Cost of day surgery in a private hospital

Average customer rating: 4.3/5
Written by Joshua Malin
Reviewed by Steven Spicer
Updated 08 March, 2024

Expert tips for day surgery

Our health insurance expert, Steven Spicer, has some expert tips for when you’re considering day surgery.

Steven Spicer
Executive General Manager – Health, Life & Energy

Some health funds have no-gap agreements with certain day surgeries

Some health funds offer no-gap for accommodation or doctors’ fees for services included in your policy at specific agreement day facilities (a hospital that partners with your fund); if this is something you think you’ll benefit from, compare policies and shop around until you find the one that suits you. Keep in mind that you’ll still need to pay your excess where applicable.

You may only need to pay one excess

In most instances, your excess is only payable once per year (per person), meaning if you need a follow-on procedure after day surgery, you won’t need to pay the excess again. For example, if you go for arthroscopy and find out you need an anterior cruciate ligament (ACL) reconstruction, you may not need to pay the excess again when you go in for that treatment provided that it happens in the same year (this could be based on calendar year or membership year depending on your health fund). If you only paid a half excess, or the excess was waived for your day procedure, you’ll be required to pay the remaining or full excess if you go in for treatment again that year.

Be prepared to pay your excess on admission

The excess is typically paid to the hospital on admission for treatment. The hospital won’t need your fund membership card but it’s beneficial to have your policy number if they ask for it.

The cost of day surgery in a private hospital

Out of pocket costs for day surgery

Gap cover agreements

Are there health funds with no excess for day surgery?

Day surgery and private health insurance

Is day surgery covered by health insurance?

Are certain day surgeries excluded from private hospital policies?

Are there waiting periods for day surgery under private health insurance?

What is the difference between inpatient and outpatient services?

Other benefits of private health insurance

Examples of common day surgeries in Australia

  • Cataract surgery and ophthalmology
  • Endoscopy (an internal examination that doesn’t require major surgery)
  • Wisdom teeth removal
  • Arthroscopy (examination and/or treatment of damage to the interior of a joint)
  • Cystoscopy (examination and/or treatment of the bladder and urethra)
  • Dilation and curettage (light scraping of the womb)
  • Ear grommets (plastic ventilation tubes that treat ear infections).

Day procedures may be available for health specialty areas, including orthopaedic, paediatric, gynaecology or urology services. This depends on the type of healthcare required and the surgical services used.

Meet our health insurance expert, Steven Spicer

Steven Spicer
Executive General Manager – Health, Life & Energy

As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.

Australian Government Department of Health, MBS Online: Medicare Benefits Schedule. Accessed January 2023

2 Australian Government, Medical Cost Finder – Grommets/myringotomy. Accessed July 2023

3 Commonwealth Ombudsman, Policy Exclusions and Restrictions. Accessed January 2023