Aortic Aneurysm Stent-Graft (EVAR/TEVAR) Cost Calculator
This calculator estimates the out-of-pocket cost of aortic aneurysm treatment in Korea and keeps the same pure calculation model as the Korean page. It covers endovascular stent-graft repair of an abdominal aneurysm (EVAR), thoracic aneurysm (TEVAR), a complex fenestrated or branched repair that preserves the renal and visceral arteries (FEVAR/BEVAR), and traditional open surgical graft replacement — all on 2026 Korean rules. The defining feature of aortic aneurysm cost is that the stent-graft device dominates the bill: a thoracic stent-graft is about KRW 6,300,000 per piece, and a repair often uses a main body plus iliac limbs and extensions, so EVAR and TEVAR frequently cost more in total than open surgery, which uses a cheap Dacron graft. Aortic aneurysm and dissection (I71) qualify for the cardiac special-case program, so a treatment admission reduces the covered copay to 5 percent.
Procedure options and covered fees
Abdominal aortic aneurysm (AAA) is treated endovascularly by EVAR: a stent-graft is pushed through the groin femoral arteries and deployed across the aneurysm, so blood flows through an artificial channel and the sac is excluded, with a short 2 to 3 day stay. The model uses a KRW 3,500,000 covered procedure fee plus KRW 6,000,000 per stent-graft piece, with 4 pieces covered (main body, iliac limbs, extensions). Thoracic aneurysm (TAA) is treated by TEVAR at KRW 4,000,000 procedure fee plus KRW 6,300,000 per piece, with up to 3 trunk pieces covered.
A fenestrated or branched complex repair (FEVAR/BEVAR) is used when the aneurysm is near the renal or visceral arteries; a custom graft with holes or branches keeps those vessels perfused, at a higher device cost (about KRW 8,000,000 per piece in the model). Open surgical replacement opens the abdomen or chest to replace the aortic segment with a Dacron graft: the device is cheap (about KRW 500,000) but it is major surgery with an ICU stay and 12 or more inpatient days, so the covered procedure fee is high (KRW 9,000,000; the Korean open aortic surgery fee rose from KRW 1,400,000 to KRW 3,850,000 in January 2025).
- Covered ICU day is KRW 600,000 and general ward day is KRW 150,000.
- A ruptured aneurysm (rAAA) adds a severe-care surcharge and extra ICU and ward days automatically.
- Stent-graft pieces beyond the covered limit become selective benefit at 80 percent self-pay (not reduced by the 5 percent special case).
Stent-graft material cost and selective benefit drive the bill
For endovascular repair the cost driver is not the procedure fee but the stent-graft device. A thoracic piece is about KRW 6,300,000, and an EVAR uses a main body plus both iliac limbs and possibly extensions, so device cost alone can reach tens of millions of won. Entering the number of stent-graft pieces scales the material cost in the calculator so it matches the real procedure size.
Korean health insurance sets a covered piece limit — up to 3 trunk pieces for thoracic, and a body-plus-limbs allowance for abdominal. Pieces within the limit are covered and get the 5 percent special-case rate, but pieces beyond the limit become selective benefit at 80 percent self-pay, which the 5 percent special case and the out-of-pocket ceiling do not reduce. The result separates the covered material cost from the selective-benefit excess so you can see the real burden of a complex repair.
Cardiac special-case copay — why 5 percent
Aortic aneurysm and dissection (I71) are cardiac special-case conditions under the Ministry of Health and Welfare notice on special-case cost sharing. When you are admitted for treatment and undergo a listed operation — percutaneous endovascular aortic stent-graft placement (EVAR/TEVAR) or open graft replacement — the covered copay drops from 20 percent to 5 percent. The 2025 expansion of the cardiac special case clarified that aortic aneurysm and dissection are included.
Unlike the cancer special case (separate registration, 5 years), the cardiac and cerebrovascular special case applies automatically through the hospital claim with no separate registration, but only for up to 30 days per operation from the surgery (or diagnosis) date; later outpatient visits and surveillance revert to the ordinary rate. A purely diagnostic admission does not qualify — it must be a treatment (surgery) admission. The 5 percent applies to covered items only: selective-benefit excess graft (80 percent), upper-grade room charges, and post-day-30 CT surveillance are not reduced.
EVAR versus open surgery
Endovascular repair (EVAR/TEVAR) and open graft replacement have opposite cost structures. EVAR/TEVAR carry a large device cost but a short 2 to 3 day stay and fast recovery, while open surgery has a cheap graft but major-surgery cost from general anesthesia, ICU, and a 2 to 3 week stay. This mirrors coiling versus clipping for brain aneurysm — which is cheaper depends on device count and length of stay.
The choice is driven by anatomy and patient condition, not only cost: a sufficient landing zone favors EVAR/TEVAR, while a short neck or complex branch anatomy may need FEVAR or open surgery. Younger, healthier patients may prefer open surgery for durability, while older patients with comorbidities often prefer the faster recovery of EVAR — so discuss the trade-off with the treating team.
Ruptured aneurysm and lifelong CT surveillance
A ruptured aortic aneurysm (rAAA) is a high-mortality emergency; emergency EVAR or open surgery with ICU care, transfusion, and a long stay drives the total cost up. Rupture surgery is still a cardiac special case, but the 5 percent applies for at most 30 days from surgery, so complications that extend the stay beyond 30 days revert to the 20 percent ordinary rate. Selecting rupture in the calculator automatically raises the ICU and ward days to reflect the emergency.
Unruptured aneurysms are treated preventively when the diameter exceeds a threshold (about 5.0 cm for a fusiform abdominal aneurysm, about 5.5 cm for thoracic) or grows quickly. After EVAR/TEVAR, lifelong surveillance is needed to watch for endoleak (blood leaking between the graft and the sac) or graft migration — typically CT at 1, 6, and 12 months and yearly thereafter. Surveillance after the 30-day special-case window is at the ordinary rate, so enter expected follow-up cost in the other non-covered field to gauge the long-term burden.
How to read the result
Enter the procedure (EVAR, TEVAR, FEVAR, or open surgery), rupture status, special-case application, stent-graft piece count (for endovascular types), and ICU and ward days. Then set hospital grade, insurance type, upper-grade room days, other non-covered cost (surveillance CT, special materials), private indemnity generation, income decile, and the out-of-pocket ceiling. The result shows covered self-pay after the ceiling, the selective-benefit excess at 80 percent, the special-case 5 percent versus 20 percent comparison, a procedure comparison, the ceiling refund, and the final cost after private indemnity and the tax credit.
This is a cost-planning estimate based on 2026 Korean rules, not medical advice. Public single-price tables for aortic surgery do not exist, so the device and fee figures are defensible market estimates (the thoracic stent-graft at about KRW 6,300,000 per piece is confirmed; abdominal, fenestrated, and fee figures are estimates) that vary with hospital, anatomy, device count, and complications. Confirm details with the treating vascular team, the insurer, and the hospital quote.
This calculator is based on Korean rules (2026 National Health Insurance cardiac special-case program for aortic aneurysm and dissection, selective benefit for stent-graft pieces beyond the covered limit, the out-of-pocket ceiling, and Income Tax Act Article 59-4 medical expense tax credit), with market cost estimates for stent-graft devices and procedure fees. Figures are planning estimates, not medical advice, an insurer decision, or a hospital quote.