Objectives To compare the direct costs of the index hospitalization and 30-day morbidity and mortality incurred during robotic and conventional coronary artery bypass grafting at a single institution based on hospital clinical and financial records. Design Retrospective study, propensity-matched groups with one-to-one nearest neighbor matching. Setting University hospital, a tertiary care center. Participants Two thousand eighty-eight consecutive patients who underwent primary coronary artery bypass grafting (CABG) from January 2007 to March 2012. Interventions One hundred forty-one matched pairs were created and analyzed. Measurements and Main Results Robotic CABG was associated with a decrease in operative time (5.61±1.1 v 6.6±1.15 hours, p<0.001), a lower need for blood transfusion (12.8% v 22.6%, p = 0.04), a shorter length of stay (6 4-9) v 7 5-11 days, p = 0.001), a shorter ICU stay (31 24-49 hours v 52 32-96.5 hours, p<0.001) and lower NY state complications composite rate (4.26% v 13.48%, p = 0.01). In spite of that, the cost of robotic procedures was not significantly different from matched conventional cases ($18,717.35 11,316.1-34,550.6 versus $18,601 13,137-50,194.75, p = 0.13), except 26 hybrid coronary revascularizations in which angioplasty was performed on the same admission (hybrid 25,311.1 18,537.1-41,167.85 versus conventional 18,966.13 13,337.75-56,021.75, p = 0.02). Conclusion Robotically assisted CABG does not increase the cost of the index hospitalization when compared to conventional CABG unless hybrid revascularization is performed on the same admission.