Biliary Tract (Bile Duct & Gallbladder) Cancer Surgery Cost Calculator
This calculator estimates the out-of-pocket cost of biliary tract cancer treatment in Korea and keeps the same pure calculation model as the Korean page. Biliary tract cancer covers bile duct cancer (cholangiocarcinoma: intrahepatic C22.1 and extrahepatic C24) and gallbladder cancer (C23). The surgery depends on where the tumor sits: extended (radical) cholecystectomy for gallbladder cancer, liver resection plus bile duct resection and biliary reconstruction for intrahepatic or perihilar (Klatskin) tumors, and pancreaticoduodenectomy (the Whipple procedure) for distal bile duct cancer. Biliary stenting or drainage (ERCP or PTBD) relieves obstructive jaundice, and chemotherapy (gemcitabine plus cisplatin, with or without durvalumab, or adjuvant capecitabine) is priced per cycle, all on 2026 Korean rules.
Treatment options by tumor location and covered fees
Gallbladder cancer is found incidentally during gallstone (laparoscopic cholecystectomy) surgery in 20 to 30 percent of cases. Very early tumors (T1a) are cured by simple cholecystectomy, but T1b and beyond need extended (radical) cholecystectomy, which removes liver segments IVb and V with the gallbladder plus regional lymph nodes. The model uses KRW 15,000,000 as the covered base fee, so the 5 percent special-case self-pay is roughly KRW 800,000 with the ward fee.
Intrahepatic and perihilar (Klatskin) cholangiocarcinoma need liver resection plus bile duct resection and biliary reconstruction (hepaticojejunostomy), often with caudate lobectomy — the most complex hepatobiliary surgery, using KRW 24,000,000 covered with a 2 to 4 week stay. Distal bile duct cancer uses the Whipple procedure at KRW 22,000,000 covered. Robotic bile duct or gallbladder surgery charges the robot fee entirely out of pocket (KRW 6,000,000 to KRW 15,000,000, average KRW 10,000,000 before regional and hospital adjustment), while the covered surgery base is zero.
- Preoperative biliary drainage (ERCP stent or PTBD) for obstructive jaundice adds KRW 2,000,000 as a covered add-on for resection surgery types.
- Covered ward fee is KRW 100,000 per inpatient day.
- Biliary stenting or drainage alone (for jaundice control) uses about KRW 3,000,000 covered for a short admission and can be repeated when a stent occludes.
- Chemotherapy is billed per cycle and repeated; the model multiplies the per-cycle covered fee by the number of cycles.
Why biliary drainage (jaundice relief) matters
Because bile duct, gallbladder, and pancreatic head cancers block the bile duct, jaundice, itching, dark urine, pale stool, and cholangitis are common. When bile cannot drain the liver function drops and the patient cannot tolerate major surgery, so surgeons often place an ERCP self-expanding metal stent (SEMS) or a percutaneous transhepatic biliary drain (PTBD) to decompress the duct before resection. Selecting the biliary-drainage option adds the covered drainage procedure fee to the surgery cost.
For unresectable locally advanced or metastatic disease, biliary stenting becomes the main treatment: it relieves jaundice, itching, and cholangitis and greatly improves quality of life. Stents can occlude over time and may need replacement, and fever or abdominal pain can signal cholangitis that needs an immediate hospital visit.
Chemotherapy is a repeated per-cycle cost
Advanced or metastatic biliary tract cancer is treated with gemcitabine plus cisplatin (GC) as the first-line standard (ABC-02), repeated every 3 weeks. Since TOPAZ-1, GC plus durvalumab immunotherapy is used first-line for advanced disease, and after resection capecitabine is the oral adjuvant standard (BILCAP). The model prices GC at about KRW 800,000 per cycle, GC plus durvalumab at about KRW 2,500,000 per cycle, and capecitabine at about KRW 300,000 per cycle.
The real chemotherapy cost is per-cycle fee multiplied by the number of cycles. All are covered by National Health Insurance and cancer special-case registration lowers the covered copay to 5 percent per cycle, though immunotherapy (durvalumab) coverage can depend on indication and timing, so confirm with the treating physician. Without special-case registration, outpatient chemotherapy at a tertiary hospital can carry a copay as high as 60 percent, which is why registering first matters so much.
Cancer special-case copay and resectability
Ordinary inpatient treatment uses a 20 percent NHI copay. Biliary tract cancer special-case registration (cancer code V193) reduces the covered copay to 5 percent for 5 years when registered within 30 days of diagnosis, but it never applies to the non-covered robotic surgery fee, upper-grade room charges, pain-control injections, or proton and carbon-ion therapy. Inpatient days beyond day 31 may use 10 percent rather than 5 percent. This is grounded in National Health Insurance Act Article 44 and Enforcement Decree Article 19 and annex 2.
Resectability and location drive the treatment path and cost. Resectable disease is operated first; borderline-resectable disease is prepared with biliary drainage or portal vein embolization to grow the future liver remnant, then extended resection; locally advanced or metastatic disease uses chemotherapy and palliative stenting. The resectability input is informational and does not change the fee, but it flags whether surgery alone is appropriate.
Robotic surgery, indemnity, and tax credit
Robotic bile duct or gallbladder surgery is mostly used for distal bile duct cancer (robotic Whipple) or radical cholecystectomy, and the robot fee is entirely self-pay. Because open resection remains the standard for biliary tract cancer and the survival or complication advantage of robotic surgery is not clearly established, the calculator shows a robot-versus-covered-surgery comparison so patients can weigh the extra cost. The robot fee can also face private indemnity disputes, where the insurer argues the covered open or laparoscopic surgery was medically sufficient.
The estimate separates covered procedure fee, covered ward fee, robotic fee, room surcharge, pain-control injection, caregiver cost, private indemnity reimbursement, and the Korean medical expense tax credit (3 percent of salary threshold, 15 percent credit rate, with no KRW 7,000,000 cap for cancer patients as severe-disease patients under Income Tax Act Article 59-4). The annual copay ceiling (about KRW 870,000 to KRW 8,430,000 by income decile in 2026) can refund excess covered copay, and public health center cancer cost support (up to KRW 3,000,000 per year) may apply.
How to read the result
Enter the treatment (extended cholecystectomy, liver plus bile duct resection, Whipple, biliary stent, chemotherapy, or robotic surgery), resectability, special-case registration, and either biliary drainage (for surgery) or the chemotherapy regimen and cycle count. The result shows covered and non-covered self-pay, the chemotherapy cycle accumulation, the robot-versus-covered surgery comparison, the special-case 5 percent versus 20 percent comparison, and the final cost after private indemnity and tax credit.
This is a cost-planning estimate based on 2026 Korean rules, not medical advice. Public single-price tables for biliary surgery do not exist, so surgery figures are defensible market-estimate ranges that vary with hospital, stage, extent of resection, complications, and drugs used. Confirm details with the treating multidisciplinary team, the insurer, and the hospital quote.
This calculator is based on Korean rules (2026 National Health Insurance cancer special-case program, Income Tax Act Article 59-4 medical expense tax credit, and market cost estimates for biliary tract cancer surgery, biliary drainage, and chemotherapy). Figures are planning estimates, not medical advice, an insurer decision, or a hospital quote.