Stroke is a catastrophic disease with a significant economic burden, particularly for neurointervention procedures such as mechanical thrombectomy and coiling. A disparity exists between standard costs and actual billing charges for these procedures at Dr. Mohammad Hoesin Hospital Palembang. This study aimed to analyze the factors influencing hospitalization costs of stroke patients undergoing mechanical thrombectomy or coiling. This was an analytical cross-sectional study with retrospective data collection from medical records of stroke patients who underwent mechanical thrombectomy or coiling at Dr. Mohammad Hoesin Hospital Palembang from January 2024 to September 2025. The study included 32 patients who underwent mechanical thrombectomy and 67 who underwent coiling. Sampling technique used was total sampling. Bivariate and multivariate analyses were performed to identify factors influencing hospitalization costs. The mean actual hospitalization cost for mechanical thrombectomy was IDR 97,679,947 ± 80,403,149, while for coiling it was IDR 119,286,035 ± 77,330,119 (approximately 20% higher). In the mechanical thrombectomy group, multivariate analysis revealed length of stay as the only significant independent factor influencing hospitalization costs (p<0.05). Meanwhile, in the coiling group, four significant independent factors were identified: complications, aggravating factors, NIHSS score, and number of coils (p<0.05). The factors influencing hospitalization costs differ between mechanical thrombectomy and coiling. For mechanical thrombectomy, length of stay is the dominant factor, whereas for coiling, clinical severity (complications, aggravating factors, NIHSS score) and procedural complexity (number of coils) are the main cost determinants.