OBJECTIVES: This study quantified the total direct healthcare costs of aortic and mitral valvular disease to insurers and patients, stratified by asymptomatic and symptomatic disease status. METHODS: Using 1996-2011 data from the Medical Expenditure Panel Survey (MEPS), a large, nationally-representative database from the US, this study performed descriptive analyses of the total annual healthcare costs to insurers and patients for aortic and mitral valve disease. The healthcare costs were reported at the individual and US aggregate levels. Individuals with aortic and mitral valve disease were identified by International Classification of Disease Codes, 9^threvision and stratified as either symptomatic or asymptomatic based on the presence of comorbid conditions. RESULTS: The MEPS database included 148 patients with aortic disease and 1,057 with mitral valve disease. Asymptomatic patients comprised 64% and 70% of the population for aortic disease and mitral valve disease, respectively. Symptomatic aortic disease patients incurred higher overall annual healthcare direct costs per patient compared to asymptomatic patients ($30,146 vs. $16,065). Symptomatic mitral valve disease patients incurred greater annual healthcare costs per patient compared to asymptomatic patients ($14,054 vs. $7,198). Because these were direct costs, the majority of the healthcare expenditures were borne by the insurer (range 79% to 90% based on type of disease and symptom status) rather than the patient. When aggregated to the US population, the overall annual direct cost was $4.5 billion and $10 billion for aortic disease and mitral valve disease, respectively. Approximately 75% and 52% of the total annual direct cost was attributed to symptomatic aortic valve and mitral valve disease patients, respectively. CONCLUSIONS: These findings indicate that the total direct healthcare costs of valvular disease are quite large. Symptomatic patients incur disproportionately greater healthcare costs, possibly due to costly surgical interventions required to treat their valvular disease.