Cardiac surgery and interventional cardiology: what the state covers in 2026 and when patients go abroad

What do cardiac surgery and interventional cardiology include?

Cardiac surgery covers open operations on the heart and great vessels: coronary bypass, which creates a new route for blood around a blocked artery, valve repair or replacement, aortic surgery and correction of congenital heart defects. Interventional cardiology deals with some of the same problems by catheter, through a small skin puncture: coronary angiography, stenting, and closure of certain defects with an occluder. Electrophysiology covers rhythm management devices, such as pacemakers and defibrillators.

Which method suits a particular patient is decided jointly by the cardiologist and the cardiac surgeon, often at a multidisciplinary meeting. This guide does not recommend any method: it explains who funds what, what is left for the family and how to prepare if treatment abroad is planned. If you have doubts about your doctor's recommendation, ask for an independent assessment as described in the second opinion guide.

Emergency and planned procedures: what does Universal Healthcare cover?

Emergency cases

Acute myocardial infarction and unstable angina with haemodynamic instability are listed among the critical conditions in the Universal Healthcare emergency care annex, and the management of critical conditions is funded with no co-payment in all main categories. For other emergency hospitalisations, the category's co-payment applies. In such cases the family does not need to apply: the clinic notifies the Agency of the case itself and asks you only for identity details.

Planned operations

Planned bypass, valve surgery or planned stenting is funded under the Universal Healthcare planned surgery component, which has an annual limit of GEL 15,000. In the standard package the co-payment is 30% of the reimbursable amount, but no more than GEL 1,500; in protected groups it is 20%, up to GEL 1,000, and for pensioners 10%, up to GEL 500. The exceptions concern children: in the standard package, cardiac surgery and related tests for patients under 18 carry no co-payment, and in the protected group the same rule applies to children aged 0-5 and children with disabilities. Veterans of pension age and veterans with a severe disability status are not subject to a co-payment.

When planning, bear two things in mind. First, a planned operation needs an approval letter issued by the National Health Agency, so the clinic must submit the application in good time. Second, the GEL 15,000 limit is annual, and other planned operations in the same year count towards it. Details and how to obtain the letter are in the guide to Universal Healthcare.

Defibrillators

Under Annex 1.8 to Resolution No. 36, the National Health Agency buys single-chamber and dual-chamber implantable cardioverter-defibrillators and cardiac resynchronisation defibrillators centrally and hands them to clinics free of charge, and no patient co-payment is provided for on this device. If your doctor has prescribed such a device, ask the clinic whether it is available under this rule.

Congenital heart defects: how is surgery funded at any age?

Surgical and catheter treatment of congenital heart defects is governed by a separate Universal Healthcare annex, Annex 1.11, updated by Government Resolution No. 196 of 15 May 2026. The beneficiaries are citizens of Georgia with a congenital heart defect and other persons defined by the programme, with no age limit, which means the annex also applies to an adult patient who needs the defect corrected later in life.

• Tariffs by category. Surgical procedures are divided into six categories, from GEL 10,176 to GEL 59,884, and catheter procedures into separate categories, from GEL 2,265 to GEL 18,529. The clinic determines which category a particular operation falls into.
• Share reimbursed. The programme covers 70% of the actual cost, but no more than the category's tariff.
• No co-payment. Patients under 18, beneficiaries in the group of socially vulnerable people and those treated as equivalent, veterans of pension age and veterans with a severe disability status.
• Reduced co-payment. Adult beneficiaries in a protected group have 80% of the cost funded, and people of pension age 90%.

This annex is an exception to the general DRG rule for inpatient care and works with its own tariffs. In addition, the resolution requires providers to submit outcome indicators, and from 1 March 2028 only facilities that meet the indicator requirements will provide this service. For the family, this means that when choosing a clinic it is worth asking whether it keeps records of its outcomes.

When is a child's heart surgery abroad funded?

If the cardiac surgery method a child's defect requires is not performed in Georgia, the 2026 Referral Services Programme provides for treatment abroad for patients under 18 under the terms of the "Paediatric Cardiac Surgery Convention". The beneficiary is determined by the referral commission in a decision recorded in its minutes, and the foreign provider and funding terms are set by the convention itself. A child covered by the relevant Tbilisi municipal programme is excluded from this component.

For a parent, the most important document is the report of the paediatric cardiologist or cardiac surgeon explaining why the operation cannot be done in Georgia. Added to this are the echocardiography recordings and reports, CT scans or catheterisation data where needed, the child's birth certificate and the parent's identity document. All state channels for children's treatment are described together in the guide to children's treatment, and the question of the other parent's consent when a child travels with one parent is covered on the power of attorney page.

Funding sources in one table

The table is based on the consolidated text of Resolution No. 36 as of 18 September 2026 and the 2026 state programmes. Actual funding in each case is set by a decision of the agency or the commission.

Where do gaps appear and how can they be covered?

After heart surgery, families are most often left with something to pay for three reasons. The first is the co-payment, which in the standard package can be up to GEL 1,500. The second is the annual limit running out, when several procedures are done in one year or the cost of a complex operation exceeds GEL 15,000. The third is costs not included in the programme case, for example long-term medicines after the operation or rehabilitation.

For the co-payment and the part above the limit, people apply to City Hall and the referral commission in parallel. Both ask for written information from the clinic on how much Universal Healthcare funded and how much remains for the patient, so get this document before the operation. Some medicines for chronic cardiovascular diseases are covered for certain groups by a separate Universal Healthcare annex, as described in the guide to funding for medicines.

Advocat.Ge lawyers prepare applications, handle correspondence with City Hall and, in the event of a refusal, the appeal, as part of our funding search service.

Adult heart surgery abroad: when, and what does the clinic need?

Adult patients mainly consider going abroad when they need a repeat operation, a very complex combined procedure or a technique that a particular centre performs more often, and also to get a second opinion. Our country guides list heart surgery as a common reason for travel to Germany, Israel, Italy, France and India; each covers the visa, payment and how to check the clinic.

What a cardiac surgery centre asks for a preliminary assessment

• the echocardiography report and, if possible, the recording;
• the coronary angiography or other catheter study recording in digital format (DICOM) and the report, because the surgeon reviews the images personally;
• an electrocardiogram, recent laboratory test results and, where needed, a CT scan;
• the cardiologist's report, Form 100 and a full list of current medicines with doses;
• reports of previous operations or stenting, with details of the implanted stent, valve or device.

Based on this material, the clinic draws up a preliminary plan and cost estimate. If the patient's condition does not allow an ordinary flight, the airline will ask for medical clearance, and in some cases a medical escort is needed; this is covered by our ICU ambulance team service. Whether and when the patient can fly is assessed by the treating cardiologist.

Documents, translation and after your return

1. Collect the original records

   Imaging discs and reports, discharge summaries and Form 100 with the ICD-10 code. How to get your full medical history from a clinic is explained in a separate guide.

2. Translate what the clinic will read

   A foreign centre needs a translation into English or its own language; for the commission, the foreign cost estimate must be translated into Georgian and notarised.

3. Plan your medicines

   Long-term medicines are often prescribed after the operation. Prepare a supply and a translation of the prescription in advance; the rules are in the guide to travelling with medicines.

4. Translate the discharge summary when you return

   For follow-up, your Georgian cardiologist needs the operation report, the discharge summary and the details of the implanted valve or stent in Georgian.

We translate imaging reports through our imaging report translation service, discharge summaries under our discharge summary translation procedure, and we prepare the documents needed for a medical visa through our medical visa service.

Frequently asked questions about funding for cardiac surgery