Tympanoplasty and Middle Ear Surgery Cost Planner Korea
Organize a Korean myringoplasty, tympanoplasty, mastoidectomy, or ossiculoplasty quote into covered patient payment, full patient payment, non-covered care, follow-up, insurance, and household funding.
Health cost scenario inputs
Enter Korea-related chronic care, eldercare, therapy, procedure, fertility, diagnostic, or medical tourism assumptions. Results are simplified planning estimates.
Insurance or support amount
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Estimated self-pay with reserve
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Monthly reserve target
₩0
6 month plan
This English page is a compact household-funding scenario backed by a deep South Korea-specific myringoplasty, tympanoplasty, mastoidectomy, and ossiculoplasty cost guide. The exact Korean calculator distinguishes a hospital-confirmed covered patient quote from a covered total before copay so a rate is not applied twice. It separately tracks covered patient payment, full patient payment or selective benefit, non-covered care, preoperative tests, follow-up, medicines and dressings, confirmed insurance payment, travel and lodging, income interruption, contingency, and 3-, 6-, and 12-month funding targets. It does not invent a nationwide average, double a unilateral quote for bilateral surgery, infer private-indemnity payment, or determine coverage. Ordinary NHI cost sharing was checked against National Health Insurance Act Article 44 effective January 2, 2026, Enforcement Decree Article 19 and Annex 2 effective February 19, 2026: general inpatient care is 20 percent for age 16 and older and 5 percent for age 15 and younger, while outpatient rates vary by provider level and location. Current billing anchors include S5651 and S5652 for myringoplasty, S5640 and S5641 for tympanoplasty, S5671 through S5674 for mastoidectomy categories, and S5791 and S5792 for ossiculoplasty, verified against MOHW Notice 2026-141 effective July 1, 2026 and HIRA KDRG Version 1.5. Medical Service Act Article 45 supplies the non-covered fee disclosure context. This is budget planning, not diagnosis, treatment advice, a hospital quote, an NHIS or insurer decision, or a reimbursement guarantee. Verified July 29, 2026.
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What this Korea tympanoplasty cost planner does
Tympanoplasty and related middle ear operations do not have one reliable nationwide patient price in South Korea.
A provider quote can change with the disease extent, operative approach, one-ear or two-ear plan, mastoid work, ossicular reconstruction, anesthesia, admission, room choice, tests, materials, and National Health Insurance treatment of each billed item.
A public procedure code is useful for reading an itemized bill, but it is not the price of the entire surgical episode.
The exact Korean calculator therefore starts from a hospital-confirmed patient quote or a covered total before copay instead of inventing an average.
It separates covered patient payment, full patient payment or selective-benefit amounts, non-covered charges, preoperative care, follow-up, medicines and dressings, confirmed insurance payment, travel and lodging, income interruption, contingency, and the monthly funding target.
The compact English scenario above takes the final combined patient-and-household quote, subtracts only confirmed insurance or support, adds the chosen contingency rate, and divides the result by the funding months.
Zero is a blank planning value, not a free procedure
The editable defaults are zero because this page does not substitute a made-up national average for your provider quote.
Ask the hospital for the expected patient amount and an itemized estimate, then enter only figures that you can identify.
This is budget planning, not medical advice, a coverage decision, an insurer promise, or a hospital quotation.
Myringoplasty, tympanoplasty, mastoidectomy, and ossiculoplasty are different scopes
A simple label such as “ear surgery” can hide materially different operative plans.
The Korean Disease Control and Prevention Agency describes chronic middle ear disease in the context of tympanic membrane perforation, ossicular damage, adhesive disease, suppurative disease, and cholesteatoma.
Korean otolaryngology references also describe preoperative hearing assessment and temporal-bone imaging when clinically indicated, with the operative extent determined by the individual condition.
Korean middle ear surgery pathways, billing-code anchors, and quote questions| Pathway | Code anchors | What to verify in the quote |
|---|
| Myringoplasty | S5651 · S5652 | Perforation repair, endoscopic approach, anesthesia, and admission scope |
| Tympanoplasty | S5640 · S5641 | Middle ear disease removal, membrane reconstruction, and approach |
| Mastoidectomy component | S5671–S5674 | Mastoid extent, cavity method, and multiple-procedure billing |
| Ossiculoplasty component | S5791 · S5792 | Reconstruction method, material, and separately charged items |
These anchors appear in the January 2026 HIRA KDRG Version 1.5 publication and relate to the current Korean health-insurance procedure list.
They do not determine your diagnosis, surgical need, benefit eligibility, complete claim code set, or final charge.
Do not double a unilateral amount automatically
Bilateral or multiple procedures can share admission and anesthesia resources and can be subject to specific multiple-procedure billing rules.
Use the provider’s complete bilateral or combined-operation quote rather than multiplying a one-ear number by two.
Read the Korean bill in separate cost buckets
A Korean receipt or detailed calculation statement may distinguish benefit patient payment, full patient payment, and non-covered charges.
Keeping those columns separate matters because the annual National Health Insurance out-of-pocket ceiling and private indemnity treatment do not necessarily apply to every bucket in the same way.
Covered patient payment
This is the patient share of covered care after the relevant cost-sharing rule is applied.
If the hospital already gives this patient amount, do not multiply it by 20 percent again.
Full patient payment or selective benefit
A charge inside the insurance framework may still be assigned fully or at a distinct selective-benefit share to the patient.
Enter the amount identified by the provider instead of assuming it is ordinary non-covered care.
Non-covered care
Examples can include a room upgrade, a selected material, or another provider-disclosed item, depending on the case.
Medical Service Act Article 45 requires disclosure of non-covered fees, so use the hospital notice and quote rather than an online anecdote.
Preoperative, follow-up, and household costs
Add the patient amounts for planned consultations, hearing tests, imaging, medicines, dressings, and follow-up.
Track transport, parking, lodging, and verified patient or caregiver income interruption outside the medical subtotal.
Two quote modes prevent double application of a copay rate
Comparison of patient quote and covered total input modes| Mode | Use it when | Covered patient amount |
|---|
| Patient quote | The hospital has stated what the patient pays for the covered portion | Use the entered amount unchanged |
| Covered total | Only the covered amount before patient cost sharing is available | Apply the applicable ordinary rate or a provider-confirmed manual rate |
How the compact English scenario relates to the exact Korean calculator
The English input labeled patient medical and household quote is the combined base after you have organized the covered patient payment, full patient payment, non-covered care, preoperative and follow-up care, medicines, travel, lodging, and income interruption.
The insurance or support field is capped by the gross quote in the compact calculation.
The contingency percentage is added after confirmed support, and the final amount is divided by the selected funding months.
For item-by-item Korean billing analysis, use the dedicated Korean interface on this calculator’s primary route.
Ordinary 2026 Korean National Health Insurance cost sharing
National Health Insurance Act Article 44, Enforcement Decree Article 19 and Annex 2, and the NHIS patient-cost guide provide the general framework used in the covered-total mode.
These are ordinary rates, not a guarantee for every item or every patient category.
Ordinary South Korean inpatient and outpatient National Health Insurance patient shares in 2026| Setting | Patient group or location | Ordinary share | Planner treatment |
|---|
| Inpatient | Age 16 and older | 20% | Applies to the ordinary covered total only |
| Inpatient | Age 15 and younger | 5% | F018 identifier, with item-specific exceptions possible |
| Clinic outpatient | Ordinary case | 30% | Useful only for an eligible covered outpatient total |
| Hospital outpatient | Rural township / urban area | 35% / 40% | Select by provider location |
| General hospital outpatient | Rural township / urban area | 45% / 50% | Select by provider location |
| Tertiary outpatient | Ordinary case | Consultation in full + 60% of the remainder | Separate consultation within the covered total |
When not to use the ordinary table
Medical Aid, lower-income support, registered special cases, infant outpatient care, pregnancy-related rules, meals, selected benefits, premium rooms, specific devices, and individual reductions can follow other rules.
When the hospital has already confirmed the patient quote or a different rate, use that evidence instead of forcing an ordinary percentage.
Worked example for the exact calculation model
The following numbers are hypothetical inputs used to explain the arithmetic, not Korean average prices or a recommended budget.
Assume an adult inpatient covered total of KRW 4,000,000, which gives an ordinary covered patient payment of KRW 800,000 at 20 percent.
Hypothetical tympanoplasty household cost example in Korean won| Stage | Arithmetic | Result |
|---|
| Covered patient payment | KRW 4,000,000 × 20% | KRW 800,000 |
| Direct medical cost | Covered 800,000 + full-pay 100,000 + non-covered 500,000 + pre-op 150,000 + follow-up 120,000 + medicines 80,000 | KRW 1,750,000 |
| After confirmed insurance | KRW 1,750,000 − KRW 500,000 | KRW 1,250,000 |
| Household base | Medical 1,250,000 + travel 100,000 + income interruption 800,000 | KRW 2,150,000 |
| Contingency | KRW 2,150,000 × 10% | KRW 215,000 |
| Net household burden | KRW 2,150,000 + KRW 215,000 | KRW 2,365,000 |
| Six-month target | KRW 2,365,000 ÷ 6, rounded up | KRW 394,167 per month |
Child inpatient comparison
Applying the ordinary 5 percent inpatient share for a patient age 15 or younger to the same covered total gives KRW 200,000.
The KRW 600,000 difference from the adult example concerns only that covered subtotal, not the complete hospital and household cost.
Tertiary outpatient comparison
If KRW 50,000 of a KRW 4,000,000 covered outpatient total is the consultation fee, the general formula gives KRW 50,000 plus 60 percent of KRW 3,950,000, or KRW 2,420,000.
Do not apply this outpatient illustration to an inpatient operation.
Step-by-step planning workflow
- Identify the proposed scope. Record whether the discussion concerns myringoplasty, tympanoplasty, a mastoidectomy component, an ossiculoplasty component, another combination, one ear, or both ears
- Ask what the quoted number means. Confirm whether it is the covered total before patient cost sharing or the covered amount already payable by the patient
- Separate the bill columns. Keep ordinary covered patient payment, full patient payment or selective benefit, and non-covered charges distinct
- Add care around the admission. Include provider-confirmed preoperative visits and tests, follow-up, procedures, medicines, and dressings for the chosen planning window
- Subtract confirmed support only. Do not infer a private indemnity payment solely from policy generation or membership status
- Add household cash-flow effects. Include travel, parking, lodging, and documented patient or caregiver income interruption
- Choose contingency and funding months. Compare the final burden over three, six, or twelve months without treating the funding period as a clinical recovery forecast
Practical use cases
Compare two Korean hospital estimates
Hospital A may report a patient-pay figure while Hospital B reports a covered gross figure.
Normalize the quote basis first, then compare included surgery, testing, room, material, and non-covered scope.
Plan when cholesteatoma may change the extent
Imaging and intraoperative findings can affect the operation described by the clinical team.
Record the provider’s stated range and potential additions, then use a transparent contingency instead of an invented automatic price.
Avoid underbudgeting for a child
The ordinary inpatient covered share may be 5 percent for a patient age 15 or younger.
Non-covered care, room choices, caregiver lodging, travel, and income interruption do not all become 5 percent.
Compare cash flow before and after insurance
Private indemnity depends on the contract, enrollment date, deductible, exclusions, limits, documents, and claim review.
Keep support at zero until a usable amount is confirmed, or compare a no-payment case with the insurer-confirmed case.
Questions for the hospital and insurer
Hospital billing and clinical team
- Is this number a covered gross total or a covered patient-pay quote
- Which operation components and ear sides are included
- How are multiple or bilateral procedures treated in the estimate
- Which amounts are full patient payment, selective benefit, or non-covered
- Are anesthesia, admission, room, tests, materials, and discharge medicines included
- What preoperative and follow-up patient costs are expected
Private insurer and NHIS
- Does the stated operation and code fall within the policy wording
- What inpatient, outpatient, and non-covered deductibles or limits apply
- Which certificate, operation record, receipt, and itemized statement are needed
- What payment amount is currently confirmed and how long can review take
- Which covered patient payments are eligible for the annual NHIS ceiling
- How a later NHIS refund interacts with private indemnity settlement
Tips, limits, and safety
- Match calculator buckets to the benefit patient payment, full patient payment, and non-covered columns on the Korean statement
- Do not let confirmed insurance support exceed the direct amount it can actually reimburse
- Record the quote date and hospital contact because the operative plan and estimate can change
- Do not treat the funding months as an estimate of hospital stay, healing time, hearing outcome, or time away from work
- Use the annual out-of-pocket ceiling only after checking eligible covered amounts and exclusions with NHIS
- Prioritize clinical assessment over budgeting for an abrupt hearing change, severe pain or vertigo, high fever, facial weakness, or another concerning acute change
This planner cannot choose an operation
It does not diagnose tympanic membrane perforation, chronic otitis media, cholesteatoma, ossicular injury, or hearing loss.
It does not recommend myringoplasty, tympanoplasty, mastoidectomy, ossiculoplasty, an endoscopic approach, a bilateral plan, or any other treatment.
It does not predict operative success, hearing improvement, complications, recurrence, admission length, or recovery time.
Discuss the clinical plan with the treating otolaryngology team.
Frequently asked questions
Can this page tell me the average Korean tympanoplasty price?
No.
A procedure-code amount does not include the whole episode, and actual patient charges depend on scope, combined operations, admission, materials, and coverage treatment.
Use a provider-confirmed patient quote or covered total.
Should I multiply a patient quote by 20 percent?
No, if the quote already states the covered amount payable by the patient.
Apply an ordinary rate only when the number is explicitly the covered total before patient cost sharing.
Does the 5 percent child inpatient rate apply to the whole family budget?
No.
It is the ordinary share for eligible covered inpatient care for a patient age 15 or younger.
It does not make all non-covered items, room charges, caregiver lodging, travel, or income interruption equal to 5 percent.
Is full patient payment the same as non-covered care?
Not necessarily.
Korean billing statements can distinguish a full patient-payment amount inside the benefit framework from a non-covered amount.
Preserve the provider’s classification when entering the exact Korean calculator.
Why is a two-ear choice not doubled automatically?
Bilateral and multiple-procedure billing can include shared costs and specific calculation rules.
Enter the provider’s complete quote for the actual combined plan.
Does the planner estimate private indemnity insurance?
No.
Reimbursement depends on the contract, enrollment date, deductibles, exclusions, limits, documents, and claim review.
Enter only an amount confirmed by the insurer, or leave support at zero.
Why is an expected NHIS ceiling refund not deducted automatically?
Eligibility depends on annual accumulated covered patient payments, the individual ceiling tier, and excluded amounts.
Non-covered charges are not all reimbursed by the ceiling.
Use an amount only after confirmation from NHIS.
Sources and verification date
The cost-sharing context was verified on July 29, 2026 against National Health Insurance Act Article 44 effective January 2, 2026, Enforcement Decree Article 19 and Annex 2 effective February 19, 2026, and the NHIS benefit scope and patient-cost guide.
The current procedure-list context was checked against MOHW Notice 2026-141 effective July 1, 2026 and HIRA KDRG Version 1.5 published in January 2026.
Non-covered disclosure context was checked against Medical Service Act Article 45 in the current version effective April 7, 2026.
Clinical scope descriptions use KDCA otitis media information, Korean Society of Otorhinolaryngology material, Asan Medical Center tympanoplasty information, and Seoul National University Hospital cholesteatoma information.
Turn the hospital estimate into a household funding plan
Confirm whether the quote is a covered gross total or a patient-pay amount, preserve each billing bucket, and add care around the admission and household cash-flow effects.
Save the result with the quote date and revisit it after the hospital or insurer clarifies any missing item.