The Cost of Common Medical Procedures in 2023

According to a report by the Productivity Commission in 2023, the number of Australians delaying or avoiding medical treatment due to cost soared by over 50%. 

Unfortunately, taking care of our health is usually not optional, which makes it a big expense you might have no say in parting with.

That’s where knowing how much some of the most common medical procedures can cost could come in handy, as you can get a rough idea of what you could be in for and, more importantly, how much of that procedure is covered by our healthcare system.

In this article, we’ll break down the cost of Australia's most common medical procedures and provide some tips to make medical care more affordable.

On this page:

• What are the most common medical procedures in Australia?
• Common medical procedures by age
• Out-of-pocket costs explained
• What can affect the cost of medical treatment?
• The average costs of common medical procedures in Australia
• How to save money on medical procedures in 2023
• Is private health insurance worth it?
• About our Medical Loans

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What are the most common medical procedures in Australia?

Based on data from sources such as the Australian Institute of Health and Welfare (AIHW) and the Australian Bureau of Statistics (ABS), here are 10 of Australia's most common medical procedures (in no particular order).

1. Colonoscopy: Colonoscopies are widely performed to detect early colon cancer and other gastrointestinal issues. According to the AIHW, over 700,000 colonoscopies were performed in 2018-2019.
2. Cataract Surgery: Cataract surgery is a prevalent procedure among older Australians, as it helps restore vision by removing the clouded lens and replacing it with an artificial lens. The AIHW reported over 240,000 cataract surgeries in 2018-2019.
3. Gastroscopy: Gastroscopies are performed to diagnose and treat gastrointestinal conditions by examining the lining of the esophagus, stomach, and duodenum. Over 400,000 gastroscopy procedures were performed in 2018-2019.
4. Knee Replacement Surgery: With Australia's ageing population, the demand for joint replacement surgeries, particularly knee replacements, is rising. Around 50,000 knee replacement surgeries took place in 2018-2019.
5. Hip Replacement Surgery: Like knee replacements, hip replacement surgeries are common among older Australians, helping to relieve pain and restore mobility. According to the AIHW, there were around 40,000 hip replacement surgeries in 2018-2019.
6. Hysterectomy: This surgical procedure involves the removal of a woman's uterus and is performed for various reasons, such as cancer and endometriosis. AIHW reported over 30,000 hysterectomy procedures in 2018-2019.
7. Cholecystectomy: Involves the surgical removal of the gallbladder and is commonly performed to treat gallstones. The AIHW reported over 60,000 cholecystectomy procedures in 2018-2019.
8. Appendectomy: Appendectomies are performed to remove an inflamed or infected appendix, preventing further complications such as rupture or abscess. The AIHW reported around 25,000 appendectomy procedures in 2018-2019.
9. Tonsillectomy: Tonsillectomies are surgeries performed to remove the tonsils, primarily to treat recurrent tonsillitis or sleep apnea in children. According to the ABS, there were over 30,000 tonsillectomy procedures in 2019.
10. Caesarean Section: C-sections are surgical procedures for delivering babies through an incision in the mother's abdomen and uterus. The ABS reported that around 33% of all births in Australia were through C-sections in 2019.

See also: The Cost of Dental Procedures in 2023

Common medical procedures by age

The top 10 listed above are generally the most common, but the results will vary depending on the age range and even gender, as well as other factors. For example, a teenage male won’t be getting a C-section anytime soon but could be far more likely to need help with dental procedures and sports injuries.

Here are some of the most common medical procedures based on age group.

Children and Adolescents (0-17 years)	Young Adults (18-35 years)	Middle-Aged Adults (36-64 years)	Elderly Adults (65+ years)
Tonsillectomy Dental procedures Asthma management	Dermatological procedures (skin) Sports injuries Dental procedures	Gastrointestinal procedures Joint replacement surgeries Cancer screenings	Cardiovascular procedures Joint replacement surgeries Cataract surgery

What are ‘out-of-pocket costs’?

An out-of-pocket cost is the difference between the amount a doctor charges for a medical service and what Medicare and any private health insurer pay.

Also known as a gap fee or payment, out-of-pocket costs are common but can vary significantly. If Medicare and your private health insurer contribute to your medical fee, your out-of-pocket cost is reduced.

Examples of out-of-pocket costs commonly charged in Australia include:

• Medical costs: charged by surgeons, anaesthetists or other medical specialists for their expertise.
• Hospital costs: charged for staying in the hospital and paying for things like food, accommodation, nursing and care.
• Pharmacy costs: the cost of prescribed medication provided to you or purchased by you to treat your condition.
• Prostheses costs: the cost of surgically implanted things like artificial hips or knees.

What can affect the cost of medical treatment?

As you’ll soon see, the cost of medical treatment in Australia can vary wildly from one operation to another, even for the same procedure. Some of the main reasons for this are as follows:

• Your location: hospitals and specialists in rural and regional areas can cost more than the same procedures in urban areas, while private hospitals can also be more expensive than public ones. 
• The cost of technology and equipment: the more advanced the technology, the more expensive the procedure will likely be.
• Specialist fees: the more experienced and skilled the specialist, the higher the fees in most cases.
• Hospital fees: your care and accommodation costs can add a big chunk to your overall bill. The more care you need, the more it will likely cost.
• The complexity of the procedure: more complex and time-consuming procedures tend to be more expensive.
• Your characteristics: certain patient characteristics, such as age, weight, and overall health status, can also influence the cost of medical procedures.

The average costs of common medical procedures in Australia

Below are the average costs for each of the above medical procedures in Australia according to the Government’s Medical Costs Finder Tool.

Jump to each section:

• Colonoscopy costs
• Cataract surgery costs
• Gastroscopy costs
• Knee replacement costs
• Hysterectomy costs
• Hip replacement surgery costs
• Cholecystectomy costs
• Tonsillectomy costs
• Caesarean section costs

Colonoscopy: average costs 2023

• Average total cost: $1,200
• Medicare covers: $560
• Insurer covers: $470
• Out-of-pocket costs: $150
• Private patients with no out-of-pocket costs: 83%
• Hospital fees without insurance: $660

Fees and costs by state: Colonoscopy

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	83%	$1,300	$250
VIC	79%	$1,100	$130
QLD	80%	$1,200	$130
SA	90%	$1,200	$120
WA	95%	$1,100	$110
TAS	88%	$1,200	$20
ACT	51%	$1,300	$330

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Cataract surgery: average costs 2023

• Average total cost: $2,000
• Medicare covers: $770
• Insurer covers: $840
• Out-of-pocket costs: $370
• Hospital fees without insurance: $2,400

Fees and costs by state: Cataract surgery

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	69%	$2,100	$500
VIC	30%	$1,900	$300
QLD	40%	$2,100	$450
SA	49%	$1,900	$300
WA	85%	$1,700	$110
ACT	18%	$1,200	$1,200

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Gastroscopy: average costs 2023

• Average total cost: $940
• Medicare covers: $420
• Insurer covers: $370
• Out-of-pocket costs: $140
• Hospital fees without insurance: $530

Fees and costs by state: Gastroscopy

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	83%	$960	$190
VIC	79%	$910	$130
QLD	80%	$960	$100
SA	91%	$930	$100
WA	94%	$850	$130
TAS	91%	$880	$100
ACT	59%	$1,000	$210

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Knee replacement surgery: average costs 2023

• Average total cost: $4,800
• Medicare covers:$1,900
• Insurer covers: $1,800
• Out-of-pocket costs: $680
• Patients with no out-of-pocket costs: 32%
• Hospital fees without insurance: $18,000

Fees and costs by state: Knee replacement surgery

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	38%	$5,200	$1,100
VIC	20%	$5,100	$600
QLD	22%	$4,800	$990
SA	30%	$4,600	$350
WA	55%	$4,000	$350
TAS	47%	$4,200	$500
ACT	13%	$8,800	$6,200

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Hysterectomy: average costs 2023

• Average total cost: $2,800
• Medicare covers: $1,100
• Insurer covers: $1,100
• Out-of-pocket costs: $500
• Patients with no out-of-pocket costs: 42%
• Hospital fees without insurance: $6,800

Fees and costs by state: Hysterectomy

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	52%	$2,800	$500
VIC	36%	$2,600	$420
QLD	38%	$2,800	$510
SA	21%	$2,800	$300
WA	52%	$2,800	$450
TAS	32%	$2,700	$350

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Hip replacement surgery: average costs 2023

• Average total cost: $5,000
• Medicare covers: $1,900
• Insurer covers: $1,900
• Out-of-pocket costs: $690
• Patients with no out-of-pocket costs: 29%
• Hospital fees without insurance: $20,000

Fees and costs by state: Hip replacement surgery

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	33%	$5,300	$1,100
VIC	18%	$5,500	$730
QLD	19%	$5,000	$1,000
SA	28%	$4,700	$350
WA	55%	$4,200	$450
ACT	17%	$5,800	$3,300

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Cholecystectomy: average costs 2023

• Average total cost: $2,800
• Medicare covers: $1,200
• Insurer covers: $1,100
• Out-of-pocket costs: $400
• Patients with no out-of-pocket costs: 35%
• Hospital fees without insurance: $4,500

Fees and costs by state: Cholecystectomy

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	48%	$2,900	$500
VIC	26%	$2,900	$350
QLD	24%	$2,900	$500
SA	32%	$2,600	$200
WA	49%	$2,600	$230
ACT	12%	$3,600	$1,800

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Tonsillectomy: average costs 2023

• Average total cost: $1,600
• Medicare covers: $480
• Insurer covers: $500 
• Out-of-pocket costs: $500
• Patients with no out-of-pocket costs: 23%
• Hospital fees without insurance: $2,000

Fees and costs by state: Tonsillectomy

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	30%	$2,100	$1,300
VIC	21%	$1,600	$500
QLD	22%	$1,700	$570
SA	19%	$1,500	$430
WA	25%	$1,500	$550

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

Caesarean Section: average costs 2023

• Average total cost: $4,600
• Medicare covers: $2,100
• Insurer covers: $2,000
• Out-of-pocket costs: $500
• Patients with no out-of-pocket costs: 42%
• Hospital fees without insurance: $9,600

Fees and costs by state: C-Section

State	% with no out-of-pocket costs	Typical specialists' fees	Patients typically paid
NSW	43%	$4,600	$500
VIC	38%	$4,400	$450
QLD	46%	$4,800	$500
SA	25%	$5,000	$300
WA	72%	$4,900	$440

Accurate as at May 2023. The prices above are estimates for specialists' fees; Please refer to your medical professional for an accurate cost estimation.

How to save money on medical procedures in 2023

Here are some practical tips you can use to save money on your medical expenses both now and in the future.

Compare medical specialists

Before undergoing any medical procedure, it’s essential to compare prices from different healthcare providers, doctors and specialists. Prices for medical procedures can vary significantly between hospitals and clinics, and each specialist can charge their own set of fees, so do your research and shop around for the best prices.

Compare health insurance too

As the tables above demonstrate, out-of-pocket costs without health insurance can be in the thousands. Health insurance can be a great way to save money if you need to pay for surgery, but the ongoing costs can be very steep. For example, you can expect to pay between $125 - $291 per month for a combined hospital and extras policy on average.

Review your health insurance policy coverage to save money on medical procedures and ensure you receive maximum benefits. Different policies will have different premiums and offer different levels of coverage: you can compare policies for free using the Australian Government’s compare health insurance policies tool. 

Speak to your health fund

Specifically ask your insurer if they cover you for the treatment you need, how much they’ll cover you for and whether there’s a waiting period or not. Get the Medicare item number from your GP or specialist and quote it to them to be sure. You can also:

• Ask if you’ll have to pay an excess or co-payment.
• Get a list of surgeons they have an agreement with.
• Get a list of hospitals they have an agreement with if any

Stay as fit and healthy as possible

Preventing health issues through regular exercise, healthy eating, and maintaining a healthy lifestyle can help reduce the need for medical procedures in the first place. Staying healthy can help prevent chronic conditions from developing, which can be costly to manage in the long run.

This obviously may not be possible for everyone, but speaking to a qualified health professional can give you some ideas for how you can keep your physical fitness as high as it can be.

Utilise Medicare and government subsidies if you can

The Australian Government offers various different subsidies and programs to help eligible individuals manage their healthcare expenses. For example, the Pharmaceutical Benefits Scheme (PBS) provides subsidies for prescription medications, and the Medical Expenses Tax Offset can provide a tax benefit for eligible medical expenses.

If you can withstand the waiting periods that might apply in public hospitals, going through the public system for your healthcare needs can also be a good way to save money, but it’s worth weighing up the pros and cons of public and private healthcare first…

Is private health insurance worth it? 

Whether you should have private health insurance depends on your health situation. While you might not think you’re likely to need private health coverage, you never really know. Health insurance is designed to provide peace of mind against the unexpected. And as you can see, the out-of-pocket costs for some of these common procedures can be in the thousands of dollars.

For a detailed breakdown of the pros, cons and costs of private health insurance and Medicare, see our article on whether you need health insurance. It might be worth considering getting personal advice from a qualified financial or medical professional if you’re unsure whether health insurance is necessary.

About our Medical Loans

If you’ve got an expensive medical procedure but would prefer to avoid dipping into your savings to pay for it, don’t worry. Jac’s got your back, both figuratively and literally, if you’re getting a back operation done.

One of our most popular loan purposes is a medical loan: a loan you can take out to pay for a procedure over a set period of time in manageable instalments. Our medical loans are available for up to $25,000 and as little as $2,100, so there’s a good chance we could cover most medical expenses.

Check out how our medical loans could help, or contact our customer service team today if you have any questions.

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