Heart Bypass Surgery Cost

Typical costs:

• For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays and coinsurance of 10%-50% or more, which could easily reach the yearly out-of-pocket maximum. Heart bypass surgery typically is covered by health insurance when medically necessary.
• For patients not covered by health insurance, heart bypass surgery typically costs about $70,000-$200,000 or more. Costs depend on the facility, but tend to be on the lower end without complications and on the higher end with complications. For example, St. Mary's Hospital^[1] in Wisconsin charges about $71,000. Dartmouth-Hitchcock Medical Center^[2] in New Hampshire charges about $94,000, including doctor fee, after a 30% uninsured discount. Saint Elizabeth Regional Medical Center^[3] in Nebraska charges about $90,000-$110,000, not including the doctor fee. And Baptist Memorial Health Care in Tennessee typically charges about $75,000-$115,000, not including doctor fee, but cost can increase to $215,000 or more with major complications. A surgeon fee can add $5,000 or more to the final bill.
• According to an American Heart Association report^[4] , the average hospital charge for heart bypass surgery -- not including doctor fee -- is $117,094.

• In coronary artery bypass grafting, also known as heart bypass surgery^[5] , the patient is placed under general anesthesia and hooked up to a heart-lung bypass machine that does the work of the heart. The surgeon then removes a blood vessel from one part of the patient's body -- such as the chest, legs or arm -- and attaches it to the coronary artery to bypass the blockage.
• If the surgeon bypasses more than one artery in the heart, the operation might be referred to as a double, triple or quadruple bypass. Recovery^[6] requires a hospital stay of about six to seven days or longer, and about six to eight weeks off from work.

• Patients typically require one or more sessions of physical therapy to learn how to move without harming the incision and to learn exercises to assist recovery. This typically costs $50-$350 per session. The University of Washington Medical Center Cardiac Surgery Clinic has information on physical therapy^[7] after heart surgery.
• Drugs prescribed after bypass surgery might include a blood thinning medication such as warfarin (brand name Coumadin) or Plavix to prevent blood clots, a beta-blocker to slow the heart rate, a statin to lower cholesterol and an ACE inhibitor to control blood pressure and heart failure. At Drugstore.com, Warfarin typically costs about $15-$25 per month for the generic, depending on the dose, or $50- $70 for the brand name, and Plavix costs about $200 or more per month. Beta-blockers^[8] and statins^[9] can cost $10-$200 a month, depending on the drug. And ACE inhibitors^[10] can cost $10-$100 per month.

• Many hospitals give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System^[11] in California offers a 35% discount.

• A cardiologist can provide a referral to a cardiothoracic surgeon. Or, the CardioThoracic Surgery Network offers a state-by-state surgeon locator^[12] . A cardiothoracic surgeon should be certified by the American Board of Thoracic Surgery and should have completed a general surgery residency and a residency in cardiothoracic surgery.
• It is important to ask the surgeon about all treatment options, risks and if there are alternatives to surgery. WebMD has a guide for patients^[13] trying to decide whether to have heart bypass surgery or pursue alternatives such as angioplasty.

1.  www.wipricepoint.org/Basic_INP.aspx
2.  patients.dartmouth-hitchcock.org/billing_questions/out_of_pocket_estimator_dhmc.html
3.  tp.chi.acelogicus.net/nese/Default.aspx
4.  circ.ahajournals.org/content/123/4/e18.full.pdf
5.  www.webmd.com/heart-disease/guide/heart-disease-bypass-surgery
6.  my.clevelandclinic.org/heart/disorders/recovery_ohs.aspx
7.  healthonline.washington.edu/document/health_online/pdf/Physical_Therapy_After_Card...
8.  www.consumerreports.org/health/resources/pdf/best-buy-drugs/2pager_BetaBlockers.pdf
9.  www.consumerreports.org/health/best-buy-drugs/statins.htm
10.  www.consumerreports.org/health/best-buy-drugs/ace-inhibitors.htm
11.  www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
12.  www.ctsnet.org/members/bystate.cfm?ms=surgeons&o=sts
13.  www.webmd.com/heart-disease/features/bpyass-surgery-stents-options

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