What is the Average Cost of Bypass Surgery?

Coronary Artery Bypass Surgery Costs in India: What to Expect

Coronary artery bypass surgery is a crucial procedure that helps re-establish proper blood circulation to the heart in individuals with blocked or narrowed arteries. Medically referred to as coronary artery bypass graft (CABG) surgery, it not only alleviates symptoms like chest pain but also enhances the function of the heart and increases life expectancy. 

However, as is the case with any serious surgery, it comes with significant expenses that vary according to several crucial factors. From the selection of hospital and surgical procedure to the existence of insurance coverage, numerous factors are involved when calculating the overall cost. 

Read ahead to understand the average cost of bypass surgery in India, the factors that influence it, and how health insurance can help reduce the financial burden.

What is the Average Bypass Surgery Cost?

Heart surgery is normally an expensive medical intervention. In India, open-heart bypass surgery on average costs between approximately ₹1.5 lakhs and ₹10 lakhs. The actual amount can vary significantly depending on several factors, as well as any additional necessary treatments or tests.

What are the Factors Affecting the Cost of Bypass Surgery in India?

The cost of bypass surgery in India can vary significantly based on several influencing factors. The following are some key factors that can impact the overall cost:

1.Aortic Valve Replacement

In some cases, bypass surgery might involve replacing the aortic valve, which controls blood flow between the heart's left ventricle and the aorta. This is typically required for patients with conditions such as aortic stenosis or aortic regurgitation. The inclusion of valve replacement can raise the overall cost due to the complexity of the procedure.

2.Hospital Location

The geographical location of the medical facility plays a significant role in determining the cost of care. Hospitals situated in metropolitan cities like Delhi, Mumbai, or Bangalore tend to charge more due to higher operating expenses and a greater demand for quality healthcare services.

3.Type of Procedure

The specific surgical technique used can also affect the pricing. Traditional open-heart surgery generally incurs higher costs compared to minimally invasive techniques, which often lead to quicker recovery times and reduced hospital stays.

4.Surgeon’s Fees

The expertise and reputation of the cardiac surgeon also influence the cost. Surgeons with extensive experience or those who are highly sought after may charge a premium for their services.

5.Anesthesia Charges

The type and duration of anaesthesia required during the operation can influence the overall expense. General anaesthesia, which requires a skilled anesthesiologist and more comprehensive monitoring, is typically more costly than local anaesthesia.

6.Duration of Hospital Stay

The number of days a patient remains hospitalised directly affects the cost. Extended stays result in higher charges for room accommodations, nursing services, meals, and post-operative care.

7.Use of Advanced Technology

The availability and use of cutting-edge medical equipment can raise the cost of the procedure. For instance, some hospitals, such as Apollo, employ advanced technologies like Transit Time Flow Doppler to ensure the proper functioning of grafts, offering more accurate intraoperative assessments.

8Additional Procedures or Tests

Sometimes, patients may require supplementary diagnostic tests or procedures either before or after surgery. These additional medical services can contribute to the total cost.

9.Health Insurance Coverage

If a patient has health insurance, it may cover a significant portion or even all of the surgery costs. This can make bypass surgery more financially accessible for insured individuals.

Does Health Insurance Cover the Cost of Bypass Surgery in India?

While most health insurance policies offer some level of coverage for bypass surgery, the extent of that coverage can vary significantly depending on several key factors. Those factors include:

1.Policy Inclusions

Reviewing your health insurance policy in detail is the first step. Bypass surgery is often classified as a major medical procedure, which typically qualifies for comprehensive coverage. However, the specific terms and conditions will outline exactly what is covered.

2.Network Hospitals and Doctors

Choosing a hospital and surgeon within your insurer’s approved network can help minimise out-of-pocket expenses. Working with network providers ensures that a larger portion of the costs is directly covered by your insurance company.

3.Pre-authorisation Requirements

Most insurance providers require pre-authorisation before the procedure is carried out. This administrative process confirms your eligibility and the scope of coverage. Without it, you risk having your claim partially or entirely denied.

4.Deductibles, Co-pays, and Co-insurance

Even with insurance, you may still be responsible for certain expenses. These include deductibles (the amount you pay before insurance kicks in), co-pays (a fixed fee for services), and co-insurance (a percentage of the total cost that you share with the insurer).

5.Coverage Limits

Some policies have caps on the amount they will pay for specific procedures. It’s important to be aware of these limits to avoid unexpected financial burdens after surgery.

6.Policy Exclusions

Every insurance plan has exclusions, such as specific conditions or treatments that are not covered. Pre-existing heart conditions, certain lifestyle choices, or specific complications may be excluded from coverage under your policy, so be sure to read the fine print carefully.

Understanding the cost of bypass surgery and the factors that influence it empowers patients to make informed decisions. By exploring different hospitals, comparing treatment options, and carefully reviewing health insurance policies, patients can effectively manage their expenses and access the care they need. 

At Star Health, we also offer coverage for bypass surgery and other heart-related conditions under our Star Cardiac Care Insurance Policy, which is specially tailored to meet your needs. We provide hassle-free claim settlements with reduced turnaround time across over 14,000 network hospitals in India.