Heart Pacemaker (Bradycardia) Procedure Cost Calculator
This calculator estimates the out-of-pocket cost of a permanent pacemaker for bradycardia (a slow heart rate) in Korea, and keeps the same pure calculation model as the Korean page for a single-chamber device (VVI/AAI), a dual-chamber device (DDD), a leadless device (Micra), a generator (battery) replacement, and a cardiac resynchronization pacemaker (CRT-P). Bradycardia from sick sinus syndrome or atrioventricular (AV) block that no longer responds to medication is treated with a permanent pacemaker, which is covered by Korean National Health Insurance and further reduced by the cardiac special-case program (code V192) on 2026 Korean rules.
Device types and covered fees
A dual-chamber pacemaker (DDD) places one lead in the atrium and one in the ventricle to restore natural AV synchrony, and it is the standard treatment for AV block and sick sinus syndrome. The model uses about KRW 1,800,000 for the procedure fee, KRW 4,500,000 for the covered pulse generator, and KRW 600,000 per lead (two leads), plus a covered ward fee of KRW 150,000 per day, so the covered total is roughly KRW 8,100,000 and the 5 percent special-case self-pay is about KRW 405,000.
A single-chamber pacemaker (VVI/AAI) uses one lead and is chosen when AV synchrony is not required, such as bradycardia with atrial fibrillation; its covered generator is smaller (about KRW 2,200,000). A generator (battery) replacement reuses the existing leads and changes only the pulse generator, so the lead cost is zero and the stay is usually one day. A CRT-P uses three leads and is for heart failure (not bradycardia alone), so its generator and total are higher.
- Covered lead material is KRW 600,000 per lead; leadless and replacement use zero leads.
- Covered ward fee is KRW 150,000 per inpatient day.
- The pulse generator (device) material cost is the largest part of the covered total.
- CRT-P (three leads) is a heart-failure indication, shown for reference, not bradycardia alone.
Leadless pacemaker (Micra) is a 50 percent selective benefit
A leadless pacemaker sits directly inside the heart with no lead wire, so it avoids lead complications (dislodgement, venous occlusion) and leaves no chest scar. It became covered in December 2024. For high-risk patients it is an essential benefit at a 5 percent copay, but for everyone else it is a selective benefit at a 50 percent copay, and because the device costs about KRW 7,000,000, the self-pay can exceed KRW 3,500,000, far above a dual-chamber covered device.
The three high-risk criteria are: transvenous lead placement is impossible or has failed (venous stenosis/occlusion, congenital anomaly), a history of cardiac implantable electronic device (CIED) infection, and hemodialysis through an arteriovenous fistula. Leadless devices also only provide single-chamber (VVI) pacing, so they may not suit bradycardia that needs AV synchrony. The calculator shows the leadless (50 percent selective) versus dual-chamber (5 percent covered) self-pay side by side.
Cardiac special-case copay (V192) and the 30-day limit
The Ministry of Health and Welfare notice on special copay calculation lists “pacemaker implantation (Simbakgi-geochisul)” in the cardiac-disease special-case surgery list, so a permanent pacemaker qualifies for special case V192 and the covered copay drops from the ordinary inpatient 20 percent to 5 percent. Unlike the cancer special case (5 years), the cardiac special case applies for at most 30 days from the surgery date, and cardiac/cerebrovascular special cases apply automatically through the hospital claim with no separate registration.
The 5 percent applies only to covered items. Upper-grade room surcharges and other non-covered items are always fully self-paid, and the leadless selective-benefit 50 percent does not drop to 5 percent (only the high-risk essential benefit is 5 percent). Combined with the annual out-of-pocket ceiling, the special case makes even a high-cost implant affordable.
Battery replacement, ceiling, indemnity, and tax credit
A pacemaker battery lasts about 7 to 10 years for conventional devices (5 to 12 years by model and use) and about 15 to 16 years for the Micra2 leadless device released in 2026. When it runs out, a generator replacement reuses the leads and changes only the generator, usually with a one-day stay, and the replacement surgery re-qualifies for the 30-day special case. The calculator projects the expected battery life and the estimated replacement self-pay.
The 2026 annual out-of-pocket ceiling ranges from about KRW 900,000 (income decile 1) to KRW 8,430,000 (decile 10) and refunds covered self-pay above the cap, usually the following August. Pacemaker implantation is reimbursed as inpatient medical expense by private indemnity insurance (the ceiling-refunded amount is not double-paid, and upper-grade room surcharges are usually reimbursed only up to 50 percent). The Korean medical expense tax credit (Income Tax Act Article 59-4) refunds 15 percent of expense above 3 percent of salary, on the self-pay remaining after indemnity and ceiling refunds.
How to read the result
Enter the device type (single-chamber, dual-chamber, leadless, generator replacement, or CRT-P), the bradycardia indication, whether leadless is high-risk, the special-case status, stay days, hospital level, insurance type, income decile, private indemnity generation, and salary. The result shows covered and non-covered self-pay, the special-case 5 percent versus 20 percent comparison, the leadless versus dual-chamber comparison, the battery replacement projection, the ceiling refund, and the final cost after indemnity and tax credit.
This is a cost-planning estimate based on 2026 Korean rules, not medical advice. Public single-price tables for pacemaker surgery do not exist, so device and total figures are defensible market-estimate ranges that vary with hospital, device brand, lead count, and patient condition. Confirm details with the treating cardiologist, the insurer, and the hospital quote.
This calculator is based on Korean rules (2026 National Health Insurance covered fees, the cardiac special case V192 at 5 percent for 30 days, the leadless selective benefit at 50 percent, the annual out-of-pocket ceiling, and Income Tax Act Article 59-4 medical expense tax credit). Figures are planning estimates, not medical advice, an insurer decision, or a hospital quote.