allow you every two years up to claim to $400 per prosthesis or up to $800 if you need a prosthesis for both breasts.
- Medications: Pain relief and antibiotics might be needed. These are usually Pharmaceutical Benefits Scheme (PBS) items, requiring a co-payment at the pharmacy.
- Physiotherapy: Rehabilitation might be needed to regain arm movement and reduce the risk lymphoedema. You may be able to claim some of this through extras cover.
How long will I have to wait for a mastectomy?
The answer depends on whether you’re using the public or private system:
- Public: In 2023–24, half of Australian public patients with a breast cancer diagnosis had surgery within 15 days, and nearly all patients (90%) were admitted for surgery within 30 days.1Australian Institute of Health and Welfare – Cancer surgery waiting times However, with breast reconstruction, you might face delays or be told it has to be done as a separate surgery later on. Not all public hospitals offer breast reconstruction, or if your local one does, you might have to wait for years.
- Private: You’ll have shorter waiting times than the public system and can have greater control (and flexibility) over the schedules.
When it comes to your private health insurance, you might need to review any waiting periods. If you have recently taken out a new health insurance policy or upgraded to cover this surgery, there is a 12-month waiting period for pre-existing conditions.
Unfortunately, given the urgent nature of cancer treatment, uninsured patients who just received a cancer diagnosis can’t wait this long and may need to rely on the public system.
What level of health insurance do I need to cover a mastectomy?
Mastectomy falls under the ‘breast surgery (medically necessary)’ category, which is typically found under bronze and higher tier policies.
If you’re also looking into breast reconstruction, this procedure requires the ‘plastic and reconstructive surgery (medically necessary)’ clinical category, which is typically found on silver tier policies and above.
Keep in mind that hospital cover only applies to procedures that are considered medically necessary. This means your policy won’t pay for cosmetic or plastic surgery if it isn’t required for medical reasons.
Helpful tip
If you want cover for both a mastectomy and breast reconstruction, remember that they usually fall under different levels of hospital cover. If you have a bronze policy, your mastectomy will be covered, but the reconstruction might not be. ‘Plastic and reconstructive surgery (medically necessary)’ is usually only covered under silver policies and above.
It’s always a good idea to check with your health fund (or talk to health insurance comparison experts if you’re still shopping around) so you have peace of mind when it matters most.
Andres Gutierrez
General Manager – Health
Frequently asked questions
Is mastectomy a big surgery?
Yes, mastectomy is a major surgery requiring general anaesthetic and a hospital stay of up to a week. Recovery times vary, but most patients take a few days (or weeks if they had it with breast reconstruction) to feel better.
Why is there an out-of-pocket cost for breast reconstruction in a private hospital?
Reconstruction is complex and takes longer than a standard mastectomy. Plastic surgeons and breast surgeons could charge fees well above the government’s MBS schedule to reflect their expertise and time. Insurance covers the gap up to a point, but the remainder falls squarely on you. There are also implants and tissue expanders to consider, which could both be out-of-pocket expenses.
What is the cost of breast reconstruction in a public hospital?
It’s free for public patients. However, access is the issue. Not all public hospitals offer immediate reconstruction (if at all), and waiting lists for ‘delayed’ reconstruction can last years as it’s often considered elective compared to the cancer removal itself.
Is breast reconstruction surgery worth the cost?
This is deeply personal decision. For many patients, reconstruction is a vital part of feeling ‘whole’ again after cancer. If choosing your surgeon is important to your mental health and recovery, the cost of going private may be worth the investment.
Find and compare plans
A mastectomy doesn’t just take a toll on your physical and emotional well-being – it can also bring unexpected financial challenges. If you’re feeling the weight of it all, know that you’re not alone, and that it’s okay to look for clarity.
Taking time to understand your health cover can be one helpful step. And if you’d like support as you look into hospital cover for mastectomy and reconstruction, our team can help you explore your options – whether that’s over the phone on 1800 784 772 or by using our online comparison tool to find and compare policies at your own pace.
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