Brain Tumor Surgery and Gamma Knife Cost Calculator
This calculator estimates the out-of-pocket cost of brain tumor treatment in Korea and keeps the same pure calculation model as the Korean page. A brain tumor is a neoplasm inside the skull: malignant primary brain cancer (glioblastoma and others, C71), benign tumors (meningioma, acoustic neuroma, pituitary adenoma), or metastatic tumors that spread from another cancer. The cost depends on the tumor type and the treatment chosen — open craniotomy resection, Gamma Knife stereotactic radiosurgery (SRS), or endoscopic transsphenoidal surgery — and can range from a few million to tens of millions of won. The most important rule is the cancer special case: not only malignant tumors but also benign meningioma (D32) and acoustic neuroma (D33) fall in the cancer special-case code range, so a registered patient pays 5% instead of 20% for five years. All figures use 2026 Korean rules.
Craniotomy vs Gamma Knife vs transsphenoidal surgery
Open craniotomy resection opens the skull and removes the tumor under a surgical microscope. It allows maximal resection and a tissue diagnosis, so it is the first choice for large or symptomatic tumors, but surgery takes five to six hours and the stay is 10 to 14 days with neuro-ICU observation. The model uses about KRW 10,000,000 covered for the procedure (a total covered bill of roughly KRW 15–25 million with the ward), and malignant craniotomy adds extra ICU and ward days for edema management.
Gamma Knife stereotactic radiosurgery (SRS) focuses radiation from many angles onto the lesion without any incision. It has been covered by Korean NHI since 2004, recovery is fast (same day to one night), and it is especially useful for small, deep, residual, recurrent, or multiple metastatic lesions. Endoscopic transsphenoidal surgery reaches a pituitary tumor through the nostrils without opening the skull, so the stay is only two to three days; it is co-managed by neurosurgery and otolaryngology with endocrine testing.
- Craniotomy: covered procedure ~KRW 10,000,000, ICU 2–3 days, ward 12–14 days.
- Gamma Knife (SRS): covered ~KRW 5,500,000, same-day to one night, covered since 2004.
- Transsphenoidal: covered ~KRW 7,000,000, 2–3 day stay, minimally invasive for pituitary tumors.
- Covered ward fee: KRW 600,000 per ICU day, KRW 150,000 per general ward day.
The cancer special case covers benign brain tumors too
The single biggest cost driver is the cancer (severe-disease) special case, registration code V193. Its eligible diagnosis codes include not only malignant neoplasms (C00–C97) but also benign neoplasms of the brain and central nervous system (D32–D33). So a benign meningioma (D32) or acoustic neuroma (D33) that many people assume is not eligible is in fact registrable, dropping the covered self-pay from 20% to 5%.
Unlike the cerebrovascular special case for a brain aneurysm, which lasts only 30 days, the cancer special case lasts five years from the confirmation date and can be re-registered if the tumor recurs or persists. If you register within 30 days of diagnosis, it applies retroactively to the confirmation date; later registration applies from the application date.
- Malignant (glioblastoma, C71) and metastatic tumors: 5% special-case self-pay for 5 years.
- Benign meningioma (D32) and acoustic neuroma (D33): benign but in the special-case code range, so 5%.
- Pituitary adenoma: 5% under D44.3 (uncertain behavior) coding, or 20% under D35.2 alone.
- Not registered: ordinary 20% inpatient self-pay applies.
Malignant, benign, and metastatic tumors
Glioblastoma is the most common malignant primary brain tumor. Standard care is maximal surgical resection followed by radiation plus temozolomide (the Stupp protocol); the calculator adds the concomitant chemoradiation phase as a covered add-on for malignant tumors, while the six-cycle maintenance phase and follow-up MRIs are separate. Note that the Gliadel wafer (carmustine implant) is excluded because it left the Korean market in 2009 and is no longer standard care.
Benign meningioma, acoustic neuroma, and pituitary adenoma can be cured by craniotomy or, for suitable lesions, Gamma Knife, and pituitary tumors are often removed by minimally invasive transsphenoidal surgery. Metastatic brain tumors — spread from lung, breast, or other cancers — are frequently treated with Gamma Knife because it can treat several lesions without an incision, and they inherit the primary cancer special-case 5%.
Out-of-pocket ceiling, private indemnity, and tax credit
The annual out-of-pocket ceiling refunds covered self-pay (including the 5% special-case amount) above the income-tier cap, which for 2026 is provisionally about KRW 900,000 to KRW 8,430,000 by income decile (finalized each August). Non-covered items, selective benefits, and upper-grade room surcharges are excluded from the ceiling, so they belong to the private indemnity (silson) domain, where covered self-pay is reimbursed after the generation-specific deductible and the room surcharge is usually paid at only 50%.
For the medical expense tax credit, a registered severe-disease patient has no KRW 7,000,000 cap under Income Tax Act Article 59-4 — the full out-of-pocket amount above 3% of salary is credited at 15%, while an unregistered patient keeps the KRW 7,000,000 cap. Private insurance reimbursement and the ceiling refund are excluded from the credit base, so the estimate is computed on the true net out-of-pocket amount.
How to read the result
Enter the tumor type (malignant, benign, pituitary, or metastatic), the treatment (craniotomy, Gamma Knife, or transsphenoidal), special-case registration, and — for malignant tumors — whether concomitant temozolomide chemoradiation is given, plus ICU and ward days, hospital level, indemnity generation, and income decile. The result shows the 20% versus 5% special-case comparison, a craniotomy-vs-Gamma-Knife-vs-transsphenoidal comparison, the ceiling refund, the private indemnity estimate, the tax credit, and the final net cost.
This is a cost-planning estimate based on 2026 Korean rules, not medical advice. Public single-price tables for brain tumor surgery and Gamma Knife do not exist, so figures are defensible market-estimate ranges that vary with tumor location, size, length of stay, complications, and hospital. Confirm details with the treating neurosurgery team, the insurer, and the hospital quote.
This calculator is based on Korean rules (2026 National Health Insurance cancer special-case program with benign meningioma and acoustic neuroma in the D32–D33 code range, Gamma Knife covered since 2004, the out-of-pocket ceiling, and Income Tax Act Article 59-4 medical expense tax credit), plus market cost estimates for craniotomy, Gamma Knife radiosurgery, and transsphenoidal surgery. Figures are planning estimates, not medical advice, an insurer decision, or a hospital quote.