Laparoscopic Cholecystectomy Cost in a Philippine Private Hospital

For those suffering from gallstones, an operation may be their best relief. There are also instances when the only choice left is to go under the surgeon’s knife.

The operation can either be (1) to remove the gallstones or (2) to remove the gallbladder itself. 

Cholecystectomy is the removal of the gallbladder. Laparoscopy is a procedure which uses specialised medical device that will make a few tiny incisions to do a procedure. 

Laparoscopic Cholecystectomy is a surgical procedure to remove the gallbladder using a special instrument. Several tiny incisions are done on the stomach, then a small camera is inserted into the body via the tiny incision, this will guide the surgeon during the procedure. 

The old operation method is to make one big cut in the stomach of the patient to remove the gallbladder. In the newer method, the resulting surgical wound is small, less prone to infection, and will heal faster.

There are some who prefers to follow the natural method in removing gallstones, which include the drinking of apple juice, epsom salt, virgin olive oil, etc.. The step by step procedure on how to do gallstone removal naturally usually pops-up in viral Facebook posts from time to time. Is it effective? There are those who swears by the effectivity of removing gallstones with apple juice. They say that following this ‘natural method’ will result to the stones getting smaller to be easily excreted by the body. 

Keep the gallbladder healthy!

The gallbladder or “apdo” collects and stores bile – this is the liquid that helps the body digest fats. 

Some of the food to avoid to prevent gallstones from forming includes food with high saturated fat content example fatty portions of meat, sausages, hotdogs, butter, cream, cakes. 

A few symptoms that gallstones are present includes the following: 

Abdominal pain

Bloating

Nausea

Vomiting

iSensey recommends consulting a doctor if you experience the symptoms.

PRE-OPERATING EXPENSE

Before any surgery is done, the doctor will usually ask for the patient to undergo whole abdominal ct scan to pinpoint the stones and it’s location. Our patient was charged PHP 13,200 for this scan done in a private hospital in Cebu. This expense is PRIOR to surgery. 

How Much It Cost For Gallstones – Gallbladder Removal in the Philippines?

There are two types of operation to remove the gallbladder and along with it the gallstones: open surgery which is cheaper but longer to heal due to bigger cut and laparascopy surgery which is faster to heal due to small cut/incisions but is more expensive because of the specialise medical equipment that will be used for the operation.

In the Philippines, the “no billing policy” in government hospitals are in effect. So if the patient underwent cholecystectomy or gallbladder removal in a a government medical facility or hospital, then the amount that patient, especially if indigent, will pay will be very minimal or none at all “0.00” because of the “zero billing” or “no billing policy”.

Currently, there are several public hospitals like the Philippine General Hospital (PGH), Zamboanga City Medical Center (ZCMC), Batangas Medical Center, and Cebu’s Vicente Sotto Memorial Medical Center which already performs gallstones removal as well as laparoscopic cholecystectomy. We recommend that you first consult with the hospital admin about operation fee and about the no billing policy. 

The cons of having the operation in a public hospital is that typically government hospitals have long queue of patients waiting for an operation schedule. What if the patient is already suffering acute pain from the gallstones, can he or she bear it until a schedule opens up?

Now, most major private hospitals nationwide are equipped with the needed medical machines to handle operations like  laparoscopy cholecystectomy. The downside is that private hospital is equal to more expense, higher cost. 

If patient has Philhealth and HMO which can cover the operation then the surgery expense even if done in a private hospital or medical facility will be significantly brought down. 

*Check with your HMO if laparoscopy cholecystectomy procedure is covered. There are HMO companies which treats this as new procedure and won’t cover it, or there is an inner limit. Some HMO covers gallbladder open surgery but not laparoscopy cholecystectomy. 

*Prepaid health cards usually will not cover surgery. Most prepaid health cards covers only emergency, viral, and bacterial ailments. Make sure to read the fine prints of the HMO offer before you buy a prepaid health card or sign-up for a plan.

LAPAROSCOPY CHOLECYSTECTOMY EXPENSE

We have here an actual billing of a private hospital in Cebu for an 80+ year old patient who needed to have her gallbladder removed. The reason given by the doctor why go for cholecystectomy is that in her case, if only the stones will be removed, there is a possibility that the gallstones will come back because of her advanced age. The recommendation is to remove the gallbladder once and for all. 

The doctor also said that if there will be no operation implemented asap, the stones may move or get dislodged. If the stones will reach the pancreas then the situation will become life-threatening and more complicated. So the patient’s family opted to have the gallbladder removed altogether per md recommendation. 

These are the private hospital’s itemised list of charges for the Laparoscopy Cholecystectomy done early 2019.  Hospital is located in Cebu. 

Laparoscopic Surgeon Fee: PHP 25,000 (originally PHP 31,200 but Philhealth will shoulder PHP 6,200 )

Anaesthesiologist Fee: PHP 13,000 (originally PHP 16,100 but Philhealth will shoulder PHP 3,100)

LAPAROSCOPIC CHOLECYSTECTOMY procedure fee: PHP 20,000

CHOLECYSTECTOMY TRA KNC17: PHP 27,930 (this charged was later on removed by the hospital since the surgeon brought and used his own instrument for the surgery)

Tissue Biopsy – Small (1-2 Blocks): PHP 1,430

Consumables from Pharmacy: PHP 2,023.88

Consumable from NS: PHP 5,699.72

Anesthesia Machine Per Procedure: PHP 1,500

Cautery Machine first 2 hours: PHP 1,500

Use of Cautery Pad: PHP 780

Oxygen Charges: PHP 216

Cardiac Monitor Charges: PHP 250

PACU Fee First 2 Hours: PHP 200

Operating Fee First 2 Hours: PHP 1,485

The patient is also suffering from hypertension so there is a Cardio doctor assisting the surgery which is another expense:

Cardiology MD fee: PHP 12,500 (originally PHP 15,600 but Philhealth will shoulder 3,100 discount)

PHILHEALTH DEDUCTION

One benefit of becoming a member of Philhealth is that the surgery is covered and the member-patient will get bill deduction.

As of 2019, the Philhealth case rate for cholecystectomy is P31,000. 40% of 31K (PHP 12,400) will be for the doctor’s professional fee; this amount will be divided among all the attending doctors. 60% of 31K (PHP 18,600) will be allocated for the operation itself. Philhealth will pay the P31,000 directly to the hospital so the patient will see the P31K as “deduction” in the total bill. 

Total doctor professional fee BEFORE Philhealth share was deducted from the bill (3 MDs namely surgeon, anaesthesiologist, cardio):  P25,000 + P16,100 + P12,500 = P53,600

Total Philhealth deduction for the doctor’s fee: 

P6,200 + P3,100 + P3,100 = P12,400

If you don’t have Philhealth, you will pay the total doctors’ professional fee which can be as much as P40,000 and up.

Patient is a senior citizen so there was additional senior citizen discount on the total hospital bill.  A total of 4 stones were retrieved from the gallbladder for this patient. 

Another iSensey reader also shared the total amount paid for his father’s laparoscopic surgery, removal of gallstones done in a Tondo private hospital last 2017. He signed up for a package so the total amount paid for the surgery was only PHP 70,000 after Philhealth deduction. 

In summary, the cost of a laparoscopic cholecystectomy is a minimum of PHP 100,000 in a Philippine private hospital BEFORE deduction of Philhealth benefit. The total hospital expense can get higher depending on number of days stay in the hospital plus all other ailments being treated, plus type of private hospital. If you can find a hospital / surgeon who offers surgery package, the cost of the operation may be cheaper.

Open gallbladder surgery is generally cheaper versus laparoscopic cholecystectomy.

Hope this gives you an idea of the expense when it comes to gallbladder removal in the Philippines.