MBS Category 3
Therapeutic procedures: MBS items and fees.
All 3,409 items in Category 3, with each item’s schedule fee and Medicare benefits, from the MBS edition of 1 November 2026.
Source: the MBS XML file of 1 November 2026, published by the Department of Health, Disability and Ageing. We update these pages for each MBS edition.
T1 Miscellaneous Therapeutic Procedures
109 items
| Item | Description | Fee and benefits |
|---|---|---|
| 13015 | Hyperbaric oxygen therapy, for treatment of localised non‑neurological soft tissue radiation injuries excluding radiation‑induced soft tissue lymphoedema of the arm after treatment for breast cancer, performed in a comprehensive hyperbaric medicine facility under the supervision of a medical practitioner qualified in hyperbaric medicine, for a period in the hyperbaric chamber of at least 1 hour 30 minutes and not more than 3 hours, including any associated attendance (H) | $304.95 75% benefit $228.75 |
| 13020 | Hyperbaric oxygen therapy, for treatment of decompression illness, gas gangrene, air or gas embolism, diabetic wounds (including diabetic gangrene and diabetic foot ulcers) or necrotising soft tissue infections (including necrotising fasciitis or Fournier’s gangrene), or for the prevention and treatment of osteoradionecrosis, performed in a comprehensive hyperbaric medicine facility, under the supervision of a medical practitioner qualified in hyperbaric medicine, for a period in the hyperbaric chamber of at least 1 hour 30 minutes and not more than 3 hours, including any associated attendance (H) | $309.80 75% benefit $232.35 |
| 13025 | Hyperbaric oxygen therapy, for treatment of decompression illness, air or gas embolism, performed in a comprehensive hyperbaric medicine facility, under the supervision of a medical practitioner qualified in hyperbaric medicine, for a period in the hyperbaric chamber greater than 3 hours, including any associated attendance—per hour (or part of an hour) (H) | $138.45 75% benefit $103.85 |
| 13030 | Hyperbaric oxygen therapy performed in a comprehensive hyperbaric medicine facility, if the medical practitioner is pressurised in the hyperbaric chamber for the purpose of providing continuous life‑saving emergency treatment, including any associated attendance—per hour (or part of an hour) (H) | $195.55 75% benefit $146.70 |
| 13100 | Supervision in hospital by a medical specialist of—haemodialysis, haemofiltration, haemoperfusion or peritoneal dialysis, including all professional attendances, if the total attendance time on the patient by the supervising medical specialist exceeds 45 minutes in one day (H) | $163.60 75% benefit $122.70 |
| 13103 | Supervision in hospital by a medical specialist of—haemodialysis, haemofiltration, haemoperfusion or peritoneal dialysis, including all professional attendances, if the total attendance time on the patient by the supervising medical specialist does not exceed 45 minutes in one day (H) | $85.25 75% benefit $63.95 |
| 13104 | Planning and management of home dialysis (either haemodialysis or peritoneal dialysis), by a consultant physician in the practice of his or her specialty of renal medicine, for a patient with end-stage renal disease, and supervision of that patient on self-administered dialysis, to a maximum of 12 claims per year | $177.05 85% benefit $150.50 |
| 13105 | Haemodialysis for a patient with end‑stage renal disease if: (a) the service is provided by a registered nurse, an Aboriginal and Torres Strait Islander health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner; and (b) the service is supervised by the medical practitioner (either in person or remotely); and (c) the patient’s care is managed by a nephrologist; and (d) the patient is treated or reviewed by the nephrologist every 3 to 6 months (either in person or remotely); and (e) the patient is not an admitted patient of a hospital; and (f) the service is provided in a Modified Monash 7 area | $708.55 100% benefit $708.55 |
| 13106 | DECLOTTING OF AN ARTERIOVENOUS SHUNT | $145.20 75% benefit $108.90 85% benefit $123.45 |
| 13109 | INDWELLING PERITONEAL CATHETER (Tenckhoff or similar) FOR DIALYSIS INSERTION AND FIXATION OF (Anaes.) | $272.55 75% benefit $204.45 85% benefit $231.70 |
| 13110 | INDWELLING PERITONEAL CATHETER (Tenckhoff or similar) FOR DIALYSIS , removal of (including catheter cuffs) (Anaes.) | $273.50 75% benefit $205.15 85% benefit $232.50 |
| 13200 | New 85% benefit on 1 November 2026Assisted reproductive technologies superovulated treatment cycle proceeding to oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13201, 13202, 13203 or 13218 applies, being services rendered during one treatment cycle—initial cycle in a single calendar year | $3,723.25 75% benefit $2,792.45 85% benefit $3,614.75 was $3,618.75 |
| 13201 | New 85% benefit on 1 November 2026Assisted reproductive technologies superovulated treatment cycle proceeding to oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13200, 13202, 13203 or 13218 applies, being services rendered during one treatment cycle—each cycle after the first in a single calendar year | $3,482.70 75% benefit $2,612.05 85% benefit $3,374.20 was $3,378.20 |
| 13202 | Assisted reproductive technologies superovulated treatment cycle that is cancelled before oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones and ultrasound examinations, but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13200, 13201, 13203 or 13218 applies, being services rendered during one treatment cycle | $557.20 75% benefit $417.90 85% benefit $473.65 |
| 13203 | Ovulation monitoring services for artificial insemination or gonadotrophin, stimulated ovulation induction, including quantitative estimation of hormones and ultrasound examinations, being services rendered during one treatment cycle but excluding a service to which item 13200, 13201, 13202, 13212, 13215 or 13218 applies | $582.50 75% benefit $436.90 85% benefit $495.15 |
| 13207 | Biopsy of an embryo, from a patient who is eligible for a service described in item 73384 under clause 2.7.3A of the pathology services table (see PR.7.1), for the purpose of providing a sample for pre-implantation genetic testing—applicable to one or more tests performed in one assisted reproductive treatment cycle | $132.25 75% benefit $99.20 85% benefit $112.45 |
| 13209 | Planning and management of a referred patient by a specialist for the purpose of treatment by assisted reproductive technologies or for artificial insemination—applicable once during a treatment cycle | $101.30 75% benefit $76.00 85% benefit $86.15 |
| 13212 | Oocyte retrieval for the purpose of assisted reproductive technologies—only if rendered in connection with a service to which item 13200 or 13201 applies (Anaes.) | $424.25 75% benefit $318.20 85% benefit $360.65 |
| 13215 | Transfer of embryos or both ova and sperm to the uterus or fallopian tubes, excluding artificial insemination—only if rendered in connection with a service to which item 13200, 13201 or 13218 applies, being services rendered in one treatment cycle (Anaes.) | $133.05 75% benefit $99.80 85% benefit $113.10 |
| 13218 | New 85% benefit on 1 November 2026Preparation of frozen or donated embryos or donated oocytes for transfer to the uterus or fallopian tubes, by any means and including quantitative estimation of hormones and all treatment counselling but excluding artificial insemination services rendered in one treatment cycle and excluding a service to which item 13200, 13201, 13202, 13203 or 13212 applies (Anaes.) | $949.75 75% benefit $712.35 85% benefit $841.25 was $845.25 |
| 13221 | Preparation of semen for the purpose of artificial insemination—only if rendered in connection with a service to which item 13203 applies | $60.80 75% benefit $45.60 85% benefit $51.70 |
| 13241 | Open surgical testicular sperm retrieval, unilateral, using operating microscope, including the exploration of scrotal contents, with biopsy, for the purposes of intracytoplasmic sperm injection, for male factor infertility, not being a service associated with a service to which item 13218 or 37604 applies (H) (Anaes.) | $1,017.40 75% benefit $763.05 |
| 13251 | Intracytoplasmic sperm injection for the purpose of assisted reproductive technologies, for male factor infertility, excluding a service to which item 13203 or 13218 applies | $500.30 75% benefit $375.25 85% benefit $425.30 |
| 13260 | Processing and cryopreservation of semen for fertility preservation treatment before or after completion of gonadotoxic treatment for malignant or non-malignant conditions, in a post-pubertal male in Tanner stages II-V, up to 60 years old, if the patient is referred by a specialist or consultant physician, initial cryopreservation of semen (not including storage) - one of a maximum of two semen collection cycles per patient in a lifetime. | $496.70 75% benefit $372.55 85% benefit $422.20 |
| 13290 | SEMEN, collection of, from a patient with spinal injuries or medically induced impotence, for the purposes of analysis, storage or assisted reproduction, by a medical practitioner using a vibrator or electro-ejaculation device including catheterisation and drainage of bladder where required | $244.40 75% benefit $183.30 85% benefit $207.75 |
| 13300 | Umbilical or scalp vein catheterisation in a neonate with or without infusion or cannulation of a vein (H) | $68.15 75% benefit $51.15 |
| 13303 | Umbilical artery catheterisation with or without infusion (H) | $101.00 75% benefit $75.75 |
| 13306 | Blood transfusion with venesection and complete replacement of blood, including collection from donor (H) | $399.90 75% benefit $299.95 |
| 13309 | Blood transfusion with venesection and complete replacement of blood, using blood already collected (H) | $340.95 75% benefit $255.75 |
| 13312 | BLOOD for pathology test, collection of, BY FEMORAL OR EXTERNAL JUGULAR VEIN PUNCTURE IN INFANTS | $34.05 75% benefit $25.55 85% benefit $28.95 |
| 13318 | Central vein catheterisation by open exposure, in a patient under 12 years of age (H) (Anaes.) | $272.20 75% benefit $204.15 |
| 13319 | Central vein catheterisation in a neonate via peripheral vein (H) (Anaes.) | $272.20 75% benefit $204.15 |
| 13400 | Restoration of cardiac rhythm by electrical stimulation (cardioversion), other than in the course of cardiac surgery (H) (Anaes.) | $115.95 75% benefit $87.00 |
| 13506 | Gastro‑oesophageal balloon intubation for control of bleeding from gastric oesophageal varices (H) | $220.75 75% benefit $165.60 |
| 13700 | Harvesting of homologous (including allogeneic) or autologous bone marrow for the purpose of transplantation (H) (Anaes.) | $398.95 75% benefit $299.25 |
| 13703 | Transfusion of blood including collection from donor, when used for intra‑operative normovolaemic haemodilution, other than a service associated with a service to which item 22052 applies (H) | $142.95 75% benefit $107.25 |
| 13706 | Transfusion of blood or bone marrow already collected | $99.75 75% benefit $74.85 85% benefit $84.80 |
| 13750 | Therapeutic haemapheresis for the removal of plasma or cellular (or both) elements of blood, utilising continuous or intermittent flow techniques, including morphological tests for cell counts and viability studies, if performed; continuous monitoring of vital signs, fluid balance, blood volume and other parameters with continuous registered nurse attendance under the supervision of a consultant physician, other than a service associated with a service to which item 13755 applies—each day (H) | $163.60 75% benefit $122.70 |
| 13755 | Donor haemapheresis for the collection of blood products for transfusion, utilising continuous or intermittent flow techniques, including morphological tests for cell counts and viability studies; continuous monitoring of vital signs, fluid balance, blood volume and other parameters; with continuous registered nurse attendance under the supervision of a consultant physician—other than a service associated with a service to which item 13750 applies—each day (H) | $163.60 75% benefit $122.70 |
| 13757 | THERAPEUTIC VENESECTION for the management of haemochromatosis, polycythemia vera or porphyria cutanea tarda | $87.30 75% benefit $65.50 85% benefit $74.25 |
| 13760 | In vitro processing with cryopreservation of bone marrow or peripheral blood, for autologous stem cell transplantation for a patient receiving high‑dose chemotherapy for management of: (a) aggressive malignancy; or (b) malignancy that has proven refractory to prior treatment (H) | $912.80 75% benefit $684.60 |
| 13761 | Extracorporeal photopheresis for the treatment of chronic graft‑versus‑host disease, if: (a) the person is: (i) has received allogeneic haematopoietic stem cell transplantation; and (ii) has been diagnosed with chronic graft versus host disease following the transplantation; and (iii) steroid treatment is clinically unsuitable as the disease is steroid refractory or the person is steroid‑dependent or steroid‑intolerant; and (b) the person has not previously received extracorporeal photopheresis treatment; and (c) the service is delivered using an integrated, closed extracorporeal photopheresis system; and (d) the service is provided in combination with the use of methoxsalen that is listed on the Pharmaceutical Benefits Scheme; and (e) the service is provided by, or on behalf of, a specialist or consultant physician who: (i) is practising in the speciality of haematology or oncology; and (ii) has experience with allogeneic bone marrow transplantation. Applicable once per treatment session (H) | $2,195.20 75% benefit $1,646.40 |
| 13762 | Extracorporeal photopheresis for the treatment of chronic graft‑versus‑host disease, if: (a) the person is: (i) has received allogeneic haematopoietic stem cell transplantation; and (ii) has been diagnosed with chronic graft versus host disease following the transplantation; and (iii) steroid treatment is clinically unsuitable as the disease is steroid refractory or the person is steroid‑dependent or steroid‑intolerant; and (b) the person has previously received an extracorporeal photopheresis treatment cycle and had a partial or complete response in at least one organ in response to treatment; and (c) the person requires further extracorporeal photopheresis; and (d) the service is delivered using an integrated, closed extracorporeal photopheresis system; and (e) the service is provided in combination with the use of methoxsalen that is listed on the Pharmaceutical Benefits Scheme; and (f) the service is provided by, or on behalf of, a specialist or consultant physician who: (i) is practising in the speciality of haematology or oncology; and (ii) has experience with allogeneic bone marrow transplantation. Applicable once per treatment session (H) | $2,195.20 75% benefit $1,646.40 |
| 13815 | Central vein catheterisation, including under ultrasound guidance where clinically appropriate, by percutaneous or open exposure other than a service to which item 13318 applies (H) (Anaes.) | $136.05 75% benefit $102.05 |
| 13818 | Right heart balloon catheter, insertion of, including pulmonary wedge pressure and cardiac output measurement (H) (Anaes.) | $136.10 75% benefit $102.10 |
| 13830 | Intracranial pressure, monitoring of, by intraventricular or subdural catheter, subarachnoid bolt or similar, by a specialist or consultant physician—each day (H) | $90.15 75% benefit $67.65 |
| 13832 | Peripheral cannulation, including under ultrasound guidance where clinically appropriate, for veno‑arterial cardiopulmonary extracorporeal life support (H) | $1,055.40 75% benefit $791.55 |
| 13834 | Veno–arterial cardiopulmonary extracorporeal life support, management of—the first day (H) | $590.80 75% benefit $443.10 |
| 13835 | Veno–arterial cardiopulmonary extracorporeal life support, management of—each day after the first (H) | $137.45 75% benefit $103.10 |
| 13837 | Veno-venous pulmonary extracorporeal life support, management of—the first day (H) | $590.80 75% benefit $443.10 |
| 13838 | Veno-venous pulmonary extracorporeal life support, management of—each day after the first (H) | $137.45 75% benefit $103.10 |
| 13839 | ARTERIAL PUNCTURE and collection of blood for diagnostic purposes | $27.65 75% benefit $20.75 85% benefit $23.55 |
| 13840 | Peripheral cannulation, including under ultrasound guidance where clinically appropriate, for veno-venous pulmonary extracorporeal life support (H) | $707.10 75% benefit $530.35 |
| 13842 | Intra-arterial cannulation, including under ultrasound guidance where clinically appropriate, for the purpose of intra-arterial pressure monitoring or arterial blood sampling (or both) No separate ultrasound item is payable with this item | $111.95 75% benefit $84.00 85% benefit $95.20 |
| 13848 | Counterpulsation by intra‑aortic balloon‑management, including associated consultations and monitoring of parameters by means of full haemodynamic assessment and management on several occasions on a day—each day (H) | $186.85 75% benefit $140.15 |
| 13851 | Ventricular assist device (excluding intravascular microaxial ventricular assist device inserted into the right ventricle), management of, for a patient admitted to an intensive care unit for implantation of the device or for complications arising from implantation or management of the device—first day (H) | $590.80 75% benefit $443.10 |
| 13854 | Ventricular assist device (excluding intravascular microaxial ventricular assist device inserted into the right ventricle), management of, for a patient admitted to an intensive care unit, including management of complications arising from implantation or management of the device—each day after the first day (H) | $137.45 75% benefit $103.10 |
| 13857 | AIRWAY ACCESS, ESTABLISHMENT OF AND INITIATION OF MECHANICAL VENTILATION (other than in the context of an anaesthetic for surgery), outside an Intensive Care Unit, for the purpose of subsequent ventilatory support in an Intensive Care Unit | $175.25 75% benefit $131.45 85% benefit $149.00 |
| 13870 | (Note: See para T1.8 of Explanatory Notes to this Category for definition of an Intensive Care Unit) MANAGEMENT of a patient in an Intensive Care Unit by a specialist or consultant physician who is immediately available and exclusively rostered for intensive care - including initial and subsequent attendances, electrocardiographic monitoring, arterial sampling and bladder catheterisation - management on the first day (H) | $433.45 75% benefit $325.10 |
| 13873 | MANAGEMENT of a patient in an Intensive Care Unit by a specialist or consultant physician who is immediately available and exclusively rostered for intensive care - including all attendances, electrocardiographic monitoring, arterial sampling and bladder catheterisation - management on each day subsequent to the first day (H) | $321.45 75% benefit $241.10 |
| 13876 | CENTRAL VENOUS PRESSURE, pulmonary arterial pressure, systemic arterial pressure or cardiac intracavity pressure, continuous monitoring by indwelling catheter in an intensive care unit and managed by a specialist or consultant physician who is immediately available and exclusively rostered for intensive care - once only for each type of pressure on any calendar day (up to a maximum of 4 pressures) (H) | $92.05 75% benefit $69.05 |
| 13881 | AIRWAY ACCESS, ESTABLISHMENT OF AND INITIATION OF MECHANICAL VENTILATION, in an Intensive Care Unit, not in association with any anaesthetic service, by a specialist or consultant physician for the purpose of subsequent ventilatory support (H) | $175.25 75% benefit $131.45 |
| 13882 | VENTILATORY SUPPORT in an Intensive Care Unit, management of, by invasive means, or by non-invasive means where the only alternative to non-invasive ventilatory support would be invasive ventilatory support, by a specialist or consultant physician who is immediately available and exclusively rostered for intensive care, each day (H) | $137.95 75% benefit $103.50 |
| 13885 | CONTINUOUS ARTERIO VENOUS OR VENO VENOUS HAEMOFILTRATION, in an intensive care unit, management by a specialist or consultant physician who is immediately available and exclusively rostered for intensive care - on the first day (H) | $183.90 75% benefit $137.95 |
| 13888 | CONTINUOUS ARTERIO VENOUS OR VENO VENOUS HAEMOFILTRATION, in an intensive care unit, management by a specialist or consultant physician who is immediately available and exclusively rostered for intensive care - on each day subsequent to the first day (H) | $92.05 75% benefit $69.05 |
| 13899 | Preparation of Goals of Care is provided outside of an intensive care unit. Refer to explanatory note TN.1.11 for further information about Goals of Care attendance Professional attendance, outside an intensive care unit, for at least 60 minutes spent in preparation of goals of care for a gravely ill patient lacking current goals of care, by a specialist in the specialty of intensive care who takes overall responsibility for the preparation of the goals of care for the patient Item 13899 cannot be co-claimed with item 13870 or item 13873 on the same day | $320.55 75% benefit $240.45 85% benefit $272.50 |
| 13950 | Parenteral administration of one or more antineoplastic agents, including agents used in cytotoxic chemotherapy or monoclonal antibody therapy but not agents used in anti-resorptive bone therapy or hormonal therapy, by or on behalf of a specialist or consultant physician—attendance for one or more episodes of administration Note: The fee for item 13950 contains a component which covers the accessing of a long-term drug delivery device. TN.1.27 refers | $129.30 75% benefit $97.00 85% benefit $109.95 |
| 14050 | UVA or UVB phototherapy administered in a whole body cabinet or hand and foot cabinet including associated consultations other than the initial consultation, if treatment is initiated and supervised by a specialist in the specialty of dermatology Applicable not more than 150 times in a 12 month period | $63.20 75% benefit $47.40 85% benefit $53.75 |
| 14100 | Laser photocoagulation using laser radiation in the treatment of vascular abnormalities of the head or neck, including any associated consultation, if: (a) the abnormality is visible from 3 metres; and (b) photographic evidence demonstrating the need for this service is documented in the patient notes; to a maximum of 4 sessions (including any sessions to which this item or any of items 14106 to 14118 apply) in any 12 month period (Anaes.) | $182.45 75% benefit $136.85 85% benefit $155.10 |
| 14106 | Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café au lait macules and naevi of Ota, other than melanocytic naevi (common moles), if the abnormality is visible from 3 metres, including any associated consultation, up to a maximum of 6 sessions (including any sessions to which this item or any of items 14100 to 14118 apply) in any 12 month period—area of treatment less than 150 cm2 (Anaes.) | $191.70 75% benefit $143.80 85% benefit $162.95 |
| 14115 | Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café au lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which this item or any of items 14100 to 14118 apply) in any 12 month period—area of treatment 150 cm2 to 300 cm2 (Anaes.) | $307.00 75% benefit $230.25 85% benefit $260.95 |
| 14118 | Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café au lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which this item or any of items 14100 to 14115 apply) in any 12 month period—area of treatment more than 300 cm2 (Anaes.) | $389.85 75% benefit $292.40 85% benefit $331.40 |
| 14124 | Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café‑au‑lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, if: (a) a seventh or subsequent session (including any sessions to which this item or any of items 14100 to 14118 apply) is indicated in a 12 month period commencing on the day of the first session; and (b) photographic evidence demonstrating the need for this service is documented in the patient notes (Anaes.) | $182.45 75% benefit $136.85 85% benefit $155.10 |
| 14201 | POLY-L-LACTIC ACID, one or more injections of, for the initial session only, for the treatment of severe facial lipoatrophy caused by antiretroviral therapy, when prescribed in accordance with the National Health Act 1953 - once per patient | $283.50 75% benefit $212.65 85% benefit $241.00 |
| 14202 | POLY-L-LACTIC ACID, one or more injections of (subsequent sessions), for the continuation of treatment of severe facial lipoatrophy caused by antiretroviral therapy, when prescribed in accordance with the National Health Act 1953 | $143.50 75% benefit $107.65 85% benefit $122.00 |
| 14203 | HORMONE OR LIVING TISSUE IMPLANTATION, by direct implantation involving incision and suture (Anaes.) | $61.20 75% benefit $45.90 85% benefit $52.05 |
| 14206 | Hormone or living tissue implantation—by cannula | $103.00 75% benefit $77.25 85% benefit $87.55 |
| 14212 | Intussusception, management of fluid or gas reduction for (H) (Anaes.) | $221.70 75% benefit $166.30 |
| 14216 | Professional attendance on a patient by a psychiatrist, who has undertaken training in Repetitive Transcranial Magnetic Stimulation (rTMS), for treatment mapping for rTMS, if the patient: (a) has not previously received any prior transcranial magnetic stimulation therapy in a public or private setting; and (b) is at least 18 years old; and (c) is diagnosed with a major depressive episode; and (d) has failed to receive satisfactory improvement for the major depressive episode despite the adequate trialling of at least 2 different classes of antidepressant medications, unless contraindicated, and all of the following apply: (i) the patient’s adherence to antidepressant treatment has been formally assessed; (ii) the trialling of each antidepressant medication has been at the recommended therapeutic dose for a minimum of 3 weeks; (iii) where clinically appropriate, the treatment has been titrated to the maximum tolerated therapeutic dose; and (e) has undertaken psychological therapy, if clinically appropriate | $214.45 75% benefit $160.85 85% benefit $182.30 |
| 14217 | Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of up to 35 services provided by, or on behalf of, a psychiatrist who has undertaken training in rTMS, if the patient has previously received a service under item 14216—each service up to 35 services | $184.00 75% benefit $138.00 85% benefit $156.40 |
| 14218 | Implanted infusion pump, refilling of reservoir with a therapeutic agent or agents for infusion to the subarachnoid space or accessing the side port to assess catheter patency, with or without pump reprogramming, for the management of chronic pain, including cancer pain | $117.25 75% benefit $87.95 85% benefit $99.70 |
| 14219 | Professional attendance on a patient by a psychiatrist, who has undertaken training in Repetitive Transcranial Magnetic Stimulation (rTMS), for treatment mapping for rTMS, if the patient: (a) is at least 18 years old; and (b) is diagnosed with a major depressive episode; and (c) has failed to receive satisfactory improvement for the major depressive episode despite the adequate trialling of at least 2 different classes of antidepressant medications, unless contraindicated, and all of the following apply: (i) the patient’s adherence to antidepressant treatment has been formally assessed; (ii) the trialling of each antidepressant medication has been at the recommended therapeutic dose for a minimum of 3 weeks; (iii) where clinically appropriate, the treatment has been titrated to the maximum tolerated therapeutic dose; and (d) has undertaken psychological therapy, if clinically appropriate; and (e) has previously received an initial service under item 14217 and the patient: (i) has relapsed after a remission following the initial service; and (ii) has had a satisfactory clinical response to the service under item 14217 (which has been assessed by a validated major depressive disorder tool at least 4 months after receiving that service) | $214.45 75% benefit $160.85 85% benefit $182.30 |
| 14220 | Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of up to 15 services provided by, or on behalf of, a psychiatrist who has undertaken training in rTMS, if the patient has previously received: (a) a service under item 14217 (which was not provided in the previous 4 months); and (b) a service under item 14219 Each service up to 15 services | $184.00 75% benefit $138.00 85% benefit $156.40 |
| 14221 | LONG-TERM IMPLANTED DEVICE FOR DELIVERY OF THERAPEUTIC AGENTS, accessing of, not being a service associated with a service to which item 13950 applies | $62.85 75% benefit $47.15 85% benefit $53.45 |
| 14224 | Electroconvulsive therapy, with or without the use of stimulus dosing techniques, including any electroencephalographic monitoring and associated consultation (H) (Anaes.) | $184.00 75% benefit $138.00 |
| 14227 | IMPLANTED INFUSION PUMP, REFILLING of reservoir, with baclofen, for infusion to the subarachnoid or epidural space, with or without re-programming of a programmable pump, for the management of severe chronic spasticity | $117.25 75% benefit $87.95 85% benefit $99.70 |
| 14234 | Infusion pump or components of an infusion pump, removal or replacement of, and connection to intrathecal or epidural catheter, and loading of reservoir with baclofen, with or without programming of the pump, for the management of severe chronic spasticity (Anaes.) | $433.15 75% benefit $324.90 |
| 14237 | Infusion pump or components of an infusion pump, subcutaneous implantation of, and intrathecal or epidural spinal catheter insertion, and connection of pump to catheter, and loading of reservoir with baclofen, with or without programming of the pump, for the management of severe chronic spasticity (Anaes.) | $789.80 75% benefit $592.35 |
| 14245 | New wording on 1 November 2026Immunomodulating agent supplied under the pharmaceutical benefits scheme, administration of, by intravenous infusion lasting at least 2 hours—applicable once per day | $117.25 75% benefit $87.95 85% benefit $99.70 |
| 14247 | Extracorporeal photopheresis for the treatment of erythrodermic stage III‑IVa T4 M0 cutaneous T‑cell lymphoma; if (a) the service is provided in the initial six months of treatment; and (b) the service is delivered using an integrated, closed extracorporeal photopheresis system; and (c) the patient is 18 years old or over; and (d) the patient has received prior systemic treatment for this condition and experienced either disease progression or unacceptable toxicity while on this treatment; and (e) the service is provided in combination with the use of Pharmaceutical Benefits Scheme‑subsidised methoxsalen; and (f) the service is supervised by a specialist or consultant physician in the speciality of haematology. Applicable once per treatment cycle (H) | $2,215.00 75% benefit $1,661.25 |
| 14249 | Extracorporeal photopheresis for the continuing treatment of erythrodermic stage III‑IVa T4 M0 cutaneous T‑cell lymphoma; if (a) in the preceding 6 months: (i) a service to which item 14247 applies has been provided; and (ii) the patient has demonstrated a response to this service; and (iii) the patient requires further treatment; and (b) the service is delivered using an integrated, closed extracorporeal photopheresis system; and (c) the patient is 18 years old or over; and (d) the service is provided in combination with the use of Pharmaceutical Benefits Scheme‑subsidised methoxsalen; and (e) the service is supervised by a specialist or consultant physician in the speciality of haematology. Applicable once per treatment cycle (H) | $2,215.00 75% benefit $1,661.25 |
| 14255 | Resuscitation of a patient provided for at least 30 minutes but less than 1 hour, by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the specialist described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019 (Anaes.) | $177.55 75% benefit $133.20 85% benefit $150.95 |
| 14256 | Resuscitation of a patient provided for at least 1 hour but less than 2 hours, by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the specialist described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019 (Anaes.) | $341.50 75% benefit $256.15 85% benefit $290.30 |
| 14257 | Resuscitation of a patient provided for at least 2 hours, by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the specialist described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019 (Anaes.) | $680.15 75% benefit $510.15 85% benefit $578.15 |
| 14258 | Resuscitation of a patient provided for at least 30 minutes but less than 1 hour, by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the practitioner described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036 (Anaes.) | $133.30 75% benefit $100.00 85% benefit $113.35 |
| 14259 | Resuscitation of a patient provided for at least 1 hour but less than 2 hours, by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the practitioner described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036 (Anaes.) | $256.15 75% benefit $192.15 85% benefit $217.75 |
| 14260 | Resuscitation of a patient provided for at least 2 hours, by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the practitioner described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036 (Anaes.) | $510.10 75% benefit $382.60 85% benefit $433.60 |
| 14263 | Minor procedure on a patient by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the specialist described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019 (Anaes.) | $62.55 75% benefit $46.95 85% benefit $53.20 |
| 14264 | Procedure (except a minor procedure) on a patient by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the specialist described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019 (Anaes.) | $140.70 75% benefit $105.55 85% benefit $119.60 |
| 14265 | Minor procedure on a patient by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the practitioner described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036 (Anaes.) | $46.85 75% benefit $35.15 85% benefit $39.85 |
| 14266 | Procedure (except a minor procedure) on a patient by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital, in conjunction with an attendance on the patient by the practitioner described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036 (Anaes.) | $105.50 75% benefit $79.15 85% benefit $89.70 |
| 14270 | Management, without aftercare, of all fractures and dislocations suffered by a patient that: (a) is provided by a specialist in the practice of the specialist's specialty of emergency medicine in conjunction with an attendance on the patient by the specialist described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017 or 5019; and (b) occurs at a recognised emergency department of a private hospital (Anaes.) | $157.75 75% benefit $118.35 85% benefit $134.10 |
| 14272 | Management, without aftercare, of all fractures and dislocations suffered by a patient that: (a) is provided by a medical practitioner (except a specialist in the practice of the specialist's specialty of emergency medicine) in conjunction with an attendance on the patient by the practitioner described in item 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036; and (b) occurs at a recognised emergency department of a private hospital (Anaes.) | $118.35 75% benefit $88.80 85% benefit $100.60 |
| 14277 | Application of chemical or physical restraint of a patient by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital | $177.55 75% benefit $133.20 85% benefit $150.95 |
| 14278 | Application of chemical or physical restraint of a patient by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital | $133.30 75% benefit $100.00 85% benefit $113.35 |
| 14280 | Anaesthesia (whether general anaesthesia or not) of a patient that: (a) is managed by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital; and (b) occurs in conjunction with an attendance on the patient that is described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036; and (c) is not anaesthesia provided by a specialist anaesthetist to which an item in Group T7 or T10 applies | $177.55 75% benefit $133.20 85% benefit $150.95 |
| 14283 | Anaesthesia (whether general anaesthesia or not) of a patient that: (a) is managed by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital; and (b) occurs in conjunction with an attendance on the patient that is described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036; and (c) is not anaesthesia provided by a specialist anaesthetist to which an item in Group T7 or T10 applies | $133.30 75% benefit $100.00 85% benefit $113.35 |
| 14285 | Emergent intubation, airway management or both of a patient that: (a) is managed by a specialist in the practice of the specialist’s specialty of emergency medicine at a recognised emergency department of a private hospital; and (b) occurs in conjunction with an attendance on the patient that is described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036; and (c) is not anaesthesia provided by a specialist anaesthetist to which an item in Group T7 or T10 applies | $177.55 75% benefit $133.20 85% benefit $150.95 |
| 14288 | Emergent intubation, airway management or both of a patient that: (a) is managed by a medical practitioner (except a specialist in the practice of the specialist’s specialty of emergency medicine) at a recognised emergency department of a private hospital; and (b) occurs in conjunction with an attendance on the patient that is described in item 5001, 5004, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5021, 5022, 5027, 5030, 5031, 5032, 5033, 5035 or 5036; and (c) is not anaesthesia provided by a specialist anaesthetist to which an item in Group T7 or T10 applies | $133.30 75% benefit $100.00 85% benefit $113.35 |
T2 Radiation Oncology
44 items
| Item | Description | Fee and benefits |
|---|---|---|
| 15900 | Breast, malignant tumour, targeted intraoperative radiation therapy, using an Intrabeam® or Xoft® Axxent® device, delivered at the time of breast‑conserving surgery (partial mastectomy or lumpectomy) for a patient who: (a) is 45 years of age or over; and (b) has a T1 or small T2 (less than or equal to 3 cm in diameter) primary tumour; and (c) has a histologic grade 1 or 2 tumour; and (d) has an oestrogen‑receptor positive tumour; and (e) has a node negative malignancy; and (f) is suitable for wide local excision of a primary invasive ductal carcinoma that was diagnosed as unifocal on conventional examination and imaging; and (g) has no contra‑indications to breast irradiation Applicable once per breast per lifetime (H) | $299.20 75% benefit $224.40 |
| 15902 | New 85% benefit on 1 November 2026Megavoltage planning—level 1.1 Simple complexity single‑field radiation therapy simulation and dosimetry for treatment planning, without imaging for field setting, if: (a) all of the following apply in relation to the simulation: (i) the simulation is to one site; (ii) localisation is based on clinical mark‑up and image‑based simulation is not required; (iii) patient set‑up and immobilisation techniques are suitable for two‑dimensional radiation therapy treatment, with wide margins and allowance for movement; and (b) all of the following apply in relation to the dosimetry: (i) the planning process is required to deliver a prescribed dose to a point, either at depth or on the surface of the patient; (ii) based on review and assessment by a radiation oncologist, the planning process does not require the differential of dose between target, organs at risk and normal tissue dose; (iii) delineation of structures is not possible or required, and field borders will delineate the treatment volume; (iv) doses are calculated in reference to a point, either at depth or on the surface of the patient, from tables, charts or data from a treatment planning system Applicable once per course of treatment | $762.15 75% benefit $571.65 85% benefit $653.65 was $657.65 |
| 15904 | New 85% benefit on 1 November 2026Megavoltage planning—level 1.2 Simple complexity radiation therapy simulation and dosimetry for treatment planning, with imaging for field setting, if: (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for two‑dimensional radiation therapy dose planning; (ii) patient set‑up and immobilisation techniques are suitable for two‑dimensional radiation therapy treatment where interfraction reproducibility is required; (iii) imaging datasets are acquired for the relevant region of interest to be planned; and (b) all of the following apply in relation to the dosimetry: (i) the two‑dimensional planning process is required to calculate dose to a volume, however a dose‑volume histogram is not required to complete the planning process; (ii) based on review and assessment by a radiation oncologist, the two‑dimensional planning process is not required to maximise the differential between target dose and normal tissue dose; (iii) the target (which may include gross, clinical and planning targets as a composite structure or field border outline), as defined in the prescription, is rendered as a two‑dimensional structure as field borders or a volume; (iv) organs at risk are delineated if required, and assessment of dose to these structures is derived from dose point calculations, rather than full calculation and inclusion in a dose‑volume histogram; (v) dose calculations are calculated using a specialised algorithm, with prescription and plan details approved and recorded with the plan Applicable once per course of treatment | $1,116.65 75% benefit $837.50 85% benefit $1,008.15 was $1,012.15 |
| 15906 | New 85% benefit on 1 November 2026Megavoltage planning—level 2.1 Three‑dimensional radiation therapy simulation and dosimetry for treatment planning, without motion management, if: (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for three‑dimensional planning without consideration of motion management; (ii) patient set‑up and immobilisation techniques are reproducible for treatment; (iii) a high‑quality dataset is acquired in treatment position for the relevant region of interest to be planned and treated with image verification; and (b) all of the following apply in relation to the dosimetry: (i) the three‑dimensional planning process is required to calculate dose to three‑dimensional volume structures and requires a dose‑volume histogram to complete the planning process; (ii) based on review and assessment by a radiation oncologist, the three‑dimensional planning process is required to optimise the differential between target dose and normal tissue dose; (iii) the planning target volume is rendered as a three‑dimensional structure on planning outputs (three‑dimensional plan review, three‑planar sections review or dose‑volume histogram); (iv) organs at risk are delineated, and assessment of dose to these structures is derived from calculation and inclusion in a dose‑volume histogram Applicable once per course of treatment | $1,721.70 75% benefit $1,291.30 85% benefit $1,613.20 was $1,617.20 |
| 15908 | New 85% benefit on 1 November 2026Megavoltage planning—level 2.2 Three‑dimensional radiation therapy simulation and dosimetry for treatment planning with motion management, if: (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for complex three‑dimensional planning with consideration of motion management; (ii) patient set‑up and immobilisation techniques are reproducible for treatment; (iii) a high‑quality three‑dimensional or four‑dimensional image volume dataset is acquired in treatment position for the relevant region of interest to be planned and treated with image verification; and (b) all of the following apply in relation to the dosimetry: (i) the three‑dimensional planning process is required to calculate dose to three‑dimensional volume structures (which must include structures moving with physiologic processes) and requires a dose‑volume histogram to complete the planning process; (ii) based on review and assessment by a radiation oncologist, the three‑dimensional planning process is required to optimise the differential between target dose and normal tissue dose; (iii) the planning target volume is rendered as a three‑dimensional structure on planning outputs (three‑dimensional plan review, three‑planar sections review or dose‑volume histogram); (iv) organs at risk are delineated, and assessment of dose to these structures is derived from full calculation and inclusion in a dose‑volume histogram Applicable once per course of treatment | $2,783.40 75% benefit $2,087.55 85% benefit $2,674.90 was $2,678.90 |
| 15910 | New 85% benefit on 1 November 2026Megavoltage planning—level 3.1 Standard intensity modulated radiation therapy (IMRT) simulation and dosimetry for treatment planning, if: (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for single‑dose level IMRT planning without motion management; (ii) patient set‑up and immobilisation techniques are suitable for image volume data acquisition and reproducible IMRT treatment; (iii) a high‑quality three‑dimensional image volume dataset is acquired in treatment position for the relevant region of interest to be planned and treated with image verification; and (b) all of the following apply in relation to the dosimetry: (i) the IMRT planning process is required to calculate dose to a single‑dose level volume structure and requires a dose‑volume histogram to complete the planning process; (ii) based on review and assessment by a radiation oncologist, the IMRT planning process optimises the differential between target dose, organs at risk and normal tissue dose; (iii) all relevant gross tumour volumes, clinical target volumes, planning target volumes and organs at risk are rendered as volumes and nominated with planning dose objectives; (iv) organs at risk are nominated as planning dose constraints; (v) dose calculations and dose‑volume histograms are generated in an inverse planned process using a specialised algorithm, with prescription and plan details approved and recorded with the plan; (vi) a three‑dimensional image volume dataset is used for the relevant region to be planned and treated with image verification Applicable once per course of treatment | $4,352.40 75% benefit $3,264.30 85% benefit $4,243.90 was $4,247.90 |
| 15912 | New 85% benefit on 1 November 2026Megavoltage re‑planning—level 3.1 Additional dosimetry plan for re‑planning of standard intensity modulated radiation therapy (IMRT) treatment, if: (a) an initial treatment plan described in item 15910 or 15914 has been prepared; and (b) treatment adjustments to the initial plan are inadequate to satisfy treatment protocol requirements Applicable once per course of treatment | $2,176.20 75% benefit $1,632.15 85% benefit $2,067.70 was $2,071.70 |
| 15914 | New 85% benefit on 1 November 2026Megavoltage planning—level 3.2 Complex intensity modulated radiation therapy (IMRT) simulation and dosimetry for treatment planning, if (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for multiple‑dose level IMRT planning or single‑dose level IMRT planning requiring motion management; (ii) patient set‑up and immobilisation techniques are suitable for image volume data acquisition and reproducible IMRT treatment; (iii) a high‑quality three‑dimensional or four‑dimensional volume dataset is acquired in treatment position for the relevant region of interest to be planned and treated with image verification; and (b) all of the following apply in relation to the dosimetry: (i) the IMRT planning process is required to calculate dose to multiple‑dose level volume structures or single‑dose level volume structures (including structures moving with physiologic processes or requiring precise positioning with respect to beam edges) and requires a dose‑volume histogram to complete the planning process; (ii) based on review and assessment by a radiation oncologist, the IMRT planning process optimises the differential between target dose, organs at risk and normal tissue dose; (iii) all relevant gross tumour targets, clinical target volumes, planning target volumes, internal target volumes and organs at risk are rendered and nominated with planning dose objectives; (iv) organs at risk are nominated as planning dose constraints; (v) dose calculations and dose‑volume histograms are generated in an inverse planned process using a specialised algorithm, with prescription and plan details approved and recorded with the plan; (vi) a three‑dimensional or four‑dimensional image volume dataset is used for the relevant region to be planned and treated, with image verification for a multiple‑dose level IMRT planning or single‑dose level IMRT planning requiring motion management Applicable once per course of treatment | $6,255.35 75% benefit $4,691.55 85% benefit $6,146.85 was $6,150.85 |
| 15916 | New 85% benefit on 1 November 2026Megavoltage re‑planning—level 3.2 Additional dosimetry plan for re‑planning of complex intensity modulated radiation therapy (IMRT) treatment, if: (a) an initial treatment plan described in item 15910 or 15914 has been prepared; and (b) treatment adjustments to the initial plan are inadequate to satisfy treatment protocol requirements Applicable once per course of treatment | $3,127.65 75% benefit $2,345.75 85% benefit $3,019.15 was $3,023.15 |
| 15918 | New 85% benefit on 1 November 2026Megavoltage planning—level 4 Intracranial stereotactic radiation therapy (SRT) simulation and dosimetry for treatment planning, if: (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for multiple non‑coplanar, rotational or fixed beam stereotactic delivery; (ii) precise personalised patient set‑up and immobilisation techniques are suitable for reliable imaging acquisition and reproducible SRT small‑field and ablative treatments; (iii) a high‑quality three‑dimensional image volume dataset is acquired in treatment position for the intracranial lesions to be planned and treated and verified; and (b) all of the following apply in relation to the dosimetry: (i) the planning process is required to calculate dose to single or multiple target structures and requires a dose‑volume histogram to complete the planning process; (ii) based on review and assessment by a radiation oncologist, the planning process maximises the differential between target dose, organs at risk and normal tissue dose; (iii) all relevant gross tumour volumes, clinical target volumes, planning target volumes and organs at risk are rendered and nominated with planning dose objectives; (iv) organs at risk are nominated as planning dose constraints; (v) dose calculations and dose‑volume histograms are generated using a validated stereotactic‑type algorithm, with prescription and plan details approved and recorded with the plan Applicable once per course of treatment | $7,013.95 75% benefit $5,260.50 85% benefit $6,905.45 was $6,909.45 |
| 15920 | New 85% benefit on 1 November 2026Megavoltage planning—level 4 Stereotactic body radiation therapy (SBRT) simulation and dosimetry for treatment planning, if: (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for inverse planning with multiple non‑coplanar, rotational or fixed beam stereotactic delivery or intensity modulated radiation therapy (IMRT) stereotactic delivery; (ii) personalised patient set‑up and immobilisation techniques are suitable for reliable imaging acquisition and reproducible, including techniques to minimise motion of organs at risk and targets; (iii) small‑field and ablative treatment is used; (iv) a high‑quality three‑dimensional or four‑dimensional image volume dataset is acquired in treatment position for the relevant region of interest to be planned, treated and verified (through daily planar or volumetric image guidance strategies); and (b) all of the following apply in relation to the dosimetry: (i) the planning process is required to calculate dose to single or multiple target structures and requires a dose‑volume histogram to complete the planning process; (ii) based on review and assessment by a radiation oncologist, the planning process maximises the differential between target dose, organs at risk and normal tissue dose; (iii) all relevant gross tumour volumes, clinical target volumes, planning target volumes and organs at risk are rendered and nominated with planning dose objectives; (iv) organs at risk are nominated as planning dose constraints; (v) dose calculations and dose‑volume histograms are generated using a validated stereotactic‑type algorithm, with prescription and plan details approved and recorded with the plan Applicable once per course of treatment | $7,013.95 75% benefit $5,260.50 85% benefit $6,905.45 was $6,909.45 |
| 15922 | New 85% benefit on 1 November 2026Megavoltage re‑planning—level 4 Additional dosimetry plan for re‑planning of intracranial stereotactic radiation therapy (SRT) or stereotactic body radiation therapy (SBRT) treatment, if: (a) an initial treatment plan at a level that is equivalent to or higher than that described in item 15918 or 15920 has been prepared; and (b) treatment adjustments to the initial plan are inadequate to satisfy treatment protocol requirements Applicable once per course of treatment | $3,507.00 75% benefit $2,630.25 85% benefit $3,398.50 was $3,402.50 |
| 15924 | New 85% benefit on 1 November 2026Megavoltage planning—level 5 Specialised radiation therapy simulation and dosimetry for treatment planning, if both of the following apply in relation to the simulation: (a) treatment set‑up and technique specifications are in preparation for a specialised case with general anaesthetic or sedation supervised by an anaesthetist; (b) a high‑quality three‑dimensional or four‑dimensional image volume dataset is acquired in treatment position for the relevant region of interest to be planned and treated with image verification Applicable once per course of treatment (Anaes.) | $7,403.00 75% benefit $5,552.25 85% benefit $7,294.50 was $7,298.50 |
| 15926 | New 85% benefit on 1 November 2026Megavoltage planning—level 5 Specialised radiation therapy simulation and dosimetry for treatment planning, if: (a) all of the following apply in relation to the simulation: (i) treatment set‑up and technique specifications are in preparation for a specialised application such as total skin electron therapy (TSE) or total body irradiation (TBI); (ii) reproducible personalised patient set‑up and immobilisation techniques are suitable to implement three‑dimensional radiation therapy, intensity modulated radiation therapy (IMRT) (including multiple non‑coplanar, rotational or fixed beam treatment delivery) or a specialised total body treatment delivery method; (iii) a specialised dataset of anatomical dimensions is acquired in the treatment position for TSE or TBI; and (b) all of the following apply in relation to the dosimetry: (i) total TSE, TBI, IMRT or multiple non‑coplanar, rotational or fixed beam treatment is used; (ii) the final dosimetry plan is validated by a radiation therapist and a medical physicist, using quality assurance processes; (iii) the final dosimetry plan is approved, prior to treatment delivery, by a radiation oncologist Applicable once per course of treatment | $7,403.00 75% benefit $5,552.25 85% benefit $7,294.50 was $7,298.50 |
| 15928 | New 85% benefit on 1 November 2026Megavoltage re‑planning—level 5 Additional dosimetry plan for re‑planning of specialised radiation therapy if: (a) an initial treatment plan described in 15924 or 15926 has been prepared; and (b) treatment adjustments to the initial plan are inadequate to satisfy treatment protocol requirements Applicable once per course of treatment (Anaes.) | $3,701.50 75% benefit $2,776.15 85% benefit $3,593.00 was $3,597.00 |
| 15930 | Megavoltage treatment—level 1.1 Radiation therapy for simple, single‑field treatment (including electron beam treatments), if: (a) the treatment does not use imaging for field setting; and (b) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (c) the treatment is delivered to implement a one‑dimensional plan; and (d) a two‑dimensional single‑field treatment delivery mode is utilised Applicable up to twice per plan per day | $95.90 75% benefit $71.95 85% benefit $81.55 |
| 15932 | Megavoltage treatment—level 1.2 Radiation therapy and image verification for simple treatment, with imaging for field setting, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) image‑guided radiation therapy (IGRT) imaging is used to implement a two‑dimensional plan, and (c) two‑dimensional treatment is delivered; and (d) image verification decisions and actions are documented in the patient’s record Applicable up to twice per plan per day | $119.45 75% benefit $89.60 85% benefit $101.55 |
| 15934 | Megavoltage treatment—level 2.1 Radiation therapy and image verification for three‑dimensional treatment, without motion management, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) image‑guided radiation therapy (IGRT) imaging is used to implement a standard three‑dimensional plan; and (c) three‑dimensional treatment is delivered; and (d) image verification decisions and actions are documented in the patient’s record Applicable up to twice per plan per day | $268.90 75% benefit $201.70 85% benefit $228.60 |
| 15936 | Megavoltage treatment—level 2.2 Radiation therapy and image verification for three‑dimensional treatment, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) image‑guided radiation therapy (IGRT) imaging is used to implement a complex three‑dimensional plan; and (c) complex three‑dimensional treatment is delivered with management of motion; and (d) image decisions and actions are documented in the patient’s record Applicable up to twice per plan per day | $292.50 75% benefit $219.40 85% benefit $248.65 |
| 15938 | Megavoltage treatment—level 3.1 Standard single‑dose level intensity modulated radiation therapy (IMRT) treatment and image verification, without motion management, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) image‑guided radiation therapy (IGRT) imaging is used to implement an IMRT plan described in item 15910 or 15914 Applicable up to twice per plan per day | $292.50 75% benefit $219.40 85% benefit $248.65 |
| 15940 | Megavoltage treatment—level 3.2 Complex multiple‑dose level intensity modulated radiation therapy (IMRT) treatment, or single‑dose level IMRT treatment requiring motion management, and image verification, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) image‑guided radiation therapy (IGRT) imaging is used (with motion management functionality if required) to implement an IMRT plan described in item 15910 or 15914; and (c) radiation field positioning requires accurate dose delivery to the target; and (d) image decisions and actions are documented in the patient’s record Applicable up to twice per plan per day | $321.75 75% benefit $241.35 85% benefit $273.50 |
| 15942 | New 85% benefit on 1 November 2026Megavoltage treatment—level 4 Intracranial stereotactic radiation therapy treatment and image verification, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) image‑guided radiation therapy (IGRT) or minimally invasive stereotactic frame localisation is used to implement an intracranial stereotactic treatment plan at a level described in item 15918; and (c) radiation field positioning requires accurate dose delivery to the target; and (d) image decisions and actions are documented in the patient’s record Applicable once per day | $829.30 75% benefit $622.00 85% benefit $720.80 was $724.80 |
| 15944 | New 85% benefit on 1 November 2026Megavoltage treatment—level 4 Stereotactic body radiation therapy (SBRT) treatment and image verification, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) image‑guided radiation therapy (IGRT) is used (with motion management functionality if required) to implement a stereotactic body radiation therapy plan at a level described in item 15920; and (c) radiation field positioning requires accurate dose delivery to the target; and (d) image decisions and actions are documented in the patient’s record Applicable once per day per site, for a maximum of 2 sites | $829.30 75% benefit $622.00 85% benefit $720.80 was $724.80 |
| 15946 | New 85% benefit on 1 November 2026Megavoltage treatment—level 5 Specialised radiation therapy treatment and verification, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) a specialised technique is used to implement a treatment plan with general anaesthetic or sedation supervised by an anaesthetist Applicable once per plan per day | $953.70 75% benefit $715.30 85% benefit $845.20 was $849.20 |
| 15948 | New 85% benefit on 1 November 2026Megavoltage treatment—level 5Specialised radiation therapy treatment and verification, if: (a) the treatment is delivered using a device that is included in the Australian Register of Therapeutic Goods; and (b) a specialised technique, such as total skin electron therapy (TSE) or total body irradiation (TBI), is used to implement a treatment plan described in item 15926 Applicable up to twice per day | $953.70 75% benefit $715.30 85% benefit $845.20 was $849.20 |
| 15950 | Kilovoltage planning Simple complexity single‑field radiation therapy simulation and dosimetry for treatment planning without imaging for field setting, if: (a) both of the following apply in relation to the simulation: (i) localisation is based on clinical mark‑up and image‑based simulation is not required; (ii) patient set‑up and immobilisation techniques are suitable for two‑dimensional radiation therapy treatment, with wide margins and allowance for movement; and (b) all of the following apply in relation to the dosimetry: (i) the planning process is required to deliver a prescribed dose to a point, either at depth or on the surface of the patient; (ii) based on review and assessment by a radiation oncologist, the planning process does not require the differential of dose between target, organs at risk and normal tissue dose; (iii) delineation of structures is not possible or required, and field borders will delineate the treatment volume; (iv) doses are calculated in reference to a point, either at depth or on the surface of the patient, from tables, charts or data from a treatment planning system Applicable once per course of treatment | $214.00 75% benefit $160.50 85% benefit $181.90 |
| 15952 | Delivery of kilovoltage radiation therapy (50 kV to 500 kV range) to one anatomical site (excluding orbital structures where there is placement of an internal eye shield) | $57.60 75% benefit $43.20 85% benefit $49.00 |
| 15954 | Delivery of kilovoltage radiation therapy (50 kV to 500 kV range) to each additional anatomical site following delivery to one anatomical site treated under item 15952 (excluding orbital structures where there is placement of an internal eye shield) | $23.15 75% benefit $17.40 85% benefit $19.70 |
| 15956 | Delivery of kilovoltage radiation therapy (50 kV to 500 kV range) to orbital structures where there is placement of an internal eye shield | $70.85 75% benefit $53.15 85% benefit $60.25 |
| 15958 | Simple placement or insertion of any of the following kinds of brachytherapy device, without image guidance: (a) intracavitary vaginal cylinder, vaginal ovoids, vaginal ring or vaginal mould; (b) surface mould or applicator, with catheters fixed to or embedded into mould or applicator, on external surface of body; including the removal of applicators, catheters or needles | $111.80 75% benefit $83.85 85% benefit $95.05 |
| 15960 | Complex construction and manufacture of a personalised brachytherapy applicator or mould, derived from three-dimensional image volume datasets, including the removal of applicators, catheters or needles | $154.20 75% benefit $115.65 85% benefit $131.10 |
| 15962 | Complex insertion of any of the following kinds of brachytherapy device, with image guidance and if a radiation oncologist is in attendance at the initiation of the service: (a) intrauterine tubes with or without ovoids, ring or cylinder; (b) endocavity applicators; (c) intraluminal catheters for treatment of bronchus, trachea, oesophagus, nasopharynx, bile duct; (d) endovascular catheters for treatment of vessels; including the removal of applicators, catheters or needles (Anaes.) | $335.30 75% benefit $251.50 85% benefit $285.05 |
| 15964 | Complex insertion and removal of hybrid intracavitary and interstitial brachytherapy applicators, or intracavitary and multi catheter applicators, with image guidance and if a radiation oncologist is in attendance at the initiation of the service (Anaes.) | $447.15 75% benefit $335.40 85% benefit $380.10 |
| 15966 | Complex insertion of any of the following kinds of interstitial brachytherapy implants not requiring surgical exposure, with image guidance, and if a radiation oncologist is in attendance during the service: (a) catheters or needles for temporary implants; (b) radioactive sources for permanent implants; (c) breast applicators, single channel and multi‑channel strut devices; including the removal of applicators, catheters or needles (Anaes.) | $558.85 75% benefit $419.15 85% benefit $475.05 |
| 15968 | New 85% benefit on 1 November 2026Complex insertion of any of the following interstitial brachytherapy implants requiring surgical exposure (other than a service to which item 15900 applies), if a radiation oncologist is in attendance at the initiation of the service: (a) catheters, needles or applicators to a region requiring surgical exposure; (b) radioactive sources for permanent implants; (c) surface moulds during intraoperative brachytherapy; (d) plastic catheters or stainless steel needles, requiring surgical exposure; including implantation and removal of applicators, catheters or needles (Anaes.) | $876.00 75% benefit $657.00 85% benefit $767.50 was $771.50 |
| 15970 | Simple level dosimetry for brachytherapy plans prescribed to surface or depth from catheter and library plans, if: (a) the planning process is required to deliver a prescribed dose to a three‑dimensional volume, and relative to a single line or multiple channel delivery applicator; and (b) the planning process does not require the differential of dose between the target, organs at risk and normal tissue dose; and (c) delineation of structures is not required; and (d) dose calculations are performed in reference to the surface or a point at depth (two‑dimensional plan) from tables, charts or data from a treatment planning system library plan | $145.35 75% benefit $109.05 85% benefit $123.55 |
| 15972 | Simple level dosimetry re‑planning of an initial brachytherapy plan described in item 15970 if treatment adjustments to that initial plan are inadequate to satisfy treatment protocol requirements | $72.70 75% benefit $54.55 85% benefit $61.80 |
| 15974 | New 85% benefit on 1 November 2026Intermediate level dosimetry calculated on a volumetric dataset for intracavitary or intraluminal or endocavity applicators, for brachytherapy plans that have three‑dimensional image datasets acquired as part of simulation, if: (a) the planning process is required to deliver the prescribed dose to a three‑dimensional volume, and relative to multiple line for channel delivery applicators (excluding interstitial catheters and needles and multi‑catheter devices); and (b) based on review and assessment by a radiation oncologist, the planning process requires the differential of dose between target, organs at risk and normal tissue dose using avoidance strategies (which include placement of sources and/or dwell‑times or tissue packing); and (c) delineation of structures is required as part of the planning process to produce a dose‑volume histogram integral to the avoidance strategies; and (d) dose calculations are performed on a personalised basis, which must include three‑dimensional dose calculation to target and organ‑at‑risk volumes; and (e) dose calculations and the dose‑volume histogram are approved and recorded with the plan | $974.70 75% benefit $731.05 85% benefit $866.20 was $870.20 |
| 15976 | Intermediate level dosimetry re‑planning of an initial brachytherapy plan described in item 15974 if treatment adjustments to that initial plan are inadequate to satisfy treatment protocol requirements | $487.40 75% benefit $365.55 85% benefit $414.30 |
| 15978 | New 85% benefit on 1 November 2026Complex level dosimetry for brachytherapy plans that contain multiple needles, catheters or radiation sources, calculated on the three‑dimensional volumetric dataset, if: (a) the planning process is required to deliver a prescribed dose to a target volume relative to multiple channel delivery applicators, needles or catheters or radiation sources; and (b) based on review and assessment by a radiation oncologist, the planning process requires the differential of doses between the target, organs at risk and normal tissue dose using avoidance strategies (which include the placement of sources and/or dwell times or tissue packing; and (c) delineation of structures is required as part of the planning process, in order to produce a dose‑volume histogram to review and assess the plan; and (d) dose calculations are performed on a personalised basis, which must include three‑dimensional dose calculation to target and organ at risk volumes; and (e) dose calculations and the dose‑volume histogram are approved and recorded with the plan | $1,132.65 75% benefit $849.50 85% benefit $1,024.15 was $1,028.15 |
| 15980 | Complex level dosimetry re‑planning of an initial brachytherapy plan described in item 15978 if treatment adjustments to the initial plan are inadequate to satisfy treatment protocol requirements | $566.40 75% benefit $424.80 85% benefit $481.45 |
| 15982 | Brachytherapy treatment, if: (a) the service is performed by radiation therapists and medical physicists; and (b) a radiation oncologist is in attendance during the service; and (c) the treatment is to implement a brachytherapy treatment plan described in any of items 15970, 15972, 15974, 15976, 15978 and 15980 | $424.70 75% benefit $318.55 85% benefit $361.00 |
| 15984 | Verification of position of brachytherapy applicators, needles, catheters or radioactive sources, if: (a) a two‑dimensional or three‑dimensional volumetric image set, or a validated in‑vivo dosimetry measurement, is required to facilitate an adjustment to the applicators, needles, catheters or dosimetry plan; and (b) decisions using the acquired images are based on action algorithms and enacted immediately prior to, or during, treatment, where treatment is preceded by manipulation or adjustment of delivery applicator or adjustment of the dosimetry plan; and (c) the service is associated with a service to which any of the following items apply: (i) items 15958 to 15968; (ii) item 15982 | $156.45 75% benefit $117.35 85% benefit $133.00 |
| 15990 | New 85% benefit on 1 November 2026Proton beam dosimetry, and proton-photon comparative plan reporting, to assess eligibility for proton beam therapy via the Medical Treatment Overseas Program if: (a) proton planning is required to calculate dose to single or multiple-target structures and requires a dose-volume histogram to complete the planning process; and (b) the proton planning process optimises the differential between target dose, organs at risk, and normal tissue dose, based on review and assessment by a radiation oncologist; and (c) all relevant gross tumour volumes, clinical target volumes and organs at risk are rendered as volumes and nominated with planning dose objectives; and (d) organs at risk are nominated as planning dose constraints; and (e) dose calculations and dose-volume histograms are generated in an inverse planned process, using a specialised calculation algorithm, with prescription and plan details approved and recorded with the plan; and (f) a three-dimensional or four-dimensional image volume dataset is used for the relevant region to be planned and verified; and (g) the final proton dosimetry plan is: (i) validated by a radiation therapist and a medical physicist, using quality assurance processes; and (ii) approved by the radiation oncologist; and (h) a proton-photon comparative plan report is generated; and (i) the service is bulk-billed | $7,728.65 75% benefit $5,796.50 85% benefit $7,620.15 was $7,624.15 |
T3 Therapeutic Nuclear Medicine
9 items
| Item | Description | Fee and benefits |
|---|---|---|
| 16003 | New 85% benefit on 1 November 2026Intra-cavitary administration of a therapeutic dose of Yttrium 90 (not including preliminary paracentesis and other than a service to which item 35404, 35406 or 35408 applies or a service associated with selective internal radiation therapy) (Anaes.) | $1,698.50 75% benefit $1,273.90 85% benefit $1,590.00 was $1,594.00 |
| 16006 | New 85% benefit on 1 November 2026Administration of a therapeutic dose of Iodine 131 for thyroid cancer by single dose technique | $1,144.95 75% benefit $858.75 85% benefit $1,036.45 was $1,040.45 |
| 16009 | Administration of a therapeutic dose of Iodine 131 for thyrotoxicosis by single dose technique | $554.65 75% benefit $416.00 85% benefit $471.50 |
| 16012 | New 85% benefit on 1 November 2026Intravenous administration of a therapeutic dose of Phosphorous 32 | $3,185.75 75% benefit $2,389.35 85% benefit $3,077.25 was $3,081.25 |
| 16015 | New 85% benefit on 1 November 2026Administration of Strontium 89 for the relief of bone pain due to skeletal metastases (as indicated by a positive bone scan), if systemic antineoplastic therapy is unavailable or has failed to control the patient’s disease and either: a) the disease is poorly controlled by conventional radiotherapy; or b) conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain. | $4,890.05 75% benefit $3,667.55 85% benefit $4,781.55 was $4,785.55 |
| 16018 | New 85% benefit on 1 November 2026Administration of 153 Sm-lexidronam for the relief of bone pain due to skeletal metastases (as indicated by a positive bone scan), if systemic antineoplastic therapy is unavailable or has failed to control the patient’s disease, and: a) the disease is poorly controlled by conventional radiotherapy; or b) conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain. | $5,261.65 75% benefit $3,946.25 85% benefit $5,153.15 was $5,157.15 |
| 16050 | New 85% benefit on 1 November 2026Administration of Lutetium 177 PSMA, followed within 36 hours by whole body Lu-PSMA SPECT, for treatment of a patient with metastatic castrate resistant prostate cancer who is: (a) PSMA-positive as determined by PSMA PET (defined as SUVmax >15 at a single site of disease and SUVmax >10 at all sites of measurable disease) after disease progression and (b) prior treatment includes at least one taxane chemotherapy and at least one androgen receptor signalling inhibitor. Applicable once per cycle, up to a maximum of 2 cycles in the initial treatment phase. | $8,208.00 75% benefit $6,156.00 85% benefit $8,099.50 was $8,103.50 |
| 16055 | New 85% benefit on 1 November 2026Administration of Lutetium 177 PSMA, followed within 36 hours by whole body Lu-PSMA SPECT, for treatment of a patient with metastatic castrate resistant prostate cancer, if:(a) a service to which item 16050 applies has been provided; and(b) the patient has not developed disease progression while receiving Lutetium 177 PSMA for this condition. Applicable once per cycle, up to a maximum of 4 cycles in the continuing treatment phase. | $8,208.00 75% benefit $6,156.00 85% benefit $8,099.50 was $8,103.50 |
| 16060 | New 85% benefit on 1 November 2026177Lutetium-DOTA-somatostatin receptor agonist treatment cycle for patients with histologically confirmed and inoperable neuroendocrine neoplasm (NEN), either locally advanced or metastatic, with documented disease progression or uncontrolled symptoms related to their NEN despite standard therapy who: a) have high tumour somatostatin receptor expression demonstrated on whole body 68Ga DOTA somatostatin agonist PET study; and b) are considered suitable for a course of 177Lutetium-DOTA-somatostatin receptor agonist therapy by a formally convened NEN multidisciplinary board. Includes the necessary patient preparation, administration and treatment, immediate patient aftercare required for the treatment cycle, consultation with the supervising specialist within 36 hours of treatment, and a post-infusion SPECT if performed. | $9,999.95 75% benefit $7,500.00 85% benefit $9,891.45 was $9,895.45 |
T4 Obstetrics
51 items
| Item | Description | Fee and benefits |
|---|---|---|
| 16400 | Antenatal service provided by a practice midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, applicable 10 times for a pregnancy, if: (a) the service is provided on behalf of, and under the supervision of, a medical practitioner; and (b) the service is provided at, or from, a practice location in a regional, rural or remote area; and (c) the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner; and (d) the service is not provided for an admitted patient of a hospital or approved day facility | $32.65 85% benefit $27.80 |
| 16401 | Professional attendance at consulting rooms or a hospital by a specialist in the practice of the specialist’s specialty of obstetrics after referral of the patient to the specialist—initial attendance in a single course of treatment | $102.35 75% benefit $76.80 85% benefit $87.00 |
| 16404 | Professional attendance at consulting rooms or a hospital by a specialist in the practice of the specialist’s specialty of obstetrics after referral of the patient to the specialist—an attendance after the initial attendance in a single course of treatment | $51.50 75% benefit $38.65 85% benefit $43.80 |
| 16406 | Antenatal professional attendance by an obstetrician or general practitioner, as part of a single course of treatment when the patient is referred by a participating midwife Applicable once for a pregnancy | $160.35 75% benefit $120.30 85% benefit $136.30 |
| 16407 | Postnatal professional attendance (other than a service to which any other item applies) if the attendance: (a) is by an obstetrician or general practitioner; and (b) is in hospital or at consulting rooms; and (c) is between 4 and 8 weeks after the birth; and (d) lasts at least 20 minutes; and (e) includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and (f) is for a pregnancy in relation to which a service to which item 82140 applies is not provided Payable once only for a pregnancy | $85.80 75% benefit $64.35 85% benefit $72.95 |
| 16408 | New wording on 1 November 2026Postnatal attendance (other than attendance at consulting rooms, a hospital or a residential care home or a service to which any other item applies) if the attendance:(a) is by: (i) a midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or (ii) an obstetrician; or (iii) a general practitioner; and (b) is between 1 week and 4 weeks after the birth; and (c) lasts at least 20 minutes; and (d) is for a patient who was privately admitted for the birth; and (e) is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 applies is not provided Payable once only for a pregnancy | $63.90 85% benefit $54.35 |
| 16500 | Antenatal attendance | $56.45 75% benefit $42.35 85% benefit $48.00 |
| 16501 | External cephalic version for breech presentation, after 36 weeks, if no contraindication exists, in a unit with facilities for caesarean section, including pre and post version CTG, with or without tocolysis, other than a service to which items 55718 to 55728 and 55768 to 55774 apply—chargeable whether or not the version is successful and limited to a maximum of 2 ECVs per pregnancy | $168.20 75% benefit $126.15 85% benefit $143.00 |
| 16502 | Polyhydramnios, unstable lie, multiple pregnancy, pregnancy complicated by diabetes or anaemia, threatened premature labour treated by bed rest only or oral medication, requiring admission to hospital—a professional attendance that is not a routine antenatal attendance, applicable once per day | $56.45 75% benefit $42.35 85% benefit $48.00 |
| 16505 | Threatened abortion, threatened miscarriage or hyperemesis gravidarum, requiring admission to hospital, treatment of—an attendance that is not a routine antenatal attendance | $56.45 75% benefit $42.35 85% benefit $48.00 |
| 16508 | Pregnancy complicated by acute intercurrent infection, fetal growth restriction, threatened premature labour with ruptured membranes or threatened premature labour treated by intravenous therapy, requiring admission to hospital—professional attendance (other than a service to which item 16533 applies) that is not a routine antenatal attendance, applicable once per day | $56.45 75% benefit $42.35 85% benefit $48.00 |
| 16509 | Pre‑eclampsia, eclampsia or antepartum haemorrhage, treatment of—professional attendance (other than a service to which item 16534 applies) that is not a routine antenatal attendance | $56.45 75% benefit $42.35 85% benefit $48.00 |
| 16511 | Cervix, purse string ligation of (Anaes.) | $263.15 75% benefit $197.40 85% benefit $223.70 |
| 16512 | Cervix, removal of purse string ligature of (Anaes.) | $76.00 75% benefit $57.00 85% benefit $64.60 |
| 16514 | Antenatal cardiotocography in the management of high risk pregnancy (not during the course of the confinement) | $43.85 75% benefit $32.90 85% benefit $37.30 |
| 16515 | New 85% benefit on 1 November 2026Management of vaginal birth as an independent procedure, if the patient’s care has been transferred by another medical practitioner for management of the birth and the attending medical practitioner has not provided antenatal care to the patient, including all attendances related to the birth (Anaes.) | $755.05 75% benefit $566.30 85% benefit $646.55 was $650.55 |
| 16518 | Management of labour, incomplete, if the patient’s care has been transferred to another medical practitioner for completion of the birth (Anaes.) | $539.30 75% benefit $404.50 85% benefit $458.45 |
| 16519 | New 85% benefit on 1 November 2026Management of labour and birth by any means (including Caesarean section) including post‑partum care for 5 days (Anaes.) | $830.60 75% benefit $622.95 85% benefit $722.10 was $726.10 |
| 16520 | Caesarean section and post‑operative care for 7 days, if the patient’s care has been transferred by another medical practitioner for management of the confinement and the attending medical practitioner has not provided any of the antenatal care (H) (Anaes.) | $755.05 75% benefit $566.30 |
| 16522 | Management of labour and birth, or birth alone, (including caesarean section), on or after 23 weeks gestation, if in the course of antenatal supervision or intrapartum management one or more of the following conditions is present, including postnatal care for 7 days: (a) fetal loss; (b) multiple pregnancy; (c) antepartum haemorrhage that is: (i) of greater than 200 ml; or (ii) associated with disseminated intravascular coagulation; (d) placenta praevia on ultrasound in the third trimester with the placenta within 2 cm of the internal cervical os; (e) baby with a birth weight less than or equal to 2,500 g; (f) trial of vaginal birth in a patient with uterine scar where there has been a planned vaginal birth after caesarean section; (g) trial of vaginal breech birth where there has been a planned vaginal breech birth; (h) prolonged labour greater than 12 hours with partogram evidence of abnormal cervimetric progress as evidenced by cervical dilatation at less than 1 cm/hr in the active phase of labour (after 3 cm cervical dilatation and effacement until full dilatation of the cervix); (i) acute fetal compromise evidenced by: (i) scalp pH less than 7.15; or (ii) scalp lactate greater than 4.0; (j) acute fetal compromise evidenced by at least one of the following significant cardiotocograph abnormalities: (i) prolonged bradycardia (less than 100 bpm for more than 2 minutes); (ii) absent baseline variability (less than 3 bpm); (iii) sinusoidal pattern; (iv) complicated variable decelerations with reduced (3 to 5 bpm) or absent baseline variability; (v) late decelerations; (k) pregnancy induced hypertension of at least 140/90 mm Hg associated with: (i) at least 2+ proteinuria on urinalysis; or (ii) protein-creatinine ratio greater than 30 mg/mmol; or (iii) platelet count less than 150 x 109/L; or (iv) uric acid greater than 0.36 mmol/L; (l) gestational diabetes mellitus requiring at least daily blood glucose monitoring; (m) mental health disorder (whether arising prior to pregnancy, during pregnancy or postpartum) that is demonstrated by: (i) the patient requiring hospitalisation; or (ii) the patient receiving ongoing care by a psychologist or psychiatrist to treat the symptoms of a mental health disorder; or (iii) the patient having a GP mental health treatment plan; or (iv) the patient having a management plan prepared in accordance with item 291; (n) disclosure or evidence of domestic violence; (o) any of the following conditions either diagnosed pre-pregnancy or evident at the first antenatal visit before 20 weeks gestation: (i) pre-existing hypertension requiring antihypertensive medication prior to pregnancy; (ii) cardiac disease (co-managed with a specialist physician and with echocardiographic evidence of myocardial dysfunction); (iii) previous renal or liver transplant; (iv) renal dialysis; (v) chronic liver disease with documented oesophageal varices; (vi) renal insufficiency in early pregnancy (serum creatinine greater than 110 mmol/L); (vii) neurological disorder that confines the patient to a wheelchair throughout pregnancy; (viii) maternal height of less than 148 cm; (ix) a body mass index greater than or equal to 40; (x) pre-existing diabetes mellitus on medication prior to pregnancy; (xi) thyrotoxicosis requiring medication; (xii) previous thrombosis or thromboembolism requiring anticoagulant therapy through pregnancy and the early puerperium; (xiii) thrombocytopenia with platelet count of less than 100,000 prior to 20 weeks gestation; (xiv) HIV, hepatitis B or hepatitis C carrier status positive; (xv) red cell or platelet iso-immunisation; (xvi) cancer with metastatic disease; (xvii) illicit drug misuse during pregnancy (Anaes.) | $1,950.10 75% benefit $1,462.60 |
| 16527 | New 85% benefit on 1 November 2026Management of vaginal birth, if the patient’s care has been transferred by a participating midwife for management of the birth, including all attendances related to the birth Applicable once for a pregnancy (Anaes.) | $755.05 75% benefit $566.30 85% benefit $646.55 was $650.55 |
| 16528 | Caesarean section and post‑operative care for 7 days, if the patient’s care has been transferred by a participating midwife for management of the birth Applicable once for a pregnancy (H) (Anaes.) | $755.05 75% benefit $566.30 |
| 16530 | Management of pregnancy loss, from 14 weeks to 15 weeks and 6 days gestation, other than a service to which item 16531, 35640 or 35643 applies (Anaes.) | $460.00 75% benefit $345.00 85% benefit $391.00 |
| 16531 | Management of pregnancy loss, from 16 weeks to 22 weeks and 6 days gestation, other than a service to which item 16530, 35640 or 35643 applies (Anaes.) | $920.00 75% benefit $690.00 |
| 16533 | Pregnancy complicated by acute intercurrent infection, fetal growth restriction, threatened premature labour with ruptured membranes or threatened premature labour treated by intravenous therapy, requiring admission to hospital—each professional attendance lasting at least 40 minutes that is not a routine antenatal attendance, to a maximum of 3 services per pregnancy | $126.35 75% benefit $94.80 |
| 16534 | Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of—each professional attendance lasting at least 40 minutes that is not a routine antenatal attendance, to a maximum of 3 services per pregnancy | $126.35 75% benefit $94.80 |
| 16564 | Evacuation of retained products of conception (placenta, membranes or mole) as a complication of confinement, with or without curettage of the uterus, as an independent procedure (H) (Anaes.) | $260.90 75% benefit $195.70 |
| 16567 | Management of postpartum haemorrhage by special measures such as packing of uterus, as an independent procedure (H) (Anaes.) | $381.55 75% benefit $286.20 |
| 16570 | Acute inversion of the uterus, vaginal correction of, as an independent procedure (H) (Anaes.) | $498.05 75% benefit $373.55 |
| 16571 | Cervix, repair of extensive laceration or lacerations (Anaes.) | $381.55 75% benefit $286.20 85% benefit $324.35 |
| 16573 | Third degree tear, involving anal sphincter muscles and rectal mucosa, repair of, as an independent procedure (H) (Anaes.) | $310.90 75% benefit $233.20 |
| 16590 | Planning and management, by a practitioner, of a pregnancy if: (a) the practitioner intends to take primary responsibility for management of the pregnancy and any complications, and to be available for the birth; and (b) the patient intends to be privately admitted for the birth; and (c) the pregnancy has progressed beyond 28 weeks gestation; and (d) the practitioner has maternity privileges at a hospital or birth centre; and (e) the service includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and (f) a service to which item 16591 applies is not provided in relation to the same pregnancy Applicable once for a pregnancy | $446.15 75% benefit $334.65 85% benefit $379.25 |
| 16591 | Planning and management, by a practitioner, of a pregnancy if: (a) the pregnancy has progressed beyond 28 weeks gestation; and (b) the service includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and (c) a service to which item 16590 applies is not provided in relation to the same pregnancy Applicable once for a pregnancy | $170.75 75% benefit $128.10 85% benefit $145.15 |
| 16600 | Amniocentesis, diagnostic | $76.00 75% benefit $57.00 85% benefit $64.60 |
| 16603 | Chorionic villus sampling, by any route | $145.90 75% benefit $109.45 85% benefit $124.05 |
| 16606 | Fetal blood sampling, using interventional techniques from umbilical cord or fetus, including fetal neuromuscular blockade and amniocentesis (Anaes.) | $291.15 75% benefit $218.40 85% benefit $247.50 |
| 16609 | Fetal intravascular blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling (H) (Anaes.) | $593.65 75% benefit $445.25 |
| 16612 | FOETAL INTRAPERITONEAL BLOOD TRANSFUSION, using blood already collected, including neuromuscular blockade, amniocentesis and foetal blood sampling - not performed in conjunction with a service described in item 16609 (Anaes.) | $467.10 75% benefit $350.35 85% benefit $397.05 |
| 16615 | Fetal intraperitoneal blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling—performed in conjunction with a service described in item 16609 (H) (Anaes.) | $248.80 75% benefit $186.60 |
| 16618 | Amniocentesis, therapeutic, when indicated because of polyhydramnios with at least 500 ml being aspirated (H) | $248.80 75% benefit $186.60 |
| 16621 | Amnioinfusion, for diagnostic or therapeutic purposes in the presence of severe oligohydramnios (H) | $248.80 75% benefit $186.60 |
| 16624 | Fetal fluid filled cavity, drainage of (H) | $358.15 75% benefit $268.65 |
| 16627 | Feto‑amniotic shunt, insertion of, into fetal fluid filled cavity, including neuromuscular blockade and amniocentesis (H) | $728.90 75% benefit $546.70 |
| 91850 | Antenatal video service provided by a practice midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if: (a) the service is provided on behalf of, and under the supervision of, a medical practitioner; and (b) the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner | $32.65 85% benefit $27.80 |
| 91851 | Postnatal video attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if: (a) is between 4 and 8 weeks after the birth; and (b) lasts at least 20 minutes in duration; and (c) includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and (d) is for a pregnancy in relation to which a service to which item 82140 applies is not provided. Applicable once for a pregnancy | $85.80 85% benefit $72.95 |
| 91852 | Postnatal video attendance (other than a service to which any other item applies) if:(a) the attendance is rendered by: (i) a practice midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or (ii) an obstetrician; or (iii) a general practitioner; and (b) is between 1 week and 4 weeks after the birth; and (c) lasts at least 20 minutes; and (d) is for a patient who was privately admitted for the birth; and (e) is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 of the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020 or item 91214, 91215, 91221 or 91222 is not provided. Applicable once for a pregnancy | $63.90 85% benefit $54.35 |
| 91853 | Antenatal video attendance | $56.45 85% benefit $48.00 |
| 91855 | Antenatal phone service provided by a practice midwife, nurse or an Aboriginal and Torres Strait Islander health practitioner, to a maximum of 10 services per pregnancy, if: (a) the service is provided on behalf of, and under the supervision of, a medical practitioner; and (b) the service is not performed in conjunction with another antenatal attendance item in Group T4 for the same patient on the same day by the same practitioner. | $32.65 85% benefit $27.80 |
| 91856 | Postnatal phone attendance by an obstetrician or general practitioner (other than a service to which any other item applies) if: (a) is between 4 and 8 weeks after the birth; and (b) lasts at least 20 minutes in duration; and (c) includes a mental health assessment (including screening for drug and alcohol use and domestic violence) of the patient; and (d) is for a pregnancy in relation to which a service to which item 82140 applies is not provided. Applicable once for a pregnancy | $85.80 85% benefit $72.95 |
| 91857 | Postnatal phone attendance (other than a service to which any other item applies) if: (a) the attendance is rendered by: (i) a practice midwife (on behalf of and under the supervision of the medical practitioner who attended the birth); or (ii) an obstetrician; or (iii) a general practitioner; and (b) is between 1 week and 4 weeks after the birth; and (c) lasts at least 20 minutes; and (d) is for a patient who was privately admitted for the birth; and (e) is for a pregnancy in relation to which a service to which item 82130, 82135 or 82140 of the Health Insurance (Section 3C Midwife and Nurse Practitioner Services) Determination 2020 or item 91214, 91215, 91221 or 91222 is not provided. Applicable once for a pregnancy | $63.90 85% benefit $54.35 |
| 91858 | Antenatal phone attendance. | $56.45 85% benefit $48.00 |
T6 Anaesthetics
10 items
| Item | Description | Fee and benefits |
|---|---|---|
| 17610 | ANAESTHETIST, PRE-ANAESTHESIA CONSULTATION (Professional attendance by a medical practitioner in the practice of ANAESTHESIA) - a BRIEF consultation involving a targeted history and limited examination (including the cardio-respiratory system) - AND of not more than 15 minutes s duration, not being a service associated with a service to which items 2801 - 3000 apply | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 17615 | Professional attendance by a medical practitioner in the practice of anaesthesia for a consultation on a patient undergoing advanced surgery or who has complex medical problems, involving a selective history and an extensive examination of multiple systems and the formulation of a written patient management plan documented in the patient notes - and of more than 15 minutes but not more than 30 minutes duration, not being a service associated with a service to which items 2801 - 3000 applies | $103.95 75% benefit $78.00 85% benefit $88.40 |
| 17620 | Professional attendance by a medical practitioner in the practice of anaesthesia for a consultation on a patient undergoing advanced surgery or who has complex medical problems involving a detailed history and comprehensive examination of multiple systems and the formulation of a written patient management plan documented in the patient notes - and of more than 30 minutes but not more than 45 minutes duration, not being a service associated with a service to which items 2801 - 3000 apply | $144.00 75% benefit $108.00 85% benefit $122.40 |
| 17625 | Professional attendance by a medical practitioner in the practice of anaesthesia for a consultation on a patient undergoing advanced surgery or who has complex medical problems involving an exhaustive history and comprehensive examination of multiple systems , the formulation of a written patient management plan following discussion with relevant health care professionals and/or the patient, involving medical planning of high complexity documented in the patient notes - and of more than 45 minutes duration, not being a service associated with a service to which items 2801 - 3000 apply | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 17640 | ANAESTHETIST, REFERRED CONSULTATION (other than prior to anaesthesia) (Professional attendance by a specialist anaesthetist in the practice of ANAESTHESIA where the patient is referred to him or her) - a BRIEF consultation involving a short history and limited examination - AND of not more than 15 minutes duration, not being a service associated with a service to which items 2801 - 3000 apply | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 17645 | - a consultation involving a selective history and examination of multiple systems and the formulation of a written patient management plan - AND of more than 15 minutes but not more than 30 minutes duration, not being a service associated with a service to which items 2801 - 3000 apply. | $103.95 75% benefit $78.00 85% benefit $88.40 |
| 17650 | - a consultation involving a detailed history and comprehensive examination of multiple systems and the formulation of a written patient management plan - AND of more than 30 minutes but not more than 45 minutes duration, not being a service associated with a service to which items 2801 - 3000 apply | $144.00 75% benefit $108.00 85% benefit $122.40 |
| 17655 | - a consultation involving an exhaustive history and comprehensive examination of multiple systems and the formulation of a written patient management plan following discussion with relevant health care professionals and/or the patient, involving medical planning of high complexity, - AND of more than 45 minutes duration, not being a service associated with a service to which items 2801 - 3000 apply. | $183.35 75% benefit $137.55 85% benefit $155.85 |
| 17680 | ANAESTHETIST, CONSULTATION, OTHER (Professional attendance by an anaesthetist in the practice of ANAESTHESIA) - a consultation immediately prior to the institution of a major regional blockade in a patient in labour, where no previous anaesthesia consultation has occurred, not being a service associated with a service to which items 2801 - 3000 apply. | $103.95 75% benefit $78.00 85% benefit $88.40 |
| 17690 | - Where a pre-anaesthesia consultation covered by an item in the range 17615-17625 is performed in-rooms if: (a) the service is provided to a patient prior to an admitted patient episode of care involving anaesthesia; and (b) the service is not provided to an admitted patient of a hospital; and (c) the service is not provided on the day of admission to hospital for the subsequent episode of care involving anaesthesia services; and (d) the service is of more than 15 minutes duration not being a service associated with a service to which items 2801 - 3000 apply. | $48.00 75% benefit $36.00 85% benefit $40.80 |
T7 Regional Or Field Nerve Blocks
43 items
| Item | Description | Fee and benefits |
|---|---|---|
| 18213 | Intravenous regional anaesthesia of limb by retrograde perfusion of local anaesthetic agent | $106.05 75% benefit $79.55 85% benefit $90.15 |
| 18216 | Intrathecal, combined spinal-epidural or epidural infusion of a therapeutic substance, initial injection or commencement of, including up to 1 hour of continuous attendance by the medical practitioner (H) (Anaes.) | $227.30 75% benefit $170.50 |
| 18219 | Intrathecal, combined spinal-epidural or epidural infusion of a therapeutic substance, initial injection or commencement of, if continuous attendance by the medical practitioner extends beyond the first hour (H) (Anaes.) Derived fee: The fee for item 18216 plus $22.75 for each additional 15 minutes or part thereof beyond the first hour of attendance by the medical practitioner. | Derived |
| 18222 | Continuous infusion or injection by catheter of a therapeutic substance (not contrast agent) to maintain regional anaesthesia or analgesia, subsequent injection or revision of, if the period of continuous medical practitioner attendance is 15 minutes or less | $45.10 75% benefit $33.85 85% benefit $38.35 |
| 18225 | Continuous infusion or injection by catheter of a therapeutic substance (not contrast agent) to maintain regional anaesthesia or analgesia, subsequent injection or revision of, if the period of continuous medical practitioner attendance is more than 15 minutes | $59.85 75% benefit $44.90 85% benefit $50.90 |
| 18226 | Intrathecal, combined spinal‑epidural or epidural infusion of a therapeutic substance, initial injection or commencement of, including up to 1 hour of continuous attendance by the medical practitioner—for a patient in labour, if the service is provided between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday (H) | $340.90 75% benefit $255.70 |
| 18227 | Intrathecal, combined spinal‑epidural or epidural infusion of a therapeutic substance, initial injection or commencement of, if continuous attendance by a medical practitioner extends beyond the first hour—for a patient in labour, if the service is provided between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday (H) Derived fee: The fee for item 18226 plus $34.25 for each additional 15 minutes or part there of beyond the first hour of attendance by the medical practitioner. | Derived |
| 18228 | Interpleural block, initial injection or commencement of infusion of a therapeutic substance, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18230 | Intrathecal or epidural injection of neurolytic substance (not contrast agent) by any route, including transforaminal route (Anaes.) | $285.35 75% benefit $214.05 85% benefit $242.55 |
| 18232 | Intrathecal or epidural injection (including translaminar and transforaminal approaches) of therapeutic substance or substances (anaesthetic, steroid or chemotherapeutic agents):(a) other than a service to which another item in this Group applies; and (b) not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach (Anaes.) | $227.30 75% benefit $170.50 85% benefit $193.25 |
| 18233 | EPIDURAL INJECTION of blood for blood patch (Anaes.) | $227.30 75% benefit $170.50 85% benefit $193.25 |
| 18234 | Trigeminal nerve, primary branch (ophthalmic, maxillary or mandibular branches, excluding infraorbital nerve), injection of an anaesthetic agent or steroid, but not in association with a service to which an item in Group T8 applies, unless a targeted percutaneous technique is used (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18236 | Trigeminal nerve, peripheral branch (including infraorbital nerve), injection of an anaesthetic agent, but not in association with a service to which an item in Group T8 applies, unless a targeted percutaneous technique is used (Anaes.) | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18238 | Facial nerve, injection of an anaesthetic agent, other than a service associated with a service to which item 18240 applies, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $45.10 75% benefit $33.85 85% benefit $38.35 |
| 18240 | RETROBULBAR OR PERIBULBAR INJECTION of an anaesthetic agent | $112.00 75% benefit $84.00 85% benefit $95.20 |
| 18242 | GREATER OCCIPITAL NERVE, injection of an anaesthetic agent (Anaes.) | $45.10 75% benefit $33.85 85% benefit $38.35 |
| 18244 | Vagus nerve, injection of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $120.70 75% benefit $90.55 85% benefit $102.60 |
| 18248 | PHRENIC NERVE, injection of an anaesthetic agent | $106.05 75% benefit $79.55 85% benefit $90.15 |
| 18250 | SPINAL ACCESSORY NERVE, injection of an anaesthetic agent | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18252 | Cervical plexus, injection of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $120.70 75% benefit $90.55 85% benefit $102.60 |
| 18254 | Brachial plexus, injection of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $120.70 75% benefit $90.55 85% benefit $102.60 |
| 18256 | SUPRASCAPULAR NERVE, injection of an anaesthetic agent | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18258 | INTERCOSTAL NERVE (single), injection of an anaesthetic agent | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18260 | INTERCOSTAL NERVES (multiple), injection of an anaesthetic agent | $106.05 75% benefit $79.55 85% benefit $90.15 |
| 18262 | Ilio inguinal, iliohypogastric or genitofemoral nerves, one or more of, injections of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach (Anaes.) | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18264 | Pudendal nerve or dorsal nerve (or both), injection of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $120.70 75% benefit $90.55 85% benefit $102.60 |
| 18266 | Ulnar, radial or median nerve, main trunk of, one or more of, injections of an anaesthetic agent, not being associated with a brachial plexus block, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18268 | OBTURATOR NERVE, injection of an anaesthetic agent | $106.05 75% benefit $79.55 85% benefit $90.15 |
| 18270 | FEMORAL NERVE, injection of an anaesthetic agent | $106.05 75% benefit $79.55 85% benefit $90.15 |
| 18272 | SAPHENOUS, SURAL, POPLITEAL OR POSTERIOR TIBIAL NERVE, MAIN TRUNK OF, 1 or more of, injection of an anaesthetic agent | $74.85 75% benefit $56.15 85% benefit $63.65 |
| 18276 | PARAVERTEBRAL NERVES, injection of an anaesthetic agent, (multiple levels) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18278 | Sciatic nerve, injection of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach | $106.05 75% benefit $79.55 85% benefit $90.15 |
| 18280 | Sphenopalatine ganglion, injection of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18282 | Carotid sinus, injection of an anaesthetic agent, as an independent percutaneous procedure (H) | $120.70 75% benefit $90.55 |
| 18284 | Cervical or thoracic sympathetic chain, injection of an anaesthetic agent (H) (Anaes.) | $176.70 75% benefit $132.55 |
| 18286 | Lumbar or pelvic sympathetic chain, injection of an anaesthetic agent (H) (Anaes.) | $176.70 75% benefit $132.55 |
| 18288 | Coeliac plexus or splanchnic nerves, injection of an anaesthetic agent, not in association with a service to which an item in Group T8 applies, unless the nerve block is performed using a targeted percutaneous approach (H) (Anaes.) | $176.70 75% benefit $132.55 |
| 18290 | Cranial nerve other than trigeminal, destruction by a neurolytic agent under image guidance, other than a service associated with the injection of botulinum toxin (Anaes.) | $298.85 75% benefit $224.15 85% benefit $254.05 |
| 18292 | Nerve branch, destruction by a neurolytic agent under image guidance, other than a service to which another item in this Group applies or a service associated with the injection of botulinum toxin except a service to which item 18354 applies (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18294 | Coeliac plexus or splanchnic nerves, destruction by a neurolytic agent under image guidance (H) (Anaes.) | $210.70 75% benefit $158.05 |
| 18296 | Lumbar or pelvic sympathetic chain, destruction by a neurolytic agent under image guidance (H) (Anaes.) | $180.15 75% benefit $135.15 |
| 18297 | Assistance at the administration of an epidural blood patch (a service to which item 18233 applies) by another medical practitioner | $71.00 75% benefit $53.25 85% benefit $60.35 |
| 18298 | CERVICAL OR THORACIC SYMPATHETIC CHAIN, destruction by a neurolytic agent (Anaes.) | $210.70 75% benefit $158.05 85% benefit $179.10 |
T11 Botulinum Toxin Injections
18 items
| Item | Description | Fee and benefits |
|---|---|---|
| 18350 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of hemifacial spasm in a patient who is at least 12 years of age, including all such injections on any one day | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18351 | Clostridium Botulinum Type A Toxin-Haemagglutinin Complex (Dysport), injection of, for the treatment of hemifacial spasm in a patient who is at least 18 years of age, including all such injections on any one day | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18353 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox) or Clostridium Botulinum Type A Toxin-Haemagglutinin Complex (Dysport) or IncobotulinumtoxinA (Xeomin), injection of, for the treatment of cervical dystonia (spasmodic torticollis), including all such injections on any one day | $298.85 75% benefit $224.15 85% benefit $254.05 |
| 18354 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), Clostridium Botulinum Type A Toxin-Haemagglutinin Complex (Dysport) or IncobotulinumtoxinA (Xeomin), injection of, for the treatment of dynamic equinus foot deformity (including equinovarus and equinovalgus) due to spasticity from cerebral palsy, if: (a) the patient is at least 2 years of age; and (b) the treatment is for all or any of the muscles subserving one functional activity and supplied by one motor nerve, with a maximum of 4 sets of injections for the patient on any one day (with a maximum of 2 sets of injections for each lower limb), including all injections per set (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18355 | IncobotulinumtoxinA (Xeomin), injection of, for the treatment of chronic sialorrhea in a patient who is at least 2 years of age, if the condition is due to a neurological or neurodevelopmental disorder, including all such injections on any one day (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18360 | New wording on 1 November 2026Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), Clostridium Botulinum Type A Toxin Haemagglutinin Complex (Dysport) or IncobotulinumtoxinA (Xeomin), injection of, for the treatment of moderate to severe focal spasticity if:(a) the patient is at least 18 years of age; and (b) the spasticity is associated with a previously diagnosed neurological disorder; and (c) the treatment is provided as: (i) second line therapy when standard treatment for the conditions has failed; or (ii) an adjunct to physical therapy; and (d) the treatment is for all or any of the muscles subserving one functional activity and supplied by one motor nerve, with a maximum of 4 sets of injections for the patient on any one day (with a maximum of 2 sets of injections for each limb), including all injections per set; and (e) the treatment is not provided on the same occasion as a service mentioned in item 18365 | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18361 | Clostridium Botulinum Type A Toxin-Haemagglutinin Complex (Dysport) or Botulinum Toxin Type A Purified Neurotoxin Complex (Botox) or IncobotulinumtoxinA (Xeomin), injection of, for the treatment of moderate to severe upper limb spasticity due to cerebral palsy if: (a) the patient is at least 2 years of age; and (b) the treatment is for all or any of the muscles subserving one functional activity and supplied by one motor nerve, with a maximum of 4 sets of injections for the patient on any one day (with a maximum of 2 sets of injections for each upper limb), including all injections per set (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18362 | Botulinum Toxin type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of severe primary axillary hyperhidrosis, including all injections on any one day, if: (a) the patient is at least 12 years of age; and (b) the patient has been intolerant of, or has not responded to, topical aluminium chloride hexahydrate; and (c) the patient has not had treatment with botulinum toxin within the immediately preceding 4 months; and (d) if the patient has had treatment with botulinum toxin within the previous 12 months - the patient had treatment on no more than 2 separate occasions (Anaes.) | $295.30 75% benefit $221.50 85% benefit $251.05 |
| 18365 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox) or Clostridium Botulinum Type A Toxin-Haemagglutinin Complex (Dysport) or IncobotulinumtoxinA (Xeomin), injection of, for the treatment of moderate to severe spasticity of the upper limb following an acute event, if: (a) the patient is at least 18 years of age; and (b) treatment is provided as: (i) second line therapy when standard treatment for the condition has failed; or (ii) an adjunct to physical therapy; and (c) the patient does not have established severe contracture in the limb that is to be treated; and (d) the treatment is for all or any of the muscles subserving one functional activity and supplied by one motor nerve, with a maximum of 4 sets of injections for the patient on any one day (with a maximum of 2 sets of injections for each upper limb), including all injections per set; and (e) for a patient who has received treatment on 2 previous separate occasions - the patient has responded to the treatment | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18366 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of strabismus, including all such injections on any one day and associated electromyography (Anaes.) | $187.25 75% benefit $140.45 85% benefit $159.20 |
| 18368 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of spasmodic dysphonia, including all such injections on any one day | $319.60 75% benefit $239.70 85% benefit $271.70 |
| 18369 | Clostridium Botulinum Type A Toxin-Haemagglutinin Complex (Dysport) or IncobotulinumtoxinA (Xeomin), injection of, for the treatment of unilateral blepharospasm in a patient who is at least 18 years of age, including all such injections on any one day (Anaes.) | $53.90 75% benefit $40.45 85% benefit $45.85 |
| 18370 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of unilateral blepharospasm in a patient who is at least 12 years of age, including all such injections on any one day (Anaes.) | $53.90 75% benefit $40.45 85% benefit $45.85 |
| 18372 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of bilateral blepharospasm, in a patient who is at least 12 years of age; including all such injections on any one day (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18374 | Clostridium Botulinum Type A Toxin-Haemagglutinin Complex (Dysport) or IncobotulinumtoxinA (Xeomin), injection of, for the treatment of bilateral blepharospasm in a patient who is at least 18 years of age, including all such injections on any one day (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18375 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), intravesical injection of, with cystoscopy, for the treatment of urinary incontinence, including all such injections on any one day, if: (a) the urinary incontinence is due to neurogenic detrusor overactivity as demonstrated by urodynamic study of a patient with: (i) multiple sclerosis; or (ii) spinal cord injury; or (iii) spina bifida and who is at least 18 years of age; and (b) the patient has urinary incontinence that is inadequately controlled by anti-cholinergic therapy, as manifested by having experienced at least 14 episodes of urinary incontinence per week before commencement of treatment with botulinum toxin type A; and (c) the patient is willing and able to self-catheterise; and (d) the requirements relating to botulinum toxin type A under the Pharmaceutical Benefits Scheme are complied with; and (e) treatment is not provided on the same occasion as a service described in item 104, 105, 110, 116, 119, 11900 or 11919 For each patient - applicable not more than once except if the patient achieves at least a 50% reduction in urinary incontinence episodes from baseline at any time during the period of 6 to 12 weeks after first treatment (Anaes.) | $275.15 75% benefit $206.40 |
| 18377 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), injection of, for the treatment of chronic migraine, including all injections in 1 day, if: (a) the patient is at least 18 years of age; and (b) the patient has experienced an inadequate response, intolerance or contraindication to at least 3 prophylactic migraine medications before commencement of treatment with botulinum toxin, as manifested by an average of 15 or more headache days per month, with at least 8 days of migraine, over a period of at least 6 months, before commencement of treatment with botulinum toxin; and (c) the requirements relating to botulinum toxin type A under the Pharmaceutical Benefits Scheme are complied with For each patient-applicable not more than twice except if the patient achieves and maintains at least a 50% reduction in the number of headache days per month from baseline after 2 treatment cycles (each of 12 weeks duration) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 18379 | Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), intravesical injection of, with cystoscopy, for the treatment of urinary incontinence, including all such injections on any one day, if: (a) the urinary incontinence is due to idiopathic overactive bladder in a patient: and (b) the patient is at least 18 years of age; and (c) the patient has urinary incontinence that is inadequately controlled by at least 2 alternative anti- cholinergic agents, as manifested by having experienced at least 14 episodes of urinary incontinence per week before commencement of treatment with botulinum toxin; and (d) the patient is willing and able to self-catheterise; and (e) treatment is not provided on the same occasion as a service mentioned in item 104, 105, 110, 116, 119, 11900 or 11919 For each patient-applicable not more than once except if the patient achieves at least a 50% reduction in urinary incontinence episodes from baseline at any time during the period of 6 to 12 weeks after first treatment (H) (Anaes.) | $275.15 75% benefit $206.40 |
T10 Relative Value Guide For Anaesthesia
486 items
| Item | Description | Fee and benefits |
|---|---|---|
| 20100 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin, subcutaneous tissue, muscles, salivary glands or superficial vessels of the head including biopsy, not being a service to which another item in this Subgroup applies (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20102 | Initiation of the management of anaesthesia for plastic repair of cleft lip (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20104 | Initiation of the management of anaesthesia for electroconvulsive therapy (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20120 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on external, middle or inner ear, including biopsy, not being a service to which another item in this Subgroup applies (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20124 | Initiation of the management of anaesthesia for otoscopy (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20140 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on eye, not being a service to which another item in this Group applies (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20142 | Initiation of the management of anaesthesia for lens surgery (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20143 | Initiation of the management of anaesthesia for retinal surgery (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20144 | Initiation of the management of anaesthesia for corneal transplant (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20145 | Initiation of the management of anaesthesia for vitrectomy (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20146 | Initiation of the management of anaesthesia for biopsy of conjunctiva (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20147 | Initiation of the management of anaesthesia for squint repair (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20148 | INITIATION OF MANAGEMENT OF ANAESTHESIA for ophthalmoscopy (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 20160 | Initiation of the management of anaesthesia for intranasal procedures on nose or accessory sinuses, other than a service to which another item in this Subgroup applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20162 | Initiation of the management of anaesthesia for intranasal surgery for malignancy or for intranasal ablation (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20164 | Initiation of the management of anaesthesia for biopsy of soft tissue of the nose and accessory sinuses (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20170 | INITIATION OF MANAGEMENT OF ANAESTHESIA for intraoral procedures, including biopsy, not being a service to which another item in this Subgroup applies (6 basic units) | $142.20 75% benefit $106.65 85% benefit $120.90 |
| 20172 | Initiation of the management of anaesthesia for repair of cleft palate (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20174 | Initiation of the management of anaesthesia for excision of retropharyngeal tumour (H) (9 basic units) | $213.30 75% benefit $160.00 |
| 20176 | Initiation of the management of anaesthesia for radical intraoral surgery (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20190 | Initiation of the management of anaesthesia for procedures on facial bones, other than a service to which another item in this Subgroup applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20192 | Initiation of the management of anaesthesia for extensive surgery on facial bones (including prognathism and extensive facial bone reconstruction) (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20210 | Initiation of the management of anaesthesia for intracranial procedures, other than a service to which another item in this Subgroup applies (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20212 | Initiation of the management of anaesthesia for subdural taps (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20214 | Initiation of the management of anaesthesia for burr holes of the cranium (H) (9 basic units) | $213.30 75% benefit $160.00 |
| 20216 | Initiation of the management of anaesthesia for intracranial vascular procedures, including those for aneurysms or arterio‑venous abnormalities (H) (20 basic units) | $474.00 75% benefit $355.50 |
| 20220 | Initiation of the management of anaesthesia for spinal fluid shunt procedures (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20222 | Initiation of the management of anaesthesia for ablation of an intracranial nerve (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20225 | Initiation of the management of anaesthesia for all cranial bone procedures (H) (12 basic units) | $284.40 75% benefit $213.30 |
| 20230 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the head or face (H) (12 basic units) | $284.40 75% benefit $213.30 |
| 20300 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the neck not being a service to which another item in this Subgroup applies (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20305 | Initiation of the management of anaesthesia for incision and drainage of large haematoma, large abscess, cellulitis or similar lesion or epiglottitis, causing life threatening airway obstruction (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20320 | Initiation of the management of anaesthesia for procedures on oesophagus, thyroid, larynx, trachea, lymphatic system, muscles, nerves or other deep tissues of the neck, other than a service to which another item in this Subgroup applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20321 | Initiation of the management of anaesthesia for laryngectomy, hemi laryngectomy, laryngopharyngectomy or pharyngectomy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20330 | Initiation of the management of anaesthesia for laser surgery to the airway (excluding nose and mouth) (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20350 | Initiation of the management of anaesthesia for procedures on major vessels of neck, other than a service to which another item in this Subgroup applies (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20352 | Initiation of the management of anaesthesia for simple ligation of major vessels of neck (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20355 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the neck (H) (12 basic units) | $284.40 75% benefit $213.30 |
| 20400 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the anterior part of the chest, not being a service to which another item in this Subgroup applies (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 20401 | Initiation of the management of anaesthesia for procedures on the breast, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20402 | Initiation of management of anaesthesia for reconstructive procedures on breast, including implant reconstruction and exchange (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20403 | Initiation of management of anaesthesia for axillary dissection or sentinel node biopsy (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20404 | Initiation of the management of anaesthesia for mastectomy (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20405 | Initiation of the management of anaesthesia for reconstructive procedures on the breast using myocutaneous flaps (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20406 | Initiation of the management of anaesthesia for radical or modified radical procedures on breast with internal mammary node dissection (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 20410 | Initiation of the management of anaesthesia for electrical conversion of arrhythmias (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20420 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the posterior part of the chest not being a service to which another item in this Subgroup applies (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20440 | Initiation of the management of anaesthesia for percutaneous bone marrow biopsy of the sternum (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20450 | Initiation of the management of anaesthesia for procedures on clavicle, scapula or sternum, other than a service to which another item in this Subgroup applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20452 | Initiation of the management of anaesthesia for radical surgery on clavicle, scapula or sternum (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20470 | Initiation of the management of anaesthesia for partial rib resection, other than a service to which another item in this Subgroup applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20472 | Initiation of the management of anaesthesia for thoracoplasty (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20474 | Initiation of the management of anaesthesia for radical procedures on chest wall (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 20475 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the anterior or posterior thorax (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20500 | Initiation of the management of anaesthesia for open procedures on the oesophagus (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20520 | INITIATION OF MANAGEMENT OF ANAESTHESIA for all closed chest procedures (including rigid oesophagoscopy or bronchoscopy), not being a service to which another item in this Subgroup applies (6 basic units) | $142.20 75% benefit $106.65 85% benefit $120.90 |
| 20522 | Initiation of the management of anaesthesia for needle biopsy of pleura (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20524 | Initiation of the management of anaesthesia for pneumocentesis (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20526 | Initiation of the management of anaesthesia for thoracoscopy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20528 | Initiation of the management of anaesthesia for mediastinoscopy (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20540 | Initiation of the management of anaesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, or mediastinum, other than a service to which another item in this Subgroup applies (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 20542 | Initiation of the management of anaesthesia for pulmonary decortication (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20546 | Initiation of the management of anaesthesia for pulmonary resection with thoracoplasty (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20548 | Initiation of the management of anaesthesia for intrathoracic repair of trauma to trachea and bronchi (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20560 | Initiation of the management of anaesthesia for: (a) open procedures on the heart, pericardium or great vessels of the chest; or (b) percutaneous insertion of a valvular prosthesis (H) (20 basic units) | $474.00 75% benefit $355.50 |
| 20600 | Initiation of the management of anaesthesia for procedures on cervical spine or spinal cord, or both, other than a service to which another item in this Subgroup applies (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20604 | Initiation of the management of anaesthesia for posterior cervical laminectomy with the patient in the sitting position (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 20620 | Initiation of the management of anaesthesia for procedures on thoracic spine or spinal cord, or both, other than a service to which another item in this Subgroup applies (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20622 | Initiation of the management of anaesthesia for thoracolumbar sympathectomy (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 20630 | Initiation of the management of anaesthesia for procedures in lumbar region, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20632 | Initiation of the management of anaesthesia for lumbar sympathectomy (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20634 | Initiation of the management of anaesthesia for chemonucleolysis (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20670 | Initiation of the management of anaesthesia for extensive spine or spinal cord procedures, or both (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 20680 | Initiation of the management of anaesthesia for manipulation of spine when performed in the operating theatre of a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 20690 | Initiation of the management of anaesthesia for percutaneous spinal procedures, other than a service to which another item in this Subgroup applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20700 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the upper anterior abdominal wall, not being a service to which another item in this Subgroup applies (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 20702 | INITIATION OF MANAGEMENT OF ANAESTHESIA for percutaneous liver biopsy (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 20703 | Initiation of the management of anaesthesia for procedures on the nerves, muscles, tendons and fascia of the upper abdominal wall, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20704 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the anterior or posterior upper abdomen (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20706 | Initiation of the management of anaesthesia for laparoscopic procedures in the upper abdomen, including laparoscopic cholecystectomy, other than a service to which another item in this Subgroup applies (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20730 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the upper posterior abdominal wall, not being a service to which another item in this Subgroup applies (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20740 | Initiation of the management of anaesthesia for upper gastrointestinal endoscopic procedures (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20745 | Initiation of the management of anaesthesia for any of the following: (a) upper gastrointestinal endoscopic procedures in association with acute gastrointestinal haemorrhage; (b) endoscopic retrograde cholangiopancreatography; (c) upper gastrointestinal endoscopic ultrasound; (d) percutaneous endoscopic gastrostomy; (e) upper gastrointestinal endoscopic mucosal resection of tumour (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20750 | Initiation of the management of anaesthesia for hernia repairs to the upper abdominal wall, other than a service to which another item in this Subgroup applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20752 | Initiation of the management of anaesthesia for repair of incisional hernia or wound dehiscence, or both (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20754 | Initiation of the management of anaesthesia for procedures on an omphalocele (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20756 | Initiation of the management of anaesthesia for transabdominal repair of diaphragmatic hernia (H) (9 basic units) | $213.30 75% benefit $160.00 |
| 20770 | Initiation of the management of anaesthesia for procedures on major upper abdominal blood vessels (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20790 | Initiation of the management of anaesthesia for procedures within the peritoneal cavity in the upper abdomen, including any of the following: (a) open cholecystectomy; (b) gastrectomy; (c) laparoscopic assisted nephrectomy; (d) bowel shunts (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20791 | Initiation of the management of anaesthesia for bariatric surgery in a patient with clinically severe obesity (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20792 | Initiation of the management of anaesthesia for partial hepatectomy (excluding liver biopsy) (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 20793 | Initiation of the management of anaesthesia for extended or trisegmental hepatectomy (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20794 | Initiation of the management of anaesthesia for pancreatectomy, partial or total (H) (12 basic units) | $284.40 75% benefit $213.30 |
| 20798 | Initiation of the management of anaesthesia for neuro endocrine tumour removal in the upper abdomen (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20799 | Initiation of the management of anaesthesia for percutaneous procedures on an intra‑abdominal organ in the upper abdomen (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20800 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the lower anterior abdominal walls, not being a service to which another item in this Subgroup applies (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 20802 | INITIATION OF MANAGEMENT OF ANAESTHESIA for lipectomy of the lower abdomen (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20803 | Initiation of the management of anaesthesia for procedures on the nerves, muscles, tendons and fascia of the lower abdominal wall, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20804 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the anterior or posterior lower abdomen (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20806 | Initiation of the management of anaesthesia for laparoscopic procedures in the lower abdomen (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20810 | Initiation of the management of anaesthesia for lower intestinal endoscopic procedures (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20815 | Initiation of the management of anaesthesia for extracorporeal shock wave lithotripsy to urinary tract (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20820 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin, its derivatives or subcutaneous tissue of the lower posterior abdominal wall (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 20830 | Initiation of the management of anaesthesia for hernia repairs in lower abdomen, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20832 | Initiation of the management of anaesthesia for repair of incisional herniae or wound dehiscence, or both, of the lower abdomen (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20840 | Initiation of the management of anaesthesia for all open procedures within the peritoneal cavity in the lower abdomen, including appendicectomy, other than a service to which another item in this Subgroup applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20841 | Initiation of the management of anaesthesia for bowel resection, including laparoscopic bowel resection, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20842 | Initiation of the management of anaesthesia for amniocentesis (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20844 | Initiation of the management of anaesthesia for abdominoperineal resection, including pull through procedures, ultra low anterior resection and formation of bowel reservoir (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20845 | Initiation of the management of anaesthesia for radical prostatectomy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20846 | Initiation of the management of anaesthesia for radical hysterectomy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20847 | Initiation of the management of anaesthesia for ovarian malignancy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20848 | Initiation of the management of anaesthesia for pelvic exenteration (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20850 | Initiation of the management of anaesthesia for caesarean section (H) (12 basic units) | $284.40 75% benefit $213.30 |
| 20855 | Initiation of the management of anaesthesia for caesarean hysterectomy or hysterectomy within 24 hours of birth (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20860 | Initiation of the management of anaesthesia for extraperitoneal procedures in lower abdomen, including those on the urinary tract, other than a service to which another item in this Subgroup applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20862 | Initiation of the management of anaesthesia for renal procedures, including upper one‑third of ureter (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20863 | Initiation of the management of anaesthesia for nephrectomy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20864 | Initiation of the management of anaesthesia for total cystectomy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20866 | Initiation of the management of anaesthesia for adrenalectomy (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20867 | Initiation of the management of anaesthesia for neuro endocrine tumour removal in the lower abdomen (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20868 | Initiation of the management of anaesthesia for renal transplantation (donor or recipient) (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20880 | Initiation of the management of anaesthesia for procedures on major lower abdominal vessels, other than a service to which another item in this Subgroup applies (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 20882 | Initiation of the management of anaesthesia for inferior vena cava ligation (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20884 | Initiation of the management of anaesthesia for percutaneous umbrella insertion (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20886 | Initiation of the management of anaesthesia for percutaneous procedures on an intra‑abdominal organ in the lower abdomen (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20900 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the perineum not being a service to which another item in this Subgroup applies (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 20902 | Initiation of the management of anaesthesia for anorectal procedures (including surgical haemorrhoidectomy, but not banding of haemorrhoids) (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20904 | Initiation of the management of anaesthesia for radical perineal procedures, including radical perineal prostatectomy or radical vulvectomy (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20905 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the perineum (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20906 | Initiation of the management of anaesthesia for vulvectomy (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20910 | INITIATION OF MANAGEMENT OF ANAESTHESIA for transurethral procedures (including urethrocystoscopy), not being a service to which another item in this Subgroup applies (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 20911 | Initiation of the management of anaesthesia for endoscopic ureteroscopic surgery including laser procedures (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20912 | Initiation of the management of anaesthesia for transurethral resection of bladder tumour or tumours (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20914 | Initiation of the management of anaesthesia for transurethral resection of prostate (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20916 | Initiation of the management of anaesthesia for bleeding post-transurethral resection (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 20920 | Initiation of management of anaesthesia for procedures on external genitalia, not being a service to which another item in this Subgroup applies. (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 20924 | Initiation of the management of anaesthesia for procedures on undescended testis, unilateral or bilateral (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20926 | Initiation of the management of anaesthesia for radical orchidectomy, inguinal approach (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20928 | Initiation of the management of anaesthesia for radical orchidectomy, abdominal approach (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20930 | Initiation of the management of anaesthesia for orchiopexy, unilateral or bilateral (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20932 | Initiation of the management of anaesthesia for complete amputation of penis (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20934 | Initiation of the management of anaesthesia for complete amputation of penis with bilateral inguinal lymphadenectomy (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20936 | Initiation of the management of anaesthesia for complete amputation of penis with bilateral inguinal and iliac lymphadenectomy (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20938 | Initiation of the management of anaesthesia for insertion of penile prosthesis (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20940 | INITIATION OF MANAGEMENT OF ANAESTHESIA for per vagina and vaginal procedures (including biopsy of vagina, cervix or endometrium), not being a service to which another item in this Subgroup applies (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 20942 | Initiation of the management of anaesthesia for vaginal procedures (including repair operations and urinary incontinence procedures) (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20943 | INITIATION OF MANAGEMENT OF ANAESTHESIA for transvaginal assisted reproductive services (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 20944 | Initiation of the management of anaesthesia for vaginal hysterectomy (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 20946 | Initiation of the management of anaesthesia for vaginal birth (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 20948 | Initiation of the management of anaesthesia for purse string ligation of cervix, or removal of purse string ligature, or removal of purse string ligature (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20950 | Initiation of the management of anaesthesia for culdoscopy (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20952 | Initiation of the management of anaesthesia for hysteroscopy (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 20954 | Initiation of the management of anaesthesia for correction of inverted uterus (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 20956 | INITIATION OF MANAGEMENT OF ANAESTHESIA for evacuation of retained products of conception, as a complication of confinement (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 20958 | Initiation of the management of anaesthesia for manual removal of retained placenta or for repair of vaginal or perineal tear following birth (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 20960 | Initiation of the management of anaesthesia for vaginal procedures in the management of post-partum haemorrhage, if the blood loss isgreater than 500 ml (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 21100 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the anterior pelvic region (anterior to iliac crest), except external genitalia (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21110 | Initiation of the management of anaesthesia for procedures on the skin, its derivatives or subcutaneous tissue of the pelvic region (posterior to iliac crest), except perineum (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21112 | Initiation of the management of anaesthesia for percutaneous bone marrow biopsy of the anterior iliac crest (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21114 | Initiation of the management of anaesthesia for percutaneous bone marrow biopsy of the posterior iliac crest (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21116 | Initiation of the management of anaesthesia for percutaneous bone marrow harvesting from the pelvis (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21120 | Initiation of the management of anaesthesia for procedures on the bony pelvis (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21130 | Initiation of the management of anaesthesia for body cast application or revision, when performed in the operating theatre of a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21140 | Initiation of the management of anaesthesia for interpelviabdominal (hindquarter) amputation (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21150 | Initiation of the management of anaesthesia for radical procedures for tumour of the pelvis, except hindquarter amputation (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21155 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the anterior or posterior pelvis (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21160 | Initiation of the management of anaesthesia for closed procedures involving symphysis pubis or sacroiliac joint, when performed in the operating theatre of a hospital (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21170 | Initiation of the management of anaesthesia for open procedures involving symphysis pubis or sacroiliac joint (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21195 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the upper leg (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21199 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on nerves, muscles, tendons, fascia or bursae of the upper leg (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 21200 | Initiation of the management of anaesthesia for closed procedures involving hip joint, when performed in the operating theatre of a hospital (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21202 | Initiation of the management of anaesthesia for arthroscopic procedures of the hip joint (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21210 | Initiation of the management of anaesthesia for open procedures involving hip joint, other than a service to which another item in this Subgroup applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21212 | Initiation of the management of anaesthesia for hip disarticulation (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21214 | Initiation of management of anaesthesia for primary total hip replacement. (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21215 | Initiation of management of anaesthesia for revision total hip replacement (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21216 | Initiation of the management of anaesthesia for bilateral total hip replacement (H) (14 basic units) | $331.80 75% benefit $248.85 |
| 21220 | Initiation of the management of anaesthesia for closed procedures involving upper two-thirds of femur, when performed in the operating theatre of a hospital (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21230 | Initiation of the management of anaesthesia for open procedures involving upper two-thirds of femur, other than a service to which another item in this Subgroup applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21232 | Initiation of the management of anaesthesia for above knee amputation (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21234 | Initiation of the management of anaesthesia for radical resection of the upper two‑thirds of femur (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21260 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures involving veins of upper leg, including exploration (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 21270 | Initiation of the management of anaesthesia for procedures involving arteries of upper leg, including bypass graft, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21272 | Initiation of the management of anaesthesia for femoral artery ligation (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21274 | Initiation of the management of anaesthesia for femoral artery embolectomy (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21275 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the upper leg (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21280 | Initiation of the management of anaesthesia for microsurgical reimplantation of upper leg (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21300 | Initiation of the management of anaesthesia for procedures on the skin or subcutaneous tissue of the knee or popliteal area, or both (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21321 | Initiation of the management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of knee or popliteal area, or both (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21340 | Initiation of the management of anaesthesia for closed procedures on lower one‑third of femur, when performed in the operating theatre of a hospital (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21360 | Initiation of the management of anaesthesia for open procedures on lower one‑third of femur (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21380 | Initiation of the management of anaesthesia for closed procedures on knee joint when performed in the operating theatre of a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21382 | Initiation of the management of anaesthesia for arthroscopic procedures of knee joint (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21390 | Initiation of the management of anaesthesia for closed procedures on upper ends of tibia, fibula or patella, or any of them, when performed in the operating theatre of a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21392 | Initiation of the management of anaesthesia for open procedures on upper ends of tibia, fibula or patella, or any of them (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21400 | Initiation of the management of anaesthesia for open procedures on knee joint, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21402 | Initiation of the management of anaesthesia for knee replacement (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 21403 | Initiation of the management of anaesthesia for bilateral knee replacement (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21404 | Initiation of the management of anaesthesia for disarticulation of knee (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21420 | Initiation of the management of anaesthesia for cast application, removal or repair, involving knee joint, undertaken in a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21430 | Initiation of the management of anaesthesia for procedures on veins of knee or popliteal area, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21432 | Initiation of the management of anaesthesia for repair of arteriovenous fistula of knee or popliteal area (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21440 | Initiation of the management of anaesthesia for procedures on arteries of knee or popliteal area, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21445 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the knee or popliteal area (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21460 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of lower leg, ankle, or foot (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21461 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on nerves, muscles, tendons, or fascia of lower leg, ankle, or foot, not being a service to which another item in this Subgroup applies (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 21462 | INITIATION OF MANAGEMENT OF ANAESTHESIA for closed procedures on lower leg, ankle, or foot (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21464 | Initiation of the management of anaesthesia for arthroscopic procedure of ankle joint (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21472 | Initiation of the management of anaesthesia for repair of Achilles tendon (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21474 | Initiation of the management of anaesthesia for gastrocnemius recession (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21480 | Initiation of the management of anaesthesia for open procedures on bones of lower leg, ankle or foot, including amputation, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21482 | Initiation of the management of anaesthesia for radical resection of bone involving lower leg, ankle or foot (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21484 | Initiation of the management of anaesthesia for osteotomy or osteoplasty of tibia or fibula (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21486 | Initiation of the management of anaesthesia for total ankle replacement (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 21490 | Initiation of the management of anaesthesia for lower leg cast application, removal or repair, undertaken in a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21500 | Initiation of the management of anaesthesia for procedures on arteries of lower leg, including bypass graft, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21502 | Initiation of the management of anaesthesia for embolectomy of the lower leg (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21520 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on veins of lower leg, not being a service to which another item in this Subgroup applies (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 21522 | Initiation of the management of anaesthesia for venous thrombectomy of the lower leg (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21530 | Initiation of the management of anaesthesia for microsurgical reimplantation of lower leg, ankle or foot (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21532 | Initiation of the management of anaesthesia for microsurgical reimplantation of toe (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21535 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the lower leg (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21600 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the shoulder or axilla (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21610 | Initiation of the management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of shoulder or axilla, including axillary dissection (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21620 | Initiation of the management of anaesthesia for closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint, when performed in the operating theatre of a hospital (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21622 | Initiation of the management of anaesthesia for arthroscopic procedures of shoulder joint (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21630 | Initiation of the management of anaesthesia for open procedures on humeral head and neck, sternoclavicular joint, acromioclavicular jointor shoulder joint, other than a service to which another item in this Subgroup applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21632 | Initiation of the management of anaesthesia for radical resection involving humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21634 | Initiation of the management of anaesthesia for shoulder disarticulation (H) (9 basic units) | $213.30 75% benefit $160.00 |
| 21636 | Initiation of the management of anaesthesia for interthoracoscapular (forequarter) amputation (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21638 | Initiation of the management of anaesthesia for total shoulder replacement (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21650 | Initiation of the management of anaesthesia for procedures on arteries of shoulder or axilla, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21652 | Initiation of the management of anaesthesia for procedures for axillary‑brachial aneurysm (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21654 | Initiation of the management of anaesthesia for bypass graft of arteries of shoulder or axilla (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21656 | Initiation of the management of anaesthesia for axillary‑femoral bypass graft (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21670 | Initiation of the management of anaesthesia for procedures on veins of shoulder or axilla (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21680 | Initiation of the management of anaesthesia for shoulder cast application, removal or repair, other than a service to which another item in this Subgroup applies, when undertaken in a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21682 | Initiation of the management of anaesthesia for shoulder spica application, when undertaken in a hospital (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21685 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the shoulder or the axilla (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21700 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the upper arm or elbow (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21710 | Initiation of the management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of upper arm or elbow, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21712 | Initiation of the management of anaesthesia for open tenotomy of the upper arm or elbow (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21714 | Initiation of the management of anaesthesia for tenoplasty of the upper arm or elbow (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21716 | Initiation of the management of anaesthesia for tenodesis for rupture of long tendon of biceps (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21730 | Initiation of the management of anaesthesia for closed procedures on the upper arm or elbow, when performed in the operating theatre of a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21732 | Initiation of the management of anaesthesia for arthroscopic procedures of elbow joint (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21740 | Initiation of the management of anaesthesia for open procedures on the upper arm or elbow, other than a service to which another item in this Subgroup applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21756 | Initiation of the management of anaesthesia for radical procedures on the upper arm or elbow (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21760 | Initiation of the management of anaesthesia for total elbow replacement (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 21770 | Initiation of the management of anaesthesia for procedures on arteries of upper arm, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21772 | Initiation of the management of anaesthesia for embolectomy of arteries of the upper arm (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21780 | Initiation of the management of anaesthesia for procedures on veins of upper arm, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21785 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the upper arm or elbow (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21790 | Initiation of the management of anaesthesia for microsurgical reimplantation of upper arm (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21800 | INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on the skin or subcutaneous tissue of the forearm, wrist or hand (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21810 | Initiation of the management of anaesthesia for procedures on the nerves, muscles, tendons, fascia, or bursae of the forearm, wrist or hand (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21820 | Initiation of the management of anaesthesia for closed procedures on the radius, ulna, wrist, or hand bones, when performed in the operating theatre of a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21830 | Initiation of the management of anaesthesia for open procedures on the radius, ulna, wrist, or hand bones, other than a service to which another item in this Subgroup applies (4 basic units) | $94.80 75% benefit $71.10 |
| 21832 | Initiation of the management of anaesthesia for total wrist replacement (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 21834 | Initiation of the management of anaesthesia for arthroscopic procedures of the wrist joint (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21840 | Initiation of the management of anaesthesia for procedures on the arteries of forearm, wrist or hand, other than a service to which another item in this Subgroup applies (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21842 | Initiation of the management of anaesthesia for embolectomy of artery of forearm, wrist or hand (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21850 | Initiation of the management of anaesthesia for procedures on the veins of forearm, wrist or hand, other than a service to which another item in this Subgroup applies (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21860 | Initiation of the management of anaesthesia for forearm, wrist, or hand cast application, removal or repair, when undertaken in a hospital (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21865 | Initiation of the management of anaesthesia for microvascular free tissue flap surgery involving the forearm, wrist or hand (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21870 | Initiation of the management of anaesthesia for microsurgical reimplantation of forearm, wrist or hand (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21872 | Initiation of the management of anaesthesia for microsurgical reimplantation of a finger (H) (8 basic units) | $189.60 75% benefit $142.20 |
| 21878 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves not more than 3% of total body surface (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21879 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves more than 3% but less than 10% of total body surface (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21880 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 10% or more but less than 20% of total body surface (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 21881 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 20% or more but less than 30% of total body surface (H) (9 basic units) | $213.30 75% benefit $160.00 |
| 21882 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 30% or more but less than 40% of total body surface (H) (11 basic units) | $260.70 75% benefit $195.55 |
| 21883 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 40% or more but less than 50% of total body surface (H) (13 basic units) | $308.10 75% benefit $231.10 |
| 21884 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 50% or more but less than 60% of total body surface (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21885 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 60% or more but less than 70% of total body surface (H) (17 basic units) | $402.90 75% benefit $302.20 |
| 21886 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 70% or more but less than 80% of total body surface (H) (19 basic units) | $450.30 75% benefit $337.75 |
| 21887 | Initiation of the management of anaesthesia for excision or debridement of burns, with or without skin grafting, if the area of burn involves 80% or more of total body surface (H) (21 basic units) | $497.70 75% benefit $373.30 |
| 21900 | Initiation of the management of anaesthesia for injection procedure for hysterosalpingography (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21906 | Initiation of the management of anaesthesia for injection procedure for myelography—lumbar or thoracic (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21908 | Initiation of the management of anaesthesia for injection procedure for myelography—cervical (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21910 | Initiation of the management of anaesthesia for injection procedure for myelography—posterior fossa (H) (9 basic units) | $213.30 75% benefit $160.00 |
| 21912 | Initiation of the management of anaesthesia for injection procedure for discography—lumbar or thoracic (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21914 | Initiation of the management of anaesthesia for injection procedure for discography—cervical (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21915 | Initiation of the management of anaesthesia for peripheral arteriogram (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21916 | Initiation of the management of anaesthesia for arteriograms—cerebral, carotid or vertebral (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21918 | INITIATION OF MANAGEMENT OF ANAESTHESIA for retrograde arteriogram: brachial or femoral (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 21922 | INITIATION OF MANAGEMENT OF ANAESTHESIA for computerised axial tomography scanning, magnetic resonance scanning, digital subtraction angiography scanning (6 basic units) | $142.20 75% benefit $106.65 85% benefit $120.90 |
| 21925 | Initiation of the management of anaesthesia for retrograde cystography, retrograde urethrography or retrograde cystourethrography (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21926 | Initiation of the management of anaesthesia for fluoroscopy (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21930 | Initiation of the management of anaesthesia for bronchography (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 21935 | Initiation of the management of anaesthesia for phlebography (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21936 | Initiation of the management of anaesthesia for heart—2 dimensional real time transoesophageal examination (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21939 | Initiation of the management of anaesthesia for peripheral venous cannulation (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 21941 | Initiation of the management of anaesthesia for cardiac catheterisation (including coronary arteriography, ventriculography, cardiac mappingor insertion of automatic defibrillator or transvenous pacemaker) (H) (7 basic units) | $165.90 75% benefit $124.45 |
| 21942 | Initiation of the management of anaesthesia for cardiac electrophysiological procedures including radio frequency ablation (H) (10 basic units) | $237.00 75% benefit $177.75 |
| 21943 | Initiation of the management of anaesthesia for central vein catheterisation or insertion of right heart balloon catheter (via jugular, subclavian or femoral vein) by percutaneous or open exposure (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21945 | Initiation of the management of anaesthesia for lumbar puncture, cisternal puncture or epidural injection (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21949 | Initiation of the management of anaesthesia for harvesting of bone marrow for the purpose of transplantation (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21952 | Initiation of the management of anaesthesia for diagnostic muscle biopsy to assess for malignant hyperpyrexia (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21955 | Initiation of the management of anaesthesia for electroencephalography (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21959 | Initiation of the management of anaesthesia for brain stem evoked response audiometry (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21962 | Initiation of the management of anaesthesia for electrocochleography by extratympanic method or transtympanic membrane insertion method (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21965 | Initiation of the management of anaesthesia as a therapeutic procedure if there is a clinical need for anaesthesia, not for headache of any etiology (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21969 | INITIATION OF MANAGEMENT OF ANAESTHESIA during hyperbaric therapy where the medical practitioner is not confined in the chamber (including the administration of oxygen) (8 basic units) | $189.60 75% benefit $142.20 85% benefit $161.20 |
| 21970 | Initiation of the management of anaesthesia during hyperbaric therapy, if the medical practitioner is confined in the chamber (including the administration of oxygen) (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 21973 | Initiation of the management of anaesthesia for brachytherapy using radioactive sealed sources (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21976 | Initiation of the management of anaesthesia for therapeutic nuclear medicine (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21980 | Initiation of the management of anaesthesia for radiotherapy (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 21990 | INITIATION OF MANAGEMENT OF ANAESTHESIA when no procedure ensues (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 21992 | Initiation of the management of anaesthesia performed on a patient under the age of 10 years in connection with a procedure covered by an item that does not include the word “(Anaes.)” (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 21997 | INITIATION OF MANAGEMENT OF ANAESTHESIA in connection with a procedure covered by an item that does not include the word "(Anaes.)", other than a service to which item 21965 or 21992 applies, if there is a clinical need for anaesthesia (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 22002 | Administration of blood or bone marrow, when performed in association with the management of anaesthesia (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 22007 | Endotracheal intubation with flexible fibreoptic scope associated with difficult airway, when performed in association with the management of anaesthesia (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 22008 | Double lumen endobronchial tube or bronchial blocker, insertion of, when performed in association with the management of anaesthesia (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 22012 | Monitoring that: (a) is of one of the following types of blood pressure: (i) central venous blood pressure; (ii) pulmonary arterial blood pressure; (iii) systemic arterial blood pressure; (iv) cardiac intracavity blood pressure; and (b) is conducted by indwelling catheter; and (c) is performed in association with the administration of anaesthesia for a procedure and not as a service to which item 13876 applies; and (d) is performed, on a day, on a patient who: (i) is categorised as having a high risk of complications; or (ii) during the procedure develops either complications or a high risk of complications; and (e) has not previously been performed in those circumstances on the day on the patient for that type of blood pressure (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 22014 | Monitoring that: (a) is of one of the following types of blood pressure: (i) central venous blood pressure; (ii) pulmonary arterial blood pressure; (iii) systemic arterial blood pressure; (iv) cardiac intracavity blood pressure; and (b) is conducted by indwelling catheter; and (c) is performed in association with the administration of anaesthesia for a procedure (the current procedure) and not as a service to which item 13876 applies; and (d) is performed, on a day, on a patient: (i) who is categorised as having a high risk of complications or develops during the current procedure either complications or a high risk of complications; and (ii) for whom monitoring of that type of blood pressure to which item 22012 applies has already been performed on the day in association with the administration of anaesthesia for another discrete procedure; and (e) has not previously been performed in association with the current procedure for that type of blood pressure (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 22015 | Right heart balloon catheter, insertion of, including pulmonary wedge pressure and cardiac output measurement, when performed in association with the management of anaesthesia (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 22020 | Central vein catheterisation by percutaneous or open exposure, other than a service to which item 13318 applies, when performed in association with the management of anaesthesia (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 22025 | Intra‑arterial cannulation when performed in association with the management of anaesthesia for a procedure for a patient who: (a) is categorised as having a high risk of complications; or (b) develops a high risk of complications during the procedure (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 22031 | Intrathecal or epidural injection (initial) of a therapeutic substance, with or without insertion of a catheter, in association with anaesthesia and surgery, for post‑operative pain management, other than a service associated with a service to which item 22036 applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 22032 | Introduction of a plexus or nerve block to a peripheral nerve, perioperatively performed using an in‑situ catheter in association with anaesthesia and surgery, for post‑operative pain management (H) (4 basic units) | $94.80 75% benefit $71.10 |
| 22036 | Intrathecal or epidural injection (subsequent) of a therapeutic substance, using an in‑situ catheter, in association with anaesthesia and surgery, for post‑operative pain, other than a service associated with a service to which item 22031 applies (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 22041 | Introduction of a plexus or nerve block proximal to the lower leg or forearm, perioperatively performed in the induction room, theatre or recovery room, for post‑operative pain management (H) (2 basic units) | $47.40 75% benefit $35.55 |
| 22042 | Introduction of a nerve block performed via a retrobulbar, peribulbar, or sub Tenon’s approach, or other complex eye block, when administered by an anaesthetist perioperatively (1 basic units) | $23.70 75% benefit $17.80 85% benefit $20.15 |
| 22051 | Intra‑operative transoesophageal echocardiography—monitoring in real time the structure and function of the heart chambers, valves and surrounding structures, including assessment of blood flow, with appropriate permanent recording during procedures on the heart, pericardium or great vessels of the chest, other than a service associated with a service to which item 55130, 55135 or 21936 applies (H) (9 basic units) | $213.30 75% benefit $160.00 |
| 22052 | Transfusion of blood by an anaesthetist, including collection from donor, when used for intra-operative normovolaemic haemodilution, where the service is provided on the same occasion as the administration of anaesthesia by the same anaesthetist, other than a service associated with a service to which item 13703 applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 22053 | Insertion of lumbar cerebrospinal fluid drain, by an anaesthetist at the request of the treating specialist, where the service is provided on the same occasion as the administration of anaesthesia by the same anaesthetist, other than a service associated with a service to which item 40018 applies (H) (6 basic units) | $142.20 75% benefit $106.65 |
| 22054 | Intraoperative two-dimensional or three-dimensional real time transoesophageal echocardiography by an anaesthetist, where the service: (a) is provided on the same day as a service to which item 38477, 38484, 38499, 38516 or 38517 applies; and (b) includes Doppler techniques with colour flow mapping and recordings on digital media; and (c) is performed during cardiac valve surgery (replacement or repair); and (d) incorporates sequential assessment of cardiac function and valve competence before and after the surgical procedure; and (e) is not associated with a service to which item 21936, 22051, 55118, 55130 or 55135 applies; and (f) is provided on the same occasion as the administration of anaesthesia by the same anaesthetist (H) (18 basic units) | $426.60 75% benefit $319.95 |
| 22055 | Perfusion of limb or organ using heart‑lung machine or equivalent, other than a service associated with anaesthesia to which an item in Subgroup 21 applies (H) (12 basic units) | $284.40 75% benefit $213.30 |
| 22060 | Whole body perfusion, cardiac bypass, if the heart‑lung machine or equivalent is continuously operated by a medical perfusionist, other than a service associated with anaesthesia to which an item in Subgroup 21 applies (H) (30 basic units) | $711.00 75% benefit $533.25 |
| 22065 | Induced controlled hypothermia—total body, that is: (a) a service to which item 22060 applies; and (b) not a service associated with anaesthesia, to which an item in Subgroup 21 applies (H) (5 basic units) | $118.50 75% benefit $88.90 |
| 22075 | Deep hypothermic circulatory arrest, with core temperature less than 22°c, including management of retrograde cerebral perfusion (if performed), other than a service associated with anaesthesia to which an item in Subgroup 21 applies (H) (15 basic units) | $355.50 75% benefit $266.65 |
| 22900 | INITIATION OF MANAGEMENT BY A MEDICAL PRACTITIONER OF ANAESTHESIA for extraction of tooth or teeth with or without incision of soft tissue or removal of bone (6 basic units) | $142.20 75% benefit $106.65 85% benefit $120.90 |
| 22905 | INITIATION OF MANAGEMENT OF ANAESTHESIA for restorative dental work (6 basic units) | $142.20 75% benefit $106.65 85% benefit $120.90 |
| 23010 | Anaesthesia, perfusion or assistance, if the service time is not more than 15 minutes (1 basic units) | $23.70 75% benefit $17.80 85% benefit $20.15 |
| 23025 | 16 MINUTES TO 30 MINUTES (2 basic units) | $47.40 75% benefit $35.55 85% benefit $40.30 |
| 23035 | 31 MINUTES to 45 MINUTES (3 basic units) | $71.10 75% benefit $53.35 85% benefit $60.45 |
| 23045 | 46 MINUTES to 1:00 HOUR (4 basic units) | $94.80 75% benefit $71.10 85% benefit $80.60 |
| 23055 | 1:01 HOURS to 1:15 HOURS (5 basic units) | $118.50 75% benefit $88.90 85% benefit $100.75 |
| 23065 | 1:16 HOURS to 1:30 HOURS (6 basic units) | $142.20 75% benefit $106.65 85% benefit $120.90 |
| 23075 | 1:31 HOURS to 1:45 HOURS (7 basic units) | $165.90 75% benefit $124.45 85% benefit $141.05 |
| 23085 | 1:46 HOURS to 2:00 HOURS (8 basic units) | $189.60 75% benefit $142.20 85% benefit $161.20 |
| 23091 | 2:01 HOURS TO 2:10 HOURS (9 basic units) | $213.30 75% benefit $160.00 85% benefit $181.35 |
| 23101 | 2:11 HOURS TO 2:20 HOURS (10 basic units) | $237.00 75% benefit $177.75 85% benefit $201.45 |
| 23111 | 2:21 HOURS TO 2:30 HOURS (11 basic units) | $260.70 75% benefit $195.55 85% benefit $221.60 |
| 23112 | 2:31 HOURS TO 2:40 HOURS (12 basic units) | $284.40 75% benefit $213.30 85% benefit $241.75 |
| 23113 | 2:41 HOURS TO 2:50 HOURS (13 basic units) | $308.10 75% benefit $231.10 85% benefit $261.90 |
| 23114 | 2:51 HOURS TO 3:00 HOURS (14 basic units) | $331.80 75% benefit $248.85 85% benefit $282.05 |
| 23115 | 3:01 HOURS TO 3:10 HOURS (15 basic units) | $355.50 75% benefit $266.65 85% benefit $302.20 |
| 23116 | 3:11 HOURS TO 3:20 HOURS (16 basic units) | $379.20 75% benefit $284.40 85% benefit $322.35 |
| 23117 | 3:21 HOURS TO 3:30 HOURS (17 basic units) | $402.90 75% benefit $302.20 85% benefit $342.50 |
| 23118 | 3:31 HOURS TO 3:40 HOURS (18 basic units) | $426.60 75% benefit $319.95 85% benefit $362.65 |
| 23119 | 3:41 HOURS TO 3:50 HOURS (19 basic units) | $450.30 75% benefit $337.75 85% benefit $382.80 |
| 23121 | 3:51 HOURS TO 4:00 HOURS (20 basic units) | $474.00 75% benefit $355.50 85% benefit $402.90 |
| 23170 | 4:01 HOURS TO 4:10 HOURS (21 basic units) | $497.70 75% benefit $373.30 85% benefit $423.05 |
| 23180 | 4:11 HOURS TO 4:20 HOURS (22 basic units) | $521.40 75% benefit $391.05 85% benefit $443.20 |
| 23190 | 4:21 HOURS TO 4:30 HOURS (23 basic units) | $545.10 75% benefit $408.85 85% benefit $463.35 |
| 23200 | 4:31 HOURS TO 4:40 HOURS (24 basic units) | $568.80 75% benefit $426.60 85% benefit $483.50 |
| 23210 | 4:41 HOURS TO 4:50 HOURS (25 basic units) | $592.50 75% benefit $444.40 85% benefit $503.65 |
| 23220 | 4:51 HOURS TO 5:00 HOURS (26 basic units) | $616.20 75% benefit $462.15 85% benefit $523.80 |
| 23230 | 5:01 HOURS TO 5:10 HOURS (27 basic units) | $639.90 75% benefit $479.95 85% benefit $543.95 |
| 23240 | 5:11 HOURS TO 5:20 HOURS (28 basic units) | $663.60 75% benefit $497.70 85% benefit $564.10 |
| 23250 | 5:21 HOURS TO 5:30 HOURS (29 basic units) | $687.30 75% benefit $515.50 85% benefit $584.25 |
| 23260 | New 85% benefit on 1 November 20265:31 HOURS TO 5:40 HOURS (30 basic units) | $711.00 75% benefit $533.25 85% benefit $604.35 was $606.50 |
| 23270 | New 85% benefit on 1 November 20265:41 HOURS TO 5:50 HOURS (31 basic units) | $734.70 75% benefit $551.05 85% benefit $626.20 was $630.20 |
| 23280 | New 85% benefit on 1 November 2026(5:51 HOURS TO 6:00 HOURS (32 basic units) | $758.40 75% benefit $568.80 85% benefit $649.90 was $653.90 |
| 23290 | New 85% benefit on 1 November 20266:01 HOURS TO 6:10 HOURS (33 basic units) | $782.10 75% benefit $586.60 85% benefit $673.60 was $677.60 |
| 23300 | New 85% benefit on 1 November 20266:11 HOURS TO 6:20 HOURS (34 basic units) | $805.80 75% benefit $604.35 85% benefit $697.30 was $701.30 |
| 23310 | New 85% benefit on 1 November 20266:21 HOURS TO 6:30 HOURS (35 basic units) | $829.50 75% benefit $622.15 85% benefit $721.00 was $725.00 |
| 23320 | New 85% benefit on 1 November 20266:31 HOURS TO 6:40 HOURS (36 basic units) | $853.20 75% benefit $639.90 85% benefit $744.70 was $748.70 |
| 23330 | New 85% benefit on 1 November 20266:41 HOURS TO 6:50 HOURS (37 basic units) | $876.90 75% benefit $657.70 85% benefit $768.40 was $772.40 |
| 23340 | New 85% benefit on 1 November 20266:51 HOURS TO 7:00 HOURS (38 basic units) | $900.60 75% benefit $675.45 85% benefit $792.10 was $796.10 |
| 23350 | New 85% benefit on 1 November 20267:01 HOURS TO 7:10 HOURS (39 basic units) | $924.30 75% benefit $693.25 85% benefit $815.80 was $819.80 |
| 23360 | New 85% benefit on 1 November 20267:11 HOURS TO 7:20 HOURS (40 basic units) | $948.00 75% benefit $711.00 85% benefit $839.50 was $843.50 |
| 23370 | New 85% benefit on 1 November 20267:21 HOURS TO 7:30 HOURS (41 basic units) | $971.70 75% benefit $728.80 85% benefit $863.20 was $867.20 |
| 23380 | New 85% benefit on 1 November 20267:31 HOURS TO 7:40 HOURS (42 basic units) | $995.40 75% benefit $746.55 85% benefit $886.90 was $890.90 |
| 23390 | New 85% benefit on 1 November 20267:41 HOURS TO 7:50 HOURS (43 basic units) | $1,019.10 75% benefit $764.35 85% benefit $910.60 was $914.60 |
| 23400 | New 85% benefit on 1 November 20267:51 HOURS TO 8:00 HOURS (44 basic units) | $1,042.80 75% benefit $782.10 85% benefit $934.30 was $938.30 |
| 23410 | New 85% benefit on 1 November 20268:01 HOURS TO 8:10 HOURS (45 basic units) | $1,066.50 75% benefit $799.90 85% benefit $958.00 was $962.00 |
| 23420 | New 85% benefit on 1 November 20268:11 HOURS TO 8:20 HOURS (46 basic units) | $1,090.20 75% benefit $817.65 85% benefit $981.70 was $985.70 |
| 23430 | New 85% benefit on 1 November 20268:21 HOURS TO 8:30 HOURS (47 basic units) | $1,113.90 75% benefit $835.45 85% benefit $1,005.40 was $1,009.40 |
| 23440 | New 85% benefit on 1 November 20268:31 HOURS TO 8:40 HOURS (48 basic units) | $1,137.60 75% benefit $853.20 85% benefit $1,029.10 was $1,033.10 |
| 23450 | New 85% benefit on 1 November 20268:41 HOURS TO 8:50 HOURS (49 basic units) | $1,161.30 75% benefit $871.00 85% benefit $1,052.80 was $1,056.80 |
| 23460 | New 85% benefit on 1 November 20268:51 HOURS TO 9:00 HOURS (50 basic units) | $1,185.00 75% benefit $888.75 85% benefit $1,076.50 was $1,080.50 |
| 23470 | New 85% benefit on 1 November 20269:01 HOURS TO 9:10 HOURS (51 basic units) | $1,208.70 75% benefit $906.55 85% benefit $1,100.20 was $1,104.20 |
| 23480 | New 85% benefit on 1 November 20269:11 HOURS TO 9:20 HOURS (52 basic units) | $1,232.40 75% benefit $924.30 85% benefit $1,123.90 was $1,127.90 |
| 23490 | New 85% benefit on 1 November 20269:21 HOURS TO 9:30 HOURS (53 basic units) | $1,256.10 75% benefit $942.10 85% benefit $1,147.60 was $1,151.60 |
| 23500 | New 85% benefit on 1 November 20269:31 HOURS TO 9:40 HOURS (54 basic units) | $1,279.80 75% benefit $959.85 85% benefit $1,171.30 was $1,175.30 |
| 23510 | New 85% benefit on 1 November 20269:41 HOURS TO 9:50 HOURS (55 basic units) | $1,303.50 75% benefit $977.65 85% benefit $1,195.00 was $1,199.00 |
| 23520 | New 85% benefit on 1 November 20269:51 HOURS TO 10:00 HOURS (56 basic units) | $1,327.20 75% benefit $995.40 85% benefit $1,218.70 was $1,222.70 |
| 23530 | New 85% benefit on 1 November 202610:01 HOURS TO 10:10 HOURS (57 basic units) | $1,350.90 75% benefit $1,013.20 85% benefit $1,242.40 was $1,246.40 |
| 23540 | New 85% benefit on 1 November 202610:11 HOURS TO 10:20 HOURS (58 basic units) | $1,374.60 75% benefit $1,030.95 85% benefit $1,266.10 was $1,270.10 |
| 23550 | New 85% benefit on 1 November 202610:21 HOURS TO 10:30 HOURS (59 basic units) | $1,398.30 75% benefit $1,048.75 85% benefit $1,289.80 was $1,293.80 |
| 23560 | New 85% benefit on 1 November 202610:31 HOURS TO 10:40 HOURS (60 basic units) | $1,422.00 75% benefit $1,066.50 85% benefit $1,313.50 was $1,317.50 |
| 23570 | New 85% benefit on 1 November 202610:41 HOURS TO 10:50 HOURS (61 basic units) | $1,445.70 75% benefit $1,084.30 85% benefit $1,337.20 was $1,341.20 |
| 23580 | New 85% benefit on 1 November 202610:51 HOURS TO 11:00 HOURS (62 basic units) | $1,469.40 75% benefit $1,102.05 85% benefit $1,360.90 was $1,364.90 |
| 23590 | New 85% benefit on 1 November 202611:01 HOURS TO 11:10 HOURS (63 basic units) | $1,493.10 75% benefit $1,119.85 85% benefit $1,384.60 was $1,388.60 |
| 23600 | New 85% benefit on 1 November 202611:11 HOURS TO 11:20 HOURS (64 basic units) | $1,516.80 75% benefit $1,137.60 85% benefit $1,408.30 was $1,412.30 |
| 23610 | New 85% benefit on 1 November 202611:21 HOURS TO 11:30 HOURS (65 basic units) | $1,540.50 75% benefit $1,155.40 85% benefit $1,432.00 was $1,436.00 |
| 23620 | New 85% benefit on 1 November 202611:31 HOURS TO 11:40 HOURS (66 basic units) | $1,564.20 75% benefit $1,173.15 85% benefit $1,455.70 was $1,459.70 |
| 23630 | New 85% benefit on 1 November 202611:41 HOURS TO 11:50 HOURS (67 basic units) | $1,587.90 75% benefit $1,190.95 85% benefit $1,479.40 was $1,483.40 |
| 23640 | New 85% benefit on 1 November 202611:51 HOURS TO 12:00 HOURS (68 basic units) | $1,611.60 75% benefit $1,208.70 85% benefit $1,503.10 was $1,507.10 |
| 23650 | New 85% benefit on 1 November 202612:01 HOURS TO 12:10 HOURS (69 basic units) | $1,635.30 75% benefit $1,226.50 85% benefit $1,526.80 was $1,530.80 |
| 23660 | New 85% benefit on 1 November 202612:11 HOURS TO 12:20 HOURS (70 basic units) | $1,659.00 75% benefit $1,244.25 85% benefit $1,550.50 was $1,554.50 |
| 23670 | New 85% benefit on 1 November 202612:21 HOURS TO 12:30 HOURS (71 basic units) | $1,682.70 75% benefit $1,262.05 85% benefit $1,574.20 was $1,578.20 |
| 23680 | New 85% benefit on 1 November 202612:31 HOURS TO 12:40 HOURS (72 basic units) | $1,706.40 75% benefit $1,279.80 85% benefit $1,597.90 was $1,601.90 |
| 23690 | New 85% benefit on 1 November 202612:41 HOURS TO 12:50 HOURS (73 basic units) | $1,730.10 75% benefit $1,297.60 85% benefit $1,621.60 was $1,625.60 |
| 23700 | New 85% benefit on 1 November 202612:51 HOURS TO 13:00 HOURS (74 basic units) | $1,753.80 75% benefit $1,315.35 85% benefit $1,645.30 was $1,649.30 |
| 23710 | New 85% benefit on 1 November 202613:01 HOURS TO 13:10 HOURS (75 basic units) | $1,777.50 75% benefit $1,333.15 85% benefit $1,669.00 was $1,673.00 |
| 23720 | New 85% benefit on 1 November 202613:11 HOURS TO 13:20 HOURS (76 basic units) | $1,801.20 75% benefit $1,350.90 85% benefit $1,692.70 was $1,696.70 |
| 23730 | New 85% benefit on 1 November 202613:21 HOURS TO 13:30 HOURS (77 basic units) | $1,824.90 75% benefit $1,368.70 85% benefit $1,716.40 was $1,720.40 |
| 23740 | New 85% benefit on 1 November 202613:31 HOURS TO 13:40 HOURS (78 basic units) | $1,848.60 75% benefit $1,386.45 85% benefit $1,740.10 was $1,744.10 |
| 23750 | New 85% benefit on 1 November 202613:41 HOURS TO 13:50 HOURS (79 basic units) | $1,872.30 75% benefit $1,404.25 85% benefit $1,763.80 was $1,767.80 |
| 23760 | New 85% benefit on 1 November 202613:51 HOURS TO 14:00 HOURS (80 basic units) | $1,896.00 75% benefit $1,422.00 85% benefit $1,787.50 was $1,791.50 |
| 23770 | New 85% benefit on 1 November 202614:01 HOURS TO 14:10 HOURS (81 basic units) | $1,919.70 75% benefit $1,439.80 85% benefit $1,811.20 was $1,815.20 |
| 23780 | New 85% benefit on 1 November 202614:11 HOURS TO 14:20 HOURS (82 basic units) | $1,943.40 75% benefit $1,457.55 85% benefit $1,834.90 was $1,838.90 |
| 23790 | New 85% benefit on 1 November 202614:21 HOURS TO 14:30 HOURS (83 basic units) | $1,967.10 75% benefit $1,475.35 85% benefit $1,858.60 was $1,862.60 |
| 23800 | New 85% benefit on 1 November 202614:31 HOURS TO 14:40 HOURS (84 basic units) | $1,990.80 75% benefit $1,493.10 85% benefit $1,882.30 was $1,886.30 |
| 23810 | New 85% benefit on 1 November 202614:41 HOURS TO 14:50 HOURS (85 basic units) | $2,014.50 75% benefit $1,510.90 85% benefit $1,906.00 was $1,910.00 |
| 23820 | New 85% benefit on 1 November 202614:51 HOURS TO 15:00 HOURS (86 basic units) | $2,038.20 75% benefit $1,528.65 85% benefit $1,929.70 was $1,933.70 |
| 23830 | New 85% benefit on 1 November 202615:01 HOURS TO 15:10 HOURS (87 basic units) | $2,061.90 75% benefit $1,546.45 85% benefit $1,953.40 was $1,957.40 |
| 23840 | New 85% benefit on 1 November 202615:11 HOURS TO 15:20 HOURS (88 basic units) | $2,085.60 75% benefit $1,564.20 85% benefit $1,977.10 was $1,981.10 |
| 23850 | New 85% benefit on 1 November 202615:21 HOURS TO 15:30 HOURS (89 basic units) | $2,109.30 75% benefit $1,582.00 85% benefit $2,000.80 was $2,004.80 |
| 23860 | New 85% benefit on 1 November 202615:31 HOURS TO 15:40 HOURS (90 basic units) | $2,133.00 75% benefit $1,599.75 85% benefit $2,024.50 was $2,028.50 |
| 23870 | New 85% benefit on 1 November 202615:41 HOURS TO 15:50 HOURS (91 basic units) | $2,156.70 75% benefit $1,617.55 85% benefit $2,048.20 was $2,052.20 |
| 23880 | New 85% benefit on 1 November 202615:51 HOURS TO 16:00 HOURS (92 basic units) | $2,180.40 75% benefit $1,635.30 85% benefit $2,071.90 was $2,075.90 |
| 23890 | New 85% benefit on 1 November 202616:01 HOURS TO 16:10 HOURS (93 basic units) | $2,204.10 75% benefit $1,653.10 85% benefit $2,095.60 was $2,099.60 |
| 23900 | New 85% benefit on 1 November 202616:11 HOURS TO 16:20 HOURS (94 basic units) | $2,227.80 75% benefit $1,670.85 85% benefit $2,119.30 was $2,123.30 |
| 23910 | New 85% benefit on 1 November 202616:21 HOURS TO 16:30 HOURS (95 basic units) | $2,251.50 75% benefit $1,688.65 85% benefit $2,143.00 was $2,147.00 |
| 23920 | New 85% benefit on 1 November 202616:31 HOURS TO 16:40 HOURS (96 basic units) | $2,275.20 75% benefit $1,706.40 85% benefit $2,166.70 was $2,170.70 |
| 23930 | New 85% benefit on 1 November 202616:41 HOURS TO 16:50 HOURS (97 basic units) | $2,298.90 75% benefit $1,724.20 85% benefit $2,190.40 was $2,194.40 |
| 23940 | New 85% benefit on 1 November 202616:51 HOURS TO 17:00 HOURS (98 basic units) | $2,322.60 75% benefit $1,741.95 85% benefit $2,214.10 was $2,218.10 |
| 23950 | New 85% benefit on 1 November 202617:01 HOURS TO 17:10 HOURS (99 basic units) | $2,346.30 75% benefit $1,759.75 85% benefit $2,237.80 was $2,241.80 |
| 23960 | New 85% benefit on 1 November 202617:11 HOURS TO 17:20 HOURS (100 basic units) | $2,370.00 75% benefit $1,777.50 85% benefit $2,261.50 was $2,265.50 |
| 23970 | New 85% benefit on 1 November 202617:21 HOURS TO 17:30 HOURS (101 basic units) | $2,393.70 75% benefit $1,795.30 85% benefit $2,285.20 was $2,289.20 |
| 23980 | New 85% benefit on 1 November 202617:31 HOURS TO 17:40 HOURS (102 basic units) | $2,417.40 75% benefit $1,813.05 85% benefit $2,308.90 was $2,312.90 |
| 23990 | New 85% benefit on 1 November 202617:41 HOURS TO 17:50 HOURS (103 basic units) | $2,441.10 75% benefit $1,830.85 85% benefit $2,332.60 was $2,336.60 |
| 24100 | New 85% benefit on 1 November 202617:51 HOURS TO 18:00 HOURS (104 basic units) | $2,464.80 75% benefit $1,848.60 85% benefit $2,356.30 was $2,360.30 |
| 24101 | New 85% benefit on 1 November 202618:01 HOURS TO 18:10 HOURS (105 basic units) | $2,488.50 75% benefit $1,866.40 85% benefit $2,380.00 was $2,384.00 |
| 24102 | New 85% benefit on 1 November 202618:11 HOURS TO 18:20 HOURS (106 basic units) | $2,512.20 75% benefit $1,884.15 85% benefit $2,403.70 was $2,407.70 |
| 24103 | New 85% benefit on 1 November 202618:21 HOURS TO 18:30 HOURS (107 basic units) | $2,535.90 75% benefit $1,901.95 85% benefit $2,427.40 was $2,431.40 |
| 24104 | New 85% benefit on 1 November 202618:31 HOURS TO 18:40 HOURS (108 basic units) | $2,559.60 75% benefit $1,919.70 85% benefit $2,451.10 was $2,455.10 |
| 24105 | New 85% benefit on 1 November 202618:41 HOURS TO 18:50 HOURS (109 basic units) | $2,583.30 75% benefit $1,937.50 85% benefit $2,474.80 was $2,478.80 |
| 24106 | New 85% benefit on 1 November 202618:51 HOURS TO 19:00 HOURS (110 basic units) | $2,607.00 75% benefit $1,955.25 85% benefit $2,498.50 was $2,502.50 |
| 24107 | New 85% benefit on 1 November 202619:01 HOURS TO 19:10 HOURS (111 basic units) | $2,630.70 75% benefit $1,973.05 85% benefit $2,522.20 was $2,526.20 |
| 24108 | New 85% benefit on 1 November 202619:11 HOURS TO 19:20 HOURS (112 basic units) | $2,654.40 75% benefit $1,990.80 85% benefit $2,545.90 was $2,549.90 |
| 24109 | New 85% benefit on 1 November 202619:21 HOURS TO 19:30 HOURS (113 basic units) | $2,678.10 75% benefit $2,008.60 85% benefit $2,569.60 was $2,573.60 |
| 24110 | New 85% benefit on 1 November 202619:31 HOURS TO 19:40 HOURS (114 basic units) | $2,701.80 75% benefit $2,026.35 85% benefit $2,593.30 was $2,597.30 |
| 24111 | New 85% benefit on 1 November 202619:41 HOURS TO 19:50 HOURS (115 basic units) | $2,725.50 75% benefit $2,044.15 85% benefit $2,617.00 was $2,621.00 |
| 24112 | New 85% benefit on 1 November 202619:51 HOURS TO 20:00 HOURS (116 basic units) | $2,749.20 75% benefit $2,061.90 85% benefit $2,640.70 was $2,644.70 |
| 24113 | New 85% benefit on 1 November 202620:01 HOURS TO 20:10 HOURS (117 basic units) | $2,772.90 75% benefit $2,079.70 85% benefit $2,664.40 was $2,668.40 |
| 24114 | New 85% benefit on 1 November 202620:11 HOURS TO 20:20 HOURS (118 basic units) | $2,796.60 75% benefit $2,097.45 85% benefit $2,688.10 was $2,692.10 |
| 24115 | New 85% benefit on 1 November 202620:21 HOURS TO 20:30 HOURS (119 basic units) | $2,820.30 75% benefit $2,115.25 85% benefit $2,711.80 was $2,715.80 |
| 24116 | New 85% benefit on 1 November 202620:31 HOURS TO 20:40 HOURS (120 basic units) | $2,844.00 75% benefit $2,133.00 85% benefit $2,735.50 was $2,739.50 |
| 24117 | New 85% benefit on 1 November 202620:41 HOURS TO 20:50 HOURS (121 basic units) | $2,867.70 75% benefit $2,150.80 85% benefit $2,759.20 was $2,763.20 |
| 24118 | New 85% benefit on 1 November 202620:51 HOURS TO 21:00 HOURS (122 basic units) | $2,891.40 75% benefit $2,168.55 85% benefit $2,782.90 was $2,786.90 |
| 24119 | New 85% benefit on 1 November 202621:01 HOURS TO 21:10 HOURS (123 basic units) | $2,915.10 75% benefit $2,186.35 85% benefit $2,806.60 was $2,810.60 |
| 24120 | New 85% benefit on 1 November 202621:11 HOURS TO 21:20 HOURS (124 basic units) | $2,938.80 75% benefit $2,204.10 85% benefit $2,830.30 was $2,834.30 |
| 24121 | New 85% benefit on 1 November 202621:21 HOURS TO 21:30 HOURS (125 basic units) | $2,962.50 75% benefit $2,221.90 85% benefit $2,854.00 was $2,858.00 |
| 24122 | New 85% benefit on 1 November 202621:31 HOURS TO 21:40 HOURS (126 basic units) | $2,986.20 75% benefit $2,239.65 85% benefit $2,877.70 was $2,881.70 |
| 24123 | New 85% benefit on 1 November 202621:41 HOURS TO 21:50 HOURS (127 basic units) | $3,009.90 75% benefit $2,257.45 85% benefit $2,901.40 was $2,905.40 |
| 24124 | New 85% benefit on 1 November 202621:51 HOURS TO 22:00 HOURS (128 basic units) | $3,033.60 75% benefit $2,275.20 85% benefit $2,925.10 was $2,929.10 |
| 24125 | New 85% benefit on 1 November 202622:01 HOURS TO 22:10 HOURS (129 basic units) | $3,057.30 75% benefit $2,293.00 85% benefit $2,948.80 was $2,952.80 |
| 24126 | New 85% benefit on 1 November 202622:11 HOURS TO 22:20 HOURS (130 basic units) | $3,081.00 75% benefit $2,310.75 85% benefit $2,972.50 was $2,976.50 |
| 24127 | New 85% benefit on 1 November 202622:21 HOURS TO 22:30 HOURS (131 basic units) | $3,104.70 75% benefit $2,328.55 85% benefit $2,996.20 was $3,000.20 |
| 24128 | New 85% benefit on 1 November 202622:31 HOURS TO 22:40 HOURS (132 basic units) | $3,128.40 75% benefit $2,346.30 85% benefit $3,019.90 was $3,023.90 |
| 24129 | New 85% benefit on 1 November 202622:41 HOURS TO 22:50 HOURS (133 basic units) | $3,152.10 75% benefit $2,364.10 85% benefit $3,043.60 was $3,047.60 |
| 24130 | New 85% benefit on 1 November 202622:51 HOURS TO 23:00 HOURS (134 basic units) | $3,175.80 75% benefit $2,381.85 85% benefit $3,067.30 was $3,071.30 |
| 24131 | New 85% benefit on 1 November 202623:01 HOURS TO 23:10 HOURS (135 basic units) | $3,199.50 75% benefit $2,399.65 85% benefit $3,091.00 was $3,095.00 |
| 24132 | New 85% benefit on 1 November 202623:11 HOURS TO 23:20 HOURS (136 basic units) | $3,223.20 75% benefit $2,417.40 85% benefit $3,114.70 was $3,118.70 |
| 24133 | New 85% benefit on 1 November 202623:21 HOURS TO 23:30 HOURS (137 basic units) | $3,246.90 75% benefit $2,435.20 85% benefit $3,138.40 was $3,142.40 |
| 24134 | New 85% benefit on 1 November 202623:31 HOURS TO 23:40 HOURS (138 basic units) | $3,270.60 75% benefit $2,452.95 85% benefit $3,162.10 was $3,166.10 |
| 24135 | New 85% benefit on 1 November 202623:41 HOURS TO 23:50 HOURS (139 basic units) | $3,294.30 75% benefit $2,470.75 85% benefit $3,185.80 was $3,189.80 |
| 24136 | New 85% benefit on 1 November 202623:51 HOURS TO 24:00 HOURS (140 basic units) | $3,318.00 75% benefit $2,488.50 85% benefit $3,209.50 was $3,213.50 |
| 25000 | Anaesthesia, perfusion or assistance in the management of anaesthesia, if the patient has severe systemic disease (equivalent to ASA physical status indicator 3) (1 basic units) | $23.70 75% benefit $17.80 85% benefit $20.15 |
| 25005 | Anaesthesia, perfusion or assistance in the management of anaesthesia, if the patient has severe systemic disease which is a constant threat to life (equivalent to ASA physical status indicator 4) (H) (2 basic units) | $47.40 75% benefit $35.55 |
| 25010 | Anaesthesia, perfusion or assistance in the management of anaesthesia, if the patient is not expected to survive for 24 hours, with or without the associated operation (equivalent to ASA physical status indicator 5) (H) (3 basic units) | $71.10 75% benefit $53.35 |
| 25013 | Anaesthesia, perfusion or assistance in the management of anaesthesia, if the patient is aged under 4 years (H) (1 basic units) | $23.70 75% benefit $17.80 |
| 25014 | Anaesthesia, perfusion or assistance in the management of anaesthesia, if the patient is aged 75 years or more (1 basic units) | $23.70 75% benefit $17.80 85% benefit $20.15 |
| 25020 | Anaesthesia, perfusion or assistance in the management of anaesthesia, if the patient requires immediate treatment without which there would be significant threat to life or body part—other than a service associated with a service to which item 25025, 25030 or 25050 applies (H) (2 basic units) | $47.40 75% benefit $35.55 |
| 25025 | Anaesthesia, if the patient requires immediate treatment without which there would be significant threat to life or body part and if more than 50% of the service time occurs between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday (H) (0 basic units) Derived fee: An additional amount of 50% of fee for the anaesthetic service.That is:(a) an anaesthesia item/s range 20100 - 21997 or 22900, plus (b)an item range 23010 - 24136, plus(c) if applicable,an item range 25000-25014, plus(d) where performed, any assoc therapeutic or diagnostic service range 22002-22051 | Derived |
| 25030 | Assistance in the management of anaesthesia, if the patient requires immediate treatment without which there would be significant threat to life or body part and if more than 50% of the service time occurs between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday (H) (0 basic units) Derived fee: 50% of the fee for assistance at anaesthesia. That is: (a) an assistant anaesthesia item in the range 25200 - 25205, plus (b) an item range 23010-24136, plus (c) where applicable, an item range 25000-25014, plus (d) where performed, any associated therapeutic or diagnostic service 22002 -22051 | Derived |
| 25050 | Perfusion, if the patient requires immediate treatment without which there would be significant threat to life or body part and if more than 50% of the service time occurs between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday. (H) (0 basic units) Derived fee: An additional amount of 50% of the fee for the perfusion service. That is: (a) item 22060, plus (b) an item range 23010 - 24136, plus (c) where applicable, an item range 25000 - 25014, plus (d) where performed, any associated therapeutic or diagnostic service in the range 22002-22051 or 22065-22075 | Derived |
| 25200 | Assistance in the management of anaesthesia requiring continuous anaesthesia on a patient in imminent danger of death requiring continuous life saving emergency treatment, to the exclusion of attendance on all other patients (H) (5 basic units) Derived fee: An amount of 5 base units plus an item in the range 23010 - 24136 plus, where applicable - an item in the range 25000 - 25020 plus, where performed, any associated therapeutic or diagnostic service/s in the range 22001 - 22051 | Derived |
| 25205 | Assistance in the management of elective anaesthesia, if: (a) the patient has complex airway problems; or (b) the patient is a neonate; or (c) the patient is a paediatric patient and is receiving one or more of the following services: (i) invasive monitoring, either intravascular or transoesophageal; (ii) organ transplantation; (iii) craniofacial surgery; (iv) major tumour resection; (v) separation of conjoint twins; or (d) there is anticipated to be massive blood loss (greater than 50% of blood volume) during the procedure; or (e) the patient is critically ill, with multiple organ failure; or (f) the service time of the management of anaesthesia exceeds 6 hours and the assistance is provided to the exclusion of attendance on all other patients (H) (5 basic units) Derived fee: An amount of 5 base units plus an item in the range 23010 - 24136 plus, where applicable - an item in the range 25000 - 25020 plus, where performed, any associated therapeutic or diagnostic service/s in the range 22002 - 22051 | Derived |
T8 Surgical Operations
2,632 items
| Item | Description | Fee and benefits |
|---|---|---|
| 30001 | OPERATIVE PROCEDURE, not being a service to which any other item in this Group applies, being a service to which an item in this Group would have applied had the procedure not been discontinued on medical grounds Derived fee: 50% of the fee which would have applied had the procedure not been discontinued | Derived |
| 30003 | Burns, involving 1% or more but less than 3% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, if medical practitioner is present—each attendance at which the procedure is performedNot applicable for skin reactions secondary to radiotherapy | $43.50 75% benefit $32.65 85% benefit $37.00 |
| 30006 | Burns, involving 3% or more but less than 10% of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, if medical practitioner is present—each attendance at which the procedure is performedNot applicable for skin reactions secondary to radiotherapy | $55.60 75% benefit $41.70 85% benefit $47.30 |
| 30007 | Burns, involving 10% or more of total body surface, dressing of (including redressing of any related donor site, if required), without anaesthesia, if medical practitioner is present—each attendance at which the procedure is performedNot applicable for skin reactions secondary to radiotherapy | $186.00 75% benefit $139.50 85% benefit $158.10 |
| 30010 | Burns, involving not more than 3% of total body surface, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.) | $88.50 75% benefit $66.40 |
| 30014 | Burns, involving 3% or more but less than 20% of total body surface, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.) | $186.00 75% benefit $139.50 |
| 30015 | Burns, involving 20% or more but less than 50% of total body surface, or burns of less than 20% of total body surface involving 1% or more of total body surface within the hands or face, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.) (Assist.) | $279.00 75% benefit $209.25 |
| 30016 | Burns, involving 50% or more of total body surface, dressing of (including redressing of any related donor site, if required), in an operating theatre under general anaesthesia or intravenous sedation, if medical practitioner is present (H) (Anaes.) (Assist.) | $418.45 75% benefit $313.85 |
| 30023 | WOUND OF SOFT TISSUE, traumatic, deep or extensively contaminated, debridement of, under general anaesthesia or regional or field nerve block, including suturing of that wound when performed (Anaes.) (Assist.) | $390.25 75% benefit $292.70 85% benefit $331.75 |
| 30024 | Wound of soft tissue, debridement of an extensively infected post‑surgical incision or Fournier’s gangrene, under general anaesthesia, or regional or field nerve block, including suturing of the wound if carried out (H) (Anaes.) (Assist.) | $390.25 75% benefit $292.70 |
| 30026 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, not on face or neck, small (NOT MORE THAN 7 CM LONG), superficial, not being a service to which another item in Group T4 applies (Anaes.) | $62.55 75% benefit $46.95 85% benefit $53.20 |
| 30029 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, not on face or neck, small (NOT MORE THAN 7 CM LONG), involving deeper tissue, not being a service to which another item in Group T4 applies (Anaes.) | $107.75 75% benefit $80.85 85% benefit $91.60 |
| 30032 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, on face or neck, small (NOT MORE THAN 7 CM LONG), superficial (Anaes.) | $98.70 75% benefit $74.05 85% benefit $83.90 |
| 30035 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, on face or neck, small (NOT MORE THAN 7 CM LONG), involving deeper tissue (Anaes.) | $140.70 75% benefit $105.55 85% benefit $119.60 |
| 30038 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, not on face or neck, large (MORE THAN 7 CM LONG), superficial, not being a service to which another item in Group T4 applies (Anaes.) | $107.75 75% benefit $80.85 85% benefit $91.60 |
| 30042 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, other than on face or neck, large (MORE THAN 7 CM LONG), involving deeper tissue, other than a service to which another item in Group T4 applies (Anaes.) | $222.10 75% benefit $166.60 85% benefit $188.80 |
| 30045 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, on face or neck, large (MORE THAN 7 CM LONG), superficial (Anaes.) | $140.70 75% benefit $105.55 85% benefit $119.60 |
| 30049 | SKIN AND SUBCUTANEOUS TISSUE OR MUCOUS MEMBRANE, REPAIR OF WOUND OF, other than wound closure at time of surgery, on face or neck, large (MORE THAN 7 CM LONG), involving deeper tissue (Anaes.) | $222.10 75% benefit $166.60 85% benefit $188.80 |
| 30052 | FULL THICKNESS LACERATION OF EAR, EYELID, NOSE OR LIP, repair of, with accurate apposition of each layer of tissue (Anaes.) (Assist.) | $304.00 75% benefit $228.00 85% benefit $258.40 |
| 30055 | Wounds, dressing of, under general, regional or intravenous sedation, with or without removal of sutures, other than a service associated with a service to which another item in this Group applies (Anaes.) | $88.50 75% benefit $66.40 85% benefit $75.25 |
| 30058 | Post‑operative haemorrhage, control of, under general anaesthesia, as an independent procedure (H) (Anaes.) | $172.80 75% benefit $129.60 |
| 30061 | SUPERFICIAL FOREIGN BODY, REMOVAL OF, (including from cornea or sclera), as an independent procedure (Anaes.) | $28.15 75% benefit $21.15 85% benefit $23.95 |
| 30062 | Etonogestrel subcutaneous implant, removal of (Anaes.) | $107.90 75% benefit $80.95 85% benefit $91.75 |
| 30064 | SUBCUTANEOUS FOREIGN BODY, removal of, requiring incision and exploration, including closure of wound if performed, as an independent procedure (Anaes.) | $131.55 75% benefit $98.70 85% benefit $111.85 |
| 30068 | FOREIGN BODY IN MUSCLE, TENDON OR OTHER DEEP TISSUE, removal of, as an independent procedure (Anaes.) (Assist.) | $331.25 75% benefit $248.45 85% benefit $281.60 |
| 30071 | Diagnostic biopsy of skin, as an independent procedure, if the biopsy specimen is sent for pathological examination (Anaes.) | $62.55 75% benefit $46.95 85% benefit $53.20 |
| 30072 | Diagnostic biopsy of mucous membrane, as an independent procedure, if the biopsy specimen is sent for pathological examination (Anaes.) | $62.55 75% benefit $46.95 85% benefit $53.20 |
| 30075 | DIAGNOSTIC BIOPSY OF LYMPH NODE, MUSCLE OR OTHER DEEP TISSUE OR ORGAN, as an independent procedure, if the biopsy specimen is sent for pathological examination (Anaes.) | $179.25 75% benefit $134.45 85% benefit $152.40 |
| 30078 | DIAGNOSTIC DRILL BIOPSY OF LYMPH NODE, DEEP TISSUE OR ORGAN, as an independent procedure, where the biopsy specimen is sent for pathological examination (Anaes.) | $57.95 75% benefit $43.50 85% benefit $49.30 |
| 30081 | DIAGNOSTIC BIOPSY OF BONE MARROW by trephine using open approach, where the biopsy specimen is sent for pathological examination (Anaes.) | $131.55 75% benefit $98.70 85% benefit $111.85 |
| 30084 | DIAGNOSTIC BIOPSY OF BONE MARROW by trephine using percutaneous approach where the biopsy is sent for pathological examination (Anaes.) | $70.40 75% benefit $52.80 85% benefit $59.85 |
| 30087 | DIAGNOSTIC BIOPSY OF BONE MARROW by aspiration or PUNCH BIOPSY OF SYNOVIAL MEMBRANE, where the biopsy is sent for pathological examination (Anaes.) | $35.20 75% benefit $26.40 85% benefit $29.95 |
| 30090 | DIAGNOSTIC BIOPSY OF PLEURA, PERCUTANEOUS 1 or more biopsies on any 1 occasion, where the biopsy is sent for pathological examination (Anaes.) | $153.85 75% benefit $115.40 85% benefit $130.80 |
| 30093 | DIAGNOSTIC NEEDLE BIOPSY OF VERTEBRA, where the biopsy is sent for pathological examination (Anaes.) | $205.35 75% benefit $154.05 85% benefit $174.55 |
| 30094 | DIAGNOSTIC PERCUTANEOUS ASPIRATION BIOPSY of deep organ using interventional imaging techniques - but not including imaging, where the biopsy is sent for pathological examination (Anaes.) | $226.75 75% benefit $170.10 85% benefit $192.75 |
| 30097 | Personal performance of a Synacthen Stimulation Test, including associated consultation; by a medical practitioner with resuscitation training and access to facilities where life support procedures can be implemented, if: serum cortisol at 0830-0930 hours on any day in the preceding month has been measured at greater than 100 nmol/L but less than 400 nmol/L; or in a patient who is acutely unwell and adrenal insufficiency is suspected. | $116.30 75% benefit $87.25 85% benefit $98.90 |
| 30099 | SINUS, excision of, involving superficial tissue only (Anaes.) | $107.75 75% benefit $80.85 85% benefit $91.60 |
| 30103 | SINUS, excision of, involving muscle and deep tissue (Anaes.) | $220.15 75% benefit $165.15 85% benefit $187.15 |
| 30104 | Pre-auricular sinus, excision of, on a patient 10 years of age or over (Anaes.) | $151.95 75% benefit $114.00 85% benefit $129.20 |
| 30105 | Pre‑auricular sinus, excision of, on a patient under 10 years of age (H) (Anaes.) | $197.45 75% benefit $148.10 |
| 30107 | Excision of ganglion, other than a service associated with a service to which another item in this Group applies (Anaes.) | $263.15 75% benefit $197.40 85% benefit $223.70 |
| 30166 | Removal of redundant abdominal skin and lipectomy, as a wedge excision, for functional problems following significant weight loss equivalent to at least 5 body mass index points and if there has been a stable weight for a period of at least 6 months prior to surgery, other than a service associated with a service to which item 30175, 30176, 30177, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies (H) (Anaes.) (Assist.) | $897.70 75% benefit $673.30 |
| 30169 | Removal of redundant non-abdominal skin and lipectomy for functional problems following significant weight loss equivalent to at least 5 body mass index points and if there has been a stable weight for a period of at least 6 months prior to surgery, one or 2 non-abdominal areas, other than a service associated with a service to which item 30175, 30176, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies (H) (Anaes.) (Assist.) | $718.15 75% benefit $538.65 |
| 30175 | Radical abdominoplasty, with repair of rectus diastasis, excision of skin and subcutaneous tissue, and transposition of umbilicus, not being a laparoscopic procedure, if:(a) the patient has an abdominal wall defect as a consequence of pregnancy; and(b) the patient: (i) has a diastasis of at least 3cm measured by diagnostic imaging prior to this service; and(ii) has either or both of the following: (A) at least moderately severe pain or discomfort at the site of the diastasis in the abdominal wall during functional use and the pain or discomfort has been documented in the patient’s records by the practitioner providing the service;(B) low back pain or urinary symptoms likely due to rectus diastasis and the pain or symptoms have been documented in the patient’s records by the practitioner providing the service; and (iii) has failed to respond to non-surgical conservative treatment, that must have included physiotherapy; and(iv) has not been pregnant in the last 12 months; and (c) the service is not a service associated with a service to which item 30166, 30169, 30176, 30177, 30179, 30651, 30655, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 appliesApplicable once per lifetime (H) (Anaes.) (Assist.) | $1,161.05 75% benefit $870.80 |
| 30176 | Radical abdominoplasty, with excision of skin and subcutaneous tissue, repair of musculoaponeurotic layer and transposition of umbilicus, not being a service associated with a service to which item 30166, 30169, 30175, 30177, 30179, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies, if the patient has previously had a massive intra-abdominal or pelvic tumour surgically removed (H) (Anaes.) (Assist.) | $1,179.70 75% benefit $884.80 |
| 30177 | Lipectomy, excision of skin and subcutaneous tissue associated with redundant abdominal skin and fat that is a direct consequence of significant weight loss, in conjunction with a radical abdominoplasty, with or without repair of musculoaponeurotic layer and transposition of umbilicus, not being a service associated with a service to which item 30166, 30175, 30176, 30179, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies, if: (a) there is intertrigo or another skin condition that risks loss of skin integrity and has failed 3 months of conventional (or non-surgical) treatment; and (b) the redundant skin and fat interferes with the activities of daily living; and (c) the weight has been stable for at least 6 months following significant weight loss prior to the lipectomy (H) (Anaes.) (Assist.) | $1,179.70 75% benefit $884.80 |
| 30179 | Circumferential lipectomy, as an independent procedure, to correct circumferential excess of redundant skin and fat that is a direct consequence of significant weight loss, with or without a radical abdominoplasty, not being a service associated with a service to which item 30175, 30176, 30177, 45530, 45531, 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088 or 46090 applies, if: (a) the circumferential excess of redundant skin and fat is complicated by intertrigo or another skin condition that risks loss of skin integrity and has failed 3 months of conventional (or non-surgical) treatment; and (b) the circumferential excess of redundant skin and fat interferes with the activities of daily living; and (c) the weight has been stable for at least 6 months following significant weight loss prior to the lipectomy (H) (Anaes.) (Assist.) | $1,452.00 75% benefit $1,089.00 |
| 30180 | AXILLARY HYPERHIDROSIS, partial excision for (Anaes.) | $163.40 75% benefit $122.55 85% benefit $138.90 |
| 30183 | Axillary hyperhidrosis, total excision of sweat gland bearing area (H) (Anaes.) | $295.10 75% benefit $221.35 |
| 30187 | PALMAR OR PLANTAR WARTS, removal of, by carbon dioxide laser or erbium laser, requiring admission to a hospital, or when performed by a specialist in the practice of his/her specialty, (5 or more warts) (Anaes.) | $307.60 75% benefit $230.70 85% benefit $261.50 |
| 30189 | WARTS or MOLLUSCUM CONTAGIOSUM (one or more), removal of, by any method (other than by chemical means), where undertaken in the operating theatre of a hospital, not being a service associated with a service to which another item in this Group applies (H) (Anaes.) | $176.25 75% benefit $132.20 |
| 30190 | Angiofibromas, trichoepitheliomas or other severely disfiguring tumours of the face or neck (excluding melanocytic naevi, sebaceous hyperplasia, dermatosis papulosa nigra, Campbell De Morgan angiomas and seborrheic or viral warts), suitable for laser ablation as confirmed by the opinion of a specialist in the specialty of dermatology—removal of, by carbon dioxide laser or erbium laser ablation, including associated resurfacing (10 or more tumours) (Anaes.) | $476.00 75% benefit $357.00 85% benefit $404.60 |
| 30191 | Angiofibromas, trichoepithelioma, epidermal naevi, xanthelasma, pyogenic granuloma, genital angiokeratomas, hereditary haemorrhagic telangiectasia and other severely disfiguring or recurrently bleeding tumours (excluding melanocytic naevi, sebaceous hyperplasia, dermatosis papulosa nigra, Campbell De Morgan angiomas and seborrheic or viral warts), treatment of, with carbon dioxide/erbium or other appropriate laser (or curettage and fine point diathermy for pyogenic granuloma only), if confirmed by the opinion of a specialist in the specialty of dermatology, one or more lesions. | $76.00 75% benefit $57.00 85% benefit $64.60 |
| 30192 | PREMALIGNANT SKIN LESIONS (including solar keratoses), treatment of, by ablative technique (10 or more lesions) (Anaes.) | $47.30 75% benefit $35.50 85% benefit $40.25 |
| 30196 | Malignant neoplasm of skin or mucous membrane that has been: (a) proven by histopathology; or (b) confirmed by the opinion of a specialist in the specialty of dermatology or plastic surgery where a specimen has been submitted for histologic confirmation; removal of, by serial curettage, or carbon dioxide laser or erbium laser excision‑ablation, including any associated cryotherapy or diathermy (Anaes.) | $151.10 75% benefit $113.35 85% benefit $128.45 |
| 30202 | Malignant neoplasm of skin or mucous membrane proven by histopathology or confirmed by the opinion of a specialist in the specialty of dermatology or plastic surgery—removal of, by liquid nitrogen cryotherapy using repeat freeze thaw cycles | $57.80 75% benefit $43.35 85% benefit $49.15 |
| 30207 | Skin lesions, multiple injections with glucocorticoid preparations (Anaes.) | $53.35 75% benefit $40.05 85% benefit $45.35 |
| 30210 | Keloid and other skin lesions, extensive, multiple injections of glucocorticoid preparations, if undertaken in the operating theatre of a hospital (H) (Anaes.) | $195.05 75% benefit $146.30 |
| 30216 | HAEMATOMA, aspiration of (Anaes.) | $32.75 75% benefit $24.60 85% benefit $27.85 |
| 30219 | HAEMATOMA, FURUNCLE, SMALL ABSCESS OR SIMILAR LESION not requiring admission to a hospital - INCISION WITH DRAINAGE OF (excluding aftercare) | $32.75 75% benefit $24.60 85% benefit $27.85 |
| 30223 | LARGE HAEMATOMA, LARGE ABSCESS, CARBUNCLE, CELLULITIS or similar lesion, requiring admission to a hospital, INCISION WITH DRAINAGE OF (excluding aftercare) (Anaes.) | $195.05 75% benefit $146.30 |
| 30224 | PERCUTANEOUS DRAINAGE OF DEEP ABSCESS using interventional imaging techniques - but not including imaging (Anaes.) | $284.35 75% benefit $213.30 85% benefit $241.70 |
| 30225 | ABSCESS DRAINAGE TUBE, exchange of using interventional imaging techniques - but not including imaging (Anaes.) | $320.35 75% benefit $240.30 85% benefit $272.30 |
| 30226 | MUSCLE, excision of (LIMITED), or fasciotomy (Anaes.) | $179.25 75% benefit $134.45 85% benefit $152.40 |
| 30229 | Muscle, excision of (extensive) (H) (Anaes.) (Assist.) | $326.70 75% benefit $245.05 |
| 30232 | MUSCLE, RUPTURED, repair of (limited), not associated with external wound (Anaes.) | $267.60 75% benefit $200.70 85% benefit $227.50 |
| 30235 | Muscle, ruptured, repair of (extensive), not associated with external wound (H) (Anaes.) (Assist.) | $353.90 75% benefit $265.45 |
| 30238 | FASCIA, DEEP, repair of, FOR HERNIATED MUSCLE (Anaes.) | $179.25 75% benefit $134.45 85% benefit $152.40 |
| 30241 | BONE TUMOUR, INNOCENT, excision of, not being a service to which another item in this Group applies (Anaes.) (Assist.) | $426.55 75% benefit $319.95 85% benefit $362.60 |
| 30244 | STYLOID PROCESS OF TEMPORAL BONE, removal of (Anaes.) (Assist.) | $426.55 75% benefit $319.95 |
| 30246 | PAROTID DUCT, repair of, using micro-surgical techniques (Anaes.) (Assist.) | $825.65 75% benefit $619.25 |
| 30247 | Parotid gland, total extirpation of, including removal of tumour, other than a service associated with a service to which item 39321, 39324, 39327 or 39330 applies (H) (Anaes.) (Assist.) | $884.90 75% benefit $663.70 |
| 30250 | Parotid gland, total extirpation of, with preservation of facial nerve, including: (a) removal of tumour; and (b) exposure or mobilisation of facial nerve; other than a service associated with a service to which item 39321, 39324, 39327 or 39330 applies (H) (Anaes.) (Assist.) | $1,497.40 75% benefit $1,123.05 |
| 30251 | Recurrent parotid tumour, excision of, with preservation of facial nerve, including: (a) removal of tumour; and (b) exposure or mobilisation of facial nerve; other than a service associated with a service to which item 39321, 39324, 39327 or 39330 applies (H) (Anaes.) (Assist.) | $2,300.20 75% benefit $1,725.15 |
| 30253 | Parotid gland, superficial lobectomy of, with exposure of facial nerve, including: (a) removal of tumour; and (b) exposure or mobilisation of facial nerve; other than a service associated with a service to which item 39321, 39324, 39327 or 39330 applies (H) (Anaes.) (Assist.) | $998.30 75% benefit $748.75 |
| 30255 | SUBMANDIBULAR DUCTS, relocation of, for surgical control of drooling (Anaes.) (Assist.) | $1,329.35 75% benefit $997.05 |
| 30256 | Submandibular gland, extirpation of, other than a service associated with a service to which item 31423, 31426, 31429, 31432, 31435 or 31438 applies on the same side (H) (Anaes.) (Assist.) | $533.15 75% benefit $399.90 |
| 30257 | Sialendoscopy, of submandibular or parotid duct, with or without removal of calculus or treatment of stricture (Anaes.) | $598.40 75% benefit $448.80 85% benefit $508.65 |
| 30259 | Sublingual gland, extirpation of (H) (Anaes.) | $237.65 75% benefit $178.25 |
| 30262 | SALIVARY GLAND, DILATATION OR DIATHERMY of duct (Anaes.) | $70.40 75% benefit $52.80 85% benefit $59.85 |
| 30266 | Salivary gland, removal of calculus from duct or meatotomy or marsupialisation, 1 or more such procedures. (Anaes.) | $179.25 75% benefit $134.45 85% benefit $152.40 |
| 30269 | Salivary gland, repair of cutaneous fistula of (H) (Anaes.) | $179.25 75% benefit $134.45 |
| 30272 | Tongue, partial excision of (H) (Anaes.) (Assist.) | $353.90 75% benefit $265.45 |
| 30275 | Radical excision of intra oral tumour, with or without resection of mandible, including dissection of lymph glands of neck, unilateral, other than a service associated with a service to which item 31423, 31426, 31429, 31432, 31435 or 31438 applies on the same side (H) (Anaes.) (Assist.) | $2,109.80 75% benefit $1,582.35 |
| 30278 | Tongue tie, repair of, other than: (a) a service to which another item in this Subgroup applies; or (b) a service associated with a service to which item 45009 applies (Anaes.) | $55.60 75% benefit $41.70 85% benefit $47.30 |
| 30281 | Tongue tie, mandibular frenulum or maxillary frenulum, repair of, in a patient at least 2 years old, other than a service associated with a service to which item 45009 applies (Anaes.) | $142.95 75% benefit $107.25 85% benefit $121.55 |
| 30283 | RANULA OR MUCOUS CYST OF MOUTH, removal of (Anaes.) | $245.00 75% benefit $183.75 85% benefit $208.25 |
| 30286 | Branchial cyst, removal of, on a patient 10 years of age or over (H) (Anaes.) (Assist.) | $476.20 75% benefit $357.15 |
| 30287 | Branchial cyst, removal of, on a patient under 10 years of age (H) (Anaes.) (Assist.) | $619.15 75% benefit $464.40 |
| 30289 | Branchial fistula, removal of, on a patient 10 years of age or over (Anaes.) (Assist.) | $601.15 75% benefit $450.90 |
| 30293 | Cervical oesophagostomy, or closure of cervical oesophagostomy with or without plastic repair (H) (Anaes.) (Assist.) | $533.15 75% benefit $399.90 |
| 30294 | CERVICAL OESOPHAGECTOMY with tracheostomy and oesophagostomy, with or without plastic reconstruction; or LARYNGOPHARYNGECTOMY with tracheostomy and plastic reconstruction (Anaes.) (Assist.) | $2,109.80 75% benefit $1,582.35 |
| 30296 | THYROIDECTOMY, total (Anaes.) (Assist.) | $1,225.30 75% benefit $919.00 |
| 30297 | THYROIDECTOMY following previous thyroid surgery (Anaes.) (Assist.) | $1,225.30 75% benefit $919.00 |
| 30299 | Sentinel lymph node biopsy or biopsies for breast cancer, involving dissection in an axilla, using preoperative lymphoscintigraphy and/or lymphotropic dye injection (H) (Anaes.) (Assist.) | $850.05 75% benefit $637.55 |
| 30305 | Sentinel lymph node biopsy or biopsies for breast cancer, involving dissection along internal mammary chain (H) (Anaes.) (Assist.) | $850.10 75% benefit $637.60 |
| 30306 | TOTAL HEMITHYROIDECTOMY (Anaes.) (Assist.) | $955.85 75% benefit $716.90 |
| 30310 | Partial or subtotal thyroidectomy (Anaes.) (Assist.) | $955.85 75% benefit $716.90 |
| 30311 | Sentinel lymph node biopsy or biopsies for cutaneous melanoma, using preoperative lymphoscintigraphy and/or lymphotropic dye injection, if: (a) the primary lesion is greater than 1.0 mm in depth (or at least 0.8 mm in depth in the presence of ulceration); and (b) appropriate excision of the primary melanoma has occurred; and (c) the service is not associated with a service to which item 30075, 30078, 30299, 30305, 30329, 30332, 30618, 30820, 31423, 52025 or 52027 appliesApplicable to only one lesion per occasion on which the service is provided (H) (Anaes.) (Assist.) | $745.00 75% benefit $558.75 |
| 30314 | Thyroglossal cyst or fistula or both, radical removal of, including thyroglossal duct and portion of hyoid bone, on a patient 10 years of age or over (Anaes.) (Assist.) | $547.35 75% benefit $410.55 |
| 30315 | Minimally invasive parathyroidectomy. Removal of 1 or more parathyroid adenoma through a small cervical incision for an image localised adenoma, including thymectomy. For any particular patient - applicable only once per occasion on which the service is provided. Not in association with a service to which item 30318, 30317 or 30320 applies. (Anaes.) (Assist.) | $1,364.35 75% benefit $1,023.30 |
| 30317 | Redo parathyroidectomy. Cervical re-exploration for persistent or recurrent hyperparathyroidism, including thymectomy and cervical exploration of the mediastinum. For any particular patient - applicable only once per occasion on which the service is provided. Not in association with a service to which item 30315, 30318 or 30320 applies. (Anaes.) (Assist.) | $1,633.60 75% benefit $1,225.20 |
| 30318 | Open parathyroidectomy, exploration and removal of 1 or more adenoma or hyperplastic glands via a cervical incision including thymectomy and cervical exploration of the mediastinum when performed. For any particular patient - applicable only once per occasion on which the service is provided. Not in association with a service to which item 30315, 30317 or 30320 applies. (Anaes.) (Assist.) | $1,364.35 75% benefit $1,023.30 |
| 30320 | Removal of a mediastinal parathyroid adenoma via sternotomy or mediastinal thorascopic approach. For any particular patient - applicable only once per occasion on which the service is provided. Not in association with a service to which item 30315, 30317 or 30318 applies. (Anaes.) (Assist.) | $1,633.60 75% benefit $1,225.20 |
| 30323 | Excision of phaeochromocytoma or extraadrenal paraganglioma via endoscopic or open approach. (Anaes.) (Assist.) | $1,633.60 75% benefit $1,225.20 |
| 30324 | Excision of an adrenocortical tumour or hyperplasia via endoscopic or open approach. (Anaes.) (Assist.) | $1,633.60 75% benefit $1,225.20 |
| 30326 | Thyroglossal cyst or fistula or both, radical removal of, including thyroglossal duct and portion of hyoid bone, on a patient under 10 years of age (Anaes.) (Assist.) | $711.65 75% benefit $533.75 |
| 30329 | LYMPH NODES of GROIN, limited excision of (Anaes.) | $295.55 75% benefit $221.70 85% benefit $251.25 |
| 30330 | LYMPH NODES of GROIN, radical excision of (Anaes.) (Assist.) | $860.25 75% benefit $645.20 |
| 30332 | Lymph nodes of axilla, limited excision of (H) (Anaes.) (Assist.) | $415.00 75% benefit $311.25 |
| 30336 | Lymph nodes of axilla, complete excision of (H) (Anaes.) (Assist.) | $1,245.05 75% benefit $933.80 |
| 30382 | Enterocutaneous fistula, repair of, if dissection and resection of bowel is performed, with or without anastomosis or formation of a stoma (H) (Anaes.) (Assist.) | $1,564.25 75% benefit $1,173.20 |
| 30384 | Open or minimally invasive excision of a retroperitoneal mass, 4 cm or greater in largest dimension, lasting more than 3 hours, other than a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $1,633.60 75% benefit $1,225.20 |
| 30385 | Unplanned return to theatre for laparotomy or laparoscopy for control or drainage of intra-abdominal haemorrhage following abdominal surgery (H) (Anaes.) (Assist.) | $674.30 75% benefit $505.75 |
| 30387 | Laparoscopy or laparotomy when an operation is performed on abdominal, retroperitoneal or pelvic viscera, excluding lymph node biopsy, other than a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $760.00 75% benefit $570.00 |
| 30388 | Laparotomy for abdominal trauma, including control of haemorrhage (with or without packing) and containment of contamination (H) (Anaes.) (Assist.) | $1,274.80 75% benefit $956.10 |
| 30390 | Laparoscopy, diagnostic, with or without aspiration of fluid, on a patient 10 years of age or over, if no other intra-abdominal procedure is performed (H) (Anaes.) (Assist.) | $263.15 75% benefit $197.40 |
| 30392 | RADICAL OR DEBULKING OPERATION for advanced intra-abdominal malignancy, with or without omentectomy, as an independent procedure (Anaes.) (Assist.) | $807.35 75% benefit $605.55 |
| 30396 | Laparotomy or laparoscopy for generalised intra-peritoneal sepsis (also known as peritonitis), with or without removal of foreign material or enteric contents, with lavage of the entire peritoneal cavity, with or without closure of the abdomen when performed by laparotomy (H) (Anaes.) (Assist.) | $1,216.70 75% benefit $912.55 |
| 30397 | Laparostomy, via wound previously made and left open or closed, including change of dressings or packs, with or without drainage of loculated collections (H) (Anaes.) | $278.05 75% benefit $208.55 |
| 30399 | Laparostomy, final closure of wound made at previous operation, after removal of dressings or packs (Anaes.) (Assist.) | $382.45 75% benefit $286.85 |
| 30400 | LAPAROTOMY WITH INSERTION OF PORTACATH for administration of cytotoxic therapy including placement of reservoir (Anaes.) (Assist.) | $757.00 75% benefit $567.75 |
| 30406 | PARACENTESIS ABDOMINIS (Anaes.) | $62.55 75% benefit $46.95 85% benefit $53.20 |
| 30408 | PERITONEOVENOUS shunt, insertion of (Anaes.) (Assist.) | $469.30 75% benefit $352.00 |
| 30409 | LIVER BIOPSY, percutaneous (Anaes.) | $208.75 75% benefit $156.60 85% benefit $177.45 |
| 30411 | LIVER BIOPSY by wedge excision when performed in conjunction with another intraabdominal procedure (Anaes.) | $106.30 75% benefit $79.75 |
| 30412 | Liver biopsy by core needle, when performed in conjunction with another intra‑abdominal procedure (H) (Anaes.) | $62.70 75% benefit $47.05 |
| 30414 | LIVER, subsegmental resection of, (local excision), other than for trauma (Anaes.) (Assist.) | $825.65 75% benefit $619.25 |
| 30415 | LIVER, segmental resection of, other than for trauma (Anaes.) (Assist.) | $1,651.05 75% benefit $1,238.30 |
| 30416 | Liver cysts, greater than 5 cm in diameter, marsupialisation of 4 or less (Anaes.) (Assist.) | $896.40 75% benefit $672.30 |
| 30417 | Liver cysts, greater than 5 cm in diameter, marsupialisation of 5 or more (Anaes.) (Assist.) | $1,344.55 75% benefit $1,008.45 |
| 30418 | LIVER, lobectomy of, other than for trauma (Anaes.) (Assist.) | $1,912.15 75% benefit $1,434.15 |
| 30419 | Liver tumour, other than a hepatocellular carcinoma, destruction of one or more, by local ablation, other than a service associated with a service to which item 50950 or 50952 applies (H) (Anaes.) (Assist.) | $978.00 75% benefit $733.50 |
| 30421 | Liver, extended lobectomy of, or central resections of segments 4, 5 and 8, other than for trauma (Anaes.) (Assist.) | $2,389.75 75% benefit $1,792.35 |
| 30422 | LIVER, repair of superficial laceration of, for trauma (Anaes.) (Assist.) | $808.30 75% benefit $606.25 |
| 30425 | LIVER, repair of deep multiple lacerations of, or debridement of, for trauma (Anaes.) (Assist.) | $1,564.25 75% benefit $1,173.20 |
| 30427 | LIVER, segmental resection of, for trauma (Anaes.) (Assist.) | $1,868.40 75% benefit $1,401.30 |
| 30428 | Liver, lobectomy of, for trauma (H) (Anaes.) (Assist.) | $1,998.80 75% benefit $1,499.10 |
| 30430 | Liver, extended lobectomy of, or central resections of segments 4, 5 and 8, for trauma (H) (Anaes.) (Assist.) | $2,780.65 75% benefit $2,085.50 |
| 30431 | Liver abscess, single, open or minimally invasive abdominal drainage of, excluding aftercare (H) (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30433 | Liver abscess, multiple, open or minimally invasive abdominal drainage of, excluding aftercare (Anaes.) (Assist.) | $869.00 75% benefit $651.75 |
| 30439 | Intraoperative ultrasound of biliary tract, or operative cholangiography, if the service: (a) is performed in association with an intra-abdominal procedure; and (b) is not associated with a service to which item 30442 or 30445 applies (Anaes.) (Assist.) | $222.10 75% benefit $166.60 |
| 30440 | Cholangiogram, percutaneous transhepatic, and insertion of biliary drainage tube, using interventional imaging techniques, other than a service associated with a service to which item 30451 applies (H) (Anaes.) (Assist.) | $630.05 75% benefit $472.55 |
| 30441 | Intraoperative ultrasound for staging of intra-abdominal tumours (Anaes.) | $163.15 75% benefit $122.40 |
| 30442 | CHOLEDOCHOSCOPY in conjunction with another procedure (Anaes.) | $222.10 75% benefit $166.60 |
| 30443 | Cholecystectomy, by any approach, without cholangiogram (Anaes.) (Assist.) | $768.90 75% benefit $576.70 |
| 30445 | Cholecystectomy, by any approach, with attempted or completed cholangiogram or intraoperative ultrasound of the biliary system, when performed via laparoscopic or open approach or when conversion from laparoscopic to open approach is required (Anaes.) (Assist.) | $995.95 75% benefit $747.00 |
| 30448 | Cholecystectomy, by any approach, involving removal of common duct calculi via the cystic duct, with or without stent insertion (Anaes.) (Assist.) | $1,164.55 75% benefit $873.45 |
| 30449 | Cholecystectomy with removal of common duct calculi via choledochotomy, by any approach, with or without insertion of a stent (Anaes.) (Assist.) | $1,294.85 75% benefit $971.15 |
| 30450 | Calculus of biliary tract, extraction of, using interventional imaging techniques (H) (Anaes.) (Assist.) | $627.65 75% benefit $470.75 |
| 30451 | Biliary drainage tube, exchange of, using interventional imaging techniques, other than a service associated with a service to which item 30440 applies (Anaes.) (Assist.) | $320.35 75% benefit $240.30 85% benefit $272.30 |
| 30452 | CHOLEDOCHOSCOPY with balloon dilation of a stricture or passage of stent or extraction of calculi (Anaes.) (Assist.) | $451.80 75% benefit $338.85 |
| 30454 | Choledochotomy without cholecystectomy, with or without removal of calculi (Anaes.) (Assist.) | $1,577.80 75% benefit $1,183.35 |
| 30455 | Choledochotomy with cholecystectomy, with removal of calculi, including biliary intestinal anastomosis (Anaes.) (Assist.) | $1,577.80 75% benefit $1,183.35 |
| 30457 | Choledochotomy, intrahepatic, involving removal of intrahepatic bile duct calculi (H) (Anaes.) (Assist.) | $1,651.05 75% benefit $1,238.30 |
| 30458 | TRANSDUODENAL OPERATION ON SPHINCTER OF ODDI, involving 1 or more of, removal of calculi, sphincterotomy, sphincteroplasty, biopsy, local excision of peri-ampullary or duodenal tumour, sphincteroplasty of the pancreatic duct, pancreatic duct septoplasty, with or without choledochotomy (Anaes.) (Assist.) | $1,213.65 75% benefit $910.25 |
| 30460 | CHOLECYSTODUODENOSTOMY, CHOLECYSTOENTEROSTOMY, CHOLEDOCHOJEJUNOSTOMY or Roux-en-Y as a bypass procedure when no prior biliary surgery performed (Anaes.) (Assist.) | $1,032.30 75% benefit $774.25 |
| 30461 | Radical resection of porta hepatis (including associated neuro-lymphatic tissue), for cancer, suspected cancer or choledochal cyst, including bile duct excision and biliary-enteric anastomoses, other than a service associated with a service to which item 30440, 30451 or 31454 applies (Anaes.) (Assist.) | $1,769.45 75% benefit $1,327.10 |
| 30463 | Radical resection of common hepatic duct and right and left hepatic ducts, with 2 duct anastomoses, for cancer, suspected cancer or choledochal cyst (Anaes.) (Assist.) | $2,172.65 75% benefit $1,629.50 |
| 30464 | Radical resection of common hepatic duct and right and left hepatic ducts, for cancer, suspected cancer or choledochal cyst, involving either or both of the following:(a) more than 2 anastomoses;(b) resection of segment (or major portion of segment) of liver; (Anaes.) (Assist.) | $2,607.10 75% benefit $1,955.35 |
| 30469 | Biliary stricture, repair of, after one or more operations on the biliary tree (H) (Anaes.) (Assist.) | $2,059.75 75% benefit $1,544.85 |
| 30472 | Repair of bile duct injury, including immediate reconstruction, other than a service associated with a service to which item 30584 applies (Anaes.) (Assist.) | $1,595.40 75% benefit $1,196.55 |
| 30473 | Oesophagoscopy (not being a service associated with a service to which item 41822 applies), gastroscopy, duodenoscopy or panendoscopy (1 or more such procedures), with or without biopsy, not being a service associated with a service to which item 30478 or 30479 applies. (Anaes.) | $211.95 75% benefit $159.00 85% benefit $180.20 |
| 30475 | Endoscopic dilatation of stricture of upper gastrointestinal tract (including the use of imaging intensification if clinically indicated) (H) (Anaes.) | $417.70 75% benefit $313.30 |
| 30478 | Oesophagoscopy (other than a service associated with a service to which item 41822 or 41825 applies), gastroscopy, duodenoscopy, panendoscopy or push enteroscopy, one or more such procedures, if: (a) the procedures are performed using one or more of the following endoscopic procedures: (i) polypectomy; (ii) sclerosing or adrenalin injections; (iii) banding; (iv) endoscopic clips; (v) haemostatic powders; (vi) diathermy; (vii) argon plasma coagulation; and (b) the procedures are for the treatment of one or more of the following: (i) upper gastrointestinal tract bleeding; (ii) polyps; (iii) removal of foreign body; (iv) oesophageal or gastric varices; (v) peptic ulcers; (vi) neoplasia; (vii) benign vascular lesions; (viii) strictures of the gastrointestinal tract; (ix) tumorous overgrowth through or over oesophageal stents; other than a service associated with a service to which item 30473 or 30479 applies (H) (Anaes.) | $293.95 75% benefit $220.50 |
| 30479 | Endoscopy with laser therapy, for the treatment of one or more of the following: (a) neoplasia; (b) benign vascular lesions; (c) strictures of the gastrointestinal tract; (d) tumorous overgrowth through or over oesophageal stents; (e) peptic ulcers; (f) angiodysplasia; (g) gastric antral vascular ectasia; (h) post-polypectomy bleeding; other than a service associated with a service to which item 30473 or 30478 applies (Anaes.) | $569.80 75% benefit $427.35 85% benefit $484.35 |
| 30481 | Percutaneous gastrostomy (initial procedure): (a) including any associated imaging services; and (b) excluding the insertion of a device for the purpose of facilitating weight loss (H) (Anaes.) | $427.30 75% benefit $320.50 |
| 30482 | PERCUTANEOUS GASTROSTOMY (repeat procedure): (a) including any associated imaging services; and (b) excluding the insertion of a device for the purpose of facilitating weight loss (Anaes.) | $303.85 75% benefit $227.90 85% benefit $258.30 |
| 30483 | Gastrostomy button, caecostomy antegrade enema device (chait etc.) or stomal indwelling device: (a) non-endoscopic insertion of; or (b) non-endoscopic replacement of; on a patient 10 years of age or over, excluding the insertion of a device for the purpose of facilitating weight loss (Anaes.) | $211.90 75% benefit $158.95 85% benefit $180.15 |
| 30484 | Endoscopic retrograde cholangiopancreatography, other than a service to which item 30664 or 30665 applies (H) (Anaes.) | $436.80 75% benefit $327.60 |
| 30485 | Endoscopic sphincterotomy with or without extraction of stones from common bile duct (H) (Anaes.) | $674.30 75% benefit $505.75 |
| 30488 | Small bowel intubation—as an independent procedure (H) (Anaes.) | $107.75 75% benefit $80.85 |
| 30490 | Oesophageal prosthesis, insertion of, including endoscopy and dilatation (H) (Anaes.) | $630.05 75% benefit $472.55 |
| 30491 | Bile duct, endoscopic stenting of (including endoscopy and dilatation) (H) (Anaes.) | $664.75 75% benefit $498.60 |
| 30492 | Bile duct, percutaneous stenting of (including dilatation when performed), using interventional imaging techniques (H) (Anaes.) | $942.35 75% benefit $706.80 |
| 30494 | ENDOSCOPIC BILIARY DILATATION (Anaes.) | $503.30 75% benefit $377.50 |
| 30495 | Percutaneous biliary dilatation for biliary stricture using interventional imaging techniques (H) (Anaes.) | $942.35 75% benefit $706.80 |
| 30515 | Gastroenterostomy (including gastroduodenostomy), enterocolostomy or enteroenterostomy, as an independent procedure or in combination with another procedure, only if required for irresectable obstruction, other than a service to which any of items 31569 to 31581 apply (Anaes.) (Assist.) | $843.05 75% benefit $632.30 |
| 30517 | Revision of gastroenterostomy, pyloroplasty or gastroduodenostomy (Anaes.) (Assist.) | $1,103.75 75% benefit $827.85 |
| 30518 | Partial gastrectomy, not being a service associated with a service to which any of items 31569 to 31581 apply (Anaes.) (Assist.) | $1,181.95 75% benefit $886.50 |
| 30520 | Gastric tumour, 2 cm or greater in diameter, removal of, by local excision, by laparoscopic or open approach, including any associated anastomosis, excluding polypectomy, other than a service to which item 30518 applies (Anaes.) (Assist.) | $1,016.90 75% benefit $762.70 |
| 30521 | GASTRECTOMY, TOTAL, for benign disease (Anaes.) (Assist.) | $1,729.30 75% benefit $1,297.00 |
| 30526 | Gastrectomy, total, and removal of lower oesophagus, performed by open or minimally invasive approach, with anastomosis in the mediastinum, including any of the following (if performed):(a) distal pancreatectomy;(b) nodal dissection;(c) splenectomy (Anaes.) (Assist.) | $2,580.85 75% benefit $1,935.65 |
| 30529 | ANTIREFLUX operation by fundoplasty, with OESOPHAGOPLASTY for stricture or short oesophagus (Anaes.) (Assist.) | $1,564.25 75% benefit $1,173.20 |
| 30530 | ANTIREFLUX operation by cardiopexy, with or without fundoplasty (Anaes.) (Assist.) | $938.65 75% benefit $704.00 |
| 30532 | Oesophagogastric myotomy (Heller’s operation) by endoscopic, abdominal or thoracic approach, whether performed by open or minimally invasive approach, including fundoplication when performed laparoscopically (Anaes.) (Assist.) | $1,077.70 75% benefit $808.30 |
| 30533 | OESOPHAGOGASTRIC MYOTOMY (Heller's operation) via abdominal or thoracic approach, WITH FUNDOPLASTY, with or without closure of the diaphragmatic hiatus, by laparoscopy or open operation (Anaes.) (Assist.) | $1,281.90 75% benefit $961.45 |
| 30559 | Oesophagus, local excision for tumour of (H) (Anaes.) (Assist.) | $1,016.90 75% benefit $762.70 |
| 30560 | Oesophageal perforation, repair of, by abdominal or thoracic approach, including thoracic drainage (Anaes.) (Assist.) | $1,129.55 75% benefit $847.20 |
| 30562 | Enterostomy or colostomy, closure of (not involving resection of bowel), on a patient 10 years of age or over (Anaes.) (Assist.) | $712.05 75% benefit $534.05 |
| 30563 | Colostomy or ileostomy, refashioning of, on a patient 10 years of age or over (H) (Anaes.) (Assist.) | $712.05 75% benefit $534.05 |
| 30565 | SMALL INTESTINE, resection of, without anastomosis (including formation of stoma) (Anaes.) (Assist.) | $1,042.85 75% benefit $782.15 |
| 30574 | NOTE: Multiple Operation and Multiple Anaesthetic rules apply to this item Appendicectomy, when performed in conjunction with another intra-abdominal procedure and during which a specimen is collected and sent for pathological testing (Anaes.) | $73.75 75% benefit $55.35 |
| 30577 | Initial pancreatic necrosectomy by open, laparoscopic or endoscopic approach, excluding aftercare (Anaes.) (Assist.) | $1,303.65 75% benefit $977.75 |
| 30583 | Distal pancreatectomy with splenic preservation, by open or minimally invasive approach (Anaes.) (Assist.) | $1,860.45 75% benefit $1,395.35 |
| 30584 | Pancreatico duodenectomy (Whipple’s procedure), with or without preservation of pylorus, including any of the following (if performed):(a) cholecystectomy;(b) pancreatico-biliary anastomosis;(c) gastro-jejunal anastomosis (Anaes.) (Assist.) | $3,590.65 75% benefit $2,693.00 |
| 30589 | PANCREATICO-JEJUNOSTOMY for pancreatitis or trauma (Anaes.) (Assist.) | $1,497.40 75% benefit $1,123.05 |
| 30590 | PANCREATICO-JEJUNOSTOMY following previous pancreatic surgery (Anaes.) (Assist.) | $1,651.05 75% benefit $1,238.30 |
| 30593 | Pancreatectomy, near total or total (including duodenum), with or without splenectomy (H) (Anaes.) (Assist.) | $2,259.40 75% benefit $1,694.55 |
| 30594 | PANCREATECTOMY for pancreatitis following previously attempted drainage procedure or partial resection (Anaes.) (Assist.) | $2,607.10 75% benefit $1,955.35 |
| 30596 | SPLENORRHAPHY OR PARTIAL SPLENECTOMY (Anaes.) (Assist.) | $1,073.95 75% benefit $805.50 |
| 30599 | SPLENECTOMY, for massive spleen (weighing more than 1500 grams) or involving thoraco-abdominal incision (Anaes.) (Assist.) | $1,564.25 75% benefit $1,173.20 |
| 30600 | Emergency repair of diaphragmatic laceration or hernia, following recent trauma, by any approach, including when performed in conjunction with another procedure indicated as a result of abdominal or chest trauma (Anaes.) (Assist.) | $930.15 75% benefit $697.65 |
| 30601 | Diaphragmatic hernia, congenital, or delayed presentation of traumatic rupture, repair of, by thoracic or abdominal approach, on a patient 10 years of age or over, other than a service to which any of items 31569 to 31581 apply (Anaes.) (Assist.) | $1,145.90 75% benefit $859.45 |
| 30606 | PORTAL HYPERTENSION, oesophageal transection via stapler or oversew of gastric varices with or without devascularisation (Anaes.) (Assist.) | $1,329.50 75% benefit $997.15 |
| 30608 | Small intestine, resection of, with anastomosis, on a patient under 10 years of age (Anaes.) (Assist.) | $1,506.00 75% benefit $1,129.50 |
| 30611 | Benign tumour of soft tissue (other than tumours of skin, cartilage and bone, simple lipomas covered by item 31345 and lipomata), removal of, by surgical excision, on a patient under 10 years of age, if the specimen excised is sent for histological confirmation of diagnosis, other than a service to which another item in this Group applies (Anaes.) (Assist.) | $674.35 75% benefit $505.80 85% benefit $573.20 |
| 30615 | Strangulated, incarcerated or obstructed hernia, repair of, without bowel resection, on a patient 10 years of age or over (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30618 | Lymph nodes of neck, selective dissection of one or 2 lymph node levels involving removal of soft tissue and lymph nodes from one side of the neck, on a patient under 10 years of age (H) (Anaes.) (Assist.) | $625.10 75% benefit $468.85 |
| 30619 | Laparoscopic splenectomy, on a patient under 10 years of age (Anaes.) (Assist.) | $1,120.65 75% benefit $840.50 |
| 30621 | Repair of symptomatic umbilical, epigastric or linea alba hernia requiring mesh or other repair, by open or minimally invasive approach, in a patient 10 years of age or over, other than a service to which item 30651, 30655, 38365, 38467, 38477, 38484, 38485, 38490, 38493, 38499, 38502, 38510, 38512, 38513, 38515, 38516, 38517, 38519, 38550, 38553, 38554, 38555, 38557, 38670, 38703, 38742 or 38764 applies (H) (Anaes.) (Assist.) | $487.75 75% benefit $365.85 |
| 30622 | Caecostomy, enterostomy, colostomy, enterotomy, colotomy, cholecystostomy, gastrostomy, gastrotomy, reduction of intussusception, removal of Meckel’s diverticulum, suture of perforated peptic ulcer, simple repair of ruptured viscus, reduction of volvulus, pyloroplasty or drainage of pancreas, on a patient under 10 years of age (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 30623 | Laparotomy involving division of peritoneal adhesions (if no other intra-abdominal procedure is performed), on a patient under 10 years of age (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 30626 | Laparotomy involving division of adhesions in association with another intra-abdominal procedure if the time taken to divide the adhesions is between 45 minutes and 2 hours, on a patient under 10 years of age (Anaes.) (Assist.) | $814.90 75% benefit $611.20 |
| 30627 | Laparoscopy, diagnostic, if no other intra-abdominal procedure is performed, on a patient under 10 years of age (H) (Anaes.) | $342.20 75% benefit $256.65 |
| 30628 | HYDROCELE, tapping of | $42.60 75% benefit $31.95 85% benefit $36.25 |
| 30629 | Orchidectomy, radical, including spermatic cord, unilateral, for tumour, inguinal approach, without insertion of testicular prosthesis, other than a service associated with a service to which item 30631, 30635, 30641, 30643 or 30644 applies (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30630 | Insertion of testicular prosthesis, at least 6 months following orchidectomy (H) (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 30631 | Hydrocele, removal of, other than a service associated with a service to which item 30641, 30642 or 30644 applies (H) (Anaes.) | $283.25 75% benefit $212.45 |
| 30635 | Varicocele, surgical correction of, including microsurgical techniques, other than a service associated with a service to which item 30390, 30627, 30641, 30642 or 30644 applies—one procedure (Anaes.) (Assist.) | $349.25 75% benefit $261.95 |
| 30636 | Gastrostomy button, caecostomy antegrade enema device (chait etc.) or stomal indwelling device, non-endoscopic insertion of, or non-endoscopic replacement of, on a patient under 10 years of age (Anaes.) | $279.10 75% benefit $209.35 85% benefit $237.25 |
| 30637 | Enterostomy or colostomy, closure of (not involving resection of bowel), on a patient under 10 years of age (Anaes.) (Assist.) | $925.90 75% benefit $694.45 |
| 30639 | Colostomy or ileostomy, refashioning of, on a patient under 10 years of age (H) (Anaes.) (Assist.) | $925.90 75% benefit $694.45 |
| 30640 | Repair of large and irreducible scrotal hernia, if surgery exceeds 2 hours, in a patient 10 years of age or over, other than a service to which item 30615, 30621, 30648, 30651 or 30655 applies (Anaes.) (Assist.) | $1,095.10 75% benefit $821.35 |
| 30641 | Orchidectomy, simple or subcapsular, unilateral with or without insertion of testicular prosthesis (H) (Anaes.) (Assist.) | $487.75 75% benefit $365.85 |
| 30642 | Orchidectomy, radical, including spermatic cord, unilateral, for tumour, inguinal approach, with insertion of testicular prosthesis, other than a service associated with a service to which item 30631, 30635, 30641, 30643, 30644 or 45051 applies (Anaes.) (Assist.) | $907.45 75% benefit $680.60 |
| 30643 | Exploration of spermatic cord, inguinal approach, with or without testicular biopsy, with or without excision of spermatic cord lesion, for a patient under 10 years of age, other than a service associated with a service to which item 30629, 30630 or 30642 applies (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 30644 | Exploration of spermatic cord, inguinal approach, with or without testicular biopsy, with or without excision of spermatic cord lesion, for a patient at least 10 years of age, other than a service associated with a service to which item 30629, 30630 or 30642 applies (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30645 | Appendicectomy, on a patient under 10 years of age, other than a service to which item 30574 applies (Anaes.) (Assist.) | $692.95 75% benefit $519.75 |
| 30646 | Laparoscopic appendicectomy, on a patient under 10 years of age (Anaes.) (Assist.) | $692.95 75% benefit $519.75 |
| 30648 | Femoral or inguinal hernia or infantile hydrocele, repair of, by open or minimally invasive approach, on a patient 10 years of age or over, other than a service to which item 30615 or 30651 applies (Anaes.) (Assist.) | $556.05 75% benefit $417.05 |
| 30649 | Haemorrhage, arrest of, following circumcision requiring general anaesthesia, on a patient under 10 years of age (H) (Anaes.) | $224.65 75% benefit $168.50 |
| 30651 | Ventral hernia repair involving primary fascial closure by suture, with or without onlay mesh or insertion of intraperitoneal onlay mesh repair, without closure of the defect or advancement of the rectus muscle toward the midline, by open or minimally invasive approach, in a patient 10 years of age or over, other than a service associated with a service to which item 30175, 30621, 30655 or 30657 applies (H) (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30652 | Recurrent groin hernia regardless of size of defect, repair of, with or without mesh, by open or minimally invasive approach, in a patient 10 years of age or over (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30654 | Circumcision of the penis, with topical or local analgesia, other than a service to which item 30658 applies | $55.60 75% benefit $41.70 85% benefit $47.30 |
| 30655 | Ventral hernia, repair of, with advancement of the rectus muscles to the midline using a retro-rectus, pre-peritoneal or sublay technique, by open or minimally invasive approach, in a patient 10 years of age or over, other than a service associated with a service to which item 30175, 30621 or 30651 applies (H) (Anaes.) (Assist.) | $1,095.10 75% benefit $821.35 |
| 30657 | Unilateral abdominal wall reconstruction with component separation, including transversus abdominus release and external oblique release for abdominal wall closure by mobilising the rectus abdominis muscles to the midline, by open or minimally invasive approach (Anaes.) (Assist.) | $1,559.40 75% benefit $1,169.55 |
| 30658 | Circumcision of the penis, when performed under general or regional anaesthesia and in conjunction with a service to which an item in Group T7 or Group T10 applies (Anaes.) | $169.90 75% benefit $127.45 85% benefit $144.45 |
| 30661 | Minor surgical repair following a complication from the circumcision of a penis, when performed in conjunction with a service to which an item in Group T7 or Group T10 applies, other than a service associated with a service to which item 45206 applies (H) (Anaes.) | $459.15 75% benefit $344.40 |
| 30662 | Complex surgical repair following a complication from the circumcision of a penis, including single stage local flap, if indicated, to repair one defect, on genitals (other than a service associated with a service to which item 37819, 37822, 45200, 45201, 45202, 45203 or 45206 applies) (H) (Anaes.) (Assist.) | $918.05 75% benefit $688.55 |
| 30663 | Haemorrhage, arrest of, following circumcision requiring general anaesthesia, on a patient 10 years of age or over (H) (Anaes.) | $172.80 75% benefit $129.60 |
| 30664 | Endoscopic retrograde cholangiopancreatography (ERCP), with single operator, single use peroral cholangiopancreatoscopy (POCPS) and biopsy, for the diagnosis of biliary strictures for a patient for whom: (a) a previous ERCP service has been provided; and (b) results from guided brush cytology or intraductal biopsy (or both) are indeterminate Applicable not more than 2 times in a 12 month period, or not more than 3 times in a 12 month period if the patient has been diagnosed with primary sclerosing cholangitis (PSC) (H) (Anaes.) (Assist.) | $700.70 75% benefit $525.55 |
| 30665 | Endoscopic retrograde cholangiopancreatography (ERCP), with single operator, single use peroral cholangiopancreatoscopy (POCPS) and electrohydraulic or laser lithotripsy for the removal of biliary stones that are: (a) greater than 10mm in diameter; or (b) proximal to a stricture; for a patient for whom there has been at least one failed attempt at removal via ERCP extraction techniques Applicable not more than 2 times per treatment cycle (H) (Anaes.) (Assist.) | $980.15 75% benefit $735.15 |
| 30666 | Paraphimosis or phimosis, reduction of, under general anaesthesia, with or without dorsal incision, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $56.80 75% benefit $42.60 |
| 30672 | COCCYX, excision of (Anaes.) (Assist.) | $533.15 75% benefit $399.90 |
| 30676 | Pilonidal sinus or cyst, or sacral sinus or cyst, definitive excision of (H) (Anaes.) | $453.70 75% benefit $340.30 |
| 30679 | Pilonidal sinus, injection of sclerosant fluid under anaesthesia (H) (Anaes.) | $115.25 75% benefit $86.45 |
| 30680 | Balloon enteroscopy, examination of the small bowel (oral approach), with or without biopsy, without intraprocedural therapy, for diagnosis of patients with obscure gastrointestinal bleeding if the patient: (a) has recurrent or persistent bleeding; and (b) is anaemic or has active bleeding; and (c) has had an upper gastrointestinal endoscopy and a colonoscopy performed that did not identify the cause of the bleeding; not in association with another item in this Subgroup (other than item 30682 or 30686) (H) (Anaes.) | $1,400.40 75% benefit $1,050.30 |
| 30682 | Balloon enteroscopy, examination of the small bowel (anal approach), with or without biopsy, without intraprocedural therapy, for diagnosis of patients with obscure gastrointestinal bleeding if the patient: (a) has recurrent or persistent bleeding; and (b) is anaemic or has active bleeding; and (c) has had an upper gastrointestinal endoscopy and a colonoscopy performed that did not identify the cause of the bleeding; not in association with another item in this Subgroup (other than item 30680 or 30684) (H) (Anaes.) | $1,400.40 75% benefit $1,050.30 |
| 30684 | Balloon enteroscopy, examination of the small bowel (oral approach), with or without biopsy, with one or more of the following procedures—snare polypectomy, removal of foreign body, diathermy, heater probe, laser coagulation or argon plasma coagulation, for diagnosis and management of patients with obscure gastrointestinal bleeding if the patient: (a) has recurrent or persistent bleeding; and (b) is anaemic or has active bleeding; and (c) has had an upper gastrointestinal endoscopy and a colonoscopy performed that did not identify the cause of the bleeding; not in association with another item in this Subgroup (other than item 30682 or 30686) (H) (Anaes.) | $1,723.30 75% benefit $1,292.50 |
| 30686 | Balloon enteroscopy, examination of the small bowel (anal approach), with or without biopsy, with one or more of the following procedures—snare polypectomy, removal of foreign body, diathermy, heater probe, laser coagulation or argon plasma coagulation, for diagnosis and management of patients with obscure gastrointestinal bleeding if the patient: (a) has recurrent or persistent bleeding; and (b) is anaemic or has active bleeding; and (c) has had an upper gastrointestinal endoscopy and a colonoscopy performed that did not identify the cause of the bleeding; not in association with another item in this Subgroup (other than item 30680 or 30684) (H) (Anaes.) | $1,723.30 75% benefit $1,292.50 |
| 30687 | Endoscopy with radiofrequency ablation of mucosal metaplasia for the treatment of Barrett’s Oesophagus in a single course of treatment, following diagnosis of high grade dysplasia confirmed by histological examination (H) (Anaes.) | $569.80 75% benefit $427.35 |
| 30688 | Endoscopic ultrasound (endoscopy with ultrasound imaging), with or without biopsy, for the staging of one or more of oesophageal, gastric or pancreatic cancer, not in association with another item in this Subgroup (other than item 30484, 30485, 30491 or 30494) and other than a service associated with the routine monitoring of chronic pancreatitis (H) (Anaes.) | $436.80 75% benefit $327.60 |
| 30690 | Endoscopic ultrasound (endoscopy with ultrasound imaging), with or without biopsy, with fine needle aspiration (including aspiration of the locoregional lymph nodes if performed, for the staging of one or more of oesophageal, gastric or pancreatic cancer), not in association with another item in this Subgroup (other than item 30484, 30485, 30491 or 30494) and other than a service associated with the routine monitoring of chronic pancreatitis (H) (Anaes.) | $674.30 75% benefit $505.75 |
| 30692 | Endoscopic ultrasound (endoscopy with ultrasound imaging), with or without biopsy, for the diagnosis of one or more of pancreatic, biliary or gastric submucosal tumours, not in association with another item in this Subgroup (other than item 30484, 30485, 30491 or 30494) and other than a service associated with the routine monitoring of chronic pancreatitis (H) (Anaes.) | $436.80 75% benefit $327.60 |
| 30694 | Endoscopic ultrasound (endoscopy with ultrasound imaging), with or without biopsy, with fine needle aspiration for the diagnosis of one or more of pancreatic, biliary or gastric submucosal tumours, not in association with another item in this Subgroup (other than item 30484, 30485, 30491 or 30494) and other than a service associated with the routine monitoring of chronic pancreatitis (H) (Anaes.) | $674.30 75% benefit $505.75 |
| 30720 | Appendicectomy, on a patient 10 years of age or over, whether performed by:(a) laparoscopy or right iliac fossa open incision; or(b) conversion of a laparoscopy to an open right iliac fossa incision;other than a service to which item 30574 applies (Anaes.) (Assist.) | $533.15 75% benefit $399.90 |
| 30721 | Laparotomy or laparoscopy, or laparoscopy converted to laparotomy, with or without associated biopsies, including the division of adhesions (if performed, but only if the time taken to divide adhesions is 45 minutes or less), if no other intra-abdominal procedure is performed (Anaes.) (Assist.) | $578.40 75% benefit $433.80 |
| 30722 | Laparotomy or laparoscopy, on a patient 10 years of age or over, including any of the following procedures (if performed, and including division of one or more adhesions, but only if the time taken to divide the adhesions is 45 minutes or less): (a) colostomy; (b) colotomy; (c) cholecystostomy; (d) enterostomy; (e) enterotomy; (f) gastrostomy; (g) gastrotomy; (h) caecostomy; (i) gastric fixation by cardiopexy; (j) reduction of intussusception; (k) simple repair of ruptured viscus (including perforated peptic ulcer); (l) reduction of volvulus; (m) drainage of pancreas (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30723 | Laparotomy, laparoscopy or extra-peritoneal approach, for drainage of an intra-abdominal, pancreatic or retroperitoneal collection or abscess (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 30724 | Laparotomy or laparoscopy with division of adhesions, lasting more than 45 minutes but less than 2 hours, performed either:(a) as a primary procedure; or(b) when the division of adhesions is performed in conjunction with another primary procedure—to provide access to a surgical field (but excluding mobilisation or normal anatomical dissection of the organ or structure for which the primary procedure is being carried out) (Anaes.) (Assist.) | $626.85 75% benefit $470.15 |
| 30725 | Laparotomy or laparoscopy for intestinal obstruction or division of extensive, complex adhesions, lasting 2 hours or more, performed either:a) as a primary procedure; orb) when the division of adhesions is performed in conjunction with another procedure—to provide access to a surgical field, but excluding mobilisation or normal anatomical dissection of the organ or structure for which the other procedure is being carried out (Anaes.) (Assist.) | $1,110.90 75% benefit $833.20 |
| 30730 | Small intestine, resection of, including either of the following:(a) a small bowel diverticulum (such as Meckel’s procedure) with anastomosis;(b) stricturoplasty (Anaes.) (Assist.) | $1,158.45 75% benefit $868.85 |
| 30731 | Intraoperative enterotomy for visualisation of the small intestine by endoscopy, including endoscopic examination using a flexible endoscope, with or without biopsies (Anaes.) (Assist.) | $869.00 75% benefit $651.75 |
| 30732 | Peritonectomy, lasting more than 5 hours, including hyperthermic intra-peritoneal chemotherapy (Anaes.) (Assist.) | $4,757.75 75% benefit $3,568.35 |
| 30750 | Oesophagectomy with colon or jejunal interposition graft, by any approach, including:(a) any gastrointestinal anastomoses (except vascular anastomoses); and(b) anastomoses in the chest or neck (if appropriate)One surgeon (Anaes.) (Assist.) | $2,468.35 75% benefit $1,851.30 |
| 30751 | Oesophagectomy with colon or jejunal interposition graft, by any approach, including:(a) any gastrointestinal anastomoses (except vascular anastomoses); and(b) anastomoses in the chest or neck (if appropriate)Conjoint surgery, principal surgeon (Anaes.) (Assist.) | $2,468.35 75% benefit $1,851.30 |
| 30752 | Oesophagectomy with colon or jejunal interposition graft, by any approach, including:(a) any gastrointestinal anastomoses (except vascular anastomoses); and(b) anastomoses in the chest or neck (if appropriate)Conjoint surgery, co-surgeon (Anaes.) (Assist.) | $1,851.20 75% benefit $1,388.40 |
| 30753 | Oesophagectomy, by any approach, including:(a) gastric reconstruction by abdominal mobilisation, thoracotomy or thoracoscopy; and(b) anastomosis in the neck or chestOne surgeon (Anaes.) (Assist.) | $2,059.75 75% benefit $1,544.85 |
| 30754 | Oesophagectomy, by any approach, including:(a) gastric reconstruction by abdominal mobilisation, thoracotomy or thoracoscopy; and(b) anastomosis in the neck or chestConjoint surgery, principal surgeon (Anaes.) (Assist.) | $2,059.75 75% benefit $1,544.85 |
| 30755 | Oesophagectomy by any approach, including:(a) gastric reconstruction by abdominal mobilisation, thoracotomy or thoracoscopy; and(b) anastomosis in the neck or chestConjoint surgery, co-surgeon (Anaes.) (Assist.) | $1,544.80 75% benefit $1,158.60 |
| 30756 | Antireflux operation by fundoplasty, with or without cardiopexy, by any approach, with or without closure of the diaphragmatic hiatus, other than a service to which item 30601 applies (Anaes.) (Assist.) | $1,042.85 75% benefit $782.15 |
| 30760 | Vagotomy, with or without gastroenterostomy, pyloroplasty or other drainage procedure (Anaes.) (Assist.) | $703.95 75% benefit $528.00 |
| 30761 | Bleeding peptic ulcer, control of, by laparoscopy or laparotomy, involving suture of bleeding point or wedge excision (with or without gastric resection), including either of the following (if performed):(a) vagotomy and pyloroplasty;(b) gastroenterostomy (Anaes.) (Assist.) | $908.15 75% benefit $681.15 |
| 30762 | Gastrectomy, subtotal or total radical, for carcinoma, by open or minimally invasive approach, including all necessary anastomoses, including either or both of the following (if performed):(a) extended lymph node dissection;(b) splenectomy (Anaes.) (Assist.) | $1,990.10 75% benefit $1,492.60 |
| 30763 | Gastric tumour, 2cm or greater in diameter, removal of, by local excision, by endoscopic approach, including any required anastomosis, excluding polypectomy, other than a service to which item 30518 applies (Anaes.) (Assist.) | $808.30 75% benefit $606.25 |
| 30770 | Hydatid cyst of liver, peritoneum or viscus, complete removal of contents of, with or without suture of biliary radicles, with omentoplasty or myeloplasty (Anaes.) (Assist.) | $1,001.00 75% benefit $750.75 |
| 30771 | Portal hypertension, porto-caval, meso-caval or selective spleno-renal shunt for (Anaes.) (Assist.) | $2,019.00 75% benefit $1,514.25 |
| 30780 | Intrahepatic biliary bypass of left or right hepatic ductal system by Roux-en-Y loop to peripheral ductal system (Anaes.) (Assist.) | $1,681.50 75% benefit $1,261.15 |
| 30790 | Pancreatic cyst anastomosis to stomach, duodenum or small intestine, by endoscopic, open or minimally invasive approach, with or without the use of endoscopic or intraoperative ultrasound (Anaes.) (Assist.) | $839.35 75% benefit $629.55 |
| 30791 | Pancreatic necrosectomy, by open, laparoscopic or endoscopic approach, excluding aftercare, subsequent procedure (Anaes.) (Assist.) | $521.50 75% benefit $391.15 |
| 30792 | Distal pancreatectomy with splenectomy, by open or minimally invasive approach (Anaes.) (Assist.) | $1,429.40 75% benefit $1,072.05 |
| 30800 | Splenectomy, by open or minimally invasive approach, other than a service to which item 30792 applies (Anaes.) (Assist.) | $862.05 75% benefit $646.55 |
| 30810 | Exploration of pancreas or duodenum for endocrine tumour, including associated imaging, either: (a) followed by local excision of tumour; or (b) when, after extensive exploration, no tumour is found (Anaes.) (Assist.) | $1,373.10 75% benefit $1,029.85 |
| 30820 | Lymph node of neck, biopsy of, by open procedure, if the specimen excised is sent for pathological examination (Anaes.) | $220.15 75% benefit $165.15 85% benefit $187.15 |
| 31000 | Mohs surgery of skin tumour located on the head, neck, genitalia, hand, digits, leg (below knee) or foot, utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—6 or fewer sections (Anaes.) | $695.30 75% benefit $521.50 85% benefit $591.05 |
| 31001 | New 85% benefit on 1 November 2026Mohs surgery of skin tumour located on the head, neck, genitalia, hand, digits, leg (below knee) or foot, utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—7 to 12 sections (inclusive) (Anaes.) | $869.00 75% benefit $651.75 85% benefit $760.50 was $764.50 |
| 31002 | New 85% benefit on 1 November 2026Mohs surgery of skin tumour located on the head, neck, genitalia, hand, digits, leg (below knee) or foot, utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—13 or more sections (Anaes.) | $1,042.85 75% benefit $782.15 85% benefit $934.35 was $938.35 |
| 31003 | Mohs surgery of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—6 or fewer sections Not applicable to a service performed in association with a service to which item 31000 applies (Anaes.) | $695.30 75% benefit $521.50 85% benefit $591.05 |
| 31004 | New 85% benefit on 1 November 2026Mohs surgery of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—7 to 12 sections (inclusive) Not applicable to a service performed in association with a service to which item 31001 applies (Anaes.) | $869.00 75% benefit $651.75 85% benefit $760.50 was $764.50 |
| 31005 | New 85% benefit on 1 November 2026Mohs surgery of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—13 or more sections Not applicable to a service performed in association with a service to which item 31002 applies (Anaes.) | $1,042.85 75% benefit $782.15 85% benefit $934.35 was $938.35 |
| 31206 | Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), removal of and suture, if: (a) the lesion size is not more than 10 mm in diameter; and (b) the removal is from a mucous membrane by surgical excision (other than by shave excision); and (c) the specimen excised is sent for histological examination (Anaes.) | $114.30 75% benefit $85.75 85% benefit $97.20 |
| 31211 | Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), removal of and suture, if: (a) the lesion size is more than 10 mm, but not more than 20 mm, in diameter; and (b) the removal is from a mucous membrane by surgical excision (other than by shave excision); and (c) the specimen excised is sent for histological examination (Anaes.) | $147.35 75% benefit $110.55 85% benefit $125.25 |
| 31216 | Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), removal of and suture, if: (a) the lesion size is more than 20 mm in diameter; and (b) the removal is from a mucous membrane by surgical excision (other than by shave excision); and (c) the specimen excised is sent for histological examination (Anaes.) | $171.90 75% benefit $128.95 85% benefit $146.15 |
| 31220 | Tumours (other than viral verrucae (common warts) and seborrheic keratoses), lipomas, cysts, ulcers or scars (other than scars removed during the surgical approach at an operation), removal of 4 to 10 lesions and suture, if: (a) the size of each lesion is not more than 10 mm in diameter; and (b) each removal is from cutaneous or subcutaneous tissue by surgical excision (other than by shave excision); and (c) all of the specimens excised are sent for histological examination (Anaes.) | $256.70 75% benefit $192.55 85% benefit $218.20 |
| 31221 | Tumours, cysts, ulcers or scars (other than scars removed during the surgical approach at an operation), removal of 4 to 10 lesions, if: (a) the size of each lesion is not more than 10 mm in diameter; and (b) each removal is from a mucous membrane by surgical excision (other than by shave excision); and (c) each site of excision is closed by suture; and (d) all of the specimens excised are sent for histological examination (Anaes.) | $256.70 75% benefit $192.55 85% benefit $218.20 |
| 31225 | Tumours (other than viral verrucae (common warts) and seborrheic keratoses), lipomas, cysts, ulcers or scars (other than scars removed during the surgical approach at an operation), removal of more than 10 lesions, if: (a) the size of each lesion is not more than 10 mm in diameter; and (b) each removal is from cutaneous or subcutaneous tissue or mucous membrane by surgical excision (other than by shave excision); and (c) each site of excision is closed by suture; and (d) all of the specimens excised are sent for histological examination (Anaes.) | $456.40 75% benefit $342.30 85% benefit $387.95 |
| 31227 | Tumour, lipoma or cyst, removal of single lesion by excision and suture, where removal is from subcutaneous tissue and the specimen excised is sent for histological examination (Anaes.) | $160.30 75% benefit $120.25 85% benefit $136.30 |
| 31245 | Skin and subcutaneous tissue, extensive excision of, in the treatment of suppurative hydradenitis (excision from axilla, groin or natal cleft) or sycosis barbae or nuchae (excision from face or neck) (H) (Anaes.) | $441.60 75% benefit $331.20 |
| 31250 | GIANT HAIRY or COMPOUND NAEVUS, excision of an area at least 1 percent of body surface where the specimen excised is sent for histological confirmation of diagnosis (Anaes.) | $441.60 75% benefit $331.20 85% benefit $375.40 |
| 31340 | Muscle, bone or cartilage, excision of one or more of, if clinically indicated, and if: (a) the specimen excised is sent for histological confirmation; and (b) a malignant tumour of skin covered by item 31000, 31001, 31002, 31003, 31004, 31005, 31356, 31358, 31359, 31361, 31363, 31365, 31367, 31369, 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383 is excised (Anaes.) Derived fee: 75% of the fee for excision of malignant tumour | Derived |
| 31344 | Lipoma, removal of, by surgical excision or liposuction, if:(a) the lesion:(i) is subcutaneous and 150mm or more in diameter; or(ii) is submuscular, intramuscular or involves dissection of a named nerve or vessel and is 50 mm or more in diameter; and(b) a specimen of the excised lipoma is sent for histological confirmation of diagnosis (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 31345 | Lipoma, removal of, by surgical excision or liposuction, if:(a) the lesion is: (i) subcutaneous and 50 mm or more in diameter but less than 150 mm in diameter; or(ii) sub fascial; and (b) the specimen excised is sent for histological confirmation of diagnosis (Anaes.) | $252.50 75% benefit $189.40 85% benefit $214.65 |
| 31346 | Liposuction (suction assisted lipolysis) to one regional area for contour problems of abdominal, upper arm or thigh fat because of repeated insulin injections, if: (a) the lesion is subcutaneous; and (b) the lesion is 50 mm or more in diameter; and (c) photographic and/or diagnostic imaging evidence demonstrating the need for this service is documented in the patient notes (Anaes.) | $252.50 75% benefit $189.40 85% benefit $214.65 |
| 31350 | Benign tumour of soft tissue (other than tumours of skin, cartilage and bone, simple lipomas covered by item 31345 and lipomata), removal of, by surgical excision, on a patient 10 years of age or over, if the specimen excised is sent for histological confirmation of diagnosis, other than a service to which another item in this Group applies (Anaes.) (Assist.) | $518.65 75% benefit $389.00 85% benefit $440.90 |
| 31355 | New 85% benefit on 1 November 2026MALIGNANT TUMOUR of SOFT TISSUE, excluding tumours of skin, cartilage and bone, removal of by surgical excision, where histological proof of malignancy has been obtained, not being a service to which another item in this Group applies (Anaes.) (Assist.) | $855.20 75% benefit $641.40 85% benefit $746.70 was $750.70 |
| 31356 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), definitive surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and (b) the necessary excision diameter is less than 6 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy; not in association with item 45201 (Anaes.) | $264.90 75% benefit $198.70 85% benefit $225.20 |
| 31357 | Non-malignant skin lesion (other than viral verrucae (common warts) and seborrheic keratoses), including a cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and (b) the necessary excision diameter is less than 6 mm; and (c) the excised specimen is sent for histological examination; not in association with item 45201 (Anaes.) | $131.25 75% benefit $98.45 85% benefit $111.60 |
| 31358 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), definitive surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and (b) the necessary excision diameter is 6 mm or more; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy (Anaes.) | $324.20 75% benefit $243.15 85% benefit $275.60 |
| 31359 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision), if: (a) the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia (the applicable site); and (b) the necessary excision area is at least one third of the surface area of the applicable site; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy (H) (Anaes.) | $395.15 75% benefit $296.40 |
| 31360 | Non-malignant skin lesion (other than viral verrucae (common warts) and seborrheic keratoses), including a cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and (b) the necessary excision diameter is 6 mm or more; and (c) the excised specimen is sent for histological examination (Anaes.) | $201.10 75% benefit $150.85 85% benefit $170.95 |
| 31361 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if: (a) the lesion is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is less than 14 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy; not in association with item 45201 (Anaes.) | $223.45 75% benefit $167.60 85% benefit $189.95 |
| 31362 | Non-malignant skin lesion (other than viral verrucae (common warts) and seborrheic keratoses), including a cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), surgical excision (other than by shave excision) and repair of, if: (a) the lesion is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is less than 14 mm; and (c) the excised specimen is sent for histological examination; not in association with item 45201 (Anaes.) | $160.30 75% benefit $120.25 85% benefit $136.30 |
| 31363 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), definitive surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is 14 mm or more; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy (Anaes.) | $292.35 75% benefit $219.30 85% benefit $248.50 |
| 31364 | Non-malignant skin lesion (other than viral verrucae (common warts) and seborrheic keratoses), including a cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is 14 mm or more; and (c) the excised specimen is sent for histological examination (Anaes.) | $201.10 75% benefit $150.85 85% benefit $170.95 |
| 31365 | Malignant skin lesion (other than a malignant skin lesion covered by item 31369, 31370, 31371, 31372, 31373, 31377, 31378 or 31379), surgical excision (other than by shave excision) and repair of, if: (a) the lesion is excised from any part of the body not covered by item 31356, 31358, 31359, 31361 or 31363; and (b) the necessary excision diameter is less than 15 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy; not in association with item 45201 (Anaes.) | $189.45 75% benefit $142.10 85% benefit $161.05 |
| 31366 | Non-malignant skin lesion (other than viral verrucae (common warts) and seborrheic keratoses), including a cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), surgical excision (other than by shave excision) and repair of, if: (a) the lesion is excised from any part of the body not covered by item 31357, 31360, 31362 or 31364; and (b) the necessary excision diameter is less than 15 mm; and (c) the excised specimen is sent for histological examination; not in association with item 45201 (Anaes.) | $114.30 75% benefit $85.75 85% benefit $97.20 |
| 31367 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if: (a) the lesion is excised from any part of the body not covered by item 31356, 31358, 31359, 31361 or 31363; and (b) the necessary excision diameter is at least 15 mm but not more than 30 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy; not in association with item 45201 (Anaes.) | $255.70 75% benefit $191.80 85% benefit $217.35 |
| 31368 | Non-malignant skin lesion (other than viral verrucae (common warts) and seborrheic keratoses), including a cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), surgical excision (other than by shave excision) and repair of, if: (a) the lesion is excised from any part of the body not covered by item 31357, 31360, 31362 or 31364; and (b) the necessary excision diameter is at least 15 mm but not more than 30mm; and (c) the excised specimen is sent for histological examination; not in association with item 45201 (Anaes.) | $150.30 75% benefit $112.75 85% benefit $127.80 |
| 31369 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), definitive surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from any part of the body not covered by item 31356, 31358, 31359, 31361 or 31363; and (b) the necessary excision diameter is more than 30 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy (Anaes.) | $294.30 75% benefit $220.75 85% benefit $250.20 |
| 31370 | Non-malignant skin lesion (other than viral verrucae (common warts) and seborrheic keratoses), including a cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from any part of the body not covered by item 31357, 31360, 31362 or 31364; and (b) the necessary excision diameter is more than 30 mm; and (c) the excised specimen is sent for histological examination (Anaes.) | $171.90 75% benefit $128.95 85% benefit $146.15 |
| 31371 | Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision of (other than by shave excision) including repair (if performed), including excision of the primary tumour bed, if: (a) the tumour is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and (b) the necessary excision diameter is 6 mm or more; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy (Anaes.) | $427.30 75% benefit $320.50 85% benefit $363.25 |
| 31372 | Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if: (a) the tumour is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is less than 14 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy; not in association with a service to which item 45201 applies (Anaes.) | $369.50 75% benefit $277.15 85% benefit $314.10 |
| 31373 | Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision of (other than by shave excision) including repair (if performed), including excision of the primary tumour bed, if: (a) the tumour is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is 14 mm or more; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy (Anaes.) | $427.05 75% benefit $320.30 85% benefit $363.00 |
| 31374 | Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if: (a) the tumour is excised from any part of the body not covered by item 31371, 31372 or 31373; and (b) the necessary excision diameter is less than 15 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy; not in association with a service to which item 45201 applies (Anaes.) | $337.40 75% benefit $253.05 85% benefit $286.80 |
| 31375 | Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if: (a) the tumour is excised from any part of the body not covered by item 31371, 31372 or 31373; and (b) the necessary excision diameter is at least 15 mm but not more than 30 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy; not in association with a service to which item 45201 applies (Anaes.) | $363.10 75% benefit $272.35 85% benefit $308.65 |
| 31376 | Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision of (other than by shave excision) including repair (if performed), including excision of the primary tumour bed, if: (a) the tumour is excised from any part of the body not covered by item 31371, 31372 or 31373; and (b) the necessary excision diameter is more than 30 mm; and (c) the excised specimen is sent for histological examination; and (d) malignancy is confirmed from the excised specimen or previous biopsy (Anaes.) | $420.85 75% benefit $315.65 85% benefit $357.75 |
| 31377 | Clinically suspected melanoma, surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and (b) the necessary excision diameter is less than 6 mm; and (c) the excised specimen is sent for histological examination; not in association with a service to which item 45201 applies (Anaes.) | $131.25 75% benefit $98.45 85% benefit $111.60 |
| 31378 | Clinically suspected melanoma, surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and (b) the necessary excision diameter is 6 mm or more; and (c) the excised specimen is sent for histological examination (Anaes.) | $201.10 75% benefit $150.85 85% benefit $170.95 |
| 31379 | Clinically suspected melanoma, surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from face, neck, scalp, nipple‑areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is less than 14 mm; and (c) the excised specimen is sent for histological examination; not in association with a service to which item 45201 applies (Anaes.) | $160.30 75% benefit $120.25 85% benefit $136.30 |
| 31380 | Clinically suspected melanoma, surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from face, neck, scalp, nipple‑areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and (b) the necessary excision diameter is 14 mm or more; and (c) the excised specimen is sent for histological examination (Anaes.) | $201.10 75% benefit $150.85 85% benefit $170.95 |
| 31381 | Clinically suspected melanoma, surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from any part of the body not covered by item 31377, 31378, 31379 or 31380; and (b) the necessary excision diameter is less than 15 mm; and (c) the excised specimen is sent for histological examination; not in association with a service to which item 45201 applies (Anaes.) | $114.30 75% benefit $85.75 85% benefit $97.20 |
| 31382 | Clinically suspected melanoma, surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from any part of the body not covered by item 31377, 31378, 31379 or 31380; and (b) the necessary excision diameter is at least 15 mm but not more than 30 mm; and (c) the excised specimen is sent for histological examination; not in association with a service to which item 45201 applies (Anaes.) | $150.30 75% benefit $112.75 85% benefit $127.80 |
| 31383 | Clinically suspected melanoma, surgical excision of (other than by shave excision) including repair (if performed), if: (a) the lesion is excised from any part of the body not covered by item 31377, 31378, 31379 or 31380; and (b) the necessary excision diameter is more than 30 mm; and (c) the excised specimen is sent for histological examination (Anaes.) | $171.90 75% benefit $128.95 85% benefit $146.15 |
| 31386 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if:(a) the lesion is excised from the head or neck; and(b) the necessary excision diameter is more than 50 mm; and(c) the excision involves at least 2 critical areas (eyelid, nose, ear, mouth); and(d) the excised specimen is sent for histological examination; and(e) malignancy is confirmed from the excised specimen or previous biopsy; and(f) the service is not covered by item 31387 (H) (Anaes.) (Assist.) | $855.20 75% benefit $641.40 |
| 31387 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if:(a) the lesion is excised from the head or neck; and(b) the necessary excision diameter is more than 70 mm; and(c) the excised specimen is sent for histological examination; and(d) malignancy is confirmed from the excised specimen or previous biopsy; and(e) the service is not covered by item 31386 (H) (Anaes.) (Assist.) | $769.55 75% benefit $577.20 |
| 31388 | Malignant skin lesion (other than a malignant skin lesion covered by item 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382 or 31383), surgical excision (other than by shave excision) and repair of, if:(a) the lesion is excised from the trunk or limbs; and(b) the necessary excision diameter is more than 120 mm; and(c) the excised specimen is sent for histological examination; and(d) malignancy is confirmed from the excised specimen or previous biopsy (H) (Anaes.) (Assist.) | $692.55 75% benefit $519.45 |
| 31400 | Malignant upper aerodigestive tract tumour (other than tumour of the lip), excision of, if: (a) the tumour is not more than 20 mm in diameter; and (b) histological confirmation of malignancy is obtained (H) (Anaes.) (Assist.) | $312.50 75% benefit $234.40 |
| 31403 | MALIGNANT UPPER AERODIGESTIVE TRACT TUMOUR more than 20mm and up to and including 40mm in diameter (excluding tumour of the lip), excision of, where histological confirmation of malignancy has been obtained (Anaes.) (Assist.) | $360.65 75% benefit $270.50 |
| 31406 | Malignant upper aerodigestive tract tumour more than 40 mm in diameter (excluding tumour of the lip), excision of, if histological confirmation of malignancy has been obtained (H) (Anaes.) (Assist.) | $601.05 75% benefit $450.80 |
| 31409 | PARAPHARYNGEAL TUMOUR, excision of, by cervical approach (Anaes.) (Assist.) | $1,867.35 75% benefit $1,400.55 |
| 31412 | RECURRENT OR PERSISTENT PARAPHARYNGEAL TUMOUR, excision of, by cervical approach (Anaes.) (Assist.) | $2,300.20 75% benefit $1,725.15 |
| 31423 | Lymph nodes of neck, selective dissection of one or 2 lymph node levels involving removal of soft tissue and lymph nodes from one side of the neck, on a patient 10 years of age or over, other than a service associated with a service to which item 30256 or 30275 applies on the same side (H) (Anaes.) (Assist.) | $480.95 75% benefit $360.75 |
| 31426 | Lymph nodes of neck, selective dissection of 3 lymph node levels involving removal of soft tissue and lymph nodes from one side of the neck, other than a service associated with a service to which item 30256 or 30275 applies on the same side (H) (Anaes.) (Assist.) | $961.65 75% benefit $721.25 |
| 31429 | Lymph nodes of neck, selective dissection of 4 lymph node levels on one side of the neck with preservation of one or more of: internal jugular vein, sternocleido-mastoid muscle, or spinal accessory nerve, other than a service associated with a service to which item 30256 or 30275 applies on the same side (H) (Anaes.) (Assist.) | $1,498.70 75% benefit $1,124.05 |
| 31432 | Lymph nodes of neck, bilateral selective dissection of levels I, II and III (bilateral supraomohyoid dissections), other than a service associated with a service to which item 30256 or 30275 applies on the same side (H) (Anaes.) (Assist.) | $1,602.85 75% benefit $1,202.15 |
| 31435 | Lymph nodes of neck, comprehensive dissection of all 5 lymph node levels on one side of the neck, other than a service associated with a service to which item 30256 or 30275 applies on the same side (H) (Anaes.) (Assist.) | $1,178.10 75% benefit $883.60 |
| 31438 | Lymph nodes of neck, comprehensive dissection of all 5 lymph node levels on one side of the neck with preservation of one or more of: internal jugular vein, sternocleido-mastoid muscle, or spinal accessory nerve, other than a service associated with a service to which item 30256 or 30275 applies on the same side (H) (Anaes.) (Assist.) | $1,867.35 75% benefit $1,400.55 |
| 31454 | Laparoscopy or laparotomy with drainage of bile, as an independent procedure (H) (Anaes.) (Assist.) | $674.30 75% benefit $505.75 |
| 31456 | GASTROSCOPY and insertion of nasogastric or nasoenteral feeding tube, where blind insertion of the feeding tube has failed or is inappropriate due to the patient's medical condition (Anaes.) | $293.95 75% benefit $220.50 |
| 31458 | GASTROSCOPY and insertion of nasogastric or nasoenteral feeding tube, where blind insertion of the feeding tube has failed or is inappropriate due to the patient's medical condition, and where the use of imaging intensification is clinically indicated (Anaes.) | $352.65 75% benefit $264.50 |
| 31460 | PERCUTANEOUS GASTROSTOMY TUBE, jejunal extension to, including any associated imaging services (Anaes.) (Assist.) | $427.30 75% benefit $320.50 |
| 31462 | OPERATIVE FEEDING JEJUNOSTOMY performed in conjunction with major upper gastro-intestinal resection (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 31466 | ANTIREFLUX OPERATION BY FUNDOPLASTY, via abdominal or thoracic approach, with or without closure of the diaphragmatic hiatus, revision procedure, by laparoscopy or open operation (Anaes.) (Assist.) | $1,564.30 75% benefit $1,173.25 |
| 31468 | Para-oesophageal hiatus hernia, repair of, with complete reduction of hernia, resection of sac and repair of hiatus, with or without fundoplication, other than a service associated with a service to which item 30756 or 31466 applies (Anaes.) (Assist.) | $1,718.55 75% benefit $1,288.95 |
| 31472 | Cholecystoduodenostomy, cholecystoenterostomy, choledochojejunostomy or Roux-en-y loop to provide biliary drainage or bypass, other than a service associated with a service to which item 30584 applies (Anaes.) (Assist.) | $1,610.20 75% benefit $1,207.65 |
| 31500 | Breast, benign lesion up to and including 50 mm in diameter, including simple cyst, fibroadenoma or fibrocystic disease, open surgical biopsy or excision of, with or without frozen section histology (H) (Anaes.) | $311.20 75% benefit $233.40 |
| 31503 | Breast, benign lesion more than 50 mm in diameter, excision of (H) (Anaes.) (Assist.) | $415.00 75% benefit $311.25 |
| 31506 | BREAST, ABNORMALITY detected by mammography or ultrasound where guidewire or other localisation procedure is performed, excision biopsy of (Anaes.) (Assist.) | $466.95 75% benefit $350.25 |
| 31509 | Breast, malignant tumour, open surgical biopsy of, with or without frozen section histology (H) (Anaes.) | $415.00 75% benefit $311.25 |
| 31512 | Breast, malignant tumour, complete local excision of, with or without frozen section histology, other than a service associated with a service to which:(a) item 45523 or 45558 applies; and(b) item 31513, 31514, 45520, 45522 or 45556 applies on the same side (if performed by the same medical practitioner)(H) (Anaes.) (Assist.) | $778.15 75% benefit $583.65 |
| 31513 | Breast, malignant tumour, complete local excision of, with simultaneous reshaping of the breast parenchyma using techniques such as round block or rotation flaps, other than a service associated with a service to which:(a) item 45523 or 45558 applies; and(b) item 31512, 31514, 45520, 45522 or 45556 applies on the same side(H) (Anaes.) (Assist.) | $1,017.40 75% benefit $763.05 |
| 31514 | Breast, malignant tumour, complete local excision of, with simultaneous ipsilateral pedicled breast reduction, including repositioning of the nipple, other than a service associated with a service to which:(a) item 45523 or 45558 applies; and(b) item 31512, 31513, 45520, 45522 or 45556 applies on the same side(H) (Anaes.) (Assist.) | $1,466.75 75% benefit $1,100.10 |
| 31515 | BREAST, TUMOUR SITE, re-excision of following open biopsy or incomplete excision of malignant tumour (Anaes.) (Assist.) | $522.10 75% benefit $391.60 |
| 31516 | BREAST, MALIGNANT TUMOUR, complete local excision of, with or without frozen section histology when targeted intraoperative radiation therapy (using an Intrabeam® or Xoft® Axxent® device) is performed concurrently, if the patient satisfies the requirements mentioned in paragraphs (a) to (g) of item 15900 Applicable only once per breast per lifetime (H) (Anaes.) (Assist.) | $1,037.70 75% benefit $778.30 |
| 31519 | Total mastectomy (unilateral) (H) (Anaes.) (Assist.) | $881.05 75% benefit $660.80 |
| 31520 | Total mastectomy (bilateral) (H) (Anaes.) (Assist.) | $1,541.65 75% benefit $1,156.25 |
| 31522 | Skin sparing mastectomy (unilateral) (H) (Anaes.) (Assist.) | $1,245.05 75% benefit $933.80 |
| 31523 | Skin sparing mastectomy (bilateral) (H) (Anaes.) (Assist.) | $2,178.90 75% benefit $1,634.20 |
| 31525 | Mastectomy for gynaecomastia (unilateral), with or without liposuction (suction assisted lipolysis), if:(a) breast enlargement is not due to obesity and is not proportionate to body habitus; and(b) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes;not being a service associated with a service to which item 45585 applies (H) (Anaes.) (Assist.) | $622.35 75% benefit $466.80 |
| 31526 | Mastectomy for gynaecomastia (bilateral), with or without liposuction (suction assisted lipolysis), if:(a) breast enlargement is not due to obesity and is not proportionate to body habitus; and(b) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes;not being a service associated with a service to which item 45585 applies (H) (Anaes.) (Assist.) | $1,089.20 75% benefit $816.90 |
| 31528 | Nipple sparing mastectomy (unilateral) (H) (Anaes.) (Assist.) | $1,245.05 75% benefit $933.80 |
| 31529 | Nipple sparing mastectomy (bilateral) (H) (Anaes.) (Assist.) | $2,178.90 75% benefit $1,634.20 |
| 31530 | New 85% benefit on 1 November 2026Breast, biopsy of solid tumour or tissue of, using a vacuum-assisted breast biopsy device under imaging guidance, for histological examination, if imaging has demonstrated:(a) microcalcification of lesion; or(b) impalpable lesion less than one cm in diameter;including pre-operative localisation of lesion, if performed, other than a service associated with a service to which item 31548 applies | $712.95 75% benefit $534.75 85% benefit $606.05 was $608.45 |
| 31533 | FINE NEEDLE ASPIRATION of an impalpable breast lesion detected by mammography or ultrasound, imaging guided - but not including imaging (Anaes.) | $165.05 75% benefit $123.80 85% benefit $140.30 |
| 31536 | Breast, preoperative localisation of lesion of, by hookwire or similar device, using interventional imaging techniques, but not including imaging (Anaes.) | $226.75 75% benefit $170.10 85% benefit $192.75 |
| 31537 | Insertion of a marker clip into a breast, including axilla, following a breast biopsy and using imaging (but not including the associated imaging), if additional surgery, neoadjuvant systemic therapy, follow up imaging or radiation may be required and the insertion is for any of the following reasons: (a) to mark the site of a lesion that has been totally or almost completely removed; (b) to confirm biopsy site if multiple lesions are present; (c) to confirm biopsy site of an ill-defined lesion; (d) future surgery or preoperative localisation is considered to be potentially difficult due to lesion conspicuity; (e) preoperative localisation is likely to be carried out using a modality different from the biopsy modality; (f) for correlation across modalities for diagnostic reasons (Anaes.) | $226.75 75% benefit $170.10 85% benefit $192.75 |
| 31548 | Breast, biopsy of solid tumour or tissue of, using mechanical biopsy device, for histological examination, other than a service associated with a service to which item 31530 applies (Anaes.) | $239.35 75% benefit $179.55 85% benefit $203.45 |
| 31551 | BREAST, HAEMATOMA, SEROMA OR INFLAMMATORY CONDITION including abscess, granulomatous mastitis or similar, exploration and drainage of when undertaken in the operating theatre of a hospital, excluding aftercare (Anaes.) | $259.40 75% benefit $194.55 |
| 31554 | BREAST, microdochotomy of, for benign or malignant condition (Anaes.) (Assist.) | $518.80 75% benefit $389.10 |
| 31557 | Breast central ducts, excision of, for benign condition (H) (Anaes.) (Assist.) | $415.00 75% benefit $311.25 |
| 31560 | ACCESSORY BREAST TISSUE, excision of (Anaes.) (Assist.) | $415.00 75% benefit $311.25 85% benefit $352.75 |
| 31563 | Inverted nipple, surgical eversion of, with or without flap repair, if the nipple cannot readily be everted manually (Anaes.) | $310.85 75% benefit $233.15 85% benefit $264.25 |
| 31566 | ACCESSORY NIPPLE, excision of (Anaes.) | $155.55 75% benefit $116.70 85% benefit $132.25 |
| 31569 | Adjustable gastric band, placement of, with or without crural repair taking 45 minutes or less, for a patient with clinically severe obesity (Anaes.) (Assist.) | $1,016.90 75% benefit $762.70 |
| 31572 | Gastric bypass by Roux-en-Y including associated anastomoses, with or without crural repair taking 45 minutes or less, for a patient with clinically severe obesity not being associated with a service to which item 30515 applies (Anaes.) (Assist.) | $1,251.25 75% benefit $938.45 |
| 31575 | Sleeve gastrectomy, with or without crural repair taking 45 minutes or less, for a patient with clinically severe obesity (Anaes.) (Assist.) | $1,016.90 75% benefit $762.70 |
| 31578 | Gastroplasty (excluding by gastric plication), with or without crural repair taking 45 minutes or less, for a patient with clinically severe obesity (Anaes.) (Assist.) | $1,016.90 75% benefit $762.70 |
| 31581 | Gastric bypass by biliopancreatic diversion with or without duodenal switch including gastric resection and anastomoses, with or without crural repair taking 45 minutes or less, for a patient with clinically severe obesity (Anaes.) (Assist.) | $1,251.25 75% benefit $938.45 |
| 31584 | Surgical reversal of previous bariatric procedure, including revision or conversion, if:a) the previous procedure involved any of the following:(i) placement of adjustable gastric banding;(ii) gastric bypass;(iii) sleeve gastrectomy;(iv) gastroplasty (excluding gastric plication);(v) biliopancreatic diversion; and(b) any of items 31569 to 31581 applied to the previous procedureother than a service associated with a service to which item 31585 applies (Anaes.) (Assist.) | $1,842.25 75% benefit $1,381.70 |
| 31585 | Removal of adjustable gastric band (Anaes.) (Assist.) | $995.95 75% benefit $747.00 |
| 31587 | Adjustment of gastric band as an independent procedure including any associated consultation | $117.25 75% benefit $87.95 85% benefit $99.70 |
| 31590 | Adjustment of gastric band reservoir, repair, revision or replacement of (Anaes.) (Assist.) | $301.40 75% benefit $226.05 85% benefit $256.20 |
| 32000 | LARGE INTESTINE, resection of, without anastomosis, including right hemicolectomy (including formation of stoma) (Anaes.) (Assist.) | $1,234.40 75% benefit $925.80 |
| 32003 | LARGE INTESTINE, resection of, with anastomosis, including right hemicolectomy (Anaes.) (Assist.) | $1,291.15 75% benefit $968.40 |
| 32004 | LARGE INTESTINE, subtotal colectomy (resection of right colon, transverse colon and splenic flexure) without anastomosis, not being a service associated with a service to which item 32000, 32003, 32005, 32006 or 32030 applies (H) (Anaes.) (Assist.) | $1,376.90 75% benefit $1,032.70 |
| 32005 | LARGE INTESTINE, subtotal colectomy (resection of right colon, transverse colon and splenic flexure) with anastomosis, not being a service associated with a service to which item 32000, 32003, 32004, 32006 or 32030 applies (H) (Anaes.) (Assist.) | $1,555.40 75% benefit $1,166.55 |
| 32006 | Left hemicolectomy, including the descending and sigmoid colon (including formation of stoma), other than a service associated with a service to which item 32024, 32025, 32026 or 32028 applies (H) (Anaes.) (Assist.) | $1,376.90 75% benefit $1,032.70 |
| 32009 | TOTAL COLECTOMY AND ILEOSTOMY (Anaes.) (Assist.) | $1,633.25 75% benefit $1,224.95 |
| 32012 | TOTAL COLECTOMY AND ILEORECTAL ANASTOMOSIS (Anaes.) (Assist.) | $1,804.10 75% benefit $1,353.10 |
| 32015 | TOTAL COLECTOMY WITH EXCISION OF RECTUM AND ILEOSTOMY 1 surgeon (Anaes.) (Assist.) | $2,217.30 75% benefit $1,663.00 |
| 32018 | TOTAL COLECTOMY WITH EXCISION OF RECTUM AND ILEOSTOMY, COMBINED SYNCHRONOUS OPERATION; ABDOMINAL RESECTION (including aftercare) (Anaes.) (Assist.) | $1,880.20 75% benefit $1,410.15 |
| 32021 | TOTAL COLECTOMY WITH EXCISION OF RECTUM AND ILEOSTOMY, COMBINED SYNCHRONOUS OPERATION; PERINEAL RESECTION (Assist.) | $674.30 75% benefit $505.75 |
| 32023 | Endoscopic insertion of stent or stents for large bowel obstruction, stricture or stenosis, including colonoscopy and any image intensification, where the obstruction is due to: a) a pre-diagnosed colorectal cancer, or cancer of an organ adjacent to the bowel; or b) an unknown diagnosis (Anaes.) | $664.75 75% benefit $498.60 |
| 32024 | RECTUM, HIGH RESTORATIVE ANTERIOR RESECTION WITH INTRAPERITONEAL ANASTOMOSIS (of the rectum) greater than 10 centimetres from the anal verge excluding resection of sigmoid colon alone not being a service associated with a service to which item 32000, 32030, 32106 or 32232 applies (H) (Anaes.) (Assist.) | $1,633.25 75% benefit $1,224.95 |
| 32025 | RECTUM, LOW RESTORATIVE ANTERIOR RESECTION WITH EXTRAPERITONEAL ANASTOMOSIS (of the rectum) less than 10 centimetres from the anal verge, with or without covering stoma not being a service associated with a service to which item 32000, 32030, 32106 or 32232 applies (H) (Anaes.) (Assist.) | $2,184.65 75% benefit $1,638.50 |
| 32026 | Rectum, ultra-low restorative resection, with or without covering stoma and with or without colonic reservoir, if the anastomosis is sited in the anorectal region and is 6 cm or less from the anal verge, not being a service associated with a service to which item 32000, 32030, 32106, 32117 or 32232 applies (H) (Anaes.) (Assist.) | $2,446.30 75% benefit $1,834.75 |
| 32028 | Rectum, low or ultra-low restorative resection, with per anal sutured coloanal anastomosis, with or without covering stoma and with or without colonic reservoir, not being a service associated with a service to which item 32000, 32030, 32106, 32117 or 32232 applies (H) (Anaes.) (Assist.) | $2,598.55 75% benefit $1,948.95 |
| 32030 | RECTOSIGMOIDECTOMY, including formation of stoma (H) (Anaes.) (Assist.) | $1,234.40 75% benefit $925.80 |
| 32033 | RESTORATION OF BOWEL continuity following rectosigmoidectomy or similar operation, including dismantling of the stoma (H) (Anaes.) (Assist.) | $1,804.10 75% benefit $1,353.10 |
| 32036 | SACROCOCCYGEAL AND PRESACRAL TUMOUR excision of (Anaes.) (Assist.) | $2,288.25 75% benefit $1,716.20 |
| 32039 | RECTUM AND ANUS, ABDOMINOPERINEAL RESECTION OF 1 surgeon (Anaes.) (Assist.) | $1,837.25 75% benefit $1,377.95 |
| 32042 | RECTUM AND ANUS, ABDOMINOPERINEAL RESECTION OF, COMBINED SYNCHRONOUS OPERATION abdominal resection (Anaes.) (Assist.) | $1,547.75 75% benefit $1,160.85 |
| 32045 | RECTUM AND ANUS, ABDOMINOPERINEAL RESECTION OF, COMBINED SYNCHRONOUS OPERATION perineal resection (Assist.) | $579.30 75% benefit $434.50 |
| 32046 | RECTUM and ANUS, abdomino-perineal resection of, combined synchronous operation - perineal resection where the perineal surgeon also provides assistance to the abdominal surgeon (Assist.) | $895.15 75% benefit $671.40 |
| 32047 | PERINEAL PROCTECTOMY (Anaes.) (Assist.) | $1,042.85 75% benefit $782.15 |
| 32051 | TOTAL COLECTOMY with excision of rectum and ileoanal anastomosis with formation of ileal reservoir, with or without creation of temporary ileostomy 1 surgeon (Anaes.) (Assist.) | $2,772.70 75% benefit $2,079.55 |
| 32054 | TOTAL COLECTOMY with excision of rectum and ileoanal anastomosis with formation of ileal reservoir, with or without creation of temporary ileostomy conjoint surgery, abdominal surgeon (including aftercare) (Anaes.) (Assist.) | $2,544.85 75% benefit $1,908.65 |
| 32057 | TOTAL COLECTOMY with excision of rectum and ileoanal anastomosis with formation of ileal reservoir conjoint surgery, perineal surgeon (Assist.) | $674.30 75% benefit $505.75 |
| 32060 | Restorative proctectomy, involving rectal resection with formation of ileal reservoir and ileoanal anastomosis, including ileostomy mobilisation, with or without mucosectomy or temporary loop ileostomy, 1 surgeon (H) (Anaes.) (Assist.) | $2,772.70 75% benefit $2,079.55 |
| 32063 | ILEOSTOMY CLOSURE with rectal resection and mucosectomy and ileoanal anastomosis with formation of ileal reservoir, with or without temporary loop ileostomy conjoint surgery, abdominal surgeon (including aftercare) (Anaes.) (Assist.) | $2,544.85 75% benefit $1,908.65 |
| 32066 | ILEOSTOMY CLOSURE with rectal resection and mucosectomy and ileoanal anastomosis with formation of ileal reservoir, with or without temporary loop ileostomy conjoint surgery, perineal surgeon (Assist.) | $674.30 75% benefit $505.75 |
| 32069 | ILEOSTOMY RESERVOIR, continent type, creation of, including conversion of existing ileostomy where appropriate (Anaes.) | $2,051.05 75% benefit $1,538.30 |
| 32072 | SIGMOIDOSCOPIC EXAMINATION (with rigid sigmoidoscope), with or without biopsy | $57.25 75% benefit $42.95 85% benefit $48.70 |
| 32075 | Sigmoidoscopic examination (with rigid sigmoidoscope), under general anaesthesia, with or without biopsy, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $89.85 75% benefit $67.40 |
| 32084 | Sigmoidoscopy or colonoscopy up to the hepatic flexure, with or without biopsy, other than a service associated with a service to which any of items 32219, 32222 to 32228 or 32230 applies (H) (Anaes.) | $133.35 75% benefit $100.05 |
| 32087 | Endoscopic examination of the colon up to the hepatic flexure by sigmoidoscopy or colonoscopy for the removal of one or more polyps, other than a service associated with a service to which any of items 32219, 32222 to 32228 or 32230 applies (H) (Anaes.) | $245.00 75% benefit $183.75 |
| 32094 | ENDOSCOPIC DILATATION OF COLORECTAL STRICTURES including colonoscopy (Anaes.) | $660.50 75% benefit $495.40 |
| 32095 | Endoscopic examination of small bowel with flexible endoscope passed by stoma, with or without biopsies (H) (Anaes.) | $153.00 75% benefit $114.75 |
| 32096 | RECTAL BIOPSY, full thickness, to diagnose or exclude Hirschsprung's Disease, under general anaesthesia, or under epidural or spinal (intrathecal) nerve block where undertaken in a hospital (Anaes.) (Assist.) | $307.60 75% benefit $230.70 |
| 32105 | Anorectal carcinoma—per anal full thickness excision of (H) (Anaes.) (Assist.) | $579.30 75% benefit $434.50 |
| 32106 | Anterolateral intraperitoneal rectal tumour, per anal excision of, using rectoscopy digital viewing system and pneumorectum, if:(a) clinically appropriate; and(b) removal requires dissection within the peritoneal cavity;excluding use of a colonoscope as the operating platform and not being a service associated with a service to which item 32024, 32025 or 32232 applies (H) (Anaes.) (Assist.) | $1,633.25 75% benefit $1,224.95 |
| 32108 | RECTAL TUMOUR, transsphincteric excision of (Kraske or similar operation) (Anaes.) (Assist.) | $1,196.50 75% benefit $897.40 |
| 32117 | Rectal prolapse, abdominal rectopexy of, excluding ventral mesh rectopexy, not being a service associated with a service to which item 32025 or 32026 applies (H) (Anaes.) (Assist.) | $1,503.55 75% benefit $1,127.70 |
| 32118 | Treatment of external rectal prolapse, or of symptomatic high grade rectal intussusception (the rectum descends to the level of or into the anal canal, confirmed by diagnostic imaging): (a) by minimally invasive surgery involving: (i) ventral dissection of the extra-peritoneal rectum; and (ii) suspension of the rectum from the sacral promontory by means of a prosthesis; and (b) including suspension of the vagina if performed, and any associated repair; other than a service associated with a service to which item 30390, 35595 or 35597 applies (H) (Anaes.) (Assist.) | $1,763.25 75% benefit $1,322.45 |
| 32123 | Anal stricture, anoplasty for (H) (Anaes.) (Assist.) | $398.85 75% benefit $299.15 |
| 32129 | ANAL SPHINCTER, repair (H) (Anaes.) (Assist.) | $759.65 75% benefit $569.75 |
| 32131 | RECTOCELE, transanal repair of rectocele (Anaes.) (Assist.) | $638.70 75% benefit $479.05 |
| 32135 | Treatment of haemorrhoids or rectal prolapse, including rubber band ligation or sclerotherapy or topical energy therapies for, not being a service to which item 32139 applies (Anaes.) | $80.80 75% benefit $60.60 85% benefit $68.70 |
| 32139 | Operative treatment of symptomatic haemorrhoids, including excision of anal skin tags when performed, not being a service associated with a service to which item 32135 or 32233 applies (H) (Anaes.) (Assist.) | $440.10 75% benefit $330.10 |
| 32147 | PERIANAL THROMBOSIS, incision of (Anaes.) | $53.95 75% benefit $40.50 85% benefit $45.90 |
| 32150 | Operation for anal fissure, including excision or sphincterotomy, excluding dilatation (H) (Anaes.) (Assist.) | $307.60 75% benefit $230.70 |
| 32156 | Anal fistula, subcutaneous, excision of (H) (Anaes.) | $157.60 75% benefit $118.20 |
| 32159 | ANAL FISTULA, treatment of, by excision or by insertion of a Seton, or by a combination of both procedures, involving the lower half of the anal sphincter mechanism (Anaes.) (Assist.) | $398.85 75% benefit $299.15 |
| 32162 | ANAL FISTULA, treatment of, by excision or by insertion of a Seton, or by a combination of both procedures, involving the upper half of the anal sphincter mechanism (Anaes.) (Assist.) | $579.30 75% benefit $434.50 |
| 32165 | Operative treatment of anal fistula, repair by mucosal advancement flap, including ligation of inter-sphincteric fistula tract (LIFT) or other complex sphincter sparing surgery (H) (Anaes.) (Assist.) | $759.65 75% benefit $569.75 |
| 32166 | ANAL FISTULA - readjustment of Seton (Anaes.) | $246.85 75% benefit $185.15 85% benefit $209.85 |
| 32171 | Anorectal examination, with or without biopsy, under general anaesthetic, with or without faecal disimpaction, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $106.30 75% benefit $79.75 |
| 32174 | INTR-AANAL, perianal or ischiorectal abscess, drainage of (excluding aftercare) (Anaes.) | $106.30 75% benefit $79.75 85% benefit $90.40 |
| 32175 | INTRA-ANAL, PERIANAL or ISCHIO-RECTAL ABSCESS, draining of, undertaken in the operating theatre of a hospital (excluding aftercare) (Anaes.) | $194.70 75% benefit $146.05 |
| 32183 | INTESTINAL SLING PROCEDURE prior to radiotherapy (Anaes.) (Assist.) | $672.25 75% benefit $504.20 |
| 32186 | COLONIC LAVAGE, total, intra operative (Anaes.) (Assist.) | $672.25 75% benefit $504.20 |
| 32212 | ANO-RECTAL APPLICATION OF FORMALIN in the treatment of radiation proctitis, where performed in the operating theatre of a hospital, excluding aftercare (Anaes.) | $163.15 75% benefit $122.40 |
| 32213 | Sacral nerve lead or leads, placement of, percutaneous or open, including intraoperative test stimulation and programming, for the management of faecal incontinence (H) (Anaes.) | $791.05 75% benefit $593.30 |
| 32215 | Sacral nerve electrode or electrodes, management, adjustment and electronic programming of the neurostimulator by a medical practitioner, to manage faecal incontinence, not being a service associated with a service to which item 32213, 32216, 32218 or 32237 applies. Applicable once per day for the same patient by the same practitioner | $150.10 75% benefit $112.60 85% benefit $127.60 |
| 32216 | Sacral nerve lead or leads, inserted for the management of faecal incontinence in a patient with faecal incontinence refractory to conservative non-surgical treatment, either:(a) percutaneous surgical repositioning of the lead or leads, using fluoroscopic guidance; or(b) open surgical repositioning of the lead or leads; to correct displacement or unsatisfactory positioning (including intraoperative test stimulation), not being a service associated with a service to which item 32213 applies (H) (Anaes.) | $710.45 75% benefit $532.85 |
| 32218 | Sacral nerve lead or leads, removal (H) (Anaes.) | $187.05 75% benefit $140.30 |
| 32219 | Endoscopic examination of the colon to the caecum by colonoscopy, for an asymptomatic patient following a positive result from a faecal occult blood test undertaken for screening purposes Applicable once per day under a single episode of anaesthesia or other sedation (H) (Anaes.) | $400.20 75% benefit $300.15 |
| 32221 | Removal or revision of an artificial bowel sphincter (with or without replacement) for severe faecal incontinence in the treatment of a patient for whom conservative and other less invasive forms of treatment are contraindicated or have failed (H) (Anaes.) (Assist.) | $1,081.85 75% benefit $811.40 |
| 32222 | Endoscopic examination of the colon to the caecum by colonoscopy, for a patient: (a) who has symptoms consistent with pathology of the colonic mucosa; or (b) who has anaemia or iron deficiency; or (c) for whom diagnostic imaging has shown an abnormality of the colon; or (d) who is undergoing the first examination following surgery for colorectal cancer; or (e) who is undergoing pre‑operative evaluation; or (f) for whom a repeat colonoscopy is required due to inadequate bowel preparation for the patient’s previous colonoscopy; or (g) for the management of inflammatory bowel disease; other than a service associated with a service to which item 32230 applies Applicable once on a day under a single episode of anaesthesia or other sedation (H) (Anaes.) | $400.20 75% benefit $300.15 |
| 32223 | Endoscopic examination of the colon to the caecum by colonoscopy, for a patient: (a) who has had a colonoscopy that revealed: (i) one to 4 adenomas, each of which was less than 10 mm in diameter, had no villous features and had no high grade dysplasia; or (ii) one or 2 sessile serrated lesions, each of which was less than 10 mm in diameter, and without dysplasia; or (b) who has a moderate risk of colorectal cancer due to family history; or (c) who has a history of colorectal cancer and has had an initial post‑operative colonoscopy that did not reveal any adenomas or colorectal cancer; other than a service associated with a service to which item 32230 applies Applicable once in any 5 year period (H) (Anaes.) | $400.20 75% benefit $300.15 |
| 32224 | Endoscopic examination of the colon to the caecum by colonoscopy, for a patient who has a moderate risk of colorectal cancer due to: (a) a history of adenomas, including an adenoma that: (i) was 10 mm or greater in diameter; or (ii) had villous features; or (iii) had high grade dysplasia; or (b) having had a previous colonoscopy that revealed: (i) 5 to 9 adenomas, each of which was less than 10 mm in diameter, had no villous features and had no high grade dysplasia; or (ii) one or 2 sessile serrated lesions, each of which was 10 mm or greater in diameter or had dysplasia; or (iii) a hyperplastic polyp that was 10 mm or greater in diameter; or (iv) 3 or more sessile serrated lesions, each of which was less than 10 mm in diameter and had no dysplasia; or (v) one or 2 traditional serrated adenomas, of any size; other than a service associated with a service to which item 32230 applies Applicable once in any 3 year period (H) (Anaes.) | $400.20 75% benefit $300.15 |
| 32225 | Endoscopic examination of the colon to the caecum by colonoscopy, for a patient who has a high risk of colorectal cancer due to having had a previous colonoscopy that: (a) revealed 10 or more adenomas; or (b) included a piecemeal, or possibly incomplete, excision of a large, sessile polyp; other than a service associated with a service to which item 32230 applies Applicable 4 times in any 12 month period (H) (Anaes.) | $400.20 75% benefit $300.15 |
| 32226 | Endoscopic examination of the colon to the caecum by colonoscopy, for a patient who has a high risk of colorectal cancer due to: (a) having either: (i) a known or suspected familial condition, such as familial adenomatous polyposis, Lynch syndrome or serrated polyposis syndrome; or (ii) a genetic mutation associated with hereditary colorectal cancer; or (b) having had a previous colonoscopy that revealed: (i) 5 or more sessile serrated lesions, each of which was less than 10 mm in diameter and had no dysplasia; or (ii) 3 or more sessile serrated lesions, one or more of which was 10 mm or greater in diameter or had dysplasia; or (iii) 3 or more traditional serrated adenomas, of any size; other than a service associated with a service to which item 32230 applies Applicable once in any 12 month period (H) (Anaes.) | $400.20 75% benefit $300.15 |
| 32227 | Endoscopic examination of the colon to the caecum by colonoscopy: (a) for the treatment of bleeding, including one or more of the following: (i) radiation proctitis; (ii) angioectasia; (iii) post‑polypectomy bleeding; or (b) for the treatment of colonic strictures with balloon dilatation Applicable only once on a day under a single episode of anaesthesia or other sedation (H) (Anaes.) | $561.55 75% benefit $421.20 |
| 32228 | Endoscopic examination of the colon to the caecum by colonoscopy, other than: (a) a service to which item 32219, 32222, 32223, 32224, 32225 or 32226 applies; or (b) a service associated with a service to which item 32230 applies Applicable once (H) (Anaes.) | $400.20 75% benefit $300.15 |
| 32229 | Removal of one or more polyps during colonoscopy, in association with a service to which item 32219, 32222, 32223, 32224, 32225, 32226 or 32228 applies (H) (Anaes.) | $322.80 75% benefit $242.10 |
| 32230 | Endoscopic mucosal resection using electrocautery of a non‑invasive sessile or flat superficial colorectal neoplasm which is at least 25mm in diameter, if the service is supported by photographic evidence to confirm the size of the polyp in situ Applicable once per polyp (H) (Anaes.) | $799.70 75% benefit $599.80 |
| 32231 | Rectal tumour, per anal excision of (H) (Anaes.) (Assist.) | $398.85 75% benefit $299.15 |
| 32232 | Rectal tumour, per anal excision of, using a rectoscopy digital viewing system and pneumorectum if clinically appropriate and excluding use of a colonoscope as the operating platform, not being a service associated with a service to which item 32024, 32025 or 32106 applies (H) (Anaes.) (Assist.) | $1,081.40 75% benefit $811.05 |
| 32233 | Perineal repair of rectal prolapse, not being a service associated with a service to which item 32139 applies (H) (Anaes.) (Assist.) | $768.00 75% benefit $576.00 |
| 32234 | Rectal stricture, treatment of (H) (Anaes.) | $151.90 75% benefit $113.95 |
| 32235 | Anal skin tags or anal polyps, excision of one or more of (Anaes.) | $146.55 75% benefit $109.95 85% benefit $124.60 |
| 32236 | Anal warts, removal of, under general anaesthesia, or under regional or field nerve block (excluding pudendal block), not being a service associated with a service to which item 35507 or 35508 applies (H) (Anaes.) | $208.55 75% benefit $156.45 |
| 32237 | Neurostimulator or receiver, subcutaneous placement of, replacement of, or removal of, including programming and placement and connection of an extension wire or wires to sacral nerve electrode(s), for the management of faecal incontinence (H) (Anaes.) (Assist.) | $338.25 75% benefit $253.70 |
| 32500 | Varicose veins, multiple injections of sclerosant using continuous compression techniques, including associated consultation, one or both legs, if: (a) proximal reflux of 0.5 seconds or longer has been demonstrated; and (b) the service is not for cosmetic purposes; and (c) the service is not associated with: (i) any other varicose vein operation on the same leg (excluding aftercare); or (ii) a service on the same leg (excluding aftercare) to which any of the following items apply: (A) 35200; (B) 59970 to 60078; (C) 60500 to 60509; (D) 61109 Applicable to a maximum of 6 treatments in a 12 month period (Anaes.) | $131.45 75% benefit $98.60 85% benefit $111.75 |
| 32504 | VARICOSE VEINS, multiple excision of tributaries, with or without division of 1 or more perforating veins - 1 leg - not being a service associated with a service to which item 32507, 32508, 32511, 32514 or 32517 applies on the same leg (Anaes.) | $320.35 75% benefit $240.30 85% benefit $272.30 |
| 32507 | Varicose veins, sub‑fascial ligation of one or more incompetent perforating veins in one leg of a patient, if the service: (a) is performed by open surgical technique (not including endoscopic ligation) and the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (i) ache; (ii) pain; (iii) tightness; (iv) skin irritation; (v) heaviness; (vi) muscle cramps; (vii) limb swelling; (viii) discolouration; (ix) discomfort; (x) any other signs or symptoms attributable to venous dysfunction; and (b) is not associated with: (i) any other varicose vein operation on the same leg; or (ii) a service (on the same leg) to which item 35200, 60072, 60075 or 60078 applies (H) (Anaes.) (Assist.) | $638.70 75% benefit $479.05 |
| 32508 | Varicose veins, complete dissection at the sapheno‑femoral or sapheno‑popliteal junction, with or without either ligation or stripping, or both, of the great or small saphenous veins in one leg of a patient, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (a) ache; (b) pain; (c) tightness; (d) skin irritation; (e) heaviness; (f) muscle cramps; (g) limb swelling; (h) discolouration; (i) discomfort; (j) any other signs or symptoms attributable to venous dysfunction (H) (Anaes.) (Assist.) | $638.70 75% benefit $479.05 |
| 32511 | Varicose veins, complete dissection at the sapheno‑femoral and sapheno‑popliteal junction, with or without either ligation or stripping, or both, of the great or small saphenous veins in one leg of a patient, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (a) ache; (b) pain; (c) tightness; (d) skin irritation; (e) heaviness; (f) muscle cramps; (g) limb swelling; (h) discolouration; (i) discomfort; (j) any other signs or symptoms attributable to venous dysfunction (H) (Anaes.) (Assist.) | $949.50 75% benefit $712.15 |
| 32514 | Varicose veins, ligation of the great or small saphenous vein in the same leg of a patient, with or without stripping, by re‑operation for recurrent veins in the same territory—one leg—including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (a) ache; (b) pain; (c) tightness; (d) skin irritation; (e) heaviness; (f) muscle cramps; (g) limb swelling; (h) discolouration; (i) discomfort; (j) any other signs or symptoms attributable to venous dysfunction (H) (Anaes.) (Assist.) | $1,109.30 75% benefit $832.00 |
| 32517 | Varicose veins, ligation of the great and small saphenous vein in the same leg of a patient, with or without stripping, by re‑operation for recurrent veins in either territory—one leg—including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (a) ache; (b) pain; (c) tightness; (d) skin irritation; (e) heaviness; (f) muscle cramps; (g) limb swelling; (h) discolouration; (i) discomfort; (j) any other signs or symptoms attributable to venous dysfunction (H) (Anaes.) (Assist.) | $1,428.45 75% benefit $1,071.35 |
| 32520 | Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great or small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a laser probe introduced by an endovenous catheter, if all of the following apply: (a) it is documented by duplex ultrasound that the great or small saphenous vein (whichever is to be treated) of the patient demonstrates reflux of 0.5 seconds or longer; (b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (i) ache; (ii) pain; (iii) tightness; (iv) skin irritation; (v) heaviness; (vi) muscle cramps; (vii) limb swelling; (viii) discolouration; (ix) discomfort; (x) any other signs or symptoms attributable to venous dysfunction; (c) the service does not include radiofrequency diathermy, radiofrequency ablation or cyanoacrylate adhesive; (d) the service is not associated with a service (on the same leg) to which any of the following items apply: (i) 32500 to 32507; (ii) 35200; (iii) 59970 to 60021; (iv) 60036 to 60045; (v) 60060 to 60078; (vi) 60500 to 60509; (vii) 61109 The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both) (Anaes.) | $638.70 75% benefit $479.05 85% benefit $542.90 |
| 32522 | New 85% benefit on 1 November 2026Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great and small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a laser probe introduced by an endovenous catheter, if all of the following apply: (a) it is documented by duplex ultrasound that the great and small saphenous veins of the patient demonstrate reflux of 0.5 seconds or longer; (b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (i) ache; (ii) pain; (iii) tightness; (iv) skin irritation; (v) heaviness; (vi) muscle cramps; (vii) limb swelling; (viii) discolouration; (ix) discomfort; (x) any other signs or symptoms attributable to venous dysfunction; (c) the service does not include radiofrequency diathermy, radiofrequency ablation or cyanoacrylate adhesive; (d) the service is not associated with a service (on the same leg) to which any of the following items apply: (i) 32500 to 32507; (ii) 35200; (iii) 59970 to 60021; (iv) 60036 to 60045; (v) 60060 to 60078; (vi) 60500 to 60509; (vii) 61109 The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both) (Anaes.) | $949.50 75% benefit $712.15 85% benefit $841.00 was $845.00 |
| 32523 | Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great or small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a radiofrequency catheter introduced by an endovenous catheter, if all of the following apply: (a) it is documented by duplex ultrasound that the great or small saphenous vein (whichever is to be treated) demonstrates reflux of 0.5 seconds or longer; (b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (i) ache; (ii) pain; (iii) tightness; (iv) skin irritation; (v) heaviness; (vi) muscle cramps; (vii) limb swelling; (viii) discolouration; (ix) discomfort; (x) any other signs or symptoms attributable to venous dysfunction; (c) the service does not include endovenous laser therapy or cyanoacrylate adhesive; (d) the service is not associated with a service (on the same leg) to which any of the following items apply: (i) 32500 to 32507; (ii) 35200; (iii) 59970 to 60021; (iv) 60036 to 60045; (v) 60060 to 60078; (vi) 60500 to 60509; (vii) 61109 The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both) (Anaes.) | $638.70 75% benefit $479.05 85% benefit $542.90 |
| 32526 | New 85% benefit on 1 November 2026Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great and small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a radiofrequency catheter introduced by an endovenous catheter, if all of the following apply: (a) it is documented by duplex ultrasound that the great and small saphenous veins demonstrate reflux of 0.5 seconds or longer; (b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (i) ache; (ii) pain; (iii) tightness; (iv) skin irritation; (v) heaviness; (vi) muscle cramps; (vii) limb swelling; (viii) discolouration; (ix) discomfort; (x) any other signs or symptoms attributable to venous dysfunction; (c) the service does not include endovenous laser therapy or cyanoacrylate adhesive; (d) the service is not associated with a service (on the same leg) to which any of the following items apply: (i) 32500 to 32507; (ii) 35200; (iii) 59970 to 60021; (iv) 60036 to 60045; (v) 60060 to 60078; (vi) 60500 to 60509; (vii) 61109 The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both) (Anaes.) | $949.50 75% benefit $712.15 85% benefit $841.00 was $845.00 |
| 32528 | Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great or small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using cyanoacrylate adhesive, if all of the following apply: (a) it is documented by duplex ultrasound that the great or small saphenous vein (whichever is to be treated) demonstrates reflux of 0.5 seconds or longer; (b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (i) ache; (ii) pain; (iii) tightness; (iv) skin irritation; (v) heaviness; (vi) muscle cramps; (vii) limb swelling; (viii) discolouration; (ix) discomfort; (x) any other signs or symptoms attributable to venous dysfunction; (c) the service does not include radiofrequency diathermy, radiofrequency ablation or endovenous laser therapy; (d) the service is not associated with a service (on the same leg) to which any of the following items apply: (i) 32500 to 32507; (ii) 35200; (iii) 59970 to 60021; (iv) 60036 to 60045; (v) 60060 to 60078; (vi) 60500 to 60509; (vii) 61109 The service include all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both) (Anaes.) | $638.70 75% benefit $479.05 85% benefit $542.90 |
| 32529 | New 85% benefit on 1 November 2026Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great and small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using cyanoacrylate adhesive, if all of the following apply: (a) it is documented by duplex ultrasound that the great and small saphenous veins demonstrate reflux of 0.5 seconds or longer; (b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux: (i) ache; (ii) pain; (iii) tightness; (iv) skin irritation; (v) heaviness; (vi) muscle cramps; (vii) limb swelling; (viii) discolouration; (ix) discomfort; (x) any other signs or symptoms attributable to venous dysfunction; (c) the service does not include radiofrequency diathermy, radiofrequency ablation or endovenous laser therapy; (d) the service is not associated with a service (on the same leg) to which any of the following items apply: (i) 32500 to 32507; (ii) 35200; (iii) 59970 to 60021; (iv) 60036 to 60045; (v) 60060 to 60078; (vi) 60500 to 60509; (vii) 61109 The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both) (Anaes.) | $949.50 75% benefit $712.15 85% benefit $841.00 was $845.00 |
| 32700 | ARTERY OF NECK, bypass using vein or synthetic material (Anaes.) (Assist.) | $1,719.10 75% benefit $1,289.35 |
| 32703 | INTERNAL CAROTID ARTERY, transection and reanastomosis of, or resection of small length and reanastomosis of - with or without endarterectomy (Anaes.) (Assist.) | $1,422.15 75% benefit $1,066.65 |
| 32708 | AORTIC BYPASS for occlusive disease using a straight non-bifurcated graft (Anaes.) (Assist.) | $1,701.20 75% benefit $1,275.90 |
| 32710 | AORTIC BYPASS for occlusive disease using a bifurcated graft with 1 or both anastomoses to the iliac arteries (Anaes.) (Assist.) | $1,890.25 75% benefit $1,417.70 |
| 32711 | AORTIC BYPASS for occlusive disease using a bifurcated graft with 1 or both anastomoses to the common femoral or profunda femoris arteries (Anaes.) (Assist.) | $2,079.30 75% benefit $1,559.50 |
| 32712 | ILIO-FEMORAL BYPASS GRAFTING (Anaes.) (Assist.) | $1,503.15 75% benefit $1,127.40 |
| 32715 | AXILLARY or SUBCLAVIAN TO FEMORAL BYPASS GRAFTING to 1 or both FEMORAL ARTERIES (Anaes.) (Assist.) | $1,503.15 75% benefit $1,127.40 |
| 32718 | FEMORO-FEMORAL OR ILIO-FEMORAL CROSS-OVER BYPASS GRAFTING (Anaes.) (Assist.) | $1,422.15 75% benefit $1,066.65 |
| 32721 | RENAL ARTERY, bypass grafting to (Anaes.) (Assist.) | $2,258.95 75% benefit $1,694.25 |
| 32724 | RENAL ARTERIES (both), bypass grafting to (Anaes.) (Assist.) | $2,565.10 75% benefit $1,923.85 |
| 32730 | MESENTERIC VESSEL (single), bypass grafting to (Anaes.) (Assist.) | $1,944.15 75% benefit $1,458.15 |
| 32733 | MESENTERIC VESSELS (multiple), bypass grafting to (Anaes.) (Assist.) | $2,258.95 75% benefit $1,694.25 |
| 32736 | INFERIOR MESENTERIC ARTERY, operation on, when performed in conjunction with another intra-abdominal vascular operation (Anaes.) (Assist.) | $495.00 75% benefit $371.25 |
| 32739 | FEMORAL ARTERY BYPASS GRAFTING using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with above knee anastomosis (Anaes.) (Assist.) | $1,548.10 75% benefit $1,161.10 |
| 32742 | FEMORAL ARTERY BYPASS GRAFTING using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with distal anastomosis to below knee popliteal artery (Anaes.) (Assist.) | $1,773.20 75% benefit $1,329.90 |
| 32745 | FEMORAL ARTERY BYPASS GRAFTING using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with distal anastomosis to tibio peroneal trunk or tibial or peroneal artery (Anaes.) (Assist.) | $2,025.05 75% benefit $1,518.80 |
| 32748 | FEMORAL ARTERY BYPASS GRAFTING using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with distal anastomosis within 5cms of the ankle joint (Anaes.) (Assist.) | $2,196.10 75% benefit $1,647.10 |
| 32751 | FEMORAL ARTERY BYPASS GRAFTING using synthetic graft, with lower anastomosis above or below the knee (Anaes.) (Assist.) | $1,422.15 75% benefit $1,066.65 |
| 32754 | FEMORAL ARTERY BYPASS GRAFTING, using a composite graft (synthetic material and vein) with lower anastomosis above or below the knee, including use of a cuff or sleeve of vein at 1 or both anastomoses (Anaes.) (Assist.) | $1,773.20 75% benefit $1,329.90 |
| 32757 | FEMORAL ARTERY SEQUENTIAL BYPASS GRAFTING, (using a vein or synthetic material) where an additional anastomosis is made to separately revascularise more than 1 artery - each additional artery revascularised beyond a femoral bypass (Anaes.) (Assist.) | $495.00 75% benefit $371.25 |
| 32760 | VEIN, HARVESTING OF, FROM LEG OR ARM for bypass or replacement graft when not performed on the limb which is the subject of the bypass or graft - each vein (Anaes.) (Assist.) | $485.95 75% benefit $364.50 |
| 32763 | ARTERIAL BYPASS GRAFTING, using vein or synthetic material, not being a service to which another item in this Sub-group applies (Anaes.) (Assist.) | $1,422.15 75% benefit $1,066.65 |
| 32766 | ARTERIAL OR VENOUS ANASTOMOSIS, not being a service to which another item in this Sub-group applies, as an independent procedure (Anaes.) (Assist.) | $945.15 75% benefit $708.90 |
| 32769 | ARTERIAL OR VENOUS ANASTOMOSIS not being a service to which another item in this Sub-group applies, when performed in combination with another vascular operation (including graft to graft anastomosis) (Anaes.) (Assist.) | $327.55 75% benefit $245.70 |
| 33050 | BYPASS GRAFTING to replace a popliteal aneurysm using vein, including harvesting vein (when it is the ipsilateral long saphenous vein) (Anaes.) (Assist.) | $1,741.90 75% benefit $1,306.45 |
| 33055 | BYPASS GRAFTING to replace a popliteal aneurysm using a synthetic graft (Anaes.) (Assist.) | $1,396.85 75% benefit $1,047.65 |
| 33070 | Aneurysm in the extremities, ligation, suture closure or excision of, without bypass grafting (H) (Anaes.) (Assist.) | $1,007.75 75% benefit $755.85 |
| 33075 | ANEURYSM IN THE NECK, ligation, suture closure or excision of, without bypass grafting (Anaes.) (Assist.) | $1,281.95 75% benefit $961.50 |
| 33080 | INTRA-ABDOMINAL OR PELVIC ANEURYSM, ligation, suture closure or excision of, without bypass grafting (Anaes.) (Assist.) | $1,564.85 75% benefit $1,173.65 |
| 33100 | Aneurysm of common or internal carotid artery, or both, replacement by graft of vein or synthetic material (H) (Anaes.) (Assist.) | $1,719.10 75% benefit $1,289.35 |
| 33103 | THORACIC ANEURYSM, replacement by graft (Anaes.) (Assist.) | $2,412.15 75% benefit $1,809.15 |
| 33109 | Thoraco‑abdominal aneurysm, replacement by graft including re‑implantation of arteries (H) (Anaes.) (Assist.) | $2,916.25 75% benefit $2,187.20 |
| 33112 | SUPRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by graft including re-implantation of arteries (Anaes.) (Assist.) | $2,529.10 75% benefit $1,896.85 |
| 33115 | INFRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by tube graft, not being a service associated with a service to which item 33116 applies (Anaes.) (Assist.) | $1,701.20 75% benefit $1,275.90 |
| 33116 | Infrarenal abdominal aortic aneurysm (repair), replacement by tube graft using endovascular repair procedure, excluding associated radiological services (H) (Anaes.) (Assist.) | $1,674.50 75% benefit $1,255.90 |
| 33118 | INFRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by bifurcation graft to iliac arteries (with or without excision of common iliac aneurysms) not being a service associated with a service to which item 33119 applies (Anaes.) (Assist.) | $1,890.25 75% benefit $1,417.70 |
| 33119 | Infrarenal abdominal aortic aneurysm (repair), replacement by bifurcation graft to one or both iliac arteries using endovascular repair procedure, excluding associated radiological services (H) (Anaes.) (Assist.) | $1,860.65 75% benefit $1,395.50 |
| 33121 | INFRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by bifurcation graft to 1 or both femoral arteries (with or without excision or bypass of common iliac aneurysms) (Anaes.) (Assist.) | $2,079.30 75% benefit $1,559.50 |
| 33124 | ANEURYSM OF ILIAC ARTERY (common, external or internal), replacement by graft - unilateral (Anaes.) (Assist.) | $1,449.20 75% benefit $1,086.90 |
| 33127 | Aneurysms of iliac arteries (common, external or internal), replacement by graft—bilateral (H) (Anaes.) (Assist.) | $1,899.30 75% benefit $1,424.50 |
| 33130 | ANEURYSM OF VISCERAL ARTERY, excision and repair by direct anastomosis or replacement by graft (Anaes.) (Assist.) | $1,656.15 75% benefit $1,242.15 |
| 33133 | ANEURYSM OF VISCERAL ARTERY, dissection and ligation of arteries without restoration of continuity (Anaes.) (Assist.) | $1,242.00 75% benefit $931.50 |
| 33136 | FALSE ANEURYSM, repair of, at aortic anastomosis following previous aortic surgery (Anaes.) (Assist.) | $3,132.00 75% benefit $2,349.00 |
| 33139 | FALSE ANEURYSM, repair of, in iliac artery and restoration of arterial continuity (Anaes.) (Assist.) | $1,899.30 75% benefit $1,424.50 |
| 33142 | False aneurysm, repair of, in femoral artery and restoration of arterial continuity (H) (Anaes.) (Assist.) | $1,773.20 75% benefit $1,329.90 |
| 33145 | RUPTURED THORACIC AORTIC ANEURYSM, replacement by graft (Anaes.) (Assist.) | $3,051.10 75% benefit $2,288.35 |
| 33148 | RUPTURED THORACO-ABDOMINAL AORTIC ANEURYSM, replacement by graft (Anaes.) (Assist.) | $3,789.15 75% benefit $2,841.90 |
| 33151 | RUPTURED SUPRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by graft (Anaes.) (Assist.) | $3,600.25 75% benefit $2,700.20 |
| 33154 | RUPTURED INFRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by tube graft (Anaes.) (Assist.) | $2,664.10 75% benefit $1,998.10 |
| 33157 | RUPTURED INFRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by bifurcation graft to iliac arteries (with or without excision or bypass of common iliac aneurysms) (Anaes.) (Assist.) | $2,970.10 75% benefit $2,227.60 |
| 33160 | RUPTURED INFRARENAL ABDOMINAL AORTIC ANEURYSM, replacement by bifurcation graft to 1 or both femoral arteries (Anaes.) (Assist.) | $2,970.10 75% benefit $2,227.60 |
| 33163 | RUPTURED ILIAC ARTERY ANEURYSM, replacement by graft (Anaes.) (Assist.) | $2,520.30 75% benefit $1,890.25 |
| 33166 | Ruptured aneurysm of visceral artery, replacement by anastomosis or graft (H) (Anaes.) (Assist.) | $2,520.30 75% benefit $1,890.25 |
| 33169 | RUPTURED ANEURYSM OF VISCERAL ARTERY, simple ligation of (Anaes.) (Assist.) | $1,962.15 75% benefit $1,471.65 |
| 33172 | ANEURYSM OF MAJOR ARTERY, replacement by graft, not being a service to which another item in this Sub-group applies (Anaes.) (Assist.) | $1,530.05 75% benefit $1,147.55 |
| 33175 | RUPTURED ANEURYSM IN THE EXTREMITIES, ligation, suture closure or excision of, without bypass grafting (Anaes.) (Assist.) | $1,410.10 75% benefit $1,057.60 |
| 33178 | RUPTURED ANEURYSM IN THE NECK, ligation, suture closure or excision of, without bypass grafting (Anaes.) (Assist.) | $1,793.15 75% benefit $1,344.90 |
| 33181 | RUPTURED INTRA-ABDOMINAL OR PELVIC ANEURYSM, ligation, suture closure or excision of, without bypass grafting (Anaes.) (Assist.) | $2,192.35 75% benefit $1,644.30 |
| 33500 | ARTERY OR ARTERIES OF NECK, endarterectomy of, including closure by suture (where endarterectomy of 1 or more arteries is undertaken through 1 arteriotomy incision) (Anaes.) (Assist.) | $1,358.95 75% benefit $1,019.25 |
| 33506 | INNOMINATE OR SUBCLAVIAN ARTERY, endarterectomy of, including closure by suture (Anaes.) (Assist.) | $1,521.10 75% benefit $1,140.85 |
| 33509 | AORTIC ENDARTERECTOMY, including closure by suture, not being a service associated with another procedure on the aorta (Anaes.) (Assist.) | $1,701.20 75% benefit $1,275.90 |
| 33512 | AORTO-ILIAC ENDARTERECTOMY (1 or both iliac arteries), including closure by suture not being a service associated with a service to which item 33515 applies (Anaes.) (Assist.) | $1,890.25 75% benefit $1,417.70 |
| 33515 | AORTO-FEMORAL ENDARTERECTOMY (1 or both femoral arteries) or BILATERAL ILIO-FEMORAL ENDARTERECTOMY, including closure by suture, not being a service associated with a service to which item 33512 applies (Anaes.) (Assist.) | $2,079.30 75% benefit $1,559.50 |
| 33518 | Iliac endarterectomy, including closure by suture, other than a service associated with another procedure on the iliac artery (H) (Anaes.) (Assist.) | $1,521.10 75% benefit $1,140.85 |
| 33521 | ILIO-FEMORAL ENDARTERECTOMY (1 side), including closure by suture (Anaes.) (Assist.) | $1,646.95 75% benefit $1,235.25 |
| 33524 | RENAL ARTERY, endarterectomy of (Anaes.) (Assist.) | $1,944.15 75% benefit $1,458.15 |
| 33527 | RENAL ARTERIES (both), endarterectomy of (Anaes.) (Assist.) | $2,258.95 75% benefit $1,694.25 |
| 33530 | COELIAC OR SUPERIOR MESENTERIC ARTERY, endarterectomy of (Anaes.) (Assist.) | $1,944.15 75% benefit $1,458.15 |
| 33533 | COELIAC AND SUPERIOR MESENTERIC ARTERY, endarterectomy of (Anaes.) (Assist.) | $2,258.95 75% benefit $1,694.25 |
| 33536 | INFERIOR MESENTERIC ARTERY, endarterectomy of, not being a service associated with a service to which another item in this Sub-group applies (Anaes.) (Assist.) | $1,611.15 75% benefit $1,208.40 |
| 33539 | ARTERY OF EXTREMITIES, endarterectomy of, including closure by suture (Anaes.) (Assist.) | $1,160.95 75% benefit $870.75 |
| 33542 | EXTENDED DEEP FEMORAL ENDARTERECTOMY where the endarterectomy is at least 7cms long (Anaes.) (Assist.) | $1,656.15 75% benefit $1,242.15 |
| 33545 | ARTERY, VEIN OR BYPASS GRAFT, patch grafting to by vein or synthetic material where patch is less than 3cm long (Anaes.) (Assist.) | $327.55 75% benefit $245.70 |
| 33548 | ARTERY, VEIN OR BYPASS GRAFT, patch grafting to by vein or synthetic material where patch is 3cm long or greater (Anaes.) (Assist.) | $666.20 75% benefit $499.65 |
| 33551 | VEIN, harvesting of from leg or arm for patch when not performed through same incision as operation (Anaes.) (Assist.) | $327.55 75% benefit $245.70 |
| 33554 | ENDARTERECTOMY, in conjunction with an arterial bypass operation to prepare the site for anastomosis - each site (Anaes.) (Assist.) | $326.05 75% benefit $244.55 |
| 33800 | Embolus, removal of, from artery of neck (H) (Anaes.) (Assist.) | $1,413.10 75% benefit $1,059.85 |
| 33803 | EMBOLECTOMY or THROMBECTOMY, by abdominal approach, of an artery or bypass graft of trunk (Anaes.) (Assist.) | $1,350.20 75% benefit $1,012.65 |
| 33806 | Embolectomy or thrombectomy (including the infusion of thrombolytic or other agents) from an artery or bypass graft of extremities, or embolectomy of abdominal artery via the femoral artery, item to be claimed once per extremity, regardless of the number of incisions required to access the artery or bypass graft (H) (Anaes.) (Assist.) | $972.10 75% benefit $729.10 |
| 33810 | Inferior vena cava or iliac vein, closed thrombectomy by catheter via the femoral vein (H) (Anaes.) (Assist.) | $709.15 75% benefit $531.90 |
| 33811 | INFERIOR VENA CAVA OR ILIAC VEIN, open removal of thrombus or tumour (Anaes.) (Assist.) | $2,111.05 75% benefit $1,583.30 |
| 33812 | Thrombus, removal of, from femoral or other similar large vein (H) (Anaes.) (Assist.) | $1,116.00 75% benefit $837.00 |
| 33815 | MAJOR ARTERY OR VEIN OF EXTREMITY, repair of wound of, with restoration of continuity, by lateral suture (Anaes.) (Assist.) | $1,026.00 75% benefit $769.50 |
| 33818 | MAJOR ARTERY OR VEIN OF EXTREMITY, repair of wound of, with restoration of continuity, by direct anastomosis (Anaes.) (Assist.) | $1,197.15 75% benefit $897.90 |
| 33821 | MAJOR ARTERY OR VEIN OF EXTREMITY, repair of wound of, with restoration of continuity, by interposition graft of synthetic material or vein (Anaes.) (Assist.) | $1,368.05 75% benefit $1,026.05 |
| 33824 | MAJOR ARTERY OR VEIN OF NECK, repair of wound of, with restoration of continuity, by lateral suture (Anaes.) (Assist.) | $1,304.95 75% benefit $978.75 |
| 33827 | MAJOR ARTERY OR VEIN OF NECK, repair of wound of, with restoration of continuity, by direct anastomosis (Anaes.) (Assist.) | $1,530.05 75% benefit $1,147.55 |
| 33830 | MAJOR ARTERY OR VEIN OF NECK, repair of wound of, with restoration of continuity, by interposition graft of synthetic material or vein (Anaes.) (Assist.) | $1,755.00 75% benefit $1,316.25 |
| 33833 | MAJOR ARTERY OR VEIN OF ABDOMEN, repair of wound of, with restoration of continuity by lateral suture (Anaes.) (Assist.) | $1,593.30 75% benefit $1,195.00 |
| 33836 | MAJOR ARTERY OR VEIN OF ABDOMEN, repair of wound of, with restoration of continuity by direct anastomosis (Anaes.) (Assist.) | $1,899.30 75% benefit $1,424.50 |
| 33839 | MAJOR ARTERY OR VEIN OF ABDOMEN, repair of wound of, with restoration of continuity by means of interposition graft (Anaes.) (Assist.) | $2,223.10 75% benefit $1,667.35 |
| 33842 | ARTERY OF NECK, re-operation for bleeding or thrombosis after carotid or vertebral artery surgery (Anaes.) (Assist.) | $1,098.05 75% benefit $823.55 |
| 33845 | LAPAROTOMY for control of post operative bleeding or thrombosis after intra-abdominal vascular procedure, where no other procedure is performed (Anaes.) (Assist.) | $765.20 75% benefit $573.90 |
| 33848 | EXTREMITY, re-operation on, for control of bleeding or thrombosis after vascular procedure, where no other procedure is performed (Anaes.) (Assist.) | $765.20 75% benefit $573.90 |
| 34100 | MAJOR ARTERY OF NECK, elective ligation or exploration of, not being a service associated with any other vascular procedure (Anaes.) (Assist.) | $846.15 75% benefit $634.65 |
| 34103 | Great artery (aorta or pulmonary artery) or great vein (superior or inferior vena cava), ligation or exploration of immediate branches or tributaries, or ligation or exploration of the subclavian, axillary, iliac, femoral or popliteal arteries or veins, if the service is not associated with item 32508, 32511, 32520, 32522, 32523, 32526, 32528 or 32529 - for a maximum of 2 services provided to the same patient on the same occasion (H) (Anaes.) (Assist.) | $495.00 75% benefit $371.25 |
| 34106 | Artery or vein (including brachial, radial, ulnar or tibial), ligation of, by elective operation, or exploration of, other than a service associated with another vascular procedure except those services to which item 32508, 32511, 32514 or 32517 applies (H) (Anaes.) (Assist.) | $349.15 75% benefit $261.90 |
| 34109 | TEMPORAL ARTERY, biopsy of (Anaes.) (Assist.) | $405.00 75% benefit $303.75 85% benefit $344.25 |
| 34112 | ARTERIO-VENOUS FISTULA OF AN EXTREMITY, dissection and ligation (Anaes.) (Assist.) | $1,026.00 75% benefit $769.50 |
| 34115 | ARTERIO-VENOUS FISTULA OF THE NECK, dissection and ligation (Anaes.) (Assist.) | $1,160.95 75% benefit $870.75 |
| 34118 | Arterio‑venous fistula of the abdomen, dissection and ligation (H) (Anaes.) (Assist.) | $1,656.15 75% benefit $1,242.15 |
| 34121 | ARTERIO-VENOUS FISTULA OF AN EXTREMITY, dissection and repair of, with restoration of continuity (Anaes.) (Assist.) | $1,323.00 75% benefit $992.25 |
| 34124 | ARTERIO-VENOUS FISTULA OF THE NECK, dissection and repair of, with restoration of continuity (Anaes.) (Assist.) | $1,449.20 75% benefit $1,086.90 |
| 34127 | ARTERIO-VENOUS FISTULA OF THE ABDOMEN, dissection and repair of, with restoration of continuity (Anaes.) (Assist.) | $1,899.30 75% benefit $1,424.50 |
| 34130 | Surgically created arterio‑venous fistula of an extremity, closure of (H) (Anaes.) (Assist.) | $593.95 75% benefit $445.50 |
| 34133 | SCALENOTOMY (Anaes.) (Assist.) | $666.20 75% benefit $499.65 |
| 34136 | FIRST RIB, resection of portion of (Anaes.) (Assist.) | $1,070.90 75% benefit $803.20 |
| 34139 | CERVICAL RIB, removal of, or other operation for removal of thoracic outlet compression, not being a service to which another item in this Sub-group applies (Anaes.) (Assist.) | $1,070.90 75% benefit $803.20 |
| 34142 | COELIAC ARTERY, decompression of, for coeliac artery compression syndrome, as an independent procedure (Anaes.) (Assist.) | $1,323.00 75% benefit $992.25 |
| 34145 | POPLITEAL ARTERY, exploration of, for popliteal entrapment, with or without division of fibrous tissue and muscle (Anaes.) (Assist.) | $963.00 75% benefit $722.25 |
| 34148 | CAROTID ASSOCIATED TUMOUR, resection of, with or without repair or reconstruction of internal or common carotid arteries, when tumour is 4cm or less in maximum diameter (Anaes.) (Assist.) | $1,719.10 75% benefit $1,289.35 |
| 34151 | CAROTID ASSOCIATED TUMOUR, resection of, with or without repair or reconstruction of internal or common carotid arteries, when tumour is greater than 4cm in maximum diameter (Anaes.) (Assist.) | $2,349.05 75% benefit $1,761.80 |
| 34154 | Recurrent carotid associated tumour, resection of, with or without repair or replacement of portion of internal or common carotid arteries (H) (Anaes.) (Assist.) | $2,799.25 75% benefit $2,099.45 |
| 34157 | NECK, excision of infected bypass graft, including closure of vessel or vessels (Anaes.) (Assist.) | $1,422.15 75% benefit $1,066.65 |
| 34160 | AORTO-DUODENAL FISTULA, repair of, by suture of aorta and repair of duodenum (Anaes.) (Assist.) | $2,664.10 75% benefit $1,998.10 |
| 34163 | AORTO-DUODENAL FISTULA, repair of, by insertion of aortic graft and repair of duodenum (Anaes.) (Assist.) | $3,420.15 75% benefit $2,565.15 |
| 34166 | AORTO-DUODENAL FISTULA, repair of, by oversewing of abdominal aorta, repair of duodenum and axillo-bifemoral grafting (Anaes.) (Assist.) | $3,420.15 75% benefit $2,565.15 |
| 34169 | INFECTED BYPASS GRAFT FROM TRUNK, excision of, including closure of arteries (Anaes.) (Assist.) | $1,899.30 75% benefit $1,424.50 |
| 34172 | INFECTED AXILLO-FEMORAL OR FEMORO-FEMORAL GRAFT, excision of, including closure of arteries (Anaes.) (Assist.) | $1,548.10 75% benefit $1,161.10 |
| 34175 | INFECTED BYPASS GRAFT FROM EXTREMITIES, excision of including closure of arteries (Anaes.) (Assist.) | $1,422.15 75% benefit $1,066.65 |
| 34500 | Arteriovenous shunt, external, insertion of (H) (Anaes.) (Assist.) | $369.20 75% benefit $276.90 |
| 34503 | ARTERIOVENOUS ANASTOMOSIS OF UPPER OR LOWER LIMB, in conjunction with another venous or arterial operation (Anaes.) (Assist.) | $495.00 75% benefit $371.25 |
| 34506 | ARTERIOVENOUS SHUNT, EXTERNAL, removal of (Anaes.) (Assist.) | $251.85 75% benefit $188.90 |
| 34509 | ARTERIOVENOUS ANASTOMOSIS OF UPPER OR LOWER LIMB, not in conjunction with another venous or arterial operation (Anaes.) (Assist.) | $1,170.00 75% benefit $877.50 |
| 34512 | ARTERIOVENOUS ACCESS DEVICE, insertion of (Anaes.) (Assist.) | $1,287.20 75% benefit $965.40 |
| 34515 | ARTERIOVENOUS ACCESS DEVICE, thrombectomy of (Anaes.) (Assist.) | $917.95 75% benefit $688.50 |
| 34518 | STENOSIS OF ARTERIOVENOUS FISTULA OR PROSTHETIC ARTERIOVENOUS ACCESS DEVICE, correction of (Anaes.) (Assist.) | $1,538.95 75% benefit $1,154.25 |
| 34521 | INTRA-ABDOMINAL ARTERY OR VEIN, cannulation of, for infusion chemotherapy, by open operation (excluding aftercare) (Anaes.) (Assist.) | $945.55 75% benefit $709.20 |
| 34524 | ARTERIAL CANNULATION for infusion chemotherapy by open operation, not being a service to which item 34521 applies (excluding after-care) (Anaes.) (Assist.) | $495.00 75% benefit $371.25 |
| 34527 | Central vein catheterisation by open technique, using subcutaneous tunnel with pump or access port as with central venous line catheter or other chemotherapy delivery device, including any associated percutaneous central vein catheterisation, on a patient 10 years of age or over (H) (Anaes.) | $660.25 75% benefit $495.20 |
| 34528 | Central vein catheterisation by percutaneous technique, using subcutaneous tunnel with pump or access port as with central venous line catheter or other chemotherapy delivery device, on a patient 10 years of age or over (H) (Anaes.) | $326.05 75% benefit $244.55 |
| 34529 | Central vein catheterisation by open technique, using subcutaneous tunnel with pump or access port as with central venous line catheter or other chemotherapy delivery device, including any associated percutaneous central vein catheterisation, on a patient under 10 years of age (H) (Anaes.) | $858.35 75% benefit $643.80 |
| 34530 | Central venous line, or other chemotherapy device, removal of, by open surgical procedure in the operating theatre of a hospital, on a patient 10 years of age or over (H) (Anaes.) | $244.40 75% benefit $183.30 |
| 34533 | Isolated limb perfusion, including cannulation of artery and vein at commencement of procedure, regional perfusion for chemotherapy, or other therapy, repair of arteriotomy and venotomy at conclusion of procedure (excluding after‑care) (H) (Anaes.) (Assist.) | $1,484.90 75% benefit $1,113.70 |
| 34534 | Central vein catheterisation by percutaneous technique, using subcutaneous tunnel with pump or access port as with central venous line catheter or other chemotherapy delivery device, on a patient under 10 years of age (H) (Anaes.) | $423.90 75% benefit $317.95 |
| 34538 | Central vein catheterisation by percutaneous technique, using subcutaneous tunnelled cuffed catheter or similar device, for the administration of haemodialysis or parenteral nutrition (H) (Anaes.) | $326.05 75% benefit $244.55 |
| 34539 | TUNNELLED CUFFED CATHETER, OR SIMILAR DEVICE, removal of, by open surgical procedure (Anaes.) | $244.40 75% benefit $183.30 85% benefit $207.75 |
| 34540 | Central venous line, or other chemotherapy device, removal of, by open surgical procedure in the operating theatre of a hospital, on a patient under 10 years of age (H) (Anaes.) | $317.75 75% benefit $238.35 |
| 34800 | Inferior vena cava, plication, ligation, or application of caval clip (H) (Anaes.) (Assist.) | $972.10 75% benefit $729.10 |
| 34803 | INFERIOR VENA CAVA, reconstruction of or bypass by vein or synthetic material (Anaes.) (Assist.) | $2,142.30 75% benefit $1,606.75 |
| 34806 | CROSS LEG BYPASS GRAFTING, saphenous to iliac or femoral vein (Anaes.) (Assist.) | $1,160.95 75% benefit $870.75 |
| 34809 | SAPHENOUS VEIN ANASTOMOSIS to femoral or popliteal vein for femoral vein bypass (Anaes.) (Assist.) | $1,160.95 75% benefit $870.75 |
| 34812 | VENOUS STENOSIS OR OCCLUSION, vein bypass for, using vein or synthetic material, not being a service associated with a service to which item 34806 or 34809 applies (Anaes.) (Assist.) | $1,404.05 75% benefit $1,053.05 |
| 34815 | VEIN STENOSIS, patch angioplasty for, (excluding vein graft stenosis)-using vein or synthetic material (Anaes.) (Assist.) | $1,160.95 75% benefit $870.75 |
| 34818 | VENOUS VALVE, plication or repair to restore valve competency (Anaes.) (Assist.) | $1,278.10 75% benefit $958.60 |
| 34821 | Vein transplant to restore valvular function (H) (Anaes.) (Assist.) | $1,737.15 75% benefit $1,302.90 |
| 34824 | EXTERNAL STENT, application of, to restore venous valve competency to superficial vein - 1 stent (Anaes.) (Assist.) | $593.95 75% benefit $445.50 |
| 34827 | EXTERNAL STENTS, application of, to restore venous valve competency to superficial vein or veins - more than 1 stent (Anaes.) (Assist.) | $720.15 75% benefit $540.15 |
| 34830 | External stent, application of, to restore venous valve competency to deep vein—one stent (H) (Anaes.) (Assist.) | $846.15 75% benefit $634.65 |
| 34833 | EXTERNAL STENTS, application of, to restore venous valve competency to deep vein or veins (more than 1 stent) (Anaes.) (Assist.) | $1,098.05 75% benefit $823.55 |
| 35000 | Lumbar sympathectomy (H) (Anaes.) (Assist.) | $846.15 75% benefit $634.65 |
| 35003 | CERVICAL OR UPPER THORACIC SYMPATHECTOMY by any surgical approach (Anaes.) (Assist.) | $1,098.05 75% benefit $823.55 |
| 35006 | CERVICAL OR UPPER THORACIC SYMPATHECTOMY, where operation is a reoperation for previous incomplete sympathectomy by any surgical approach (Anaes.) (Assist.) | $1,377.15 75% benefit $1,032.90 |
| 35009 | LUMBAR SYMPATHECTOMY, where operation is following chemical sympathectomy or for previous incomplete surgical sympathectomy (Anaes.) (Assist.) | $1,070.90 75% benefit $803.20 |
| 35012 | SACRAL or PRE-SACRAL SYMPATHECTOMY (Anaes.) (Assist.) | $846.15 75% benefit $634.65 |
| 35100 | ISCHAEMIC LIMB, debridement of necrotic material, gangrenous tissue, or slough in, in the operating theatre of a hospital, when debridement includes muscle, tendon or bone (Anaes.) (Assist.) | $441.15 75% benefit $330.90 |
| 35103 | ISCHAEMIC LIMB, debridement of necrotic material, gangrenous tissue, or slough in, in the operating theatre of a hospital, superficial tissue only (Anaes.) | $280.75 75% benefit $210.60 |
| 35200 | OPERATIVE ARTERIOGRAPHY OR VENOGRAPHY, 1 or more of, performed during the course of an operative procedure on an artery or vein, 1 site (Anaes.) | $205.30 75% benefit $154.00 |
| 35202 | MAJOR ARTERIES OR VEINS IN THE NECK, ABDOMEN OR EXTREMITIES, access to, as part of RE-OPERATION after prior surgery on these vessels (Anaes.) (Assist.) | $978.00 75% benefit $733.50 |
| 35300 | Transluminal balloon angioplasty of one peripheral artery or vein of one limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.) | $616.85 75% benefit $462.65 |
| 35303 | Transluminal balloon angioplasty of aortic arch branches, aortic visceral branches, or more than one peripheral artery or vein of one limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after‑care (H) (Anaes.) (Assist.) | $790.85 75% benefit $593.15 |
| 35306 | Transluminal stent insertion, one or more stents, including associated balloon dilatation for one peripheral artery or vein of one limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.) | $730.00 75% benefit $547.50 |
| 35307 | TRANSLUMINAL STENT INSERTION, 1 or more stents (not drug-eluting), with or without associated balloon dilatation, for 1 carotid artery, percutaneous (not direct), with or without the use of an embolic protection device, in patients who: - meet the indications for carotid endarterectomy; and - have medical or surgical comorbidities that would make them at high risk of perioperative complications from carotid endarterectomy, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.) | $1,341.90 75% benefit $1,006.45 |
| 35309 | Transluminal stent insertion, one or more stents, including associated balloon dilatation for visceral arteries or veins, or more than one peripheral artery or vein of one limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.) | $912.40 75% benefit $684.30 |
| 35312 | PERIPHERAL ARTERIAL ATHERECTOMY including associated balloon dilatation of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.) | $1,034.15 75% benefit $775.65 |
| 35315 | PERIPHERAL LASER ANGIOPLASTY including associated balloon dilatation of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.) | $1,034.15 75% benefit $775.65 |
| 35317 | PERIPHERAL ARTERIAL OR VENOUS CATHETERISATION with administration of thrombolytic or chemotherapeutic agents, BY CONTINUOUS INFUSION, using percutaneous approach, excluding associated radiological services or preparation, and excluding aftercare (not being a service associated with a service to which another item in Subgroup 11 of Group T1 or items 35319 or 35320 applies and not being a service associated with photodynamic therapy with verteporfin) (Anaes.) (Assist.) | $425.85 75% benefit $319.40 85% benefit $362.00 |
| 35319 | Peripheral arterial or venous catheterisation with administration of thrombolytic or chemotherapeutic agents, by pulse spray technique, using percutaneous approach, excluding associated radiological services or preparation, and excluding after-care (other than a service associated with a service to which an item in Subgroup 11 of Group T1 or item 35317 or 35320 applies, or associated with photodynamic therapy with verteporfin) (H) (Anaes.) (Assist.) | $763.30 75% benefit $572.50 |
| 35320 | Peripheral arterial or venous catheterisation with administration of thrombolytic or chemotherapeutic agents, by open exposure, excluding associated radiological services or preparation, and excluding after-care (other than a service associated with a service to which an item in Subgroup 11 of Group T1 or item 35317 or 35319 applies, or associated with photodynamic therapy with verteporfin) (H) (Anaes.) (Assist.) | $1,025.35 75% benefit $769.05 |
| 35321 | Peripheral arterial or venous catheterisation to administer agents to occlude arteries, veins or arterio-venous fistulae or to arrest haemorrhage (but not for the treatment of uterine fibroids or varicose veins), percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (other than a service associated with photodynamic therapy with verteporfin) (H) (Anaes.) (Assist.) | $973.45 75% benefit $730.10 |
| 35324 | ANGIOSCOPY not combined with any other procedure, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.) | $365.05 75% benefit $273.80 |
| 35327 | ANGIOSCOPY combined with any other procedure, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.) | $489.25 75% benefit $366.95 |
| 35330 | Insertion of inferior vena caval filter, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.) | $616.85 75% benefit $462.65 |
| 35331 | RETRIEVAL OF INFERIOR VENA CAVAL FILTER, percutaneous or by open exposure, not including associated radiological services or preparation, and not including aftercare (Anaes.) | $709.15 75% benefit $531.90 |
| 35360 | Retrieval of foreign body in PULMONARY ARTERY, percutaneous or by open exposure, not including associated radiological services or preparation, and not including aftercare (foreign body does not include an instrument inserted for the purpose of a service being rendered) (Anaes.) (Assist.) | $991.25 75% benefit $743.45 |
| 35361 | Retrieval of foreign body in RIGHT ATRIUM, percutaneous or by open exposure, not including associated radiological services or preparation, and not including aftercare (foreign body does not include an instrument inserted for the purpose of a service being rendered) (Anaes.) (Assist.) | $850.10 75% benefit $637.60 |
| 35362 | Retrieval of foreign body in INFERIOR VENA CAVA or AORTA, percutaneous or by open exposure, not including associated radiological services or preparation, and not including aftercare (foreign body does not include an instrument inserted for the purpose of a service being rendered) (Anaes.) (Assist.) | $709.15 75% benefit $531.90 |
| 35363 | Retrieval of foreign body in PERIPHERAL VEIN or PERIPHERAL ARTERY, percutaneous or by open exposure, not including associated radiological services or preparation, and not including aftercare (foreign body does not include an instrument inserted for the purpose of a service being rendered) (Anaes.) (Assist.) | $568.15 75% benefit $426.15 |
| 35401 | Vertebroplasty, for one or more fractures in one or more vertebrae, for the treatment of a painful osteoporotic thoracolumbar vertebral compression fracture of the thoracolumbar spinal segment (T11, T12, L1 or L2), if: (a) the service is performed by a specialist or consultant physician practicing in the specialist's or consultant physician's speciality of diagnostic radiology, neurosurgery, neurology or orthopaedic surgery; and (b) the specialist or consultant physician has undertaken appropriate training in the vertebroplasty procedure; and (c) pain is severe (numeric rated pain score greater than or equal to 7 out of 10); and (d) the symptoms are poorly controlled by opiate therapy; and (e) the severe pain duration is 3 weeks or less; and (f) there is MRI (or SPECT‑CT if MRI unavailable) evidence of acute vertebral fracture Applicable only once for the same fracture, but is applicable for a new fracture of the same vertebra or vertebrae (H) (Anaes.) | $817.25 75% benefit $612.95 |
| 35404 | DOSIMETRY, HANDLING AND INJECTION OF SIR-SPHERES for selective internal radiation therapy of hepatic metastases which are secondary to colorectal cancer and are not suitable for resection or ablation, used in combination with systemic chemotherapy using 5-fluorouracil (5FU) and leucovorin, not being a service to which item 35317, 35319, 35320 or 35321 applies The procedure must be performed by a specialist or consultant physician recognised in the specialties of nuclear medicine or radiation oncology on an admitted patient in a hospital. To be claimed once in the patient's lifetime only. | $414.85 75% benefit $311.15 |
| 35406 | Trans-femoral catheterisation of the hepatic artery to administer SIR-Spheres to embolise the microvasculature of hepatic metastases which are secondary to colorectal cancer and are not suitable for resection or ablation, for selective internal radiation therapy used in combination with systemic chemotherapy using 5-fluorouracil (5FU) and leucovorin, not being a service to which item 35317, 35319, 35320 or 35321 applies excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.) | $973.45 75% benefit $730.10 |
| 35408 | Catheterisation of the hepatic artery via a permanently implanted hepatic artery port to administer SIR-Spheres to embolise the microvasculature of hepatic metastases which are secondary to colorectal cancer and are not suitable for resection or ablation, for selective internal radiation therapy used in combination with systemic chemotherapy using 5-fluorouracil (5FU) and leucovorin, not being a service to which item 35317, 35319, 35320 or 35321 applies excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.) | $730.20 75% benefit $547.65 |
| 35410 | Uterine artery catheterisation with percutaneous administration of occlusive agents, for the treatment of symptomatic uterine fibroids in a patient who has been referred for uterine artery embolisation by a specialist gynaecologist, excluding associated radiological services or preparation, and excluding aftercare (H) (Anaes.) (Assist.) | $973.45 75% benefit $730.10 |
| 35412 | Intracranial aneurysm, ruptured or unruptured, endovascular occlusion with detachable coils, and assisted coiling (if performed), with parent artery preservation, not for use with liquid embolics only, including intra‑operative imaging, but in association with pre‑operative diagnostic imaging under item 60009 and one of items 60072, 60075 and 60078, including aftercare (H) (Anaes.) (Assist.) | $3,420.15 75% benefit $2,565.15 |
| 35414 | Mechanical thrombectomy, in a patient with a diagnosis of acute ischaemic stroke caused by occlusion of a large vessel of the anterior cerebral circulation, including intra-operative imaging and aftercare, if: (a) the diagnosis is confirmed by an appropriate imaging modality such as computed tomography, magnetic resonance imaging or angiography; and (b) the service is performed by a specialist or consultant physician with appropriate training that is recognised by the Conjoint Committee for Recognition of Training in Interventional Neuroradiology; and (c) the service is provided in an eligible stroke centre. For any particular patient - applicable once per presentation by the patient at an eligible stroke centre, regardless of the number of times mechanical thrombectomy is attempted during that presentation (Anaes.) (Assist.) | $4,189.15 75% benefit $3,141.90 |
| 35500 | Gynaecological examination under anaesthesia, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $97.30 75% benefit $73.00 |
| 35501 | A medical service to which item 35503, 35506, 14206 or 30062 applies, if the service is bulk‑billed in relation to the fees for: (a) that item; and (b) any other item in this Schedule applying to the service Derived fee: 40% of the fee for the co-claimed service - performed in conjunction with a service (the co-claimed service) to which any of items 35503, 35506, 14206 and/or 30062 apply. | Derived |
| 35503 | Introduction of an intra-uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy, if the service is not associated with a service to which another item in this Group applies (other than a service described in item 30062, 35501, 35506 or 35620) (Anaes.) | $221.55 75% benefit $166.20 85% benefit $188.35 |
| 35506 | Intra-uterine device, removal of under general anaesthesia, for a retained or embedded device, not being a service associated with a service to which another item in this Group applies (other than a service described in item 35501 or 35503) (H) (Anaes.) | $137.95 75% benefit $103.50 |
| 35507 | Vulval or vaginal warts, removal of under general anaesthesia, or under regional or field nerve block (excluding pudendal block), if the time taken is less than or equal to 45 minutes—other than a service associated with a service to which item 32236 applies (H) (Anaes.) | $208.75 75% benefit $156.60 |
| 35508 | Vulval or vaginal warts, removal of under general anaesthesia, or under regional or field nerve block (excluding pudendal block), if the time taken is greater than 45 minutes—other than a service associated with a service to which item 32236 applies (H) (Anaes.) (Assist.) | $307.60 75% benefit $230.70 |
| 35509 | HYMENECTOMY (Anaes.) | $107.10 75% benefit $80.35 85% benefit $91.05 |
| 35513 | Bartholin's abscess, cyst or gland, excision of (Anaes.) | $265.35 75% benefit $199.05 85% benefit $225.55 |
| 35517 | Bartholin's abscess, cyst or gland, marsupialisation of (Anaes.) | $174.85 75% benefit $131.15 85% benefit $148.65 |
| 35518 | Ovarian cyst aspiration, for cysts of at least 4 cm in diameter in a premenopausal patient and at least 2 cm in diameter in a postmenopausal patient, by abdominal or vaginal route, using interventional imaging techniques and not associated with services provided for assisted reproductive techniques, and not in cases of suspected or possible malignancy (Anaes.) | $248.80 75% benefit $186.60 85% benefit $211.50 |
| 35527 | Urethral caruncle, symptomatic excision of, if: (a) conservative management has failed; or (b) there is a suspicion of malignancy (H) (Anaes.) | $174.85 75% benefit $131.15 |
| 35533 | Vulvoplasty or labioplasty, for repair of: (a) female genital mutilation; or (b) an anomaly associated with a major congenital anomaly of the uro-gynaecological tract other than a service associated with a service to which item 35536, 37836, 37050, 37842, 37851 or 43882 applies (Anaes.) | $418.70 75% benefit $314.05 |
| 35534 | Vulvoplasty or labioplasty, in a patient aged 18 years or more, performed by a specialist in the practice of the specialist's specialty, for a structural abnormality that is causing significant functional impairment, if the patient's labium extends more than 8 cm below the vaginal introitus while the patient is in a standing resting position (Anaes.) | $418.70 75% benefit $314.05 |
| 35536 | Vulva, wide local excision or hemivulvectomy, one or both procedures, for suspected malignancy or vulval lesions with a high risk of malignancy (H) (Anaes.) (Assist.) | $417.05 75% benefit $312.80 |
| 35539 | Colposcopically directed laser therapy for histologically-confirmed high grade intraepithelial neoplastic changes of the vagina, vulva, urethra or anal canal, including any associated biopsies—one anatomical site (Anaes.) | $326.70 75% benefit $245.05 85% benefit $277.70 |
| 35545 | Colposcopically directed laser therapy for condylomata, unsuccessfully treated by other methods (Anaes.) | $219.70 75% benefit $164.80 85% benefit $186.75 |
| 35548 | VULVECTOMY, radical, for malignancy (H) (Anaes.) (Assist.) | $1,497.40 75% benefit $1,123.05 |
| 35551 | Pelvic lymph nodes, radical excision of, unilateral, or sentinel node dissection (including any pre-operative injection) (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 35552 | Pelvic lymph nodes, radical excision of, unilateral or sentinel node dissection, following similar previous dissection, radiation or chemotherapy (H) (Anaes.) (Assist.) | $1,665.05 75% benefit $1,248.80 |
| 35554 | VAGINA, DILATATION OF, as an independent procedure including any associated consultation (Anaes.) | $52.00 75% benefit $39.00 85% benefit $44.20 |
| 35557 | Vagina, complete excision of benign tumour (including Gartner duct cyst), with histological documentation (Anaes.) | $256.65 75% benefit $192.50 85% benefit $218.20 |
| 35560 | Partial or complete vaginectomy, for either or both of the following:(a) deeply infiltrating vaginal endometriosis, if accompanied by histological confirmation from excised tissue;(b) pre-invasive or invasive lesions Not being a service associated with hysterectomy for non invasive indications (H) (Anaes.) (Assist.) | $818.60 75% benefit $613.95 |
| 35561 | VAGINECTOMY, radical, for proven invasive malignancy - 1 surgeon (H) (Anaes.) (Assist.) | $1,837.25 75% benefit $1,377.95 |
| 35562 | VAGINECTOMY, radical, for proven invasive malignancy, conjoint surgery - abdominal surgeon (including aftercare) (H) (Anaes.) (Assist.) | $1,547.75 75% benefit $1,160.85 |
| 35564 | VAGINECTOMY, radical, for proven invasive malignancy, conjoint surgery - perineal surgeon (H) (Assist.) | $773.90 75% benefit $580.45 |
| 35565 | VAGINAL RECONSTRUCTION for congenital absence, gynatresia or urogenital sinus (Anaes.) (Assist.) | $818.60 75% benefit $613.95 |
| 35566 | VAGINAL SEPTUM, excision of, for correction of double vagina (Anaes.) (Assist.) | $475.45 75% benefit $356.60 |
| 35568 | Procedures for the management of symptomatic upper vaginal (vault or cervical) prolapse by sacrospinous or ilococcygeus fixation (H) (Anaes.) (Assist.) | $747.55 75% benefit $560.70 |
| 35569 | PLASTIC REPAIR TO ENLARGE VAGINAL ORIFICE (Anaes.) | $192.55 75% benefit $144.45 |
| 35570 | Anterior vaginal compartment repair by vaginal approach for pelvic organ prolapse: (a) involving repair of urethrocele and cystocele; and (b) using native tissue without graft; other than a service associated with a service to which item 35573, 35577 or 35578 applies (Anaes.) (Assist.) | $662.95 75% benefit $497.25 |
| 35571 | Posterior vaginal compartment repair by vaginal approach for pelvic organ prolapse: (a) involving repair of one or more of the following: (i) perineum; (ii) rectocoele; (iii) enterocoele; and (b) using native tissue without graft; other than a service associated with a service to which item 35573, 35577 or 35578 applies (Anaes.) (Assist.) | $662.95 75% benefit $497.25 |
| 35573 | Anterior and posterior vaginal compartment repair by vaginal approach for pelvic organ prolapse: (a) involving anterior and posterior compartment defects; and (b) using native tissue without graft; other than a service associated with a service to which item 35577 or 35578 applies (Anaes.) (Assist.) | $994.45 75% benefit $745.85 |
| 35577 | Manchester (Donald Fothergill) operation for pelvic organ prolapse, involving either or both of the following: (a) cervical amputation; (b) anterior and posterior native tissue vaginal wall repairs without graft (Anaes.) (Assist.) | $807.35 75% benefit $605.55 |
| 35578 | Colpocleisis for pelvic organ prolapse, not being a service associated with a service to which another item (other than item 35599) in this Subgroup applies (H) (Anaes.) (Assist.) | $807.35 75% benefit $605.55 |
| 35581 | Vaginal procedure for excision of graft material in symptomatic patients with graft related complications (including graft related pain or discharge and bleeding related to graft exposure), less than 2cm2 in its maximum area, either singly or in multiple pieces, other than a service associated with a service to which item 35582 or 35585 applies (Anaes.) (Assist.) | $662.95 75% benefit $497.25 |
| 35582 | Vaginal procedure for excision of graft material in symptomatic patients with graft related complications (including graft related pain or discharge and bleeding related to graft exposure), 2cm2 or more in its maximum area, either singly or in multiple pieces, other than a service associated with a service to which item 35581 or 35585 applies (Anaes.) (Assist.) | $994.45 75% benefit $745.85 |
| 35585 | Abdominal procedure, by open, laparoscopic or robot‑assisted approach, if the service: (a) is for the removal of graft material: (i) in symptomatic patients with graft related complications (including graft related pain or discharge and bleeding related to graft exposure); or (ii) where the graft has penetrated adjacent organs such as the bladder (including urethra) or bowel; and (b) if required—includes retroperitoneal dissection, and mobilisation, of either or both of the bladder and bowel; other than a service associated with a service to which item 35581 or 35582 applies (Anaes.) (Assist.) | $1,763.25 75% benefit $1,322.45 |
| 35591 | Rectovaginal fistula repair of, by vaginal route approach, not being a service associated with a service to which item 35592, 35596, 37029, 37333 or 37336 applies (H) (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 35592 | Vesicovaginal fistula closure of, by vaginal approach, not being a service associated with a service to which item 35591, 35596, 37029, 37333 or 37336 applies (H) (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 35595 | Procedure for the management of symptomatic vaginal vault or cervical prolapse, by uterosacral ligament suspension, by any approach, without graft, if the uterosacral ligaments are separately identified, transfixed and then incorporated into rectovaginal and pubocervical fascia of the vaginal vault, including cystoscopy to check ureteric integrity (H) (Anaes.) (Assist.) | $747.55 75% benefit $560.70 |
| 35596 | Fistula between genital and urinary or alimentary tracts, repair of, other than a service to which item 35591, 35592, 37029, 37333 or 37336 applies (H) (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 35597 | Sacral colpopexy, by any approach where graft or mesh is secured to vault, anterior and posterior compartments and to sacrum for correction of symptomatic upper vaginal vault prolapse (H) (Anaes.) (Assist.) | $1,763.25 75% benefit $1,322.45 |
| 35599 | Stress incontinence, procedure using a female synthetic mid-urethral sling, with diagnostic cystoscopy to assess the integrity of the lower urinary tract, other than a service associated with a service to which item 36812 applies (H) (Anaes.) (Assist.) | $907.10 75% benefit $680.35 |
| 35608 | Cervix, one or more biopsies, cauterisation (other than by chemical means), ionisation, diathermy or endocervical curettage of, with or without dilatation of cervix (Anaes.) | $76.55 75% benefit $57.45 85% benefit $65.10 |
| 35609 | Cervix, cone biopsy or amputation (H) (Anaes.) | $260.90 75% benefit $195.70 |
| 35610 | Cervix, cone biopsy for histologically proven malignancy (H) (Anaes.) | $456.60 75% benefit $342.45 |
| 35611 | Removal of cervical or vaginal polyp or polypi, with or without dilatation of cervix, not being a service associated with a service to which item 35608 applies (Anaes.) | $76.55 75% benefit $57.45 85% benefit $65.10 |
| 35612 | Cervix, residual stump, removal of, by abdominal approach for non-malignant lesions (H) (Anaes.) (Assist.) | $605.60 75% benefit $454.20 |
| 35614 | Examination of the lower genital tract using a colposcope in a patient who:(a) has a human papilloma virus related gynaecology indication; or(b) has symptoms or signs suspicious of lower genital tract malignancy; or(c) is undergoing follow-up treatment of lower genital tract malignancy; or(d) is undergoing assessment or surveillance of a vulvovaginal pre-malignant or malignant disease; or(e) is undergoing assessment or surveillance as part of an identified at risk population | $76.45 75% benefit $57.35 85% benefit $65.00 |
| 35615 | Vulva or vagina, biopsy of, when performed in conjunction with a service to which item 35614 applies | $84.25 75% benefit $63.20 85% benefit $71.65 |
| 35616 | Endometrial ablation by thermal balloon or radiofrequency electrosurgery, for abnormal uterine bleeding, with or without endometrial sampling, including any hysteroscopy performed on the same day (H) (Anaes.) | $538.10 75% benefit $403.60 |
| 35620 | Endometrial biopsy for pathological assessment in women with abnormal uterine bleeding or post-menopausal bleeding (Anaes.) | $63.85 75% benefit $47.90 85% benefit $54.30 |
| 35622 | Endometrial ablation, using hysteroscopically guided electrosurgery or laser energy for abnormal uterine bleeding, with or without endometrial sampling, not being a service associated with a service to which item 30390 applies (H) (Anaes.) | $721.10 75% benefit $540.85 |
| 35623 | Endometrial ablation and resection of myoma or uterine septum (or both), using hysteroscopic guided electrosurgery or laser energy, for abnormal uterine bleeding, with or without endometrial sampling (H) (Anaes.) | $980.60 75% benefit $735.45 |
| 35626 | Hysteroscopy for investigation of suspected intrauterine pathology, with or without local anaesthesia, including any associated endometrial biopsy, not being a service associated with a service to which item 35630 applies | $268.25 75% benefit $201.20 85% benefit $228.05 |
| 35630 | Hysteroscopy for investigation of suspected intrauterine pathology if performed under general anaesthesia, including any associated endometrial biopsy, not being a service associated with a service to which item 35626 applies (H) (Anaes.) | $219.05 75% benefit $164.30 |
| 35631 | Operative laparoscopy, including any of the following:(a) unilateral or bilateral ovarian cystectomy;(b) salpingo-oophorectomy;(c) salpingectomy for tubal pathology (including ectopic pregnancy by tubal removal or salpingostomy, but excluding sterilisation);(d) excision of mild endometriosis;not being a service associated with a service to which any other intraperitoneal or retroperitoneal procedure item (other than item 30724 or 30725) applies (H) (Anaes.) (Assist.) | $851.65 75% benefit $638.75 |
| 35632 | Complicated operative laparoscopy, including either or both of the following:(a) excision of moderate endometriosis;(b) laparoscopic myomectomy for a myoma of at least 4cm, including incision and repair of the uterus;not being a service associated with a service to which any other intraperitoneal or retroperitoneal procedure item (other than item 30724 or 30725 or 35658) applies (H) (Anaes.) (Assist.) | $1,064.40 75% benefit $798.30 |
| 35633 | Hysteroscopy, under visual guidance, including any of the following:(a) removal of an intra-uterine device;(b) removal of polyps by any method;(c) division of minor intrauterine adhesions (Anaes.) | $260.90 75% benefit $195.70 85% benefit $221.80 |
| 35635 | Hysteroscopy involving division of:(a) a uterine septum; or(b) moderate to severe intrauterine adhesions (H) (Anaes.) | $358.50 75% benefit $268.90 |
| 35636 | Hysteroscopy, resection of myoma or myoma and uterine septum (if both are performed) (H) (Anaes.) | $518.30 75% benefit $388.75 |
| 35637 | Operative laparoscopy, including any of the following: (a) excision or ablation of minimal endometriosis; (b) division of pathological adhesions; (c) sterilisation by application of clips, division, destruction or removal of tubes; not being a service associated with another laparoscopic procedure (H) NOTE: Strict legal requirements apply in relation to sterilisation procedures on minors. Medicare benefits are not payable for services not rendered in accordance with relevant Commonwealth and State and Territory law. Observe the explanatory note before submitting a claim. (Anaes.) (Assist.) | $486.65 75% benefit $365.00 |
| 35640 | Uterus, curettage of, with or without dilation (including curettage for incomplete miscarriage), if performed under:(a) general anaesthesia; or(b) epidural or spinal (intrathecal) nerve block; or(c) sedation;including procedures (if performed) to which item 35626 or 35630 applies (Anaes.) | $219.05 75% benefit $164.30 85% benefit $186.20 |
| 35641 | Severe endometriosis, laparoscopic resection of, involving 2 of the following procedures:(a) resection of the pelvic side wall including dissection of endometriosis or scar tissue from the ureter;(b) resection of the Pouch of Douglas; (c) resection of an ovarian endometrioma greater than 2 cm in diameter;(d) dissection of bowel from uterus from the level of the endocervical junction or above (H) (Anaes.) (Assist.) | $1,487.40 75% benefit $1,115.55 |
| 35643 | Evacuation of the contents of the gravid uterus by curettage or suction curettage, if performed under:(a) local anaesthesia; or(b) general anaesthesia; or(c) epidural or spinal (intrathecal) nerve block; or(d) sedation;including procedures (if performed) to which item 35626 or 35630 applies (Anaes.) | $260.90 75% benefit $195.70 85% benefit $221.80 |
| 35644 | Cervix, ablation by electrocoagulation diathermy, laser or cryotherapy, with colposcopy, including any local anaesthesia and biopsies, for previously biopsy confirmed HSIL (CIN 2/3) in a patient with a Type 1 or 2 (completely visible) transformation zone, if there is:(a) no evidence of invasive or glandular disease; and(b) no discordance between cytology and previous histology;not being a service associated with a service to which item 35647 or 35648 applies (Anaes.) | $243.75 75% benefit $182.85 85% benefit $207.20 |
| 35645 | Cervix, ablation by electrocoagulation diathermy, laser or cryotherapy, with colposcopy, including any local anaesthesia or biopsies, in conjunction with ablative therapy of additional areas of biopsy proven high grade intraepithelial lesions of one or more sites of the vagina, vulva, urethra or anus, for previously biopsy confirmed HSIL (CIN2/3) in a patient with a Type 1 of 2 (completely visible) transformation zone, if there is:(a) no evidence of invasive or glandular disease; and(b) no discordance between cytology and previous histology;not being a service associated with a service to which item 35647 or 35648 applies (Anaes.) | $381.45 75% benefit $286.10 85% benefit $324.25 |
| 35647 | Cervix, complete excision of the endocervical transformation zone, using large loop or laser therapy, including any local anaesthesia and biopsies (Anaes.) | $243.75 75% benefit $182.85 85% benefit $207.20 |
| 35648 | Cervix, complete excision of the endocervical transformation zone, using large loop or laser therapy, including any local anaesthesia and biopsies, in conjunction with ablative treatment of additional areas of biopsy-proven high grade intraepithelial lesions of one or more sites of the vagina, vulva, urethra or anus (Anaes.) | $381.45 75% benefit $286.10 85% benefit $324.25 |
| 35649 | Myomectomy, one or more myomas, when undertaken by an open abdominal approach (H) (Anaes.) (Assist.) | $641.50 75% benefit $481.15 |
| 35653 | Hysterectomy, abdominal, with or without removal of fallopian tubes and ovaries (H) (Anaes.) (Assist.) | $807.60 75% benefit $605.70 |
| 35657 | Hysterectomy, vaginal, with or without uterine curettage, inclusive of posterior culdoplasty, not being a service associated with a service to which item 35673 applies (H) (Anaes.) (Assist.) | $807.60 75% benefit $605.70 |
| 35658 | Uterus (at least equivalent in size to a 10 week gravid uterus), debulking of, prior to vaginal or laparoscopic removal at hysterectomy or myoma of at least 4 cm removed by laparoscopy when retrieved from the abdomen (H) (Anaes.) (Assist.) | $498.05 75% benefit $373.55 |
| 35661 | Hysterectomy, abdominal, that concurrently requires extensive retroperitoneal dissection with exposure of one or both ureters and complex side wall dissection, including when performed with one or more of the following procedures:(a) salpingectomy;(b) oophorectomy;(c) excision of ovarian cyst(H) (Anaes.) (Assist.) | $2,019.20 75% benefit $1,514.40 |
| 35667 | Radical hysterectomy or radical trachelectomy (with or without excision of uterine adnexae) for proven malignancy, including excision of any one or more of the following:(a) parametrium;(b) paracolpos;(c) upper vagina;(d) contiguous pelvic peritoneum;utilising nerve sparing techniques and involving ureterolysis, if performed (H) (Anaes.) (Assist.) | $1,907.25 75% benefit $1,430.45 |
| 35668 | Hysterectomy, radical (with or without excision of uterine adnexae) including excision of any one or more of the following:(a) parametrium;(b) paracolpos;(c) upper vagina;(d) contiguous pelvic peritoneum;utilising nerve sparing techniques and involving ureterolysis, if performed in a patient with malignancy and previous pelvic radiation or chemotherapy treatment (H) (Anaes.) (Assist.) | $2,215.80 75% benefit $1,661.85 |
| 35669 | Hysterectomy, peripartum, performed for histologically proven placenta increta or percreta, or placenta accreta, if the patient has been referred to another practitioner for the management of severe intractable peripartum haemorrhage (H) (Anaes.) (Assist.) | $2,215.80 75% benefit $1,661.85 |
| 35671 | Hysterectomy, peripartum, for ongoing intractable haemorrhage where other haemorrhage control techniques have failed, for the purpose of providing lifesaving emergency treatment, not being a service associated with a service to which item 35667, 35668 or 35669 applies (H) (Anaes.) (Assist.) | $1,738.20 75% benefit $1,303.65 |
| 35673 | Hysterectomy, vaginal, with or without uterine curettage, with salpingectomy, oophorectomy or excision of ovarian cyst, one or more, one or both sides, inclusive of a posterior culdoplasty, not being a service associated with a service to which item 35657 applies (H) (Anaes.) (Assist.) | $907.00 75% benefit $680.25 |
| 35674 | Ultrasound guided needling and injection of ectopic pregnancy (H) | $248.80 75% benefit $186.60 |
| 35680 | Bicornuate uterus, plastic reconstruction for (H) (Anaes.) (Assist.) | $696.60 75% benefit $522.45 |
| 35691 | STERILISATION BY INTERRUPTION OF FALLOPIAN TUBES, when performed in conjunction with Caesarean section NOTE: Strict legal requirements apply in relation to sterilisation procedures on minors. Medicare benefits are not payable for services not rendered in accordance with relevant Commonwealth and State and Territory law. Observe the explantory note before submitting a claim. (Anaes.) (Assist.) | $189.90 75% benefit $142.45 |
| 35694 | Tuboplasty (salpingostomy or salpingolysis), unilateral or bilateral, one or more procedures (H) (Anaes.) (Assist.) | $763.20 75% benefit $572.40 |
| 35697 | Microsurgical or laparoscopic tuboplasty (salpingostomy, salpingolysis or tubal implantation into uterus), UNILATERAL or BILATERAL, 1 or more procedures (Anaes.) (Assist.) | $1,132.50 75% benefit $849.40 |
| 35700 | FALLOPIAN TUBES, unilateral microsurgical or laparoscopic anastomosis of (H) (Anaes.) (Assist.) | $873.90 75% benefit $655.45 |
| 35703 | HYDROTUBATION OF FALLOPIAN TUBES as a nonrepetitive procedure (Anaes.) | $80.80 75% benefit $60.60 85% benefit $68.70 |
| 35717 | Laparotomy, involving oophorectomy, salpingectomy, salpingo-oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst—one or more such procedures, unilateral or bilateral, including adhesiolysis, for benign disease (including ectopic pregnancy by tubal removal or salpingostomy), not being a service associated with hysterectomy (H) (Anaes.) (Assist.) | $1,021.15 75% benefit $765.90 |
| 35720 | Radical debulking, involving the radical excision of a macroscopically disseminated gynaecological malignancy from the pelvic cavity, including resection of peritoneum from the following:(a) the pelvic side wall;(b) the pouch of Douglas;(c) the bladder;for macroscopic disease confined to the pelvis, not being a service associated with a service to which item 35721 applies (H) (Anaes.) (Assist.) | $1,909.00 75% benefit $1,431.75 |
| 35721 | Radical debulking, involving the radical excision of a macroscopically disseminated gynaecological malignancy from the abdominal and pelvic cavity, where cancer has extended beyond the pelvis, including any of the following:(a) resection of peritoneum over any of the following: (i) the diaphragm; (ii) the paracolic gutters; (iii) the greater or lesser omentum; (iv) the porta hepatis;(b) cytoreduction of recurrent gynaecological malignancy from the abdominal cavity following previous abdominal surgery, radiation or chemotherapy;(c) cytoreduction of recurrent gynaecological malignancy from the pelvic cavity following previous pelvic surgery, radiation or chemotherapy;not being a service to which a service associated with a service to which item 35720 or 35726 applies (H) (Anaes.) (Assist.) | $3,817.95 75% benefit $2,863.50 |
| 35723 | Para-aortic lymph node dissection from above the level of the aortic bifurcation (unilateral), for staging or restaging of gynaecological malignancy (H) (Anaes.) (Assist.) | $1,660.15 75% benefit $1,245.15 |
| 35724 | Para-aortic lymph node dissection (pelvic or above the aortic bifurcation) after prior similar dissection, radiotherapy or chemotherapy for malignancy (H) (Anaes.) (Assist.) | $2,497.65 75% benefit $1,873.25 |
| 35726 | Infra-colic omentectomy, with or without multiple peritoneal biopsies, for staging or restaging of gynaecological malignancy, not being a service associated with a service to which item 35721 applies (H) (Anaes.) (Assist.) | $578.25 75% benefit $433.70 |
| 35729 | OVARIAN TRANSPOSITION out of the pelvis, in conjunction with radical hysterectomy for invasive malignancy (Anaes.) | $260.70 75% benefit $195.55 |
| 35730 | Ovarian repositioning for one or both ovaries to preserve ovarian function, prior to gonadotoxic radiotherapy when the treatment volume and dose of radiation have a high probability of causing infertility (Anaes.) | $260.70 75% benefit $195.55 |
| 35750 | Hysterectomy, laparoscopic assisted vaginal, by any approach, including any endometrial sampling, with or without removal of the tubes or ovarian cystectomy or removal of the ovaries and tubes due to other pathology, not being a service associated with a service to which item 35595 or 35673 applies. (H) (Anaes.) (Assist.) | $939.10 75% benefit $704.35 |
| 35751 | Hysterectomy, laparoscopic, by any approach, including any endometrial sampling, with or without removal of the tubes, not being a service associated with a service to which item 35595 applies (H) (Anaes.) (Assist.) | $939.10 75% benefit $704.35 |
| 35753 | Hysterectomy, complex laparoscopic, by any approach, including endometrial sampling, with either or both of the following procedures:(a) unilateral or bilateral salpingo-oophorectomy (excluding salpingectomy);(b) excision of moderate endometriosis or ovarian cyst;including any associated laparoscopy, not being a service associated with a service to which item 35595 applies (H) (Anaes.) (Assist.) | $1,038.35 75% benefit $778.80 |
| 35754 | Hysterectomy, complex laparoscopic, by any approach, that concurrently requires either extensive retroperitoneal dissection or complex side wall dissection, or both, with any of the following procedures (if performed):(a) endometrial sampling; (b) unilateral or bilateral salpingectomy, oophorectomy or salpingo-oophorectomy;(c) excision of ovarian cyst; (d) any other associated laparoscopy; not being a service associated with a service to which item 35595 or 35641 applies (H) (Anaes.) (Assist.) | $2,006.55 75% benefit $1,504.95 |
| 35756 | Hysterectomy, laparoscopic, by any approach, if the procedure is completed by open hysterectomy for control of bleeding or extensive pathology, including any associated laparoscopy, not being a service associated with a service to which item 35595 or 35641 applies (H) (Anaes.) (Assist.) | $1,712.60 75% benefit $1,284.45 |
| 35759 | Procedure for the control of post operative haemorrhage following gynaecological surgery, under general anaesthesia, utilising a vaginal, abdominal or laparoscopic approach if no other procedure is performed (H) (Anaes.) (Assist.) | $674.30 75% benefit $505.75 |
| 36502 | PELVIC LYMPHADENECTOMY, open or laparoscopic, or both, unilateral or bilateral (Anaes.) (Assist.) | $818.60 75% benefit $613.95 |
| 36503 | RENAL TRANSPLANT (not being a service to which item 36506 or 36509 applies) (Anaes.) (Assist.) | $1,665.05 75% benefit $1,248.80 |
| 36504 | Rigid cystoscopy using blue light with hexaminolevulinate as an adjunct to white light, including catheterisation, with biopsy of bladder, not being a service associated with a service to which item 36505, 36507, 36508, 36812, 36830, 36836, 36840, 36845, 36848, 36854, 37203 or 37215 applies (H) (Anaes.) | $352.85 75% benefit $264.65 |
| 36505 | RIGID CYSTOSCOPY using blue light with hexaminolevulinate as an adjunct to white light, including catheterisation, with urethroscopy with or without urethral dilatation, not being a service associated with any other urological endoscopic procedure on the lower urinary tract except a service to which item 37327 applies. (Anaes.) | $277.30 75% benefit $208.00 85% benefit $235.75 |
| 36506 | RENAL TRANSPLANT, performed by vascular surgeon and urologist operating together vascular anastomosis including aftercare (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 36507 | Rigid cystoscopy using blue light with hexaminolevulinate as an adjunct to white light, including catheterisation, with diathermy, resection or visual laser destruction of bladder tumour or other lesion of the bladder, not being a service to which item 36840 or 36845 applies (H) (Anaes.) | $464.55 75% benefit $348.45 |
| 36508 | Rigid cystoscopy using blue light with hexaminolevulinate as an adjunct to white light, including catheterisation, with diathermy, resection or visual laser destruction of multiple tumours in more than 2 quadrants of the bladder or solitary tumour greater than 2 cm in diameter, not being a service to which item 36845 applies (H) (Anaes.) | $905.40 75% benefit $679.05 |
| 36509 | RENAL TRANSPLANT, performed by vascular surgeon and urologist operating together ureterovesical anastomosis including aftercare (Assist.) | $937.15 75% benefit $702.90 |
| 36516 | Nephrectomy, complete, by open, laparoscopic or robot-assisted approach, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 36519 | Nephrectomy, complete, by open, laparoscopic or robot-assisted approach, complicated by previous surgery on the same kidney, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,545.35 75% benefit $1,159.05 |
| 36522 | Nephrectomy, partial, by open, laparoscopic or robot-assisted approach, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,326.15 75% benefit $994.65 |
| 36525 | Nephrectomy, partial, by open, laparoscopic or robot‑assisted approach: (a) if complicated by previous surgery or ablative procedure on the same kidney; or (b) for a patient with a solitary functioning kidney; or (c) for a patient with an estimated glomerular filtration rate (eGFR) of less than 60ml/min/1.73m2; other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,884.40 75% benefit $1,413.30 |
| 36528 | Nephrectomy, radical, by open, laparoscopic or robot-assisted approach, with or without en bloc dissection of lymph nodes, with or without adrenalectomy, for a tumour less than 10 cm in diameter, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,545.35 75% benefit $1,159.05 |
| 36529 | Nephrectomy, radical, by open, laparoscopic or robot‑assisted approach, with or without en bloc dissection of lymph nodes, with or without adrenalectomy: (a) for a tumour 10 cm or more in diameter; or (b) if complicated by previous open or laparoscopic surgery on the same kidney; other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,907.25 75% benefit $1,430.45 |
| 36530 | Renal cell carcinoma, not more than 4 cm in diameter, destruction of, by percutaneous, laparoscopic or open cryoablation (including any associated imaging services), if: (a) malignancy has previously been confirmed by histopathological examination; and (b) a multi‑disciplinary team has reviewed treatment options for the patient and assessed that partial nephrectomy is not suitable; and (c) the service is not a service associated with a service to which item 36522 or 36525 applies (H) (Anaes.) | $969.25 75% benefit $726.95 |
| 36531 | Nephroureterectomy, complete, by open, laparoscopic or robot-assisted approach, including associated bladder repair and any associated endoscopic procedure, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,385.85 75% benefit $1,039.40 |
| 36532 | Nephroureterectomy, for tumour, by open, laparoscopic or robot-assisted approach, with or without en bloc dissection of lymph nodes, including associated bladder repair and any associated endoscopic procedures, other than a service to which item 36533 applies or a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,989.05 75% benefit $1,491.80 |
| 36533 | Nephroureterectomy, for tumour, by open, laparoscopic or robot-assisted approach, with or without en bloc dissection of lymph nodes, including associated bladder repair and any associated endoscopic procedures, if complicated by previous open or laparoscopic surgery on the same kidney or ureter, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $2,350.95 75% benefit $1,763.25 |
| 36537 | KIDNEY OR PERINEPHRIC AREA, EXPLORATION OF, with or without drainage of, by open exposure, not being a service to which another item in this Sub-group applies (Anaes.) (Assist.) | $827.50 75% benefit $620.65 |
| 36543 | Nephrolithotomy or pyelolithotomy, or both, extended, for one or more renal stones, including one or more of nephrostomy, pyelostomy, pedicle control with or without freezing, calyorrhaphy or pyeloplasty (H) (Anaes.) (Assist.) | $1,545.35 75% benefit $1,159.05 |
| 36546 | Extracorporeal shock wave lithotripsy (ESWL) to urinary tract and post‑treatment care for 3 days, including pre‑treatment consultations, unilateral (H) (Anaes.) | $827.50 75% benefit $620.65 |
| 36549 | Ureterolithotomy, by open, laparoscopic or robot-assisted approach (Anaes.) (Assist.) | $997.15 75% benefit $747.90 |
| 36552 | NEPHROSTOMY or pyelostomy, open, as an independent procedure (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 36558 | Renal cyst or cysts, excision or unroofing of (H) (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 36561 | Renal biopsy, performed under image guidance (closed) (Anaes.) | $206.45 75% benefit $154.85 85% benefit $175.50 |
| 36564 | Pyeloplasty, (plastic reconstruction of the pelvi-ureteric junction) by open, laparoscopic or robot-assisted approach, with or without the use of a retroperitoneal approach (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 36567 | Pyeloplasty in a kidney that is congenitally abnormal (in addition to the presence of pelvi-ureteric junction obstruction), or in a solitary kidney, by open, laparoscopic or robot-assisted approach, with or without the use of a retroperitoneal approach (Anaes.) (Assist.) | $1,216.45 75% benefit $912.35 |
| 36570 | Pyeloplasty, complicated by previous surgery on the same kidney, by open, laparoscopic or robot-assisted approach, with or without the use of a retroperitoneal approach (Anaes.) (Assist.) | $1,545.35 75% benefit $1,159.05 |
| 36573 | DIVIDED URETER, repair of (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 36576 | Kidney, exposure and exploration of, including repair or nephrectomy, for trauma, by open, laparoscopic or robot‑assisted approach, other than a service associated with: (a) any other procedure performed on the kidney, renal pelvis or renal pedicle; or (b) a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,385.85 75% benefit $1,039.40 |
| 36579 | Ureterectomy, complete or partial: (a) for a tumour within the ureter, proven by histopathology at the time of surgery; or (b) for congenital anomaly; with or without associated bladder repair (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 36585 | URETER, transplantation of, into skin (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 36588 | URETER, reimplantation into bladder (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 36591 | URETER, reimplantation into bladder with psoas hitch or Boari flap or both (Anaes.) (Assist.) | $1,326.15 75% benefit $994.65 |
| 36594 | URETER, transplantation of, into intestine (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 36597 | URETER, transplantation of, into another ureter (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 36600 | Ureter, transplantation of, into isolated intestinal segment, unilateral (H) (Anaes.) (Assist.) | $1,326.15 75% benefit $994.65 |
| 36603 | URETERS, transplantation of, into isolated intestinal segment, bilateral (Anaes.) (Assist.) | $1,545.35 75% benefit $1,159.05 |
| 36604 | Ureteric stent, passage of through percutaneous nephrostomy tube, using interventional radiology techniques, but not including imaging (H) (Anaes.) | $320.35 75% benefit $240.30 |
| 36606 | INTESTINAL URINARY RESERVOIR, continent, formation of, including formation of nonreturn valves and implantation of ureters (1 or both) into reservoir (Anaes.) (Assist.) | $2,771.80 75% benefit $2,078.85 |
| 36607 | Ureteric stent insertion of, with balloon dilatation of: (a) the pelvicalyceal system; or (b) ureter; or (c) the pelvicalyceal system and ureter; through a nephrostomy tube using interventional radiology techniques, but not including imaging (Anaes.) | $826.75 75% benefit $620.10 |
| 36608 | Ureteric stent, exchange of, percutaneously through either the ileal conduit or bladder, using interventional radiology techniques, but not including imaging, not being a service associated with a service to which items 36811 to 36854 apply (Anaes.) | $320.35 75% benefit $240.30 |
| 36609 | Intestinal urinary conduit, reservoir or ureterostomy, revision of (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 36610 | Intestinal urinary conduit, incontinent, formation of (including associated small bowel resection and anastomosis), including implantation of one or both ureters into reservoir (Anaes.) (Assist.) | $2,124.55 75% benefit $1,593.45 |
| 36611 | Intestinal urinary reservoir, continent, formation of (including associated small bowel resection and anastomosis), including formation of non-return valves and implantation of one or both ureters into reservoir, performed by open, laparoscopic or robot-assisted approach (Anaes.) (Assist.) | $3,351.00 75% benefit $2,513.25 |
| 36612 | URETER, exploration of, with or without drainage of, as an independent procedure (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 36615 | Ureterolysis, unilateral, with or without repositioning of the ureter, for obstruction of the ureter, if: (a) the obstruction: (i) is evident either radiologically or by proximal ureteric dilatation at operation; and (ii) is secondary to retroperitoneal fibrosis; and (b) there is biopsy proven fibrosis, endometriosis or cancer at the site of the obstruction at time of surgery (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 36618 | REDUCTION URETEROPLASTY (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 36621 | CLOSURE OF CUTANEOUS URETEROSTOMY (Anaes.) (Assist.) | $556.05 75% benefit $417.05 |
| 36624 | Nephrostomy, percutaneous, using interventional radiology techniques, but not including imaging (H) (Anaes.) (Assist.) | $668.05 75% benefit $501.05 |
| 36627 | Nephroscopy, percutaneous, with or without any one or more of; stone extraction, biopsy or diathermy, not being a service to which item 36639 or 36645 applies (Anaes.) | $827.50 75% benefit $620.65 |
| 36633 | Nephroscopy, percutaneous, with incision of any one or more of renal pelvis, calyx or calyces or ureter and including antegrade insertion of ureteric stent, other than a service associated with a service to which item 36627, 36639 or 36645 applies (H) (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 36636 | Nephroscopy, percutaneous, with incision of any one or more of; renal pelvis, calyx or calyces or ureter and including antegrade insertion of ureteric stent, being a service associated with a service to which item 36627, 36639 or 36645 applies (Anaes.) (Assist.) | $478.65 75% benefit $359.00 |
| 36639 | Nephroscopy, percutaneous, with destruction and extraction of one or two stones using ultrasound or electrohydraulic shock waves or lasers, other than a service to which item 36645 applies (Anaes.) | $997.15 75% benefit $747.90 |
| 36645 | NEPHROSCOPY, percutaneous, with removal or destruction of a stone greater than 3 cm in any dimension, or for 3 or more stones (Anaes.) (Assist.) | $1,276.30 75% benefit $957.25 |
| 36649 | Nephrostomy drainage tube, exchange of, using interventional radiology techniques, but not including imaging (Anaes.) (Assist.) | $320.35 75% benefit $240.30 85% benefit $272.30 |
| 36650 | Nephrostomy tube, removal of, using interventional radiology techniques, but not including imaging, if the ureter has been stented with a double J ureteric stent and that stent is left in place (Anaes.) | $179.20 75% benefit $134.40 |
| 36652 | PYELOSCOPY, retrograde, of one collecting system, with or without any one or more of, cystoscopy, ureteric meatotomy, ureteric dilatation, not being a service associated with a service to which item 36803, 36812 or 36824 applies (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 36654 | PYELOSCOPY, retrograde, of one collecting system, being a service to which item 36652 applies, plus 1 or more of extraction of stone from the renal pelvis or calyces, or biopsy or diathermy of the renal pelvis or calyces, not being a service associated with a service to which item 36656 applies to a procedure performed in the same collecting system (Anaes.) (Assist.) | $997.15 75% benefit $747.90 |
| 36656 | PYELOSCOPY, retrograde, of one collecting system, being a service to which item 36652 applies, plus extraction of 2 or more stones in the renal pelvis or calyces or destruction of stone with ultrasound, electrohydraulic or kinetic lithotripsy, or laser in the renal pelvis or calyces, with or without extraction of fragments, not being a service associated with a service to which item 36654 applies to a procedure performed in the same collecting system (Anaes.) (Assist.) | $1,276.30 75% benefit $957.25 |
| 36663 | Both: (a) percutaneous placement of sacral nerve lead or leads using fluoroscopic guidance, or open placement of sacral nerve lead or leads; and (b) intra‑operative test stimulation, to manage: (i) detrusor over‑activity that has been refractory to at least 12 months conservative non‑surgical treatment; or (ii) non‑obstructive urinary retention that has been refractory to at least 12 months conservative non‑surgical treatment (H) (Anaes.) | $791.05 75% benefit $593.30 |
| 36664 | Both: (a) percutaneous repositioning of sacral nerve lead or leads using fluoroscopic guidance, or open repositioning of sacral nerve lead or leads; and (b) intra‑operative test stimulation, to correct displacement or unsatisfactory positioning, if inserted for the management of: (i) detrusor over‑activity that has been refractory to at least 12 months conservative non‑surgical treatment; or (ii) non‑obstructive urinary retention that has been refractory to at least 12 months conservative non‑surgical treatment; other than a service to which item 36663 applies (H) (Anaes.) | $710.45 75% benefit $532.85 |
| 36665 | Sacral nerve electrode or electrodes, management and adjustment of the pulse generator by a medical practitioner, to manage detrusor overactivity or non obstructive urinary retention - each day | $150.10 75% benefit $112.60 85% benefit $127.60 |
| 36666 | Pulse generator, subcutaneous placement of, and placement and connection of extension wire or wires to sacral nerve electrode or electrodes, for the management of: (a) detrusor over‑activity that has been refractory to at least 12 months conservative non‑surgical treatment; or (b) non‑obstructive urinary retention that has been refractory to at least 12 months conservative non‑surgical treatment (H) (Anaes.) | $399.80 75% benefit $299.85 |
| 36667 | Sacral nerve lead or leads, removal of, if the lead was inserted to manage:(a) detrusor over‑activity that has been refractory to at least 12 months conservative non‑surgical treatment; or (b) non‑obstructive urinary retention that has been refractory to at least 12 months conservative non‑surgical treatment (Anaes.) | $187.05 75% benefit $140.30 85% benefit $159.00 |
| 36668 | Pulse generator, removal of, if the pulse generator was inserted to manage:(a) detrusor over‑activity that has been refractory to at least 12 months conservative non‑surgical treatment; or (b) non‑obstructive urinary retention that has been refractory to at least 12 months conservative non‑surgical treatment (Anaes.) | $187.05 75% benefit $140.30 85% benefit $159.00 |
| 36671 | Percutaneous tibial nerve stimulation, initial treatment protocol, for the treatment of overactive bladder, by a specialist urologist, gynaecologist or urogynaecologist, if: (a) the patient has been diagnosed with idiopathic overactive bladder; and (b) the patient has been refractory to, is contraindicated or otherwise not suitable for conservative treatments (including anti‑cholinergic agents); and (c) the patient is contraindicated or otherwise not a suitable candidate for botulinum toxin type A therapy; and (d) the patient is contraindicated or otherwise not a suitable candidate for sacral nerve stimulation; and (e) the patient is willing and able to comply with the treatment protocol; and (f) the initial treatment protocol comprises 12 sessions, delivered over a 3 month period; and (g) each session lasts for a minimum of 45 minutes, of which neurostimulation lasts for 30 minutes. For each patient—applicable only once, unless the patient achieves at least a 50% reduction in overactive bladder symptoms from baseline at any time during the 3 month treatment period. Not applicable for a service associated with a service to which item 36672 or 36673 applies | $239.35 75% benefit $179.55 85% benefit $203.45 |
| 36672 | Percutaneous tibial nerve stimulation, tapering treatment protocol, for the treatment of overactive bladder, including any associated consultation at the time the percutaneous tibial nerve stimulation treatment is administered, if: (a) the patient responded to the percutaneous tibial nerve stimulation initial treatment protocol and has achieved at least a 50% reduction in overactive bladder symptoms from baseline at any time during the treatment period for the initial treatment protocol; and (b) the tapering treatment protocol comprises no more than 5 sessions, delivered over a 3 month period, and the interval between sessions is adjusted with the aim of sustaining therapeutic benefit of the treatment; and (c) each session lasts for a minimum of 45 minutes, of which neurostimulation lasts for 30 minutes. Not applicable for a service associated with a service to which item 36671 or 36673 applies | $239.35 75% benefit $179.55 85% benefit $203.45 |
| 36673 | Percutaneous tibial nerve stimulation, maintenance treatment protocol, for the treatment of overactive bladder, including any associated consultation at the time the percutaneous tibial nerve stimulation treatment is administered, if: (a) the patient responded to the percutaneous tibial nerve stimulation initial treatment protocol and to the tapering treatment protocol, and has achieved at least a 50% reduction in overactive bladder symptoms from baseline at any time during the treatment period for the initial treatment protocol; and (b) the maintenance treatment protocol comprises no more than 12 sessions, delivered over a 12 month period, and the interval between sessions is adjusted with the aim of sustaining therapeutic benefit of the treatment; and (c) each session lasts for a minimum of 45 minutes, of which neurostimulation lasts for 30 minutes. Not applicable for service associated with a service to which item 36671 or 36672 applies | $239.35 75% benefit $179.55 85% benefit $203.45 |
| 36800 | BLADDER, catheterisation of, where no other procedure is performed (Anaes.) | $33.00 75% benefit $24.75 85% benefit $28.05 |
| 36803 | Ureteroscopy, of one ureter, with or without any one or more of cystoscopy, ureteric meatotomy, or ureteric dilatation, other than a service associated with a service to which item 36652, 36654, 36656, 36806, 36809, 36812, 36824 or 36848 applies (H) (Anaes.) (Assist.) | $558.15 75% benefit $418.65 |
| 36806 | Ureteroscopy, of one ureter: (a) with or without one or more of the following: (i) cystoscopy; (ii) endoscopic incision of pelviureteric junction or ureteric stricture; (iii) ureteric meatotomy; (iv) ureteric dilatation; and (b) with either or both of the following: (i) extraction of stone from the ureter; (ii) biopsy or diathermy of the ureter; other than: (c) a service associated with a service to which item 36803 or 36812 applies; or (d) a service associated with a service, performed on the same ureter, to which item 36809, 36824 or 36848 applies (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 36809 | Ureteroscopy, of one ureter, with or without any one or more of, cystoscopy, ureteric meatotomy or ureteric dilatation, plus destruction of stone in the ureter with ultrasound, electrohydraulic or kinetic lithotripsy, or laser, with or without extraction of fragments, not being a service associated with a service to which item 36803 or 36812 applies, or a service associated with a service to which item 36806, 36824 or 36848 applies to a procedure performed on the same ureter (Anaes.) (Assist.) | $997.15 75% benefit $747.90 |
| 36811 | Cystoscopy, with insertion of one or more urethral or prostatic prostheses, other than a service associated with a service to which item 37203, 37207 or 37230 applies (H) (Anaes.) | $387.05 75% benefit $290.30 |
| 36812 | Either or both of cystoscopy and urethroscopy, with or without urethral dilatation, other than a service associated with any other urological endoscopic procedure on the lower urinary tract (Anaes.) | $199.50 75% benefit $149.65 85% benefit $169.60 |
| 36815 | CYSTOSCOPY, with or without urethroscopy, for the treatment of penile warts or uretheral warts, not being a service associated with a service to which item 30189 applies (Anaes.) | $284.70 75% benefit $213.55 85% benefit $242.00 |
| 36818 | Cystoscopy, with ureteric catheterisation, unilateral or bilateral, guided by fluoroscopic imaging of the upper urinary tract, other than a service associated with a service to which item 36824 or 36830 applies (H) (Anaes.) | $331.05 75% benefit $248.30 |
| 36821 | Cystoscopy with one or more of ureteric dilatation, insertion of ureteric stent, or brush biopsy of ureter or of renal pelvis, unilateral (H) (Anaes.) (Assist.) | $386.85 75% benefit $290.15 |
| 36822 | Cystoscopy, with ureteric catheterisation, unilateral: (a) guided by fluoroscopic imaging of the upper urinary tract; and (b) including one or more of ureteric dilatation, insertion of ureteric stent, or brush biopsy of ureter or of renal pelvis; other than a service associated with a service to which item 36818, 36821 or 36830 applies (H) (Anaes.) (Assist.) | $552.45 75% benefit $414.35 |
| 36823 | Cystoscopy, with removal of ureteric stent and ureteric catheterisation, unilateral: (a) guided by fluoroscopic imaging of the upper urinary tract; and (b) including either or both of the following: (i) ureteric dilatation; (ii) insertion of ureteric stent of ureter or of renal pelvis; other than a service associated with a service to which item 36818, 36821, 36830 or 36833 applies (H) (Anaes.) (Assist.) | $635.20 75% benefit $476.40 |
| 36824 | Cystoscopy with ureteric catheterisation, unilateral or bilateral, other than a service associated with a service to which item 36818 applies (H) (Anaes.) | $255.10 75% benefit $191.35 |
| 36827 | Cystoscopy, with controlled hydro‑dilatation of the bladder, other than a service associated with a service to which item 37011 or 37245 applies (H) (Anaes.) | $275.15 75% benefit $206.40 |
| 36830 | CYSTOSCOPY, with ureteric meatotomy (Anaes.) | $243.30 75% benefit $182.50 |
| 36833 | Cystoscopy with removal of ureteric stent or other foreign body in the lower urinary tract, unilateral (Anaes.) | $331.05 75% benefit $248.30 85% benefit $281.40 |
| 36836 | Cystoscopy with biopsy of bladder, other than a service associated with a service to which item 36812, 36830, 36840, 36845, 36848, 36854, 37203 or 37215 applies (Anaes.) | $275.15 75% benefit $206.40 85% benefit $233.90 |
| 36840 | Cystoscopy, with diathermy, resection or visual laser destruction of bladder tumour or other lesion of the bladder, for: (a) a tumour or lesion in only one quadrant of the bladder; or (b) a solitary tumour of not more than 2 cm in diameter; other than a service associated with a service to which item 36845 applies (H) (Anaes.) | $386.85 75% benefit $290.15 |
| 36842 | Cystoscopy, with lavage of blood clots from bladder, including any associated cautery of prostate or bladder, other than a service associated with a service to which any of items 36812, 36827 to 36863 and 37203 apply (H) (Anaes.) | $389.20 75% benefit $291.90 |
| 36845 | Cystoscopy, with diathermy, resection or visual laser destruction of: (a) multiple tumours in 2 or more quadrants of the bladder; or (b) a solitary bladder tumour of more than 2 cm in diameter (H) (Anaes.) | $827.50 75% benefit $620.65 |
| 36848 | CYSTOSCOPY, with resection of ureterocele (Anaes.) | $275.15 75% benefit $206.40 |
| 36851 | Cystoscopy, with injection into bladder wall, other than a service associated with a service to which item 18375 or 18379 applies (H) (Anaes.) | $275.15 75% benefit $206.40 |
| 36854 | CYSTOSCOPY, with endoscopic incision or resection of external sphincter, bladder neck or both (Anaes.) | $558.15 75% benefit $418.65 |
| 36860 | Endoscopic examination of intestinal conduit or reservoir (H) (Anaes.) | $199.50 75% benefit $149.65 |
| 36863 | Litholapaxy, with or without cystoscopy (Anaes.) | $558.15 75% benefit $418.65 |
| 37000 | BLADDER, partial excision of (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 37004 | BLADDER, repair of rupture (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 37008 | Open cystostomy or cystotomy, suprapubic, other than: (a) a service to which item 37011 applies; or (b) a service associated with a service to which item 37245 applies; or (c) another open bladder procedure (H) (Anaes.) (Assist.) | $498.50 75% benefit $373.90 |
| 37011 | Suprapubic stab cystotomy, other than a service associated with a service to which item 36827 applies (Anaes.) | $111.70 75% benefit $83.80 85% benefit $94.95 |
| 37014 | BLADDER, total excision of (Anaes.) (Assist.) | $1,276.30 75% benefit $957.25 |
| 37015 | Bladder, total excision of, following previous open, laparoscopic or robot-assisted surgery, or radiation therapy or chemotherapy to the pelvis (Anaes.) (Assist.) | $1,531.50 75% benefit $1,148.65 |
| 37016 | Cystectomy, including prostatectomy and pelvic lymph node dissection, other than a service associated with a service to which items 37000, 37014, 37015, 37209, 35551 or 36502 applies (Anaes.) (Assist.) | $2,388.05 75% benefit $1,791.05 |
| 37018 | Cystectomy, including prostatectomy and pelvic lymph node dissection, following previous open, laparoscopic or robot-assisted surgery, or radiation therapy or chemotherapy to the pelvis, other than a service associated with a service to which items 37000, 37014, 37015, 37016, 37209, 35551 or 36502 applies (Anaes.) (Assist.) | $3,582.25 75% benefit $2,686.70 |
| 37019 | Cystectomy, including anterior exenteration and pelvic lymph node dissection, other than a service associated with a service to which any of items 37000, 37014, 37015, 35551, 36502, and 35653 to 35756 apply (Anaes.) (Assist.) | $2,385.40 75% benefit $1,789.05 |
| 37020 | BLADDER DIVERTICULUM, excision or obliteration of (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 37021 | Cystectomy, including anterior exenteration and pelvic lymph node dissection, following previous open, laparoscopic or robot-assisted surgery, radiation therapy or chemotherapy to the pelvis, other than a service associated with a service to which any of items 37000, 37014, 37015, 35551, 36502 and 35653 to 35756 apply (Anaes.) (Assist.) | $3,577.95 75% benefit $2,683.50 |
| 37023 | VESICAL FISTULA, cutaneous, operation for (Anaes.) | $498.50 75% benefit $373.90 |
| 37026 | CUTANEOUS VESICOSTOMY, establishment of (Anaes.) (Assist.) | $498.50 75% benefit $373.90 |
| 37029 | VESICOVAGINAL FISTULA, closure of, by abdominal approach (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37038 | VESICOINTESTINAL FISTULA, closure of, excluding bowel resection (Anaes.) (Assist.) | $827.90 75% benefit $620.95 |
| 37039 | Bladder stress incontinence, sling procedure for, using a non-autologous biological sling (Anaes.) (Assist.) | $807.35 75% benefit $605.55 |
| 37040 | Bladder stress incontinence, sling procedure for, using a non-adjustable synthetic male sling system, other than a service associated with a service to which item 37042 applies (H) (Anaes.) (Assist.) | $1,090.75 75% benefit $818.10 |
| 37041 | BLADDER ASPIRATION by needle | $55.75 75% benefit $41.85 85% benefit $47.40 |
| 37042 | Bladder stress incontinence—sling procedure for, using autologous fascial sling, including harvesting of sling, other than a service associated with a service to which item 35599 applies (H) (Anaes.) (Assist.) | $1,090.75 75% benefit $818.10 |
| 37044 | Bladder stress incontinence, suprapubic operation for (such as Burch colposuspension), open or laparoscopic route, using native tissue without graft, with diagnostic cystoscopy to assess the integrity of the lower urinary tract, not being a service associated with a service to which item 35599 or 36812 applies (H) (Anaes.) (Assist.) | $927.70 75% benefit $695.80 |
| 37045 | CONTINENT CATHETERISATION BLADDER STOMAS (eg. Mitrofanoff), formation of (Anaes.) (Assist.) | $1,710.00 75% benefit $1,282.50 |
| 37046 | Suprapubic or perineal procedure for excision of graft material, either singly or in multiple pieces, for a symptomatic patient with graft related complications (including graft related pain or discharge and bleeding related to graft exposure), if not more than one service to which this item applies has been provided to the patient by the same practitioner in the preceding 12 months (Anaes.) (Assist.) | $828.85 75% benefit $621.65 |
| 37047 | BLADDER ENLARGEMENT using intestine (Anaes.) (Assist.) | $1,994.10 75% benefit $1,495.60 |
| 37048 | Bladder neck closure for the management of urinary incontinence (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37050 | BLADDER EXSTROPHY CLOSURE, not involving sphincter reconstruction (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 37053 | BLADDER TRANSECTION AND RE-ANASTOMOSIS TO TRIGONE (Anaes.) (Assist.) | $1,025.35 75% benefit $769.05 |
| 37200 | Prostatectomy, by open, laparoscopic or robot-assisted approach (Anaes.) (Assist.) | $1,216.45 75% benefit $912.35 |
| 37201 | Prostate, transurethral radio-frequency needle ablation of, with or without cystoscopy and with or without urethroscopy, in patients with moderate to severe lower urinary tract symptoms who are not medically fit for transurethral resection of the prostate (that is, prostatectomy using diathermy or cold punch) and including services to which item 36854, 37203, 37207, 37208, 37245, 37303, 37321 or 37324 applies (H) (Anaes.) | $992.10 75% benefit $744.10 |
| 37203 | Prostatectomy, transurethral resection using cautery, with or without cystoscopy and with or without urethroscopy, and including services to which item 36854, 37201, 37207, 37208, 37245, 37303, 37321 or 37324 applies (H) (Anaes.) | $1,247.30 75% benefit $935.50 |
| 37204 | Cystoscopy with insertion of prostatic implants for the treatment of benign prostatic hyperplasia (H) (Anaes.) | $953.40 75% benefit $715.05 |
| 37205 | Prostate, ablation by water vapour with or without cystoscopy and with or without urethroscopy (H) (Anaes.) | $387.05 75% benefit $290.30 |
| 37207 | Prostate, endoscopic non-contact (side firing) visual laser ablation, with or without cystoscopy and with or without urethroscopy, and including services to which items 36854, 37201, 37203, 37245, 37303, 37321 or 37324 applies (H) (Anaes.) | $1,247.30 75% benefit $935.50 |
| 37208 | PROSTATE, endoscopic non-contact (side firing) visual laser ablation, with or without cystoscopy and with or without urethroscopy, and including services to which item 36854, 37303, 37321 or 37324 applies, continuation of, within 10 days of the procedure described by items 37201, 37203, 37207 or 37245 which had to be discontinued for medical reasons (Anaes.) | $668.05 75% benefit $501.05 |
| 37209 | PROSTATE, and/or SEMINAL VESICLE/AMPULLA OF VAS, unilateral or bilateral, total excision of, not being a service associated with a service to which item number 37210 or 37211 applies (Anaes.) (Assist.) | $1,545.35 75% benefit $1,159.05 |
| 37210 | Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated) with or without bladder neck reconstruction, other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies (Anaes.) (Assist.) | $1,907.25 75% benefit $1,430.45 |
| 37211 | Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated): (a) with or without bladder neck reconstruction; and (b) with pelvic lymphadenectomy; other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies (Anaes.) (Assist.) | $2,316.20 75% benefit $1,737.15 |
| 37213 | Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated): (a) complicated by: (i) previous radiation therapy (including brachytherapy) on the prostate; or (ii) previous ablative procedures on the prostate; and (b) with bladder neck reconstruction; other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies (Anaes.) (Assist.) | $2,860.60 75% benefit $2,145.45 |
| 37214 | Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated): (a) complicated by: (i) previous radiation therapy (including brachytherapy) on the prostate; or (ii) previous ablative procedures on the prostate; and (b) with bladder neck reconstruction and pelvic lymphadenectomy; other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies (Anaes.) (Assist.) | $3,474.65 75% benefit $2,606.00 |
| 37215 | Prostate, biopsy of, endoscopic, with or without cystoscopy (H) (Anaes.) | $498.50 75% benefit $373.90 |
| 37216 | Prostate or prostatic bed, needle biopsy of, by the transrectal route, using prostatic ultrasound guidance and obtaining one or more prostatic specimens, being a service associated with a service to which item 55603 applies (Anaes.) | $168.10 75% benefit $126.10 85% benefit $142.90 |
| 37217 | Prostate, implantation of radio-opaque fiducial markers into the prostate gland or prostate surgical bed, under ultrasound guidance, being an item associated with a service to which item 55603 applies (Anaes.) | $165.55 75% benefit $124.20 85% benefit $140.75 |
| 37218 | Prostate, injection into, one or more, excluding insertion of fiduciary markers (Anaes.) | $165.55 75% benefit $124.20 85% benefit $140.75 |
| 37219 | Prostate or prostatic bed, needle biopsy of, by the transperineal route, using prostatic ultrasound guidance and obtaining one or more prostatic specimens, being a service associated with a service to which item 55600 or 55603 applies (Anaes.) | $403.45 75% benefit $302.60 85% benefit $342.95 |
| 37220 | Prostate, radioactive seed implantation of, urological component, using transrectal ultrasound guidance: (a) for a patient with: (i) localised prostatic malignancy at clinical stages T1 (clinically inapparent tumour not palpable or visible by imaging) or T2 (tumour confined within prostate); and (ii) a Gleason score of less than or equal to 7 (Grade Group 1 to Grade Group 3); and (iii) a prostate specific antigen (PSA) of not more than 10ng/ml at the time of diagnosis; and (b) performed by a urologist at an approved site in association with a radiation oncologist; and (c) being a service associated with: (i) services to which items 15966 and 55603 apply; and (ii) a service to which item 60506 or 60509 applies (H) (Anaes.) | $1,249.80 75% benefit $937.35 |
| 37221 | Prostatic abscess, endoscopic drainage of (Anaes.) | $558.15 75% benefit $418.65 |
| 37223 | PROSTATIC COIL, insertion of, under ultrasound control (Anaes.) | $246.90 75% benefit $185.20 |
| 37224 | Prostate, diathermy or cauterisation, other than a service associated with a service to which item 37201, 37203, 37207, 37208 or 37215 applies (H) (Anaes.) | $386.85 75% benefit $290.15 |
| 37226 | Prostate or prostatic bed, needle biopsy of, using prostatic magnetic resonance imaging techniques and obtaining 1 or more prostatic specimens. (Anaes.) | $336.20 75% benefit $252.15 85% benefit $285.80 |
| 37227 | Prostate, transperineal insertion of catheters for high dose rate brachytherapy using ultrasound guidance including any associated cystoscopy, if performed at an approved site, and being a service associated with a service to which item 15966 applies (H) | $677.20 75% benefit $507.90 |
| 37245 | Prostate, endoscopic enucleation of, for the treatment of benign prostatic hyperplasia: (a) with morcellation, including mechanical morcellation or by an endoscopic technique; and (b) with or without cystoscopy; and (c) with or without urethroscopy; and other than a service associated with a service to which item 36827, 36854, 37008, 37201, 37203, 37207, 37208, 37303, 37321 or 37324 applies (H) (Anaes.) | $1,510.65 75% benefit $1,133.00 |
| 37300 | URETHRAL SOUNDS, passage of, as an independent procedure (Anaes.) | $55.75 75% benefit $41.85 85% benefit $47.40 |
| 37303 | URETHRAL STRICTURE, dilatation of (Anaes.) | $88.70 75% benefit $66.55 85% benefit $75.40 |
| 37306 | URETHRA, repair of rupture of distal section (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 37309 | URETHRA, repair of rupture of prostatic or membranous segment (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37318 | Urethroscopy, with or without cystoscopy, with one or more of biopsy, diathermy, visual laser destruction of urethral calculi or removal of foreign body or calculi (H) (Anaes.) | $331.05 75% benefit $248.30 |
| 37321 | URETHRAL MEATOTOMY, EXTERNAL (Anaes.) | $111.70 75% benefit $83.80 85% benefit $94.95 |
| 37324 | Urethrotomy or urethrostomy, internal or external (Anaes.) (Assist.) | $275.15 75% benefit $206.40 |
| 37327 | URETHROTOMY, optical, for urethral stricture (Anaes.) (Assist.) | $386.85 75% benefit $290.15 |
| 37330 | URETHRECTOMY, partial or complete, for removal of tumour (Anaes.) (Assist.) | $777.75 75% benefit $583.35 |
| 37333 | URETHROVAGINAL FISTULA, closure of (Anaes.) (Assist.) | $668.05 75% benefit $501.05 |
| 37336 | URETHRORECTAL FISTULA, closure of (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 37338 | Urethral synthetic male sling system, division or removal of, for urethral obstruction, sling erosion, pain or infection, following previous surgery for urinary incontinence, other than a service associated with a service to which item 37340 or 37341 applies (Anaes.) (Assist.) | $1,090.75 75% benefit $818.10 |
| 37339 | Periurethral or transurethral injection of urethral bulking agents for the treatment of urinary incontinence, including cystoscopy and urethroscopy, other than a service associated with a service to which item 18375 or 18379 applies (Anaes.) | $287.15 75% benefit $215.40 85% benefit $244.10 |
| 37340 | Urethral synthetic sling, division or removal of, for urethral obstruction, sling erosion, pain or infection following previous surgery for urinary incontinence, vaginal approach, other than a service associated with a service to which item 37341 or 37344 applies (Anaes.) (Assist.) | $1,090.75 75% benefit $818.10 |
| 37341 | Urethral sling, division or removal of, for urethral obstruction, sling erosion, pain or infection following previous surgery for urinary incontinence, suprapubic, combined suprapubic and vaginal or combined suprapubic and perineal approach, other than a service associated with a service to which item 37340 or 37344 applies (Anaes.) (Assist.) | $1,090.75 75% benefit $818.10 |
| 37342 | URETHROPLASTY single stage operation (Anaes.) (Assist.) | $997.15 75% benefit $747.90 |
| 37343 | URETHROPLASTY, single stage operation, transpubic approach via separate incisions above and below the symphysis pubis, excluding laparotomy, symphysectomy and suprapubic cystotomy, with or without re-routing of the urethra around the crura (Anaes.) (Assist.) | $1,665.05 75% benefit $1,248.80 |
| 37344 | Urethral autologous fascial sling (or other biological sling), division or removal of, for urethral obstruction, sling erosion, pain or infection following previous surgery for urinary incontinence, vaginal approach, other than a service to which 37340 or 37341 applies (Anaes.) (Assist.) | $1,090.75 75% benefit $818.10 |
| 37345 | URETHROPLASTY 2 stage operation first stage (Anaes.) (Assist.) | $827.50 75% benefit $620.65 |
| 37348 | URETHROPLASTY 2 stage operation second stage (Anaes.) (Assist.) | $827.50 75% benefit $620.65 |
| 37351 | URETHROPLASTY, not being a service to which another item in this Group applies (Anaes.) (Assist.) | $331.05 75% benefit $248.30 |
| 37354 | HYPOSPADIAS, meatotomy and hemicircumcision (Anaes.) (Assist.) | $386.85 75% benefit $290.15 |
| 37369 | URETHRA, excision of prolapse of (Anaes.) | $223.35 75% benefit $167.55 |
| 37372 | Urethral diverticulum, excision of (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37375 | URETHRAL SPHINCTER, reconstruction by bladder tubularisation technique or similar procedure (Anaes.) (Assist.) | $1,385.85 75% benefit $1,039.40 |
| 37381 | ARTIFICIAL URINARY SPHINCTER, insertion of cuff, perineal approach (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 37384 | ARTIFICIAL URINARY SPHINCTER, insertion of cuff, abdominal approach (Anaes.) (Assist.) | $1,385.85 75% benefit $1,039.40 |
| 37387 | ARTIFICIAL URINARY SPHINCTER, insertion of pressure regulating balloon and pump (Anaes.) (Assist.) | $386.85 75% benefit $290.15 |
| 37388 | Artificial urinary sphincter, sterile, percutaneous adjustment of filling volume | $117.25 75% benefit $87.95 85% benefit $99.70 |
| 37390 | ARTIFICIAL URINARY SPHINCTER, revision or removal of, with or without replacement (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37393 | PRIAPISM, decompression by glanular stab cavernosospongiosum shunt or penile aspiration with or without lavage (Anaes.) | $275.15 75% benefit $206.40 85% benefit $233.90 |
| 37396 | PRIAPISM, shunt operation for, not being a service to which item 37393 applies (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 37402 | PENIS, partial amputation of (Anaes.) (Assist.) | $558.15 75% benefit $418.65 |
| 37405 | PENIS, complete or radical amputation of (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37408 | PENIS, repair of laceration of cavernous tissue, or fracture involving cavernous tissue (Anaes.) (Assist.) | $558.15 75% benefit $418.65 |
| 37411 | Penis, repair of avulsion (H) (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37415 | Penis, injection of, for the investigation and treatment of erectile dysfunction. Applicable not more than twice in a 36‑month period | $55.75 75% benefit $41.85 85% benefit $47.40 |
| 37417 | Penis, correction of chordee by plication techniques including Nesbit’s corporoplasty (Anaes.) (Assist.) | $668.05 75% benefit $501.05 |
| 37418 | Penis, correction of chordee with incision or excision of fibrous plaque or plaques, with or without mobilisation of one or both of the neuro-vascular bundle and urethra (H) (Anaes.) (Assist.) | $887.45 75% benefit $665.60 |
| 37423 | Penis, lengthening by translocation of corpora, in conjunction with partial penectomy or penile epispadias secondary repair, either as primary or secondary procedures (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37426 | PENIS, artificial erection device, insertion of, into 1 or both corpora (Anaes.) (Assist.) | $1,166.45 75% benefit $874.85 |
| 37429 | PENIS, artificial erection device, insertion of pump and pressure regulating reservoir (Anaes.) (Assist.) | $386.85 75% benefit $290.15 |
| 37432 | PENIS, artificial erection device, complete or partial revision or removal of components, with or without replacement (Anaes.) (Assist.) | $1,106.80 75% benefit $830.10 |
| 37435 | PENIS, frenuloplasty as an independent procedure (Anaes.) | $111.70 75% benefit $83.80 85% benefit $94.95 |
| 37438 | Scrotum, partial excision of, for histologically proven malignancy or infection (Anaes.) (Assist.) | $331.05 75% benefit $248.30 85% benefit $281.40 |
| 37601 | SPERMATOCELE OR EPIDIDYMAL CYST, excision of, 1 or more of, on 1 side (Anaes.) | $331.05 75% benefit $248.30 85% benefit $281.40 |
| 37604 | Exploration of scrotal contents, with or without fixation and with or without biopsy, unilateral or bilateral, other than a service associated with sperm harvesting for IVF (H) (Anaes.) | $331.05 75% benefit $248.30 |
| 37605 | Transcutaneous sperm retrieval, unilateral, from either the testis or the epididymis, for the purposes of intracytoplasmic sperm injection, for male factor infertility, excluding a service to which item 13218 applies. (Anaes.) | $447.00 75% benefit $335.25 85% benefit $379.95 |
| 37606 | Open surgical sperm retrieval, unilateral, including the exploration of scrotal contents, with or without biopsy, for the purposes of intracytoplasmic sperm injection, for male factor infertility, performed in a hospital, other than a service to which item 13218 or 37604 applies (H) (Anaes.) | $663.70 75% benefit $497.80 |
| 37607 | Bilateral retroperitoneal lymph node dissection, for testicular tumour, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $1,660.15 75% benefit $1,245.15 |
| 37610 | Bilateral retroperitoneal lymph node dissection, for testicular tumour, following previous similar retroperitoneal dissection, retroperitoneal radiation therapy or chemotherapy, other than a service associated with a service to which item 30390 or 30627 applies (Anaes.) (Assist.) | $2,497.65 75% benefit $1,873.25 |
| 37613 | Epididymectomy (H) (Anaes.) | $331.05 75% benefit $248.30 |
| 37616 | VASOVASOSTOMY or VASOEPIDIDYMOSTOMY, unilateral, using operating microscope, not being a service associated with sperm harvesting for IVF (Anaes.) (Assist.) | $827.50 75% benefit $620.65 |
| 37619 | Vasovasostomy or vasoepididymostomy, unilateral, other than a service associated with sperm harvesting for IVF (H) (Anaes.) (Assist.) | $331.05 75% benefit $248.30 |
| 37623 | VASOTOMY OR VASECTOMY, unilateral or bilateral NOTE: Strict legal requirements apply in relation to sterilisation procedures on minors. Medicare benefits are not payable for services not rendered in accordance with relevant Commonwealth and State and Territory law. Observe the explanatory note before submitting a claim. (Anaes.) | $275.15 75% benefit $206.40 85% benefit $233.90 |
| 37800 | PATENT URACHUS, excision of, on a patient 10 years of age or over. (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 37801 | PATENT URACHUS, excision of, when performed on a patient under 10 years of age (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 37803 | UNDESCENDED TESTIS, orchidopexy for, not being a service to which item 37806 applies, on a patient 10 years of age or over. (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 37804 | UNDESCENDED TESTIS, orchidopexy for, not being a service to which item 37807 applies, on a patient under 10 years of age (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 37806 | Undescended testis in inguinal canal close to deep inguinal ring or within abdominal cavity, orchidopexy for, on a patient 10 years of age or over (H) (Anaes.) (Assist.) | $720.85 75% benefit $540.65 |
| 37807 | Undescended testis in inguinal canal close to deep inguinal ring or within abdominal cavity, orchidopexy for, on a patient under 10 years of age (H) (Anaes.) (Assist.) | $937.15 75% benefit $702.90 |
| 37809 | UNDESCENDED TESTIS, revision orchidopexy for, on a patient 10 years of age or over. (Anaes.) (Assist.) | $720.85 75% benefit $540.65 |
| 37810 | UNDESCENDED TESTIS, revision orchidopexy for, on a patient under 10 years of age (Anaes.) (Assist.) | $937.15 75% benefit $702.90 |
| 37812 | IMPALPABLE TESTIS, exploration of groin for, not being a service associated with a service to which items 37803, 37806 and 37809 applies, on a patient 10 years of age or over. (Anaes.) (Assist.) | $665.40 75% benefit $499.05 |
| 37813 | IMPALPABLE TESTIS, exploration of groin for, not being a service associated with a service to which items 37804, 37807 and 37810 applies, on a patient under 10 years of age (Anaes.) (Assist.) | $865.05 75% benefit $648.80 |
| 37815 | HYPOSPADIAS, examination under anaesthesia with erection test on a patient 10 years of age or over. (Anaes.) | $111.00 75% benefit $83.25 |
| 37816 | HYPOSPADIAS, examination under anaesthesia with erection test, on a patient under 10 years of age (Anaes.) | $144.35 75% benefit $108.30 |
| 37818 | Hypospadias, glanuloplasty incorporating meatal advancement, on a patient 10 years of age or over (H) (Anaes.) (Assist.) | $588.25 75% benefit $441.20 |
| 37819 | Hypospadias, glanuloplasty incorporating meatal advancement, on a patient under 10 years of age (H) (Anaes.) (Assist.) | $764.70 75% benefit $573.55 |
| 37821 | HYPOSPADIAS, distal, 1 stage repair, on a patient 10 years of age or over. (Anaes.) (Assist.) | $997.15 75% benefit $747.90 |
| 37822 | HYPOSPADIAS, distal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.) | $1,296.35 75% benefit $972.30 |
| 37824 | HYPOSPADIAS, proximal, 1 stage repair, on a patient 10 years of age or over (Anaes.) (Assist.) | $1,386.40 75% benefit $1,039.80 |
| 37825 | HYPOSPADIAS, proximal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.) | $1,802.25 75% benefit $1,351.70 |
| 37827 | HYPOSPADIAS, staged repair, first stage, on a patient 10 years of age or over (Anaes.) (Assist.) | $638.70 75% benefit $479.05 |
| 37828 | HYPOSPADIAS, staged repair, first stage, on a patient under 10 years of age (Anaes.) (Assist.) | $830.25 75% benefit $622.70 |
| 37830 | Hypospadias, staged repair, second stage, on a patient 10 years of age or over (H) (Anaes.) (Assist.) | $827.50 75% benefit $620.65 |
| 37831 | Hypospadias, staged repair, second stage, on a patient under 10 years of age (H) (Anaes.) (Assist.) | $1,075.90 75% benefit $806.95 |
| 37833 | Hypospadias, repair of urethral fistula, on a patient 10 years of age or over (Anaes.) (Assist.) | $394.90 75% benefit $296.20 |
| 37834 | Hypospadias, repair of urethral fistula, on a patient under 10 years of age (Anaes.) (Assist.) | $513.50 75% benefit $385.15 |
| 37836 | EPISPADIAS, staged repair, first stage (Anaes.) (Assist.) | $831.80 75% benefit $623.85 |
| 37839 | EPISPADIAS, staged repair, second stage (Anaes.) (Assist.) | $942.65 75% benefit $707.00 |
| 37842 | Exstrophy of bladder or epispadias, primary or secondary repair with or without bladder neck tightening, with or without ureteric reimplantation (Anaes.) (Assist.) | $1,830.15 75% benefit $1,372.65 |
| 37845 | Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty, with or without endoscopy (Anaes.) (Assist.) | $831.80 75% benefit $623.85 |
| 37848 | Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty with endoscopy and vaginoplasty (Anaes.) (Assist.) | $1,497.35 75% benefit $1,123.05 |
| 37851 | Congenital disorder of sexual differentiation, vaginoplasty for, with or without endoscopy (Anaes.) (Assist.) | $1,109.30 75% benefit $832.00 |
| 37854 | Urethral valve, destruction of, including cystoscopy and urethroscopy (Anaes.) | $438.55 75% benefit $328.95 |
| 38200 | Right heart catheterisation with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurement by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38254 or 38368 applies (H) (Anaes.) | $533.15 75% benefit $399.90 |
| 38203 | Left heart catheterisation by percutaneous arterial puncture, arteriotomy or percutaneous left ventricular puncture, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38206, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.) | $636.25 75% benefit $477.20 |
| 38206 | Right heart catheterisation with left heart catheterisation via the right heart or by another procedure, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38203, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.) | $769.15 75% benefit $576.90 |
| 38209 | Cardiac electrophysiological study—up to and including 3 catheter investigation of any one or more of—syncope, atrio‑ventricular conduction, sinus node function or simple ventricular tachycardia studies, other than a service associated with a service to which item 38212 or 38213 applies (H) (Anaes.) | $987.65 75% benefit $740.75 |
| 38212 | Cardiac electrophysiological study for: (a) the investigation of supraventricular tachycardia involving 4 or more catheters; or (b) complex tachycardia inductions; or (c) multiple catheter mapping; or (d) acute intravenous anti‑arrhythmic drug testing with pre and post drug inductions; or (e) catheter ablation to intentionally induce complete atrioventricular block; or (f) intraoperative mapping; other than a service associated with a service to which item 38209 or 38213 applies (H) (Anaes.) | $1,642.65 75% benefit $1,232.00 |
| 38213 | Cardiac electrophysiological study, performed either: (a) during insertion of implantable defibrillator; or (b) for defibrillation threshold testing at a different time to implantation; other than a service associated with a service to which item 38209 or 38212 applies (H) (Anaes.) | $489.25 75% benefit $366.95 |
| 38241 | Use of a coronary pressure wire, if the service is: (a) performed during selective coronary angiography, percutaneous angioplasty or transluminal insertion of one or more stents; and (b) to measure fractional flow reserve, non-hyperaemic pressure ratios or coronary flow reserve in intermediate coronary artery or graft lesions (stenosis of 50 to 70%); and (c) to determine whether revascularisation is appropriate, if previous functional imaging: (i) has not been performed; or (ii) has been performed but the results are inconclusive or do not apply to the vessel being interrogated; and (d) performed on one or more coronary vascular territories (H) (Anaes.) | $562.10 75% benefit $421.60 |
| 38244 | Note: (acute coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into native coronary arteries; and (c) with or without left heart catheterisation, left ventriculography or aortography; and (d) including all associated imaging; other than a service associated with a service to which 38200, 38203, 38206, 38247, 38248, 38249, 38251 or 38252 applies (H) (Anaes.) | $1,058.20 75% benefit $793.65 |
| 38247 | Note: (acute coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (c) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38248, 38249, 38251 or 38252 applies (H) (Anaes.) | $1,695.45 75% benefit $1,271.60 |
| 38248 | Note: (stable coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the of Note: TR.8.3 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38249, 38251 or 38252 applies—applicable each 3 months (H) (Anaes.) | $1,058.20 75% benefit $793.65 |
| 38249 | Note: (stable coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.3 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38251 or 38252 applies—applicable once each 3 months (H) (Anaes.) | $1,695.45 75% benefit $1,271.60 |
| 38251 | Note: (pre-operative assessment) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38252 applies—applicable once each 12 months (H) (Anaes.) | $1,058.20 75% benefit $793.65 |
| 38252 | Note: (pre-operative assessment - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary and graft angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38251 applies—applicable once each 12 months (H) (Anaes.) | $1,695.45 75% benefit $1,271.60 |
| 38254 | Right heart catheterisation: (a) performed at the same time as a service to which item 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313 or 38314 applies; and (b) including any of the following (if performed): (i) fluoroscopy; (ii) oximetry; (iii) dye dilution curves; (iv) cardiac output measurement; (v) shunt detection; (vi) exercise stress test (H) (Anaes.) | $533.15 75% benefit $399.90 |
| 38256 | Temporary transvenous pacemaking electrode, insertion of (H) (Anaes.) | $319.85 75% benefit $239.90 |
| 38270 | Balloon valvuloplasty or isolated atrial septostomy, including cardiac catheterisations before and after balloon dilatation (H) (Anaes.) (Assist.) | $1,091.90 75% benefit $818.95 |
| 38272 | Atrial septal defect or patent foramen closure: (a) for congenital heart disease in a patient with documented evidence of right heart overload or paradoxical embolism; and (b) using a septal occluder or similar device, by transcatheter approach; and (c) including right or left heart catheterisation (or both); other than a service associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.) | $1,091.90 75% benefit $818.95 |
| 38273 | Patent ductus arteriosus, transcatheter closure of, including cardiac catheterisation and any imaging associated with the service (Anaes.) (Assist.) | $1,091.90 75% benefit $818.95 |
| 38274 | Ventricular septal defect, transcatheter closure of, with cardiac catheterisation, excluding imaging (H) (Anaes.) (Assist.) | $894.50 75% benefit $670.90 |
| 38275 | Myocardial biopsy, by cardiac catheterisation (H) (Anaes.) | $356.90 75% benefit $267.70 |
| 38276 | Transcatheter occlusion of left atrial appendage, and cardiac catheterisation performed by the same practitioner, for stroke prevention in a patient who has non‑valvular atrial fibrillation, if: (a) the patient is at increased risk of thromboembolism demonstrated by: (i) a prior stroke (whether of an ischaemic or unknown type), transient ischaemic attack or non‑central nervous system systemic embolism; or (ii) at least 2 of the following risk factors: (A) an age of 65 years or more; (B) hypertension; (C) diabetes mellitus; (D) heart failure or left ventricular ejection fraction of 35% or less (or both); (E) vascular disease (prior myocardial infarction, peripheral artery disease or aortic plaque); and (b) the patient has an absolute and permanent contraindication to oral anticoagulation (confirmed by written documentation that is provided by a medical practitioner, independent of the practitioner rendering the service); and (c) the service is not associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.) | $1,091.90 75% benefit $818.95 |
| 38285 | Insertion of implantable ECG loop recorder, by a specialist or consultant physician, for the diagnosis of a primary disorder, including initial programming and testing, if: (a) the patient has recurrent unexplained syncope and does not have a structural heart defect associated with a high risk of sudden cardiac death; and (b) a diagnosis has not been achieved through all other available cardiac investigations; and (c) a neurogenic cause is not suspected (Anaes.) | $184.65 75% benefit $138.50 85% benefit $157.00 |
| 38286 | Removal of implantable ECG loop recorder (Anaes.) | $166.30 75% benefit $124.75 85% benefit $141.40 |
| 38287 | Ablation of arrhythmia circuit or focus or isolation procedure involving one atrial chamber (H) (Anaes.) (Assist.) | $2,511.75 75% benefit $1,883.85 |
| 38288 | Implantable loop recorder, insertion of, for diagnosis of atrial fibrillation, if: (a) the patient to whom the service is provided has been diagnosed as having had an embolic stroke of undetermined source; and (b) the bases of the diagnosis included the following: (i) the medical history of the patient; (ii) physical examination; (iii) brain and carotid imaging; (iv) cardiac imaging; (v) surface ECG testing including 24‑hour Holter monitoring; and (c) atrial fibrillation is suspected; and (d) the patient: (i) does not have a permanent indication for oral anticoagulants; or (ii) does not have a permanent oral anticoagulants contraindication; including initial programming and testing (Anaes.) | $230.95 75% benefit $173.25 85% benefit $196.35 |
| 38290 | ABLATION OF ARRHYTHMIA CIRCUITS OR FOCI, or isolation procedure involving both atrial chambers and including curative procedures for atrial fibrillation (Anaes.) (Assist.) | $3,198.10 75% benefit $2,398.60 |
| 38293 | Ventricular arrhythmia with mapping and ablation, including all associated electrophysiological studies performed on the same day (H) (Anaes.) (Assist.) | $3,432.75 75% benefit $2,574.60 |
| 38307 | Note: (acute coronary syndrome - 1 coronary territory with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; (ii) transluminal insertion of one or more stents; and (d) performed on one coronary vascular territory; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,121.75 75% benefit $1,591.35 |
| 38308 | Note: (acute coronary syndrome - 2 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 2 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,441.10 75% benefit $1,830.85 |
| 38309 | Percutaneous transluminal rotational atherectomy of one or more coronary arteries, including all associated imaging, if: (a) the target stenosis within at least one coronary artery is heavily calcified and balloon angioplasty with or without stenting is not feasible without rotational artherectomy; and (b) the service is performed in conjunction with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies Applicable only once on each occasion the service is performed (H) (Anaes.) (Assist.) | $1,438.65 75% benefit $1,079.00 |
| 38310 | Note: (acute coronary syndrome - 3 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 3 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,760.60 75% benefit $2,070.45 |
| 38311 | Note: (stable multi-vessel disease - 1 coronary territory with selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.4 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible under clause 5.10.17C for the service and a service to which item 38314 applies; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on one coronary vascular territory; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,121.75 75% benefit $1,591.35 |
| 38313 | Note: (stable multi-vessel disease - 2 coronary territories with selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.4 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible under clause 5.10.17C for the service and a service to which item 38314 applies; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 2 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,441.10 75% benefit $1,830.85 |
| 38314 | Note: (stable multi-vessel disease - 3 coronary territory with selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.4 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17C; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 3 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,760.60 75% benefit $2,070.45 |
| 38316 | Note: (acute coronary syndrome - 1 coronary territory without selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has been completed in the previous 3 months; and (b) including any associated coronary angiography; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on one coronary vascular territory; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313, 38314, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $1,896.80 75% benefit $1,422.60 |
| 38317 | Note: (acute coronary syndrome - 2 coronary territories without selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has been completed in the previous 3 months; and (b) including any associated coronary angiography; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 2 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,402.75 75% benefit $1,802.10 |
| 38319 | Note: (acute coronary syndrome - 3 coronary territories without selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has been completed in the previous 3 months; and (b) including any associated coronary angiography; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 3 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $2,722.10 75% benefit $2,041.60 |
| 38320 | Note: (stable multi-vessel disease - 1 coronary territory without selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.4 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible under clause 5.10.17C for the service and a service to which item 38323 applies; and (ii) for whom selective coronary angiography has been completed in the previous 3 months; and (b) including any associated coronary angiography; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on one coronary vascular territory; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38322 or 38323 applies (H) (Anaes.) (Assist.) | $1,896.80 75% benefit $1,422.60 |
| 38322 | Note: (stable multi-vessel disease - 2 coronary territories without selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.4 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible under clause 5.10.17C for the service and a service to which item 38323 applies; and (ii) for whom selective coronary angiography has been completed in the previous 3 months; and (b) including any associated coronary angiography; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 2 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320 or 38323 applies (H) (Anaes.) (Assist.) | $2,402.75 75% benefit $1,802.10 |
| 38323 | Note: (stable multi-vessel disease - 3 coronary territories without selective angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.4 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17C; and (ii) for whom selective coronary angiography has been completed in the previous 3 months; and (b) including any associated coronary angiography; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 3 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320 or 38322 applies (H) (Anaes.) (Assist.) | $2,722.10 75% benefit $2,041.60 |
| 38325 | Use of intravascular ultrasound (IVUS) during transluminal insertion of stents, to optimise procedural strategy, appropriate stent size and assessment of stent apposition, for a patient documented with: (a) one or more left main coronary artery lesions; or (b) one or more lesions at least 28mm in length in other locations; if performed in association with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies Applicable once per episode of care (for one or more lesions) (H) (Anaes.) | $553.15 75% benefit $414.90 |
| 38326 | Use of optical coherence tomography (OCT) during transluminal insertion of stents, to optimise procedural strategy, appropriate stent size and assessment of stent apposition, if: (a) the patient is documented with: (i) one or more lesions located at a bifurcation; and (ii) a planned side branch at least 2.5 mm in diameter by angiographic visual estimation; or (b) the patient is documented with stent thrombosis; or (c) both: (i) the patient is documented with one or more lesions at least 28mm in length; and (ii) either of the following apply: (A) a service to which this item applies is not performed in association with a service to which item 38325 applies because of paragraph (b) of that item; (B) a service to which this item applies is not performed, in relation to a lesion, in association with a service to which item 38325 applies because of paragraph (a) of that item, performed in relation to the same lesion; if performed in association with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies Applicable once per episode of care (for one or more lesions) (H) | $553.15 75% benefit $414.90 |
| 38350 | SINGLE CHAMBER PERMANENT TRANSVENOUS ELECTRODE, insertion, removal or replacement of, including cardiac electrophysiological services where used for pacemaker implantation (Anaes.) | $764.40 75% benefit $573.30 |
| 38353 | PERMANENT CARDIAC PACEMAKER, insertion, removal or replacement of, not for cardiac resynchronisation therapy, including cardiac electrophysiological services where used for pacemaker implantation (Anaes.) | $305.75 75% benefit $229.35 |
| 38356 | DUAL CHAMBER PERMANENT TRANSVENOUS ELECTRODES, insertion, removal or replacement of, including cardiac electrophysiological services where used for pacemaker implantation (Anaes.) | $1,002.20 75% benefit $751.65 |
| 38358 | Extraction of one or more chronically implanted transvenous pacing or defibrillator leads, by percutaneous method, with locking stylets and snares, with extraction sheaths (if any), if: (a) the leads have been in place for more than 6 months and require removal; and (b) the service is performed: (i) in association with a service to which item 61109 or 60509 applies; and (ii) by a specialist or consultant physician who has undertaken the training to perform the service; and (iii) in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and (c) if the service is performed by an interventional cardiologist—a cardiothoracic surgeon is in attendance during the service (H) (Anaes.) (Assist.) | $3,432.75 75% benefit $2,574.60 |
| 38359 | PERICARDIUM, paracentesis of (excluding aftercare) (Anaes.) | $159.90 75% benefit $119.95 85% benefit $135.95 |
| 38362 | Intra-aortic balloon pump, percutaneous insertion of (H) (Anaes.) | $460.65 75% benefit $345.50 |
| 38365 | Insertion, removal or replacement of permanent cardiac synchronisation device, if the patient: (a) has all of the following: (i) chronic heart failure, classified as New York Heart Association class III or IV (despite optimised medical therapy); (ii) left ventricular ejection fraction of less than 35%; (iii) QRS duration of greater than or equal to 130 ms; or (b) has all of the following: (i) chronic heart failure, classified as New York Heart Association class II (despite optimised medical therapy); (ii) left ventricular ejection fraction of less than 35%; (iii) QRS duration of greater than or equal to 150 ms; other than a service associated with a service to which item 38212 applies (H) (Anaes.) (Assist.) | $305.75 75% benefit $229.35 |
| 38368 | Insertion, removal or replacement of permanent transvenous left ventricular electrode, through the coronary sinus, for the purpose of cardiac resynchronisation therapy, including right heart catheterisation and any associated venograms, if the patient: (a) has all of the following: (i) chronic heart failure, classified as New York Heart Association class III or IV (despite optimised medical therapy); (ii) left ventricular ejection fraction of less than 35%; (iii) QRS duration of greater than or equal to 130 ms; or (b) has all of the following: (i) chronic heart failure, classified as New York Heart Association class II (despite optimised medical therapy); (ii) left ventricular ejection fraction of less than 35%; (iii) QRS duration of greater than or equal to 150 ms; other than a service associated with a service to which item 35200, 38200 or 38212 applies (H) (Anaes.) (Assist.) | $1,465.75 75% benefit $1,099.35 |
| 38372 | Leadless permanent cardiac pacemaker, single-chamber ventricular, percutaneous insertion of, for the treatment of bradycardia, including cardiac electrophysiological services (other than a service associated with a service to which item 38350 applies) (H) (Anaes.) | $902.85 75% benefit $677.15 |
| 38373 | Leadless permanent cardiac pacemaker, single‑chamber ventricular, percutaneous retrieval and replacement of, including cardiac electrophysiological services, during the same percutaneous procedure, if: (a) the service is performed by a specialist or consultant physician who has undertaken training to perform the service; and (b) if the service is performed at least 4 weeks after the pacemaker was inserted—the service is performed in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and (c) if the service is performed by an interventional cardiologist at least 4 weeks after the pacemaker was inserted—a cardiothoracic surgeon is in attendance during the service; other than a service associated with a service to which item 38350 applies (H) (Anaes.) | $902.85 75% benefit $677.15 |
| 38374 | Leadless permanent cardiac pacemaker, single‑chamber ventricular, percutaneous retrieval of, if: (a) the service is performed by a specialist or consultant physician who has undertaken training to perform the service; and (b) if the service is performed at least 4 weeks after the pacemaker was inserted—the service is performed in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and (c) if the service is performed by an interventional cardiologist at least 4 weeks after the pacemaker was inserted—a cardiothoracic surgeon is in attendance during the service (H) (Anaes.) | $902.85 75% benefit $677.15 |
| 38375 | Leadless permanent cardiac pacemaker, single-chamber ventricular, explantation of, by open surgical approach (H) (Anaes.) (Assist.) | $3,378.70 75% benefit $2,534.05 |
| 38376 | Percutaneous insertion of an intravascular microaxial ventricular assist device, into the left ventricle only, by arteriotomy, including all associated intraoperative imaging performed by the same practitioner, if: (a) the patient has deteriorating symptoms of cardiogenic shock (with no evidence of significant anoxic neurological injury) that are not controlled by optimal medical therapy; or (b) the patient: (i) is on veno‑arterial extra‑corporeal membrane oxygenation, for deteriorating symptoms of cardiogenic shock (with no evidence of significant anoxic neurological injury) that are not controlled by optimal medical therapy; and (ii) due to the effects of established veno‑arterial extra‑corporeal membrane oxygenation, requires unloading of the left ventricle (H) (Anaes.) | $754.35 75% benefit $565.80 |
| 38416 | Endoscopic ultrasound guided fine needle aspiration biopsy or biopsies (endoscopy with ultrasound imaging) to obtain one or more specimens from either or both of the following: (a) mediastinal masses; (b) locoregional nodes to stage non-small cell lung carcinoma; other than a service associated with a service to which an item in Subgroup 1 of this Group, or item 38417 or 55054, applies (H) (Anaes.) | $674.30 75% benefit $505.75 |
| 38417 | Endobronchial ultrasound guided biopsy or biopsies (bronchoscopy with ultrasound imaging, with or without associated fluoroscopic imaging) to obtain one or more specimens by: (a) transbronchial biopsy or biopsies of peripheral lung lesions; or (b) fine needle aspirations of one or more mediastinal masses; or (c) fine needle aspirations of locoregional nodes to stage non-small cell lung carcinoma; other than a service associated with a service to which an item in Subgroup 1 of this Group, item 38416, 38420 or 38423, or an item in Subgroup 15 of Group I3, applies (H) (Anaes.) | $674.30 75% benefit $505.75 |
| 38419 | Bronchoscopy, as an independent procedure (H) (Anaes.) | $213.05 75% benefit $159.80 |
| 38420 | Bronchoscopy with one or more endobronchial biopsies or other diagnostic or therapeutic procedures (H) (Anaes.) | $281.40 75% benefit $211.05 |
| 38422 | Bronchus, removal of foreign body in (Anaes.) (Assist.) | $440.10 75% benefit $330.10 |
| 38423 | Fibreoptic bronchoscopy with one or more transbronchial lung biopsies, with or without bronchial or broncho-alveolar lavage, with or without the use of interventional imaging (H) (Anaes.) (Assist.) | $307.60 75% benefit $230.70 |
| 38425 | Endoscopic resection of endobronchial tumours for relief of obstruction including any associated endoscopic procedures, other than a service associated with a service to which another item in Group T8 applies (H) (Anaes.) (Assist.) | $723.25 75% benefit $542.45 |
| 38426 | Trachea or bronchus, dilatation of stricture and endoscopic insertion of stent (Anaes.) (Assist.) | $542.60 75% benefit $406.95 |
| 38428 | Bronchoscopy with treatment of tracheal stricture (H) (Anaes.) | $295.10 75% benefit $221.35 |
| 38429 | Tracheal excision and repair of, without cardiopulmonary bypass (H) (Anaes.) (Assist.) | $2,059.75 75% benefit $1,544.85 |
| 38431 | Tracheal excision and repair of, with cardiopulmonary bypass (H) (Anaes.) (Assist.) | $2,786.00 75% benefit $2,089.50 |
| 38461 | TMVr, by transvenous or transeptal techniques, for permanent coaptation of mitral valve leaflets using one or more tissue approximation implants, including intra‑operative diagnostic imaging, if: (a) the patient has each of the following risk factors: (i) moderate to severe, or severe, symptomatic degenerative (primary) mitral valve regurgitation (grade 3+ or 4+); (ii) left ventricular ejection fraction of 20% or more; (iii) symptoms of mild, moderate or severe chronic heart failure (New York Heart Association class II, III or IV); and (b) as a result of a TMVr suitability case conference, the patient has been: (i) assessed as having an unacceptably high risk for surgical mitral valve replacement; and (ii) recommended as being suitable for the service; and (c) the service is performed: (i) by a cardiothoracic surgeon, or an interventional cardiologist, accredited by the TMVr accreditation committee to perform the service; and (ii) via transfemoral venous delivery, unless transfemoral venous delivery is contraindicated or not feasible; and (iii) in a hospital that is accredited by the TMVr accreditation committee as a suitable hospital for the service; and (d) a service to which this item, or item 38463, applies has not been provided to the patient in the previous 5 years (H) (Anaes.) (Assist.) | $1,714.25 75% benefit $1,285.70 |
| 38463 | TMVr, by transvenous or transeptal techniques, for permanent coaptation of mitral valve leaflets using one or more Mitraclips™, including intra‑operative diagnostic imaging, if: (a) the patient has each of the following risk factors: (i) moderate to severe, or severe, symptomatic functional (secondary) mitral valve regurgitation (grade 3+ or 4+); (ii) left ventricular ejection fraction of 20% to 50%; (iii) left ventricular end systolic diameter of not more than 70mm; (iv) symptoms of mild, moderate or severe chronic heart failure (New York Heart Association class II, III or IV) that persist despite maximally tolerated guideline directed medical therapy; and (b) as a result of a TMVr suitability case conference, the patient has been: (i) assessed as having an unacceptably high risk for surgical mitral valve replacement; and (ii) recommended as being suitable for the service; and (c) the service is performed: (i) by a cardiothoracic surgeon, or an interventional cardiologist, accredited by the TMVr accreditation committee to perform the service; and (ii) via transfemoral venous delivery, unless transfemoral venous delivery is contraindicated or not feasible; and (iii) in a hospital that is accredited by the TMVr accreditation committee as a suitable hospital for the service; and (d) a service to which this item, or item 38461, applies has not been provided to the patient in the previous 5 years (H) (Anaes.) (Assist.) | $1,714.25 75% benefit $1,285.70 |
| 38467 | Insertion, removal or replacement of permanent myocardial electrode, by open surgical approach, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,147.10 75% benefit $860.35 |
| 38471 | Insertion of implantable defibrillator, including insertion of patches for the insertion of one or more transvenous endocardial leads, if the patient has one of the following: (a) a history of haemodynamically significant ventricular arrhythmias in the presence of structural heart disease; (b) documented high-risk genetic cardiac disease; (c) ischaemic heart disease, with a left ventricular ejection fraction of less than 30% at least one month after experiencing a myocardial infarction and while on optimised medical therapy; (d) chronic heart failure, classified as New York Heart Association class II or III, with a left ventricular ejection fraction of less than 35% (despite optimised medical therapy); other than a service to which item 38212 applies (H) (Anaes.) (Assist.) | $1,259.90 75% benefit $944.95 |
| 38472 | Insertion, replacement or removal of implantable defibrillator generator, if the patient has one of the following: (a) a history of haemodynamically significant ventricular arrhythmias in the presence of structural heart disease; (b) documented high-risk genetic cardiac disease; (c) ischaemic heart disease, with a left ventricular ejection fraction of less than 30% at least one month after experiencing a myocardial infarction and while on optimised medical therapy; (d) chronic heart failure, classified as New York Heart Association class II or III, with a left ventricular ejection fraction of less than 35% (despite optimised medical therapy); other than a service to which item 38212 applies (H) (Anaes.) (Assist.) | $344.55 75% benefit $258.45 |
| 38474 | Repair, augmentation or replacement of branch pulmonary arteries—left or right (or both), with cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,596.30 75% benefit $1,947.25 |
| 38477 | Valve annuloplasty with insertion of ring, other than: (a) a service to which item 38516 or 38517 applies; or (b) a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,397.85 75% benefit $1,798.40 |
| 38484 | Aortic or pulmonary valve replacement with bioprosthesis or mechanical prosthesis, including retrograde cardioplegia (if performed), other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,429.60 75% benefit $1,822.20 |
| 38485 | MITRAL ANNULUS, reconstruction of, after decalcification, when performed in association with valve surgery (Anaes.) (Assist.) | $978.00 75% benefit $733.50 |
| 38487 | MITRAL VALVE, open valvotomy of (Anaes.) (Assist.) | $2,059.75 75% benefit $1,544.85 |
| 38490 | Reconstruction and re-implantation of sub-valvular structures, if performed in conjunction with a service to which item 38499 applies (H) (Anaes.) (Assist.) | $663.70 75% benefit $497.80 |
| 38493 | OPERATIVE MANAGEMENT of acute infective endocarditis, in association with heart valve surgery (Anaes.) (Assist.) | $2,342.95 75% benefit $1,757.25 |
| 38495 | TAVI, for the treatment of symptomatic severe aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if: (a) the TAVI Patient is at high risk for surgery; and (b) the service: (i) is performed by a TAVI Practitioner in a TAVI Hospital; and (ii) includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient; and (iii) includes valvuloplasty, if required; not being a service which has been rendered within 5 years of a service to which this item or item 38514 or 38522 applies (H) (Anaes.) (Assist.) | $1,714.25 75% benefit $1,285.70 |
| 38499 | Mitral or tricuspid valve replacement with bioprothesis or mechanical prosthesis, including retrograde cardioplegia (if performed), other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,429.60 75% benefit $1,822.20 |
| 38502 | Coronary artery bypass, including cardiopulmonary bypass, with or without retrograde cardioplegia, with or without vein grafts, and including at least one of the following: (a) harvesting of left internal mammary artery and vein graft material; (b) harvesting of left internal mammary artery; (c) harvesting of vein graft material; other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,819.90 75% benefit $2,114.95 |
| 38508 | Repair or reconstruction of left ventricular aneurysm, including plication, resection and primary and patch repairs, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,296.20 75% benefit $1,722.15 |
| 38509 | Repair of ischaemic ventricular septal rupture,, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,858.95 75% benefit $2,144.25 |
| 38510 | Artery harvesting (other than of the left internal mammary), for coronary artery bypass, if: (a) more than one arterial graft is required; and (b) the service is performed in conjunction with coronary artery bypass surgery performed by any medical practitioner (H) (Anaes.) (Assist.) | $746.85 75% benefit $560.15 |
| 38511 | Coronary artery bypass, with the aid of tissue stabilisers, if: (a) the service is performed without cardiopulmonary bypass; and (b) the service is performed in conjunction with a service to which item 38502 applies Applicable only once in conjunction with each service to which item 38502 applies (H) (Anaes.) (Assist.) | $718.15 75% benefit $538.65 |
| 38512 | Division of accessory pathway, isolation procedure, procedure on atrioventricular node or perinodal tissues involving one atrial chamber only, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,511.75 75% benefit $1,883.85 |
| 38513 | Creation of Y‑graft, T‑graft and graft‑to‑graft extensions, with micro‑arterial or micro‑venous anastomosis using microsurgical techniques, if: (a) the service is for one or more anastomoses; and (b) the service is performed in conjunction with a service to which item 38502 applies (H) (Anaes.) (Assist.) | $1,197.00 75% benefit $897.75 |
| 38514 | TAVI, for the treatment of symptomatic severe aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if: (a) the TAVI Patient is at intermediate risk for surgery; and (b) the service: is performed by a TAVI Practitioner in a TAVI Hospital; and includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient; and includes valvuloplasty, if required; and is performed in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and if performed by an interventional cardiologist, a cardiothoracic surgeon is in attendance during the service; not being a service which has been rendered within 5 years of a service to which this item or item 38495 or 38522 applies (H) (Anaes.) (Assist.) | $1,714.25 75% benefit $1,285.70 |
| 38515 | Division of accessory pathway, isolation procedure, procedure on atrioventricular node or perinodal tissues involving both atrial chambers and including curative surgery for atrial fibrillation, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $3,198.10 75% benefit $2,398.60 |
| 38516 | Simple valve repair: (a) with or without annuloplasty; and (b) including quadrangular resection, cleft closure or alfieri; and (c) including retrograde cardioplegia (if performed); other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,990.75 75% benefit $2,243.10 |
| 38517 | Complex valve repair: (a) with or without annuloplasty; and (b) including retrograde cardioplegia (if performed); and (c) including one of the following: (i) neochords; (ii) chordal transfer; (iii) patch augmentation; (iv) multiple leaflets; other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $3,681.00 75% benefit $2,760.75 |
| 38518 | Ventricular arrhythmia with mapping and muscle ablation, with or without aneurysmeotomy, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $3,432.75 75% benefit $2,574.60 |
| 38519 | Valve explant of a previous prosthesis, if performed during open cardiac surgery, not being a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,265.35 75% benefit $949.05 |
| 38522 | TAVI, for the treatment of symptomatic severe native calcific aortic stenosis, performed via transfemoral delivery, unless transfemoral delivery is contraindicated or not feasible, if: (a) the TAVI Patient is at low risk for surgery; and (b) the service: is performed by a TAVI Practitioner in a TAVI Hospital; and includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient; and includes valvuloplasty, if required; and is performed in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and if performed by an interventional cardiologist, a cardiothoracic surgeon is in attendance during the service; not being a service which has been rendered within 5 years of a service to which this item or item 38495 or 38514 applies (H) (Anaes.) (Assist.) | $1,714.25 75% benefit $1,285.70 |
| 38523 | Percutaneous transcatheter delivery of dual-filter cerebral embolic protection system during a TAVI procedure, for the reduction of postoperative embolic ischaemic strokes, if: the service is performed upon a TAVI Patient in a TAVI Hospital; and where the service is performed by the practitioner performing the TAVI procedure, the service includes all intraoperative diagnostic imaging that the TAVI Practitioner performs upon the TAVI Patient (H) (Anaes.) (Assist.) | $311.60 75% benefit $233.70 |
| 38550 | Repair or replacement of ascending thoracic aorta: (a) including: (i) cardiopulmonary bypass; and (ii) retrograde cardioplegia (if performed); and (b) not including valve replacement or repair or implantation of coronary arteries; other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,688.80 75% benefit $2,016.60 |
| 38553 | Repair or replacement of ascending thoracic aorta: (a) including: (i) aortic valve replacement or repair; and (i) cardiopulmonary bypass; and (ii) retrograde cardioplegia (if performed); and (b) not including implantation of coronary arteries; other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $3,385.25 75% benefit $2,538.95 |
| 38554 | Valve sparing aortic root surgery, with reimplantation of aortic valve and coronary arteries and replacement of the ascending aorta, including cardiopulmonary bypass, and including retrograde cardioplegia (if performed), other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $4,873.15 75% benefit $3,654.90 |
| 38555 | Simple replacement or repair of aortic arch, performed in conjunction with a service to which item 38550, 38553, 38554, 38556, 38568 or 38571 applies, including: (a) deep hypothermic circulatory arrest; and (b) peripheral cannulation for cardiopulmonary bypass; and (c) antegrade or retrograde cerebral perfusion (if performed); other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38603, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,990.75 75% benefit $2,243.10 |
| 38556 | Repair or replacement of ascending thoracic aorta, including: (a) aortic valve replacement or repair; and (b) implantation of coronary arteries; and (c) cardiopulmonary bypass; and (d) retrograde cardioplegia (if performed); other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38603, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $3,716.00 75% benefit $2,787.00 |
| 38557 | Complex replacement or repair of aortic arch, performed in conjunction with a service, performed by any medical practitioner, to which item 38550, 38553, 38554, 38556, 38568 or 38571 applies, including: (a) debranching and reimplantation of head and neck vessels; and (b) deep hypothermic circulatory arrest; and (c) peripheral cannulation for cardiopulmonary bypass; and (d) antegrade or retrograde cerebral perfusion (if performed); other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $5,176.30 75% benefit $3,882.25 |
| 38558 | Aortic repair involving augmentation of hypoplastic or interrupted aortic arch, if: (a) the patient is a neonate; and (b) the service includes: (i) the use of antegrade cerebral perfusion or deep hypothermic circulatory arrest and associated myocardial preservation; and (ii) retrograde cardioplegia; other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $5,847.75 75% benefit $4,385.85 |
| 38568 | Repair or replacement of descending thoracic aorta, without shunt or cardiopulmonary bypass, by open exposure, percutaneous or endovascular means, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,229.75 75% benefit $1,672.35 |
| 38571 | Repair or replacement of descending thoracic aorta, with shunt or cardiopulmonary bypass, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,541.70 75% benefit $1,906.30 |
| 38572 | Operative management of acute rupture or dissection, if the service: (a) is performed in conjunction with a service to which item 38550, 38553, 38554, 38555, 38556, 38557, 38558, 38568, 38571, 38706 or 38709 applies; and (b) is not associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38603, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,378.40 75% benefit $1,783.80 |
| 38600 | CENTRAL CANNULATION for cardiopulmonary bypass excluding post-operative management, not being a service associated with a service to which another item in this Subgroup applies (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 38603 | Peripheral cannulation for cardiopulmonary bypass, excluding post-operative management, other than a service: (a) in which peripheral cannulation is used in preference to central cannulation for valve or coronary bypass procedures; or (b) associated with a service to which item 38555 or 38572 applies (H) (Anaes.) (Assist.) | $1,147.10 75% benefit $860.35 |
| 38609 | Insertion of intra-aortic balloon pump, by arteriotomy, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $573.50 75% benefit $430.15 |
| 38612 | Removal of intra-aortic balloon pump, with closure of artery by direct suture, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 338816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $642.95 75% benefit $482.25 |
| 38615 | Insertion of a left or right ventricular assist device, for use as: (a) a bridge to cardiac transplantation in patients with refractory heart failure who are: (i) currently on a heart transplant waiting list, or (ii) expected to be suitable candidates for cardiac transplantation following a period of support on the ventricular assist device; or (b) acute post cardiotomy support for failure to wean from cardiopulmonary transplantation; or (c) cardio-respiratory support for acute cardiac failure which is likely to recover with short term support of less than 6 weeks; other than a service associated with a service to which: (d) item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies; or (e) another item in this Schedule applies if the service described in the item is for the use of a ventricular assist device as destination therapy in the management of a patient with heart failure who is not expected to be a suitable candidate for cardiac transplantation (H) (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 38616 | Surgical insertion of an intravascular microaxial ventricular assist device, into the left ventricle only, by arteriotomy, including all associated intraoperative imaging performed by the same practitioner, if: (a) the patient has deteriorating symptoms of cardiogenic shock (with no evidence of significant anoxic neurological injury) that are not controlled by optimal medical therapy; or (b) the patient: (i) is on veno‑arterial extra‑corporeal membrane oxygenation, for deteriorating symptoms of cardiogenic shock (with no evidence of significant anoxic neurological injury) that are not controlled by optimal medical therapy; and (ii) due to the effects of established veno‑arterial extra‑corporeal membrane oxygenation, requires unloading of the left ventricle (H) (Anaes.) | $1,131.50 75% benefit $848.65 |
| 38618 | Insertion of a left and right ventricular assist device, for use as: (a) a bridge to cardiac transplantation in patients with refractory heart failure who are: (i) currently on a heart transplant waiting list, or (ii) expected to be suitable candidates for cardiac transplantation following a period of support on the ventricular assist device; or (b) acute post cardiotomy support for failure to wean from cardiopulmonary transplantation; or (c) cardio-respiratory support for acute cardiac failure which is likely to recover with short term support of less than 6 weeks; other than a service associated with a service to which: (d) item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies; or (e) another item in this Schedule applies if the service described in the item is for the use of a ventricular assist device as destination therapy in the management of a patient with heart failure who is not expected to be a suitable candidate for cardiac transplantation (H) (Anaes.) (Assist.) | $2,285.50 75% benefit $1,714.15 |
| 38619 | Surgical removal of a left sided intravascular microaxial ventricular assist device (H) (Anaes.) | $678.70 75% benefit $509.05 |
| 38620 | Insertion of a durable left ventricular assist device capable of providing mechanical circulatory support for at least 6 months: (a) as destination therapy in the management of a patient who: (i) has refractory heart failure despite optimal medical management including device use where appropriate; and (ii) has an INTERMACS profile of 1, 2, 3 or 4; and (iii) is not expected to be a suitable candidate for cardiac transplantation; and (b) including all associated intraoperative imaging performed by the same practitioner; other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies Applicable only once per lifetime (H) (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 38621 | Left or right ventricular assist device, removal or replacement of, as an independent procedure, other than a service to which item 38619 applies, or a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38619, 38627, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $912.40 75% benefit $684.30 |
| 38624 | Left and right ventricular assist device, removal of, as an independent procedure, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38627, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,025.30 75% benefit $769.00 |
| 38627 | Extra-corporeal membrane oxygenation, bypass or ventricular assist device cannulae, adjustment and re-positioning of, by open operation, in patients supported by these devices, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38627, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $801.40 75% benefit $601.05 |
| 38637 | Patent diseased coronary artery bypass vein graft or grafts, dissection, disconnection and oversewing of, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $663.70 75% benefit $497.80 |
| 38653 | Open heart surgery, other than a service: (a) to which another item in this Group applies; or (b) associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,404.70 75% benefit $1,803.55 |
| 38670 | Cardiac tumour, excision of, involving the wall of the atrium or inter-atrial septum, without patch or conduit reconstruction, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,285.10 75% benefit $1,713.85 |
| 38673 | Cardiac tumour, excision of, involving the wall of the atrium or inter-atrial septum, requiring reconstruction with patch or conduit, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,572.05 75% benefit $1,929.05 |
| 38677 | Cardiac tumour arising from ventricular myocardium, partial thickness excision of, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,406.10 75% benefit $1,804.60 |
| 38680 | Cardiac tumour arising from ventricular myocardium, full thickness excision of including repair or reconstruction, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,854.10 75% benefit $2,140.60 |
| 38700 | Patent ductus arteriosus, shunt, collateral or other single large vessel, division or ligation of, without cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,277.50 75% benefit $958.15 |
| 38703 | Patent ductus arteriosus, shunt, collateral or other single large vessel, division or ligation of, with cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,310.80 75% benefit $1,733.10 |
| 38706 | Aorta, anastomosis or repair of, without cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,181.20 75% benefit $1,635.90 |
| 38709 | Anastomosis or repair of aorta, with cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,571.35 75% benefit $1,928.55 |
| 38715 | Main Pulmonary Artery, banding, debanding or repair of, without cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,042.30 75% benefit $1,531.75 |
| 38718 | Banding, debanding or repair of main pulmonary artery, with cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,583.20 75% benefit $1,937.40 |
| 38721 | Vena Cava, anastomosis or repair of, without cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,790.40 75% benefit $1,342.80 |
| 38724 | Vena cava, anastomosis or repair of, with cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,604.90 75% benefit $1,953.70 |
| 38727 | Anastomosis or repair of intrathoracic vessels, without cardiopulmonary bypass, performed as a primary procedure, other than a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38700, 38703, 38706, 38709, 38715, 38718, 38721, 38724, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,790.40 75% benefit $1,342.80 |
| 38730 | Anastomosis or repair of intrathoracic vessels, with cardiopulmonary bypass, performed as a primary procedure, other than a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38700, 38703, 38706, 38709, 38715, 38718, 38721, 38724, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38733 | Systemic pulmonary or Cavo-pulmonary shunt, creation of, without cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,790.40 75% benefit $1,342.80 |
| 38736 | Systemic pulmonary or Cavo-pulmonary shunt, creation of, with cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38739 | Atrial septectomy, with or without cardiopulmonary bypass, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,342.60 75% benefit $1,756.95 |
| 38742 | Atrial septal defect, closure by open exposure and direct suture or patch, for congenital heart disease in a patient with documented evidence of right heart overload or paradoxical embolism, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,303.00 75% benefit $1,727.25 |
| 38745 | Intra-atrial baffle, insertion of, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38748 | Ventricular septectomy, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38751 | Ventricular septal defect, closure by direct suture or patch, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38754 | Intraventricular baffle or conduit, insertion of, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $3,198.10 75% benefit $2,398.60 |
| 38757 | Extracardiac conduit, insertion of, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38760 | Extracardiac conduit, replacement of, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38764 | Ventricular myectomy, for relief of right or left ventricular obstruction, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38766 | Ventricular augmentation, right or left, for congenital heart disease, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18260, 33824, 38816, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $2,554.85 75% benefit $1,916.15 |
| 38800 | THORACIC CAVITY, aspiration of, for diagnostic purposes, not being a service associated with a service to which item 38803 applies | $46.05 75% benefit $34.55 85% benefit $39.15 |
| 38803 | THORACIC CAVITY, aspiration of, with therapeutic drainage (paracentesis), with or without diagnostic sample | $92.05 75% benefit $69.05 85% benefit $78.25 |
| 38812 | PERCUTANEOUS NEEDLE BIOPSY of lung (Anaes.) | $250.35 75% benefit $187.80 85% benefit $212.80 |
| 38815 | Thoracoscopy, with or without division of pleural adhesions, with or without biopsy, including insertion of intercostal catheter where necessary, other than a service associated with: (a) a service to which item 18258, 18260 or 38828 applies; or (b) a service to which item 38816 applies that is performed on the same lung (H) (Anaes.) (Assist.) | $298.85 75% benefit $224.15 |
| 38816 | Thoracotomy, exploratory, with or without biopsy, including insertion of an intercostal catheter where necessary, other than a service associated with: (a) a service to which item 18258, 18260 or 38828 applies; or (b) a service to which item 38815 applies that is performed on the same lung (H) (Anaes.) (Assist.) | $1,147.10 75% benefit $860.35 |
| 38817 | Thoracotomy, thoracoscopy or sternotomy, by any procedure: (a) including any division of adhesions if the time taken to divide the adhesions exceeds 30 minutes; and (b) other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18258, 18260, 33824, 38815, 38816, 38818, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,803.30 75% benefit $1,352.50 |
| 38818 | Thoracotomy, thoracoscopy or median sternotomy for post operative bleeding, other than a service associated with a service to which item 11704, 11705, 11707, 11714, 18258, 18260, 33824, 38815, 38816, 38817, 38828 or 45503 applies (H) (Anaes.) (Assist.) | $1,147.10 75% benefit $860.35 |
| 38820 | Lung, wedge resection of, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38820, 38821 or 38828 applies (H) (Anaes.) (Assist.) | $1,373.10 75% benefit $1,029.85 |
| 38821 | Lung, wedge resection of, 2 or more wedges, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38820 or 38828 applies (H) (Anaes.) (Assist.) | $2,059.65 75% benefit $1,544.75 |
| 38822 | Pneumonectomy, lobectomy, bilobectomy or segmentectomy, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38823, 38824 or 38828 applies (H) (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 38823 | Radical lobectomy, pneumonectomy, bilobectomy, segmentectomy or formal mediastinal node dissection (greater than 4 nodes), other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38822, 38824 or 38828 applies (H) (Anaes.) (Assist.) | $2,265.55 75% benefit $1,699.20 |
| 38824 | Segmentectomy, lobectomy, bilobectomy or pneumonectomy, including resection of chest wall, diaphragm, pericardium, and formal mediastinal node dissection (greater than 4 nodes), other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38822, 38823 or 38828 applies (H) (Anaes.) (Assist.) | $2,831.95 75% benefit $2,124.00 |
| 38828 | Intercostal drain, insertion of: (a) not involving resection of rib; and (b) excluding aftercare; and (c) other than a service associated with a service to which item 38815, 38816, 38829, 38830, 38831, 38832, 38833 or 38834 applies (Anaes.) | $159.90 75% benefit $119.95 85% benefit $135.95 |
| 38829 | Intercostal drain, insertion of, with pleurodesis: (a) not involving resection of rib; and (b) excluding aftercare; and (c) other than a service associated with a service to which item 38815, 38816, 38828, 38830, 38831, 38832, 38833 or 38834 applies (H) (Anaes.) | $197.00 75% benefit $147.75 |
| 38830 | Empyema, radical operation for, involving resection of rib, other than a service associated with a service to which item 38828, 38829, 38831, 38832, 38833 or 38834 applies (H) (Anaes.) (Assist.) | $478.00 75% benefit $358.50 |
| 38831 | Thoracoscopy or thoracotomy and drainage of paraneumonic effusion and empyema, exploratory, with or without biopsy, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38829, 38830, 38832, 38833 or 38834 applies (H) (Anaes.) (Assist.) | $1,720.65 75% benefit $1,290.50 |
| 38832 | Thoracotomy or thoracoscopy, with pulmonary decortication, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38829, 38830, 38831, 38833 or 38834 applies (H) (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 38833 | Thoracotomy or thoracoscopy, with pleurectomy or pleurodesis, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38829, 38830, 38831, 38832 or 38834 applies (H) (Anaes.) (Assist.) | $1,147.10 75% benefit $860.35 |
| 38834 | Thoracotomy and radical extra pleural pneumonectomy or radical lung preserving decortication and pleurectomy for malignancy, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38829, 38830, 38831, 38832 or 38833 applies (H) (Anaes.) (Assist.) | $4,248.10 75% benefit $3,186.10 |
| 38837 | Mediastinum, cervical exploration of, with or without biopsy, other than a service associated with a service to which item 18258, 18260, 38815, 38816 or 38828 applies (H) (Anaes.) (Assist.) | $434.55 75% benefit $325.95 |
| 38838 | Thoracotomy or thoracoscopy or sternotomy, for removal of thymus or mediastinal tumour, other than a service associated with a service to which item 18258, 18260, 38815, 38816 or 38828 applies (H) (Anaes.) (Assist.) | $1,416.50 75% benefit $1,062.40 |
| 38839 | Pericardium, subxiphoid open surgical drainage of, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828 or 38840 applies (H) (Anaes.) (Assist.) | $686.70 75% benefit $515.05 |
| 38840 | Pericardium, transthoracic (thoracotomy or thoracoscopy) open surgical drainage of, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828 or 38839 applies (H) (Anaes.) (Assist.) | $1,025.30 75% benefit $769.00 |
| 38841 | Pericardiectomy via sternotomy or thoracoscopy or anterolateral thoracotomy without cardiopulmonary bypass, other than a service associated with a service to which item 18258, 18260, 38815, 38816 or 38828 applies (H) (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 38842 | Pericardiectomy via sternotomy or anterolateral thoracotomy with cardiopulmonary bypass, other than a service associated with a service to which item 18258, 18260, 38815, 38816 or 38828 applies (H) (Anaes.) (Assist.) | $2,565.20 75% benefit $1,923.90 |
| 38845 | Sternal wire or wires, removal of, other than a service associated with a service to which item 18258, 18260, 38815, 38816 or 38828 applies (H) (Anaes.) | $329.65 75% benefit $247.25 |
| 38846 | Pectus excavatum or pectus carinatum, repair or radical correction of, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38847, 38848 or 38849 applies (H) (Anaes.) (Assist.) | $1,711.90 75% benefit $1,283.95 |
| 38847 | Pectus excavatum, repair of, with implantation of subcutaneous prosthesis, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38846, 38848 or 38849 applies (H) (Anaes.) (Assist.) | $912.40 75% benefit $684.30 |
| 38848 | Pectus excavatum, repair of, with insertion of a concave bar, by any method, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38846 or 38847 applies (H) (Anaes.) (Assist.) | $1,369.50 75% benefit $1,027.15 |
| 38849 | Pectus excavatum, removal of a concave bar, by any method, not being a service associated with a service to which item 18258, 18260, 38815, 38816, 38828, 38846 or 38847 applies (H) (Anaes.) (Assist.) | $684.70 75% benefit $513.55 |
| 38850 | Sternotomy wound, debridement of, not involving reopening of the mediastinum, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828 or 38851 applies (H) (Anaes.) | $390.75 75% benefit $293.10 |
| 38851 | Sternotomy wound, debridement of, involving curettage of infected bone, with or without removal of wires, but not involving reopening of the mediastinum, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828 or 38850 applies (H) (Anaes.) | $424.65 75% benefit $318.50 |
| 38852 | Sternum, reoperation on, for dehiscence or infection involving reopening of the mediastinum, with or without rewiring, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828 or 38853 applies (H) (Anaes.) (Assist.) | $1,146.65 75% benefit $860.00 |
| 38853 | Sternum and mediastinum, reoperation for infection of, involving muscle advancement flaps and/or greater omentum, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38828 or 38852 applies (H) (Anaes.) (Assist.) | $1,797.60 75% benefit $1,348.20 |
| 38857 | Chest wall resection, sternum and/or ribs without reconstruction, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38824, 38828 or 38858 applies (H) (Anaes.) (Assist.) | $2,172.65 75% benefit $1,629.50 |
| 38858 | Chest wall resection, sternum and / or ribs with reconstruction, other than a service associated with a service to which item 18258, 18260, 38815, 38816, 38824, 38828 or 38857 applies (H) (Anaes.) (Assist.) | $2,831.95 75% benefit $2,124.00 |
| 38859 | Plating of multiple ribs for flail segment, other than a service associated with a service to which item 18258, 18260, 38815, 38816 or 38828 applies (H) (Anaes.) (Assist.) | $1,147.10 75% benefit $860.35 |
| 38864 | Intrathoracic operations on heart, lungs, great vessels, bronchial tree, oesophagus or mediastinum, or on more than one of those organs, not being a service to which another item in this Group applies, other than a service associated with a service to which item 18258, 18260 or 38828 applies (H) (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 39000 | LUMBAR PUNCTURE (Anaes.) | $90.10 75% benefit $67.60 85% benefit $76.60 |
| 39007 | Procedure to obtain access to intracranial space (including subdural space, ventricle or basal cistern), percutaneously or by burr-hole (H) (Anaes.) | $190.80 75% benefit $143.10 |
| 39013 | Injection of one or more zygo-apophyseal or costo-transverse joints with one or more of contrast media, local anaesthetic or corticosteroid under image guidance (Anaes.) | $130.60 75% benefit $97.95 85% benefit $111.05 |
| 39014 | Medial branch block of one or more primary posterior rami, injection of an anaesthetic agent under image guidance (Anaes.) | $149.45 75% benefit $112.10 85% benefit $127.05 |
| 39015 | Intracranial parenchymal pressure monitoring device, insertion of—including burr hole (excluding after care) (Anaes.) | $450.05 75% benefit $337.55 |
| 39018 | Cerebrospinal reservoir, ventricular reservoir or external ventricular drain, insertion of, with or without stereotaxy (Anaes.) (Assist.) | $989.40 75% benefit $742.05 |
| 39100 | Injection of primary branch of trigeminal nerve (ophthalmic, maxillary or mandibular branches) with alcohol, cortisone, phenol, or similar neurolytic substance, under image guidance (Anaes.) | $284.35 75% benefit $213.30 85% benefit $241.70 |
| 39109 | Trigeminal gangliotomy by radiofrequency, balloon or glycerol, including stereotaxy (H) (Anaes.) (Assist.) | $1,696.70 75% benefit $1,272.55 |
| 39110 | Left lumbar percutaneous zygapophyseal joint denervation by radio-frequency probe, or cryoprobe, using radiological imaging control Applicable to one or more services provided in a single attendance, for not more than 3 attendances in a 12 month period (Anaes.) | $320.80 75% benefit $240.60 85% benefit $272.70 |
| 39111 | Right lumbar percutaneous zygapophyseal joint denervation by radio-frequency probe, or cryoprobe, using radiological imaging control Applicable to one or more services provided in a single attendance, for not more than 3 attendances in a 12 month period (Anaes.) | $320.80 75% benefit $240.60 85% benefit $272.70 |
| 39113 | Cranial nerve, neurectomy or intracranial decompression of, using microsurgical techniques, including stereotaxy and cranioplasty (Anaes.) (Assist.) | $2,846.30 75% benefit $2,134.75 |
| 39116 | Left thoracic percutaneous zygapophyseal joint denervation by radio-frequency probe or cryoprobe using radiological imaging control Applicable to one or more services provided in a single attendance, for not more than 3 attendances in a 12 month period (Anaes.) | $356.50 75% benefit $267.40 85% benefit $303.05 |
| 39117 | Right thoracic percutaneous zygapophyseal joint denervation by radio-frequency probe, or cryoprobe, using radiological imaging control Applicable to one or more services provided in a single attendance, for not more than 3 attendances in a 12 month period (Anaes.) | $356.50 75% benefit $267.40 85% benefit $303.05 |
| 39118 | Left cervical percutaneous zygapophyseal joint denervation by radio-frequency probe, or cryoprobe, using radiological imaging control Applicable to one or more services provided in a single attendance, for not more than 3 attendances in a 12 month period (Anaes.) | $392.10 75% benefit $294.10 85% benefit $333.30 |
| 39119 | Right cervical percutaneous zygapophyseal joint denervation by radio-frequency probe, or cryoprobe, using radiological imaging control Applicable to one or more services provided in a single attendance, for not more than 3 attendances in a 12 month period (Anaes.) | $392.10 75% benefit $294.10 85% benefit $333.30 |
| 39121 | Percutaneous cordotomy (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 39124 | CORDOTOMY OR MYELOTOMY, partial or total laminectomy for, or operation for dorsal root entry zone (Drez) lesion (Anaes.) (Assist.) | $1,935.15 75% benefit $1,451.40 |
| 39125 | Spinal catheter, insertion or replacement of, and connection to a subcutaneous implanted infusion pump, for the management of chronic pain, including cancer pain (H) (Anaes.) (Assist.) | $356.75 75% benefit $267.60 |
| 39126 | All of the following:(a) infusion pump, subcutaneous implantation or replacement of;(b) connection of the pump to a spinal catheter;(c) filling of reservoir with a therapeutic agent or agents;with or without programming the pump, for the management of chronic pain, including cancer pain (H) (Anaes.) (Assist.) | $433.15 75% benefit $324.90 |
| 39127 | Subcutaneous reservoir and spinal catheter, insertion of, for the management of chronic pain, including cancer pain (H) (Anaes.) | $566.95 75% benefit $425.25 |
| 39128 | All of the following:(a) infusion pump, subcutaneous implantation of;(b) spinal catheter, insertion of;(c) connection of pump to catheter;(d) filling of reservoir with a therapeutic agent or agents;with or without programming the pump, for the management of chronic pain, including cancer pain (H) (Anaes.) (Assist.) | $789.80 75% benefit $592.35 |
| 39129 | Peripheral lead or leads, percutaneous placement of, including intraoperative test stimulation, for the management of chronic neuropathic pain (H) (Anaes.) (Assist.) | $726.15 75% benefit $544.65 |
| 39130 | Epidural lead or leads, percutaneous placement of, including intraoperative test stimulation, for the management of chronic neuropathic pain or pain from refractory angina pectoris (H) (Anaes.) (Assist.) | $806.85 75% benefit $605.15 |
| 39131 | Epidural or peripheral nerve electrodes (management, adjustment, or reprogramming of neurostimulator), with a medical practitioner attending, for the management of chronic neuropathic pain or pain from refractory angina pectoris—each day | $153.00 75% benefit $114.75 85% benefit $130.05 |
| 39133 | Either:(a) subcutaneously implanted infusion pump, removal of; or(b) spinal catheter, removal or repositioning of;for the management of chronic pain, including cancer pain (H) (Anaes.) | $190.80 75% benefit $143.10 |
| 39134 | Neurostimulator or receiver, subcutaneous placement of, including placement and connection of extension wires to epidural or peripheral nerve electrodes, for the management of chronic neuropathic pain or pain from refractory angina pectoris (H) (Anaes.) (Assist.) | $407.60 75% benefit $305.70 |
| 39135 | Neurostimulator or receiver that was inserted for the management of chronic neuropathic pain or pain from refractory angina pectoris, open surgical removal of, performed in the operating theatre of a hospital (H) (Anaes.) (Assist.) | $190.80 75% benefit $143.10 |
| 39136 | Epidural or peripheral nerve lead that was implanted for the management of chronic neuropathic pain or pain from refractory angina pectoris, open surgical removal of, performed in the operating theatre of a hospital (H) (Anaes.) (Assist.) | $190.80 75% benefit $143.10 |
| 39137 | Epidural or peripheral nerve lead that was implanted for the management of chronic neuropathic pain or pain from refractory angina pectoris, open surgical repositioning of, to correct displacement or unsatisfactory positioning, including intraoperative test stimulation, other than a service to which item 39130, 39138 or 39139 applies (H) (Anaes.) (Assist.) | $724.55 75% benefit $543.45 |
| 39138 | Peripheral nerve lead or leads, surgical placement of, including intraoperative test stimulation, for the management of chronic neuropathic pain where the leads are intended to remain in situ long term (H) (Anaes.) (Assist.) | $806.85 75% benefit $605.15 |
| 39139 | Epidural lead, surgical placement of one or more of by partial or total laminectomy, including intraoperative test stimulation, for the management of chronic neuropathic pain or pain from refractory angina pectoris (H) (Anaes.) (Assist.) | $1,083.30 75% benefit $812.50 |
| 39140 | Epidural catheter, insertion of, under imaging control, with epidurogram and epidural therapeutic injection for lysis of adhesions (H) (Anaes.) | $350.55 75% benefit $262.95 |
| 39141 | Epidural or peripheral nerve electrodes (management, adjustment, or reprogramming of neurostimulator), with a medical practitioner attending remotely by video conference, for the management of chronic neuropathic pain or pain from refractory angina pectoris—each day | $153.00 75% benefit $114.75 85% benefit $130.05 |
| 39300 | Nerve, digital or cutaneous, primary repair of, using microsurgical techniques, other than a service associated with a service to which item 39330 applies—applicable once per nerve (H) (Anaes.) (Assist.) | $422.95 75% benefit $317.25 |
| 39303 | Nerve, digital or cutaneous, delayed repair of, using microsurgical techniques, including either or both of the following (if performed): (a) neurolysis; (b) transposition of nerve to facilitate repair; other than a service associated with a service to which item 30023 applies that is performed at the same site—applicable once per nerve (H) (Anaes.) (Assist.) | $557.90 75% benefit $418.45 |
| 39306 | Nerve trunk, primary repair of, using microsurgical techniques, other than a service associated with a service to which item 39330 applies (H) (Anaes.) (Assist.) | $810.05 75% benefit $607.55 |
| 39307 | Reconstruction of nerve trunk using biological or synthetic nerve conduit, using microsurgical techniques, other than a service associated with a service to which item 39330 applies (H) (Anaes.) (Assist.) | $986.40 75% benefit $739.80 |
| 39309 | Nerve trunk, delayed repair of, using microsurgical techniques, including either or both of the following (if performed): (a) neurolysis; (b) transposition of nerve or nerve transfer to facilitate repair; other than a service associated with: (c) a service to which item 39321 applies; or (d) a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $855.05 75% benefit $641.30 |
| 39312 | Nerve trunk, internal (interfascicular), neurolysis of, using microsurgical techniques, other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $477.05 75% benefit $357.80 |
| 39315 | Nerve trunk, nerve graft to, by cable graft, using microsurgical techniques, including any of the following (if performed): (a) harvesting of nerve graft; (b) proximal and distal anastomosis of nerve graft; (c) transposition of nerve to facilitate grafting; (d) neurolysis; other than a service associated with: (e) a service to which item 39330 applies; or (f) a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $1,233.05 75% benefit $924.80 |
| 39318 | Nerve, digital or cutaneous, nerve graft to, using microsurgical techniques, including either or both of the following (if performed): (a) harvesting of nerve graft from separate donor site; (b) proximal and distal anastomosis of nerve graft; other than a service associated with a service to which item 39330 applies (H) (Anaes.) (Assist.) | $765.20 75% benefit $573.90 |
| 39319 | Reconstruction of digital or cutaneous nerve using biological or synthetic nerve conduit, using microsurgical techniques, other than a service associated with a service to which item 39330 applies (H) (Anaes.) (Assist.) | $557.90 75% benefit $418.45 |
| 39321 | Transposition of nerve, excluding the ulnar nerve at the elbow, other than a service associated with a service to which item 39330 applies (H) (Anaes.) (Assist.) | $566.95 75% benefit $425.25 |
| 39323 | Percutaneous denervation (excluding medial branch nerve) by cryotherapy or radiofrequency probe, other than a service to which another item applies, applicable not more than 6 times for a given nerve in a 12 month period (Anaes.) | $331.25 75% benefit $248.45 85% benefit $281.60 |
| 39324 | Neurectomy or removal of tumour or neuroma from superficial peripheral nerve (Anaes.) (Assist.) | $331.25 75% benefit $248.45 85% benefit $281.60 |
| 39327 | NEURECTOMY, NEUROTOMY or removal of tumour from deep peripheral or cranial nerve, by open operation, not being a service to which item 41575, 41576, 41578 or 41579 applies (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 39328 | Neurectomy, neurotomy or removal of tumour from deep peripheral nerve, by open operation, for upper limb surgery (H) (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 39329 | Extensive neurolysis of radial, median or ulnar nerve trunk nerve in the forearm or arm, other than a service associated with: (a) a service to which item 39303, 39309, 39312, 39315, 39318, 39324 or 39327 applies; or (b) a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $422.95 75% benefit $317.25 |
| 39330 | Neurolysis by open operation without transposition, other than a service associated with: (a) a service to which item 39321, 39328, 39329, 39332, 39336, 39339, 39342, 39345, 49774 or 49775 applies; or (b) a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $331.25 75% benefit $248.45 |
| 39331 | Carpal tunnel release, including division of transverse carpal ligament or release of median nerve, by any method, including either or both of the following (if performed): (a) synovectomy; (b) neurolysis; other than a service associated with: (c) a service to which item 46339 applies; or (d) a service to which item 30023 applies that is performed at the same site (Anaes.) (Assist.) | $331.25 75% benefit $248.45 85% benefit $281.60 |
| 39332 | Revision of carpal tunnel release, including division of transverse carpal ligament or release of median nerve, by any method, including either or both of the following (if performed): (a) synovectomy; (b) neurolysis; other than a service associated with: (c) a service to which item 46339 applies; or (d) a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $496.95 75% benefit $372.75 |
| 39336 | Ulnar nerve decompression at elbow or wrist (cubital tunnel or Guyon’s canal) without transposition, by any method, including neurolysis (if performed), other than a service associated with a service to which item 30023 applies that is performed at the same site (Anaes.) (Assist.) | $331.25 75% benefit $248.45 85% benefit $281.60 |
| 39339 | Revision of ulnar nerve decompression at elbow (cubital tunnel) without transposition, by any method, including neurolysis (if performed), other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $496.95 75% benefit $372.75 |
| 39342 | Ulnar nerve decompression at elbow (cubital tunnel), including any of the following (if performed): (a) associated transposition; (b) subcutaneous or submuscular transposition of the nerve; (c) medial epicondylectomy; (d) ostetomy and reconstruction of the flexor origin; (e) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $651.95 75% benefit $489.00 |
| 39345 | Localised decompression of radial, median or ulnar nerve, or branches of, in the forearm for compressive neuropathy, including neurolysis (if performed), other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $331.25 75% benefit $248.45 |
| 39503 | Facio-hypoglossal nerve or facio-accessory nerve, anastomosis of (Anaes.) (Assist.) | $1,143.05 75% benefit $857.30 |
| 39604 | Any of the following procedures for intracranial haemorrhage or swelling: (a) craniotomy, craniectomy or burr-holes for removal of intracranial haemorrhage, including stereotaxy;(b) craniotomy or craniectomy for brain swelling, stroke, or raised intracranial pressure, including for subtemporal decompression, including stereotaxy; or(c) post-operative re-opening, including for swelling or post-operative cerebrospinal fluid leak. (Anaes.) (Assist.) | $2,146.70 75% benefit $1,610.05 |
| 39610 | Fractured skull, without brain laceration or dural penetration, repair of (Anaes.) (Assist.) | $1,143.05 75% benefit $857.30 |
| 39612 | Fractured skull, with brain laceration or dural penetration but without cerebrospinal fluid, rhinorrhoea or otorrhoea, repair of (Anaes.) (Assist.) | $1,341.15 75% benefit $1,005.90 |
| 39615 | Fractured skull, after trauma, with cerebrospinal fluid rhinorrhoea or otorrhoea, repair of, including stereotaxy and dermofat graft (Anaes.) (Assist.) | $2,288.50 75% benefit $1,716.40 |
| 39638 | Anterior or middle cranial fossa or cavernous sinus, tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, principal surgeon (Anaes.) (Assist.) | $5,095.30 75% benefit $3,821.50 |
| 39639 | Anterior or middle cranial fossa or cavernous sinus, tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, co‑surgeon (Assist.) | $4,071.75 75% benefit $3,053.85 |
| 39641 | Anterior or middle cranial fossa or cavernous sinus, tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty - one surgeon (Anaes.) (Assist.) | $5,374.35 75% benefit $4,030.80 |
| 39651 | Petro-clival, clival or foramen magnum tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty - one surgeon (Anaes.) (Assist.) | $6,630.60 75% benefit $4,972.95 |
| 39654 | Petro-clival, clival or foramen magnum tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, principal surgeon (Anaes.) (Assist.) | $5,095.30 75% benefit $3,821.50 |
| 39656 | Petro clival, clival or foramen magnum tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, co surgeon (Assist.) | $4,071.75 75% benefit $3,053.85 |
| 39700 | Skull tumour, benign or malignant, excision of, including stereotaxy and cranioplasty (Anaes.) (Assist.) | $2,169.10 75% benefit $1,626.85 |
| 39703 | Intracranial tumour, cyst or other brain tissue, either or both of: (a) burr hole and biopsy of; (b) drainage of; including stereotaxy (Anaes.) (Assist.) | $1,741.80 75% benefit $1,306.35 |
| 39710 | Intracranial tumour, one or more, biopsy, drainage, decompression or removal of, through a single craniotomy, including stereotaxy and cranioplasty (Anaes.) (Assist.) | $2,900.55 75% benefit $2,175.45 |
| 39712 | Transcranial tumour removal or biopsy of one or more of any of the following: (a) meningioma; (b) pinealoma; (c) cranio pharyngioma; (d) pituitary tumour; (e) intraventricular lesion; (f) brain stem lesion; (g) any other intracranial tumour; by any means (with or without endoscopy), through a single craniotomy, including stereotaxy and cranioplasty (Anaes.) (Assist.) | $4,430.50 75% benefit $3,322.90 |
| 39715 | Pituitary tumour, removal of, by transphenoidal approach, including stereotaxy and dermis, dermofat or fascia grafting, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $3,233.55 75% benefit $2,425.20 |
| 39718 | Arachnoidal cyst, craniotomy for, including stereotaxy and neuroendoscopy (Anaes.) (Assist.) | $1,953.20 75% benefit $1,464.90 |
| 39720 | Awake craniotomy for functional neurosurgery (Anaes.) (Assist.) | $4,144.75 75% benefit $3,108.60 |
| 39801 | Aneurysm, clipping, proximal ligation, or reinforcement of sac, including stereotaxy and cranioplasty (Anaes.) (Assist.) | $6,630.60 75% benefit $4,972.95 |
| 39803 | Intracranial arteriovenous malformation or fistula, treatment through a craniotomy, including stereotaxy, cranioplasty and all angiography (Anaes.) (Assist.) | $6,630.60 75% benefit $4,972.95 |
| 39815 | Carotid‑cavernous fistula, obliteration of—combined cervical and intracranial procedure (H) (Anaes.) (Assist.) | $2,187.00 75% benefit $1,640.25 |
| 39818 | Intracranial vascular bypass using indirect techniques, including stereotaxy (Anaes.) (Assist.) | $2,902.75 75% benefit $2,177.10 |
| 39821 | Intracranial vascular bypass using direct anastomosis techniques, including stereotaxy (Anaes.) (Assist.) | $4,135.70 75% benefit $3,101.80 |
| 39900 | Intracranial infection, treated by burr hole, including stereotaxy, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $1,741.80 75% benefit $1,306.35 |
| 39903 | Intracranial infection, treated by craniotomy, including stereotaxy, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $2,614.80 75% benefit $1,961.10 |
| 39906 | Osteomyelitis of skull or removal of infected bone flap, craniectomy for, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $954.05 75% benefit $715.55 |
| 40004 | Ventricular, lumbar or cisternal shunt diversion, insertion or revision of, including stereotaxy (Anaes.) (Assist.) | $1,980.25 75% benefit $1,485.20 |
| 40012 | Endoscopic ventriculostomy for treatment of cerebrospinal fluid circulation disorders, including stereotaxy (Anaes.) (Assist.) | $2,047.75 75% benefit $1,535.85 |
| 40018 | Lumbar cerebrospinal fluid drain, insertion of, other than a service associated with a service to which item 22053 applies (H) (Anaes.) | $190.80 75% benefit $143.10 |
| 40104 | Spinal myelomeningocele or spinal meningocele, excision and closure of, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $1,215.10 75% benefit $911.35 |
| 40106 | Chiari malformation, decompression or reconstruction of, including laminectomy, dermofat graft and stereotaxy, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $2,884.65 75% benefit $2,163.50 |
| 40109 | Encephalocoele or cranial meningocele, excision and closure of, including stereotaxy and dermofat graft (Anaes.) (Assist.) | $2,238.95 75% benefit $1,679.25 |
| 40112 | Tethered cord, release of, including lipomeningocele or diastematomyelia, multiple levels, including laminectomy and rhizolysis, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $2,860.10 75% benefit $2,145.10 |
| 40119 | Craniostenosis, operation for, other than a service associated with a service to which item 40600 applies (Anaes.) (Assist.) | $1,143.05 75% benefit $857.30 |
| 40600 | Cranioplasty, reconstructive, other than a service associated with a service to which item 39113, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39710, 39712, 39715, 39801, 39803, 40703 or 41887 applies (H) (Anaes.) (Assist.) | $1,143.05 75% benefit $857.30 |
| 40700 | Corpus callosotomy, for epilepsy, including stereotaxy (Anaes.) (Assist.) | $2,803.80 75% benefit $2,102.85 |
| 40701 | Vagus nerve stimulation therapy through stimulation of the left vagus nerve, subcutaneous placement of electrical pulse generator, for: (a) management of refractory generalised epilepsy; or (b) treatment of refractory focal epilepsy not suitable for resective epilepsy surgery (Anaes.) (Assist.) | $407.60 75% benefit $305.70 |
| 40702 | Vagus nerve stimulation therapy through stimulation of the left vagus nerve, surgical repositioning or removal of electrical pulse generator inserted for: (a) management of refractory generalised epilepsy; or (b) treatment of refractory focal epilepsy not suitable for resective epilepsy surgery (Anaes.) (Assist.) | $190.80 75% benefit $143.10 |
| 40703 | Corticectomy, topectomy or partial lobectomy, for epilepsy, including stereotaxy and cranioplasty (Anaes.) (Assist.) | $2,900.55 75% benefit $2,175.45 |
| 40704 | Vagus nerve stimulation therapy through stimulation of the left vagus nerve, surgical placement of lead, including connection of lead to left vagus nerve and intra-operative test stimulation, for: (a) management of refractory generalised epilepsy; or (b) treatment of refractory focal epilepsy not suitable for resective epilepsy surgery (Anaes.) (Assist.) | $806.85 75% benefit $605.15 |
| 40705 | Vagus nerve stimulation therapy through stimulation of the left vagus nerve, surgical repositioning or removal of lead attached to left vagus nerve for: (a) management of refractory generalised epilepsy; or (b) treatment of refractory focal epilepsy not suitable for resective epilepsy surgery (Anaes.) (Assist.) | $724.55 75% benefit $543.45 |
| 40706 | Hemispherectomy or functional hemispherectomy, for intractable epilepsy, including stereotaxy (Anaes.) (Assist.) | $4,144.80 75% benefit $3,108.60 |
| 40707 | Vagus nerve stimulation therapy through stimulation of the left vagus nerve, electrical analysis and programming of vagus nerve stimulation therapy device using external wand, for: (a) management of refractory generalised epilepsy; or (b) treatment of refractory focal epilepsy not suitable for resective epilepsy surgery | $227.05 75% benefit $170.30 85% benefit $193.00 |
| 40708 | Vagus nerve stimulation therapy through stimulation of the left vagus nerve, surgical replacement of battery in electrical pulse generator inserted for: (a) management of refractory generalised epilepsy; or (b) treating refractory focal epilepsy not suitable for resective epilepsy surgery (Anaes.) (Assist.) | $407.60 75% benefit $305.70 |
| 40709 | Intracranial electrode placement by burr hole, including stereotaxy (Anaes.) (Assist.) | $1,741.80 75% benefit $1,306.35 |
| 40712 | Intracranial electrode placement by craniotomy, single or multiple, including stereotactic EEG, including stereotaxy (Anaes.) (Assist.) | $4,144.80 75% benefit $3,108.60 |
| 40801 | Functional stereotactic procedure including computer assisted anatomical localisation, physiological localisation, and lesion production, by any method, in the basal ganglia, brain stem or deep white matter tracts, other than a service associated with deep brain stimulation for Parkinson’s disease, essential tremor or dystonia (Anaes.) (Assist.) | $2,089.55 75% benefit $1,567.20 |
| 40803 | Intracranial stereotactic procedure by any method, other than: (a) a service to which item 40801 applies; or (b) a service associated with a service to which item 39018, 39109, 39113, 39604, 39615, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39703, 39710, 39712, 39715, 39718, 39720, 39801, 39803, 39818, 39821, 39900, 39903, 40004, 40012, 40106, 40109, 40700, 40703, 40706, 40709 or 40712 applies (H) (Anaes.) (Assist.) | $1,431.10 75% benefit $1,073.35 |
| 40804 | Magnetic resonance imaging—scan of head (including magnetic resonance angiography if performed) by a radiologist on request by a specialist or consultant physician, for the sole purpose of guiding focused ultrasound for the treatment of medically refractory essential tremor in association with the services described in items 40805 and 40806, including: (a) stereotactic scan of brain, with frame in place; and (b) assistance with computerised planning; and (c) interpretation of intraprocedural imaging Applicable once per patient per lifetime (H) (Anaes.) | $1,126.05 75% benefit $844.55 |
| 40805 | Neurological assessment and evaluation during the treatment of medically refractory essential tremor with magnetic resonance imaging-guided focused ultrasound, performed by a neurologist in association with the services described in items 40804 and 40806, including: (a) assistance with target localisation incorporating anatomical and physiological techniques; and (b) continuous intraprocedural neurological assessment and evaluation Applicable once per patient per lifetime (H) (Anaes.) | $2,326.70 75% benefit $1,745.05 |
| 40806 | Treatment of medically refractory essential tremor with magnetic resonance imaging-guided focused ultrasound, performed by a neurosurgeon in association with the services described in items 40804 and 40805, including: (a) computer assisted anatomical localisation; and (b) frame placement; and (c) target verification using anatomical and physiological techniques; and (d) delivery of treatment with lesion production in the basal ganglia, brain stem, thalamus or deep white matter tracts Applicable once per patient per lifetime (H) (Anaes.) | $3,583.85 75% benefit $2,687.90 |
| 40850 | DEEP BRAIN STIMULATION (unilateral) functional stereotactic procedure including computer assisted anatomical localisation, physiological localisation including twist drill, burr hole craniotomy or craniectomy and insertion of electrodes for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability (Anaes.) (Assist.) | $2,710.35 75% benefit $2,032.80 |
| 40851 | DEEP BRAIN STIMULATION (bilateral) functional stereotactic procedure including computer assisted anatomical localisation, physiological localisation including twist drill, burr hole craniotomy or craniectomy and insertion of electrodes for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability. (Anaes.) (Assist.) | $4,743.40 75% benefit $3,557.55 |
| 40852 | DEEP BRAIN STIMULATION (unilateral) subcutaneous placement of neurostimulator receiver or pulse generator for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability. (Anaes.) (Assist.) | $407.60 75% benefit $305.70 |
| 40854 | DEEP BRAIN STIMULATION (unilateral) revision or removal of brain electrode for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability. (Anaes.) | $630.05 75% benefit $472.55 |
| 40856 | DEEP BRAIN STIMULATION (unilateral) removal or replacement of neurostimulator receiver or pulse generator for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability. (Anaes.) | $305.75 75% benefit $229.35 |
| 40858 | DEEP BRAIN STIMULATION (unilateral) placement, removal or replacement of extension lead for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability. (Anaes.) | $630.05 75% benefit $472.55 |
| 40860 | DEEP BRAIN STIMULATION (unilateral) target localisation incorporating anatomical and physiological techniques, including intra-operative clinical evaluation, for the insertion of a single neurostimulation wire for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability. (Anaes.) | $2,420.95 75% benefit $1,815.75 |
| 40862 | DEEP BRAIN STIMULATION (unilateral) electronic analysis and programming of neurostimulator pulse generator for the treatment of: Parkinson's disease where the patient's response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or Essential tremor or dystonia where the patient's symptoms cause severe disability. (Anaes.) | $227.05 75% benefit $170.30 85% benefit $193.00 |
| 40863 | Deep brain stimulation (unilateral), remote electronic analysis and programming of neurostimulator pulse generator for the treatment of: (a) Parkinson’s disease, if the patient’s response to medical therapy is not sustained and is accompanied by unacceptable motor fluctuations; or (b) essential tremor or dystonia, if the patient’s symptoms cause severe disability Applicable not more than 8 times in any 12 month period | $227.05 75% benefit $170.30 85% benefit $193.00 |
| 40905 | Craniotomy, performed by a neurosurgeon in conjunction with the correction of craniofacial abnormalities (Anaes.) (Assist.) | $720.20 75% benefit $540.15 |
| 41500 | EAR, foreign body (other than ventilating tube) in, removal of, other than by simple syringing (Anaes.) | $98.70 75% benefit $74.05 85% benefit $83.90 |
| 41501 | Examination of glottal cycles and vibratory characteristics of the vocal folds by a specialist in the practice of the specialist’s specialty of otolaryngology using videostroboscopy, including capturing audio, video, frequency and intensity, for confirmation of diagnosis , or for confirmation of treatment effectiveness where there is failure to progress or respond as expected, for: dysphonia where non stroboscopic techniques of the visualising the larynx have failed to identify any frank abnormality of the vocal folds; or benign or malignant vocal fold lesions; or premalignant or malignant laryngeal lesions; or vocal fold motion impairment or glottal insufficiency; or evaluation of vocal fold function after treatment or phonosurgery other than a service associated with a service to which item 41764 applies or with a services associated with the administration of a general anaesthetic | $222.10 75% benefit $166.60 85% benefit $188.80 |
| 41503 | Ear, foreign body in (other than ventilating tube), removal of, involving incision of external auditory canal, other than a service associated with a service to which another item in this Subgroup applies (Anaes.) | $285.85 75% benefit $214.40 85% benefit $243.00 |
| 41506 | AURAL POLYP, removal of (Anaes.) | $172.40 75% benefit $129.30 85% benefit $146.55 |
| 41509 | External auditory meatus, surgical removal of keratosis obturans from, performed under general anaesthesia, other than: (a) a service to which another item in this Subgroup applies; or (b) a service associated with a service to which item 41647 applies (H) (Anaes.) | $195.05 75% benefit $146.30 |
| 41512 | MEATOPLASTY involving removal of cartilage or bone or both cartilage and bone, not being a service to which item 41515 applies (Anaes.) (Assist.) | $701.20 75% benefit $525.90 |
| 41515 | MEATOPLASTY involving removal of cartilage or bone or both cartilage and bone, being a service associated with a service to which item 41530, 41548, 41557, 41560 or 41563 applies (Anaes.) (Assist.) | $460.20 75% benefit $345.15 |
| 41518 | EXTERNAL AUDITORY MEATUS, removal of EXOSTOSES IN (Anaes.) (Assist.) | $1,111.60 75% benefit $833.70 |
| 41521 | Correction of auditory canal stenosis, including meatoplasty, with or without grafting, other than a service associated with a service to which an item in Subgroup 18 applies (H) (Anaes.) (Assist.) | $1,183.55 75% benefit $887.70 |
| 41524 | Reconstruction of external auditory canal (H) (Anaes.) (Assist.) | $341.85 75% benefit $256.40 |
| 41527 | Myringoplasty, by trans-canal approach, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $703.25 75% benefit $527.45 |
| 41530 | Myringoplasty, post-aural or endaural approach, with or without mastoid inspection, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) | $1,145.90 75% benefit $859.45 |
| 41533 | Atticotomy without reconstruction of the bony defect, with or without myringoplasty, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,369.60 75% benefit $1,027.20 |
| 41536 | Atticotomy with reconstruction of the bony defect, with or without myringoplasty, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,534.15 75% benefit $1,150.65 |
| 41539 | Ossicular chain reconstruction, other than a service associated with a service to which item 41611 applies (H) (Anaes.) (Assist.) | $1,304.50 75% benefit $978.40 |
| 41542 | Ossicular chain reconstruction and myringoplasty, other than a service associated with a service to which item 41611 applies (H) (Anaes.) (Assist.) | $1,429.40 75% benefit $1,072.05 |
| 41545 | Mastoidectomy (cortical), other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 41548 | OBLITERATION OF THE MASTOID CAVITY (Anaes.) (Assist.) | $827.90 75% benefit $620.95 |
| 41551 | Mastoidectomy, intact wall technique, with myringoplasty, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,906.70 75% benefit $1,430.05 |
| 41554 | Mastoidectomy, intact wall technique, with myringoplasty and ossicular chain reconstruction, other than a service associated with a service to which item 41603 or another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $2,246.55 75% benefit $1,684.95 |
| 41557 | Mastoidectomy (radical or modified radical), other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,304.50 75% benefit $978.40 |
| 41560 | Mastoidectomy (radical or modified radical) and myringoplasty, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) | $1,429.40 75% benefit $1,072.05 |
| 41563 | Mastoidectomy (radical or modified radical), myringoplasty and ossicular chain reconstruction, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,769.45 75% benefit $1,327.10 |
| 41564 | Mastoidectomy (radical or modified radical), obliteration of the mastoid cavity, blind sac closure of external auditory canal and obliteration of eustachian tube, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $2,288.25 75% benefit $1,716.20 |
| 41566 | Revision of mastoidectomy (radical, modified radical or intact wall), including myringoplasty, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,304.50 75% benefit $978.40 |
| 41569 | Decompression of facial nerve in its mastoid portion, other than a service associated with a service to which item 41617 applies (H) (Anaes.) (Assist.) | $1,429.40 75% benefit $1,072.05 |
| 41572 | LABYRINTHOTOMY OR DESTRUCTION OF LABYRINTH (Anaes.) (Assist.) | $1,236.65 75% benefit $927.50 |
| 41575 | CEREBELLO PONTINE ANGLE TUMOUR, removal of by 2 surgeons operating conjointly, by transmastoid, translabyrinthine or retromastoid approach transmastoid, translabyrinthine or retromastoid procedure (including aftercare) (Anaes.) (Assist.) | $2,915.30 75% benefit $2,186.50 |
| 41576 | CEREBELLO - PONTINE ANGLE TUMOUR, removal of, by transmastoid, translabyrinthine or retromastoid approach - intracranial procedure (including aftercare) not being a service to which item 41578 or 41579 applies (Anaes.) (Assist.) | $4,373.00 75% benefit $3,279.75 |
| 41578 | CEREBELLO PONTINE ANGLE TUMOUR, removal of, by transmastoid, translabyrinthine or retromastoid approach, (intracranial procedure) - conjoint surgery, principal surgeon (Anaes.) (Assist.) | $2,915.30 75% benefit $2,186.50 |
| 41579 | CEREBELLO-PONTINE ANGLE TUMOUR, removal of, by transmastoid, translabyrinthine or retromastoid approach, (intracranial procedure) - conjoint surgery, co-surgeon (Assist.) | $2,186.40 75% benefit $1,639.80 |
| 41581 | TUMOUR INVOLVING INFRA-TEMPORAL FOSSA, removal of, involving craniotomy and radical excision of (Anaes.) (Assist.) | $3,353.15 75% benefit $2,514.90 |
| 41584 | PARTIAL TEMPORAL BONE RESECTION for removal of tumour involving mastoidectomy with or without decompression of facial nerve (Anaes.) (Assist.) | $2,301.15 75% benefit $1,725.90 |
| 41587 | TOTAL TEMPORAL BONE RESECTION for removal of tumour (Anaes.) (Assist.) | $3,134.20 75% benefit $2,350.65 |
| 41590 | ENDOLYMPHATIC SAC, TRANSMASTOID DECOMPRESSION with or without drainage of (Anaes.) (Assist.) | $1,429.40 75% benefit $1,072.05 |
| 41593 | TRANSLABYRINTHINE VESTIBULAR NERVE SECTION (Anaes.) (Assist.) | $1,862.90 75% benefit $1,397.20 |
| 41596 | RETROLABYRINTHINE VESTIBULAR NERVE SECTION or COCHLEAR NERVE SECTION, or BOTH (Anaes.) (Assist.) | $2,082.00 75% benefit $1,561.50 |
| 41599 | INTERNAL AUDITORY MEATUS, exploration by middle cranial fossa approach with cranial nerve decompression (Anaes.) (Assist.) | $2,082.00 75% benefit $1,561.50 |
| 41603 | Osseo‑integration procedure—implantation of bone conduction hearing system device, in a patient: (a) with a permanent or long term hearing loss; and (b) unable to utilise conventional air or bone conduction hearing aid for medical or audiological reasons; and (c) with bone conduction thresholds that accord with recognised criteria for the implantable bone conduction hearing device being inserted; other than a service associated with a service to which item 41554, 45794 or 45797 applies (H) (Anaes.) | $714.75 75% benefit $536.10 |
| 41608 | STAPEDECTOMY (Anaes.) (Assist.) | $1,304.50 75% benefit $978.40 |
| 41611 | Stapes mobilisation, other than a service associated with a service to which item 41539, 41542, or an item in Subgroup 18, applies (H) (Anaes.) (Assist.) | $839.35 75% benefit $629.55 |
| 41614 | Round window surgery including repair of cochleotomy, other than a service associated with a service to which item 41617 applies (H) (Anaes.) (Assist.) | $1,304.50 75% benefit $978.40 |
| 41615 | Oval window surgery, including repair of fistula, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $1,304.50 75% benefit $978.40 |
| 41617 | Cochlear implant, insertion of, including mastoidectomy, cochleotomy and exposure of facial nerve where required, other than a service associated with a service to which item 41569 or 41614 applies (H) (Anaes.) (Assist.) | $2,268.40 75% benefit $1,701.30 |
| 41618 | Middle ear implant, partially implantable, insertion of, via mastoidectomy, for patients with: (a) stable sensorineural hearing loss; and (b) outer ear pathology that prevents the use of a conventional hearing aid; and (c) a PTA4 of less than 80 dBHL; and (d) bilateral, symmetrical hearing loss with PTA thresholds in both ears within 20 dBHL (0.5‑4kHz) of each other; and (e) speech perception discrimination of at least 65% correct for word lists with appropriately amplified sound; and (f) a normal middle ear; and (g) normal tympanometry; and (h) on audiometry, an air‑bone gap of less than 10 dBHL (0.5‑4kHz) across all frequencies; and (i) no other inner ear disorders (Anaes.) (Assist.) | $2,246.55 75% benefit $1,684.95 |
| 41620 | GLOMUS TUMOUR, transtympanic removal of (Anaes.) (Assist.) | $986.90 75% benefit $740.20 |
| 41623 | GLOMUS TUMOUR, transmastoid removal of, including mastoidectomy (Anaes.) (Assist.) | $1,429.40 75% benefit $1,072.05 |
| 41626 | Incision of tympanic membrane, or installation of therapeutic agent, to the middle ear through an intact drum: (a) not including local anaesthetic; and (b) excluding aftercare; and (c) other than a service associated with a service to which item 41632 applies (Anaes.) | $172.40 75% benefit $129.30 85% benefit $146.55 |
| 41629 | Middle ear, exploration of, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 41632 | Middle ear, insertion of tube for drainage of (including myringotomy), other than a service associated with a service to which item 41626 applies (Anaes.) | $285.85 75% benefit $214.40 85% benefit $243.00 |
| 41635 | Clearance of middle ear for granuloma, cholesteatoma and polyp, one or more, with or without myringoplasty, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,369.60 75% benefit $1,027.20 |
| 41638 | Clearance of middle ear for granuloma, cholesteatoma and polyp, one or more, with or without myringoplasty with ossicular chain reconstruction, other than a service associated with a service to which another item in this Subgroup applies on the same side (H) (Anaes.) (Assist.) | $1,709.55 75% benefit $1,282.20 |
| 41641 | PERFORATION OF TYMPANUM, cauterisation or diathermy of (Anaes.) | $56.80 75% benefit $42.60 85% benefit $48.30 |
| 41644 | EXCISION OF RIM OF EARDRUM PERFORATION, not being a service associated with myringoplasty (Anaes.) | $171.05 75% benefit $128.30 85% benefit $145.40 |
| 41647 | Micro inspection of tympanic membrane and auditory canal, requiring use of operating microscope or endoscope, including any removal of wax, with or without general anaesthesia, other than a service associated with a service to which item 41509 applies. Not applicable for the removal of uncomplicated wax in the absence of other disorders of the ear (Anaes.) | $131.55 75% benefit $98.70 85% benefit $111.85 |
| 41650 | Tympanic membrane, microinspection of one or both ears under general anaesthesia, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $131.55 75% benefit $98.70 |
| 41656 | NASAL HAEMORRHAGE, POSTERIOR, ARREST OF, with posterior nasal packing with or without cauterisation and with or without anterior pack (excluding aftercare) (Anaes.) | $146.95 75% benefit $110.25 85% benefit $124.95 |
| 41659 | NOSE, removal of FOREIGN BODY IN, other than by simple probing (Anaes.) | $92.80 75% benefit $69.60 85% benefit $78.90 |
| 41662 | Nasal polyp or polypi (simple), removal of, other than a service associated with a service to which item 41702, 41703 or 41705 applies on the same side | $98.70 75% benefit $74.05 85% benefit $83.90 |
| 41668 | Nasal polyp or polypi, removal of (Anaes.) | $263.15 75% benefit $197.40 85% benefit $223.70 |
| 41671 | Septal surgery, including septoplasty, septal reconstruction, septectomy, closure of septal perforation or other modifications of the septum, not including cauterisation, by any approach, other than a service associated with a service to which item 41689, 41692 or 41693 applies (H) (Anaes.) (Assist.) | $627.75 75% benefit $470.85 |
| 41674 | Cauterisation (other than by chemical means) or cauterisation by chemical means when performed under general anaesthesia or diathermy of septum or turbinates—one or more of these procedures (including any consultation on the same occasion) other than a service associated with another operation on the nose (Anaes.) | $120.25 75% benefit $90.20 85% benefit $102.25 |
| 41677 | NASAL HAEMORRHAGE, arrest of during an episode of epistaxis by cauterisation or nasal cavity packing or both (Anaes.) | $107.75 75% benefit $80.85 85% benefit $91.60 |
| 41683 | DIVISION OF NASAL ADHESIONS, with or without stenting not being a service associated with any other operation on the nose and not performed during the postoperative period of a nasal operation (Anaes.) | $140.30 75% benefit $105.25 85% benefit $119.30 |
| 41686 | Dislocation of turbinate or turbinates, one or both sides, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $86.10 75% benefit $64.60 |
| 41689 | Turbinate reduction, partial or total, unilateral or bilateral, other than a service associated with a service to which item 41671, 41692 or 41693 applies (Anaes.) | $245.10 75% benefit $183.85 85% benefit $208.35 |
| 41692 | Turbinate, submucous resection with removal of bone, unilateral or bilateral, other than a service associated with a service to which item 41671, 41689 or 41693 applies (H) (Anaes.) | $319.65 75% benefit $239.75 |
| 41693 | Septal surgery with submucous resection of turbinates, unilateral or bilateral, other than a service associated with a service to which item 41671, 41689, 41692 or 41764 applies (H) (Anaes.) (Assist.) | $918.05 75% benefit $688.55 |
| 41698 | Maxillary antrum, proof puncture and lavage of, other than a service associated with a service to which item 41702, 41703, 41705, 41710, 41734 or 41737 applies on the same side (Anaes.) | $39.00 75% benefit $29.25 85% benefit $33.15 |
| 41701 | MAXILLARY ANTRUM, proof puncture and lavage of, under general anaesthesia (requiring admission to hospital) not being a service associated with a service to which another item in this Group applies (Anaes.) | $110.00 75% benefit $82.50 |
| 41702 | Functional sinus surgery of the ostiomeatal unit, including ethmoid, unilateral, other than a service associated with a service to which item 41662, 41698, 41703, 41705, 41710 or 41764 applies on the same side (H) (Anaes.) (Assist.) | $816.75 75% benefit $612.60 |
| 41703 | Functional sinus surgery, complete dissection of all 5 sinuses and creation of single sinus cavity, unilateral, other than a service associated with a service to which item 41662, 41698, 41702, 41705, 41710, 41734, 41737, 41752 or 41764 applies on the same side (H) (Anaes.) (Assist.) | $1,207.45 75% benefit $905.60 |
| 41704 | MAXILLARY ANTRUM, LAVAGE OF each attendance at which the procedure is performed, including any associated consultation (Anaes.) | $43.50 75% benefit $32.65 85% benefit $37.00 |
| 41705 | Functional sinus surgery, complete dissection of all 5 sinuses to create a single sinus cavity, with extended drilling of frontal sinuses, unilateral, other than a service associated with a service to which item 41662, 41698, 41702, 41703, 41710, 41734, 41737, 41752 or 41764 applies on the same side (H) (Anaes.) (Assist.) | $1,964.70 75% benefit $1,473.55 |
| 41707 | Maxillary or sphenopalatine artery, ligation of (H) (Anaes.) (Assist.) | $536.85 75% benefit $402.65 |
| 41710 | Antrostomy by any approach, other than a service associated with a service to which item 41702, 41703, 41705 or 41698 applies on the same side (H) (Anaes.) (Assist.) | $423.50 75% benefit $317.65 |
| 41713 | Vidian neurectomy or exposure of vidian canal (H) (Anaes.) (Assist.) | $725.95 75% benefit $544.50 |
| 41719 | Antrum, drainage of, through tooth socket, other than a service associated with a service to which item 41722 applies (Anaes.) | $140.70 75% benefit $105.55 85% benefit $119.60 |
| 41722 | New 85% benefit on 1 November 2026Oroantral fistula, plastic closure of, other than a service associated with a service to which item 41719 or 45009 applies (Anaes.) (Assist.) | $703.25 75% benefit $527.45 85% benefit $597.80 was $598.75 |
| 41725 | Ligation of ethmoidal artery or arteries, anterior, posterior or both, by any approach (unilateral) (H) (Anaes.) (Assist.) | $536.85 75% benefit $402.65 |
| 41728 | Removal of sinonasal or nasopharyngeal tumour, excluding inflammatory nasal polyps, by any approach (H) (Anaes.) (Assist.) | $1,073.95 75% benefit $805.50 |
| 41734 | Endoscopic Lothrop procedure or radical external frontal sinusotomy with osteoplastic flap, unilateral, other than a service associated with a service to which item 41698, 41703, 41705 or 41764 applies on the same side (H) (Anaes.) (Assist.) | $1,213.65 75% benefit $910.25 |
| 41737 | Frontal sinus, unilateral, intranasal operation on, including complete dissection of frontal recess and exposure of frontal sinus ostium (excludes simple probing, dilatation or irrigation of frontal sinus), other than a service associated with a service to which item 41698, 41703, 41705 or 41764 applies on the same side (H) (Anaes.) (Assist.) | $578.40 75% benefit $433.80 |
| 41740 | Frontal sinus, catheterisation of, other than a service associated with a service to which item 41749 applies on the same side (H) (Anaes.) | $70.40 75% benefit $52.80 |
| 41743 | Frontal sinus, trephine of, other than a service associated with a service to which item 41749 applies on the same side (H) (Anaes.) (Assist.) | $403.95 75% benefit $303.00 |
| 41746 | Paranasal sinus, radical obliteration of, including any graft harvest (H) (Anaes.) (Assist.) | $930.15 75% benefit $697.65 |
| 41749 | Paranasal sinus, external operation on, unilateral, other than a service associated with a service to which item 41740 or 41743 applies on the same side (H) (Anaes.) (Assist.) | $725.95 75% benefit $544.50 |
| 41752 | Sphenoidal sinus, unilateral, intranasal operation on, other than a service associated with a service to which item 41703 or 41705 applies on the same side (H) (Anaes.) (Assist.) | $353.90 75% benefit $265.45 |
| 41755 | EUSTACHIAN TUBE, catheterisation of (Anaes.) | $55.60 75% benefit $41.70 85% benefit $47.30 |
| 41764 | Nasendoscopy or sinoscopy or fibreoptic examination of nasopharynx and larynx, one or more of these procedures, unilateral or bilateral examination, other than a service associated with a service to which item 41693, 41702, 41703, 41705, 41734 or 41737 applies (Anaes.) | $146.95 75% benefit $110.25 85% benefit $124.95 |
| 41768 | Unilateral insertion of bioabsorbable implant for nasal airway obstruction due to lateral wall insufficiency confirmed by positive modified Cottle manoeuvre, if: (a) the procedure is provided by a specialist in the practice of the specialist’s specialty of otolaryngology or plastic surgery; and (b) the patient has a self‑reported NOSE Scale score of equal to or greater than 55; and (c) NOSE Scale evidence (with or without photographic evidence demonstrating the clinical need for this service) is documented in the patient notes; and (d) the patient has not previously received a service to which item 41769 applies Applicable once per lifetime per nostril (Anaes.) | $216.35 75% benefit $162.30 85% benefit $183.90 |
| 41769 | Bilateral insertion of bioabsorbable implant for nasal airway obstruction due to lateral wall insufficiency confirmed by positive modified Cottle manoeuvre, if: (a) the procedure is provided by a specialist in the practice of the specialist’s specialty of otolaryngology or plastic surgery; and (b) the patient has a self‑reported NOSE Scale score of equal to or greater than 55; and (c) NOSE Scale evidence (with or without photographic evidence demonstrating the clinical need for this service) is documented in the patient notes; and (d) the patient has not previously received a service to which item 41768 applies Applicable once per lifetime (Anaes.) | $324.50 75% benefit $243.40 85% benefit $275.85 |
| 41770 | PHARYNGEAL POUCH, removal of, with or without cricopharyngeal myotomy (Anaes.) (Assist.) | $839.35 75% benefit $629.55 |
| 41776 | Cricopharyngeal myotomy by any approach, including open inversion of pharyngeal pouch or endoscopic repair of pharyngeal pouch (H) (Anaes.) (Assist.) | $702.25 75% benefit $526.70 |
| 41779 | PHARYNGOTOMY (lateral), with or without total excision of tongue (Anaes.) (Assist.) | $839.35 75% benefit $629.55 |
| 41785 | Partial pharyngectomy, by any approach, with or without partial glossectomy (H) (Anaes.) (Assist.) | $1,365.00 75% benefit $1,023.75 |
| 41786 | UVULOPALATOPHARYNGOPLASTY, with or without tonsillectomy, by any means (Anaes.) (Assist.) | $882.15 75% benefit $661.65 |
| 41789 | Tonsils or tonsils and adenoids, removal of, in a patient aged less than 12 years (including any examination of the postnasal space and nasopharynx and the infiltration of local anaesthetic), not being a service to which item 41764 applies (Anaes.) | $353.90 75% benefit $265.45 |
| 41793 | Tonsils or tonsils and adenoids, removal of, in a patient 12 years of age or over (including any examination of the postnasal space and nasopharynx and the infiltration of local anaesthetic), not being a service to which item 41764 applies (Anaes.) | $444.65 75% benefit $333.50 |
| 41797 | TONSILS OR TONSILS AND ADENOIDS, ARREST OF HAEMORRHAGE requiring general anaesthesia, following removal of (Anaes.) | $172.40 75% benefit $129.30 |
| 41801 | Adenoids, removal of (including any examination of the postnasal space and nasopharynx and the infiltration of local anaesthetic), not being a service to which item 41764 applies (Anaes.) | $195.05 75% benefit $146.30 |
| 41804 | Removal of lingual tonsil (H) (Anaes.) | $107.75 75% benefit $80.85 |
| 41807 | PERITONSILLAR ABSCESS (quinsy), incision of (Anaes.) | $83.80 75% benefit $62.85 85% benefit $71.25 |
| 41810 | Uvulotomy or uvulectomy (H) (Anaes.) | $42.60 75% benefit $31.95 |
| 41813 | VALLECULAR OR PHARYNGEAL CYSTS, removal of (Anaes.) (Assist.) | $426.55 75% benefit $319.95 |
| 41822 | Oesophagoscopy, with rigid oesophagoscope, with or without biopsy, other than a service associated with a service to which item 30473 or 30478 applies (H) (Anaes.) | $230.05 75% benefit $172.55 |
| 41825 | Removal of a foreign body from the pharynx, larynx or oesophagus, by any means, other than a service associated with a service to which item 30478 applies (H) (Anaes.) (Assist.) | $426.55 75% benefit $319.95 |
| 41828 | OESOPHAGEAL STRICTURE, dilatation of, without oesophagoscopy (Anaes.) | $62.55 75% benefit $46.95 85% benefit $53.20 |
| 41831 | Oesophagus, endoscopic pneumatic dilatation of, for treatment of achalasia (H) (Anaes.) (Assist.) | $427.30 75% benefit $320.50 |
| 41832 | Oesophagus, balloon dilatation of, using interventional imaging techniques (H) (Anaes.) | $273.50 75% benefit $205.15 |
| 41834 | Total laryngectomy, including cricopharyngeal myotomy and tracheo oesophageal puncture (H) (Anaes.) (Assist.) | $1,893.65 75% benefit $1,420.25 |
| 41837 | Complete vertical hemi laryngectomy, involving removal of true and false vocal cords, including tracheostomy. Applicable only once per provider per patient per lifetime (H) (Anaes.) (Assist.) | $1,479.45 75% benefit $1,109.60 |
| 41840 | Total supraglottic laryngectomy, involving removal of ventricular folds, epiglottis and aryepiglottic folds including tracheostomy. Applicable only once per provider per patient per lifetime (H) (Anaes.) (Assist.) | $1,819.00 75% benefit $1,364.25 |
| 41843 | LARYNGOPHARYNGECTOMY or PRIMARY RESTORATION OF ALIMENTARY CONTINUITY after laryngopharyngectomy USING STOMACH OR BOWEL (Anaes.) (Assist.) | $1,599.60 75% benefit $1,199.70 |
| 41855 | Microlaryngoscopy, by any approach, with or without biopsy (H) (Anaes.) (Assist.) | $344.95 75% benefit $258.75 |
| 41861 | Microlaryngoscopy with complete removal of benign or malignant lesions of the larynx, including papillomata, by any approach or technique, unilateral, other than a service associated with a service to which item 41870 applies on the same side (H) (Anaes.) (Assist.) | $723.25 75% benefit $542.45 |
| 41867 | Microlaryngoscopy, with partial or complete arytenoidectomy or arytenoid repositioning (H) (Anaes.) (Assist.) | $734.15 75% benefit $550.65 |
| 41870 | Laryngeal augmentation or modification by injection techniques, other than a service associated with a service to which item 41879 applies or item 41861 applies on the same side (Anaes.) (Assist.) | $544.40 75% benefit $408.30 85% benefit $462.75 |
| 41873 | Larynx, fractured, operation for (H) (Anaes.) (Assist.) | $703.25 75% benefit $527.45 |
| 41876 | Larynx, external operation on, or laryngofissure, with or without cordectomy (H) (Anaes.) (Assist.) | $703.25 75% benefit $527.45 |
| 41879 | Tracheoplasty, laryngoplasty or thyroplasty, not by injection techniques, including tracheostomy, other than a service associated with a service to which item 41870 applies (H) (Anaes.) (Assist.) | $1,139.65 75% benefit $854.75 |
| 41880 | Tracheostomy by a percutaneous technique (H) (Anaes.) | $304.15 75% benefit $228.15 |
| 41881 | Tracheostomy by open exposure of the trachea (H) (Anaes.) (Assist.) | $480.95 75% benefit $360.75 |
| 41884 | Cricothyrostomy (H) (Anaes.) | $108.95 75% benefit $81.75 |
| 41885 | Trache‑oesophageal fistula, formation of, as a secondary procedure following laryngectomy, including associated endoscopic procedures (H) (Anaes.) (Assist.) | $344.60 75% benefit $258.45 |
| 41886 | Trachea, removal of foreign body in (H) (Anaes.) | $213.05 75% benefit $159.80 |
| 41887 | Pituitary tumour, removal of, by trans-sphenoidal approach, including stereotaxy and dermis, dermofat or fascia grafting, as part of conjoint surgery, other than a service associated with a service to which item 40600 applies (H) (Anaes.) (Assist.) | $3,233.55 75% benefit $2,425.20 |
| 41888 | Fractured skull, after trauma only, or spontaneous defects with cerebrospinal fluid rhinorrhoea or otorrhoea, repair of, including stereotaxy and dermofat graft (H) (Anaes.) (Assist.) | $2,288.50 75% benefit $1,716.40 |
| 41890 | Orbit, decompression of, by fenestration of 2 or more walls, or by the removal of intraorbital peribulbar and retrobulbar fat from each quadrant of the orbit, one eye by endonasal approach (H) (Anaes.) (Assist.) | $1,530.05 75% benefit $1,147.55 |
| 41907 | NASAL SEPTUM BUTTON, insertion of (Anaes.) | $146.95 75% benefit $110.25 85% benefit $124.95 |
| 41910 | DUCT OF MAJOR SALIVARY GLAND, transposition of (Anaes.) (Assist.) | $467.10 75% benefit $350.35 |
| 42503 | OPHTHALMOLOGICAL EXAMINATION under general anaesthesia, not being a service associated with a service to which another item in this Group applies (Anaes.) | $122.65 75% benefit $92.00 |
| 42504 | Implantation of a micro-bypass glaucoma surgery device or devices into the suprachoroidal space or the trabecular meshwork, if conservative therapies have failed, are likely to fail, or are contraindicated (H) (Anaes.) | $359.95 75% benefit $270.00 |
| 42505 | Complete removal of a micro‑bypass glaucoma surgery device or devices from the suprachoroidal space or the trabecular meshwork, with or without replacement, following device‑related medical complications necessitating complete removal (H) (Anaes.) | $359.95 75% benefit $270.00 |
| 42506 | Eye, enucleation of, without insertion of implant (H) (Anaes.) (Assist.) | $576.00 75% benefit $432.00 |
| 42509 | Eye, enucleation of, with insertion of non-integrated implant, without muscle attachment (H) (Anaes.) (Assist.) | $729.00 75% benefit $546.75 |
| 42510 | Eye, enucleation of, with insertion of coralline or other integrated implant, including:(a) for a coralline implant—attachment of at least the 4 rectus muscles (with or without oblique muscles) to: (i) the implant; or(ii) the implant wrap; or (b) for another integrated implant—fashioning of myoconjunctival insertion of extraocular muscles(H) (Anaes.) (Assist.) | $840.30 75% benefit $630.25 |
| 42512 | Globe, evisceration of (H) (Anaes.) (Assist.) | $576.00 75% benefit $432.00 |
| 42515 | GLOBE, EVISCERATION OF, AND INSERTION OF INTRASCLERAL BALL OR CARTILAGE (Anaes.) (Assist.) | $729.00 75% benefit $546.75 |
| 42518 | ANOPHTHALMIC ORBIT, INSERTION OF CARTILAGE OR ARTIFICIAL IMPLANT as a delayed procedure, or REMOVAL OF IMPLANT FROM SOCKET, or PLACEMENT OF A MOTILITY INTEGRATING PEG by drilling into an existing orbital implant (Anaes.) (Assist.) | $422.95 75% benefit $317.25 |
| 42521 | ANOPHTHALMIC SOCKET, treatment of, by insertion of a wired-in conformer, integrated implant or dermofat graft, as a secondary procedure (Anaes.) (Assist.) | $1,440.15 75% benefit $1,080.15 |
| 42527 | CONTRACTED SOCKET, RECONSTRUCTION INCLUDING MUCOUS MEMBRANE GRAFTING AND STENT MOULD (Anaes.) (Assist.) | $485.95 75% benefit $364.50 |
| 42530 | Orbit, exploration of, requiring removal of bone (orbitotomy) for access, with subsequent drainage or biopsy, including repair of any bone or soft tissue surgical defect, other than a service associated with a service to which item 45590 or 45594 applies on the same side (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 42533 | Orbit, exploration of, without requiring removal of bone (orbitotomy) for access, with drainage or biopsy, including repair of any bone or soft tissue surgical defect (H) (Anaes.) (Assist.) | $485.95 75% benefit $364.50 |
| 42536 | Orbit, exenteration of, including repair of any bone or soft tissue surgical defect, with or without skin graft and with or without temporalis muscle transplant (H) (Anaes.) (Assist.) | $998.85 75% benefit $749.15 |
| 42539 | Orbit, exploration of, requiring removal of bone (orbitotomy) for access, with removal of tumour or foreign body (not incisional biopsy), including repair of any bone or soft tissue surgical defect (H) (Anaes.) (Assist.) | $1,422.15 75% benefit $1,066.65 |
| 42542 | Orbit, exploration of anterior aspect, with removal of tumour or foreign body (not incisional biopsy), including repair of any bone or soft tissue surgical defect (H) (Anaes.) (Assist.) | $603.15 75% benefit $452.40 |
| 42543 | ORBIT, exploration of retrobulbar aspect with removal of tumour or foreign body (Anaes.) (Assist.) | $1,057.85 75% benefit $793.40 |
| 42545 | ORBIT, decompression of, for dysthyroid eye disease, by fenestration of 2 or more walls, or by the removal of intraorbital peribulbar and retrobulbar fat from each quadrant of the orbit, 1 eye (Anaes.) (Assist.) | $1,530.05 75% benefit $1,147.55 |
| 42548 | OPTIC NERVE MENINGES, incision of (Anaes.) (Assist.) | $908.90 75% benefit $681.70 |
| 42551 | Eye, penetrating wound or rupture of, not involving intraocular structures—repair involving suture of cornea or sclera, or both, other than a service to which item 42632 applies (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 42554 | EYE, PENETRATING WOUND OR RUPTURE OF, with incarceration or prolapse of uveal tissue repair (Anaes.) (Assist.) | $882.15 75% benefit $661.65 |
| 42557 | EYE, PENETRATING WOUND OR RUPTURE OF, with incarceration of lens or vitreous repair (Anaes.) (Assist.) | $1,233.05 75% benefit $924.80 |
| 42563 | Intraocular foreign body, removal from anterior segment (H) (Anaes.) (Assist.) | $621.20 75% benefit $465.90 |
| 42569 | INTRAOCULAR FOREIGN BODY, removal from posterior segment (Anaes.) (Assist.) | $1,233.05 75% benefit $924.80 |
| 42572 | ORBITAL ABSCESS OR CYST, drainage of (Anaes.) | $140.45 75% benefit $105.35 85% benefit $119.40 |
| 42573 | DERMOID, periorbital, excision of, on a patient 10 years of age or over (Anaes.) | $272.20 75% benefit $204.15 85% benefit $231.40 |
| 42574 | Dermoid, orbital, excision of (H) (Anaes.) (Assist.) | $578.40 75% benefit $433.80 |
| 42575 | TARSAL CYST, extirpation of (Anaes.) | $99.00 75% benefit $74.25 85% benefit $84.15 |
| 42576 | Dermoid, periorbital, excision of, on a patient under 10 years of age (H) (Anaes.) | $353.90 75% benefit $265.45 |
| 42581 | ECTROPION OR ENTROPION, tarsal cauterisation of (Anaes.) | $140.45 75% benefit $105.35 85% benefit $119.40 |
| 42584 | TARSORRHAPHY (Anaes.) (Assist.) | $331.25 75% benefit $248.45 85% benefit $281.60 |
| 42587 | TRICHIASIS (due to causes other than trachoma), treatment of by cryotherapy, laser or electrolysis - each eyelid (Anaes.) | $62.25 75% benefit $46.70 85% benefit $52.95 |
| 42588 | TRICHIASIS (due to trachoma), treatment of by cryotherapy, laser or electrolysis - each eyelid (Anaes.) | $62.25 75% benefit $46.70 85% benefit $52.95 |
| 42590 | Canthoplasty, medial or lateral, excluding when performed in conjunction with cosmetic blepharoplasty (Anaes.) (Assist.) | $405.00 75% benefit $303.75 85% benefit $344.25 |
| 42596 | Lacrimal sac, excision of, or operation on (H) (Anaes.) (Assist.) | $603.15 75% benefit $452.40 |
| 42599 | Lacrimal canalicular system, establishment of patency by closed operation using silicone tubes or similar, one eye (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 42602 | Lacrimal canalicular system, establishment of patency by open operation, one eye (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 42605 | Lacrimal canaliculus, immediate repair of (H) (Anaes.) (Assist.) | $557.90 75% benefit $418.45 |
| 42608 | LACRIMAL DRAINAGE by insertion of glass tube, as an independent procedure (Anaes.) (Assist.) | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 42610 | Nasolacrimal tube (unilateral), removal or replacement of, or lacrimal passages, probing for obstruction, unilateral, with or without lavage—under general anaesthesia (H) (Anaes.) | $115.20 75% benefit $86.40 |
| 42611 | Nasolacrimal tube (bilateral), removal or replacement of, or lacrimal passages, probing for obstruction, bilateral, with or without lavage—under general anaesthesia (H) (Anaes.) | $172.80 75% benefit $129.60 |
| 42614 | NASOLACRIMAL TUBE (unilateral), removal or replacement of, or LACRIMAL PASSAGES, probing to establish patency of the lacrimal passage and/or site of obstruction, unilateral, including lavage, not being a service associated with a service to which item 42610 applies (excluding aftercare) | $57.75 75% benefit $43.35 85% benefit $49.10 |
| 42615 | NASOLACRIMAL TUBE (bilateral), removal or replacement of, or LACRIMAL PASSAGES, probing to establish patency of the lacrimal passage and/or site of obstruction, bilateral, including lavage, not being a service associated with a service to which item 42611 applies (excluding aftercare) | $86.50 75% benefit $64.90 85% benefit $73.55 |
| 42617 | PUNCTUM SNIP operation (Anaes.) | $163.95 75% benefit $123.00 85% benefit $139.40 |
| 42620 | PUNCTUM, occlusion of, by use of a plug (Anaes.) | $63.10 75% benefit $47.35 85% benefit $53.65 |
| 42622 | PUNCTUM, permanent occlusion of, by use of electrical cautery (Anaes.) | $99.00 75% benefit $74.25 85% benefit $84.15 |
| 42623 | Dacryocystorhinostomy, external or endonasal approach, including any sinus, turbinate or uncinate operation performed by same surgeon for access, with or without silicone intubation/stenting (H) (Anaes.) (Assist.) | $837.15 75% benefit $627.90 |
| 42626 | Dacryocystorhinostomy, if a previous dacryocystorhinostomy has been performed, external or endonasal approach, including any sinus, turbinate or uncinate operation performed by same surgeon for access, with or without silicone intubation/stenting (H) (Anaes.) (Assist.) | $1,350.20 75% benefit $1,012.65 |
| 42629 | Dacryocystorhinostomy, with placement of a permanent bypass tube from the conjunctival sac to the nasal cavity (H) (Anaes.) (Assist.) | $1,017.05 75% benefit $762.80 |
| 42632 | Conjunctival peritomy or repair of corneal laceration by conjunctival flap, other than a service associated with a service to which item 42686 applies (Anaes.) | $140.45 75% benefit $105.35 85% benefit $119.40 |
| 42635 | CORNEAL PERFORATIONS, sealing of, with tissue adhesive (Anaes.) (Assist.) | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 42638 | CONJUNCTIVAL GRAFT OVER CORNEA (Anaes.) (Assist.) | $450.05 75% benefit $337.55 85% benefit $382.55 |
| 42641 | AUTOCONJUNCTIVAL TRANSPLANT, or mucous membrane graft (Anaes.) (Assist.) | $585.05 75% benefit $438.80 85% benefit $497.30 |
| 42644 | CORNEA OR SCLERA, complete removal of embedded foreign body from - not more than once on the same day by the same practitioner (excluding aftercare) (Anaes.) | $86.35 75% benefit $64.80 85% benefit $73.40 |
| 42647 | Corneal scars, removal of, by partial keratectomy, other than a service associated with a service to which item 42686 or 42650 applies (Anaes.) | $244.85 75% benefit $183.65 85% benefit $208.15 |
| 42650 | Cornea, epithelial debridement for corneal ulcer or corneal erosion (excluding after-care), other than a service associated with a service to which item 42647 applies (Anaes.) | $86.35 75% benefit $64.80 85% benefit $73.40 |
| 42651 | CORNEA, epithelial debridement for eliminating band keratopathy (Anaes.) | $192.50 75% benefit $144.40 85% benefit $163.65 |
| 42652 | New 85% benefit on 1 November 2026Corneal collagen cross linking, on a patient with a corneal ectatic disorder, with evidence of progression—per eye (Anaes.) | $1,436.30 75% benefit $1,077.25 85% benefit $1,327.80 was $1,331.80 |
| 42653 | CORNEA transplantation of (Anaes.) (Assist.) | $1,565.20 75% benefit $1,173.90 |
| 42656 | CORNEA, transplantation of, second and subsequent procedures (Anaes.) (Assist.) | $1,998.20 75% benefit $1,498.65 |
| 42662 | SCLERA, transplantation of, full thickness, including collection of donor material (Anaes.) (Assist.) | $1,079.90 75% benefit $809.95 |
| 42665 | Sclera, transplantation of, superficial or lamellar, including collection of donor material (H) (Anaes.) (Assist.) | $720.15 75% benefit $540.15 |
| 42667 | RUNNING CORNEAL SUTURE, manipulation of, performed within 4 months of corneal grafting, to reduce astigmatism where a reduction of 2 dioptres of astigmatism is obtained, including any associated consultation | $169.85 75% benefit $127.40 85% benefit $144.40 |
| 42668 | CORNEAL SUTURES, removal of, not earlier than 6 weeks after operation requiring use of slit lamp or operating microscope (Anaes.) | $90.10 75% benefit $67.60 85% benefit $76.60 |
| 42672 | Corneal incisions, to correct corneal astigmatism of more than 11/2 dioptres following anterior segment surgery, including appropriate measurements and calculations, performed as an independent procedure (H) (Anaes.) (Assist.) | $1,079.90 75% benefit $809.95 |
| 42673 | Additional corneal incisions, to correct corneal astigmatism of more than 11/2 dioptres, including appropriate measurements and calculations, performed in conjunction with other anterior segment surgery (H) (Anaes.) (Assist.) | $539.90 75% benefit $404.95 |
| 42676 | CONJUNCTIVA, biopsy of, as an independent procedure | $138.45 75% benefit $103.85 85% benefit $117.70 |
| 42677 | CONJUNCTIVA, CAUTERY OF, INCLUDING TREATMENT OF PANNUS each attendance at which treatment is given including any associated consultation (Anaes.) | $72.95 75% benefit $54.75 85% benefit $62.05 |
| 42680 | CONJUNCTIVA, cryotherapy to, for melanotic lesions or similar using CO² or N²0 (Anaes.) | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 42683 | CONJUNCTIVAL CYSTS, removal of, requiring admission to hospital or approved day-hospital facility (Anaes.) | $144.10 75% benefit $108.10 |
| 42686 | Pterygium, removal of, other than a service associated with a service to which item 42632 or 42647 applies (Anaes.) | $327.55 75% benefit $245.70 85% benefit $278.45 |
| 42689 | PINGUECULA, removal of, not being a service associated with the fitting of contact lenses (Anaes.) | $140.45 75% benefit $105.35 85% benefit $119.40 |
| 42692 | LIMBIC TUMOUR, removal of, excluding Pterygium (Anaes.) (Assist.) | $331.25 75% benefit $248.45 85% benefit $281.60 |
| 42695 | LIMBIC TUMOUR, excision of, requiring keratectomy or sclerectomy, excluding Pterygium (Anaes.) (Assist.) | $539.90 75% benefit $404.95 85% benefit $458.95 |
| 42698 | Lens extraction, excluding surgery performed to correct a refractive error, other than anisometropia that exceeds 3 dioptres and develops after the removal of cataract in the first eye (H) (Anaes.) | $711.80 75% benefit $533.85 |
| 42701 | Intraocular lens, insertion of, excluding surgery performed to correct a refractive error, other than anisometropia that exceeds 3 dioptres and develops after the removal of cataract in the first eye (H) (Anaes.) | $396.95 75% benefit $297.75 |
| 42702 | Lens extraction and insertion of intraocular lens, excluding surgery performed to correct a refractive error, other than anisometropia that exceeds 3 dioptres and develops after the removal of cataract in the first eye (H) (Anaes.) | $910.35 75% benefit $682.80 |
| 42703 | Intraocular lens or iris prosthesis, insertion of, into the posterior chamber with fixation to the iris or sclera (H) (Anaes.) (Assist.) | $684.65 75% benefit $513.50 |
| 42704 | Intraocular lens, removal or repositioning of by open operation—other than a service associated with a service to which item 42701 applies (H) (Anaes.) | $557.90 75% benefit $418.45 |
| 42705 | Lens extraction and insertion of intraocular lens, excluding surgery performed for the correction of refractive error except for anisometropia greater than 3 dioptres following the removal of cataract in the first eye, performed in association with insertion of a micro-bypass glaucoma surgery device or devices into the suprachoroidal space or trabecular meshwork, in a patient diagnosed with open angle glaucoma who is not adequately responsive to topical anti‑glaucoma medications or who is intolerant of anti‑glaucoma medication (H) (Anaes.) | $1,090.55 75% benefit $817.95 |
| 42707 | Intraocular lens, removal of and replacement with a different lens, excluding surgery performed to correct a refractive error, other than anisometropia that exceeds 3 dioptres and develops after the removal of cataract in the first eye (H) (Anaes.) | $954.05 75% benefit $715.55 |
| 42710 | Intraocular lens, removal of, and replacement with a lens inserted into the posterior chamber and fixated to the iris or sclera (H) (Anaes.) (Assist.) | $1,079.90 75% benefit $809.95 |
| 42713 | Iris or ciliary body suturing, McCannel technique or similar, for:(a) fixation of intraocular lens; or(b) repair of iris defect or cyclodialysis cleft(H) (Anaes.) (Assist.) | $450.05 75% benefit $337.55 |
| 42716 | Cataract, juvenile, removal of, including subsequent needlings (H) (Anaes.) (Assist.) | $1,431.10 75% benefit $1,073.35 |
| 42719 | Either or both of the following, via a limbal approach by any method: (a) removal of capsular or lens material; (b) removal of vitreous; other than a service associated with a service to which item 42698, 42702, 42705, 42716, 42725 or 42731 applies (H) (Anaes.) (Assist.) | $621.20 75% benefit $465.90 |
| 42725 | Vitrectomy via pars plana sclerotomy, including one or more of the following:(a) removal of vitreous; (b) division of vitreous bands; (c) removal of epiretinal membranes; (d) capsulotomy (Anaes.) (Assist.) | $1,602.00 75% benefit $1,201.50 |
| 42731 | LIMBAL OR PARS PLANA LENSECTOMY combined with vitrectomy, not being a service associated with items 42698, 42702, 42719, or 42725 (Anaes.) (Assist.) | $1,818.05 75% benefit $1,363.55 |
| 42734 | Capsulotomy, other than by laser, and other than a service associated with a service to which item 42725 or 42731 applies (H) (Anaes.) (Assist.) | $359.95 75% benefit $270.00 |
| 42743 | Anterior chamber, irrigation of blood from, as an independent procedure (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 42744 | Needle revision of glaucoma filtration bleb, following glaucoma filtering surgery (Anaes.) | $359.75 75% benefit $269.85 85% benefit $305.80 |
| 42746 | Glaucoma filtering surgery, if conservative therapies have failed, are likely to fail, or are contraindicated (H) (Anaes.) (Assist.) | $1,143.05 75% benefit $857.30 |
| 42749 | Glaucoma filtering surgery, if previous filtering surgery has been performed (H) (Anaes.) (Assist.) | $1,431.10 75% benefit $1,073.35 |
| 42750 | Subconjunctival injection of antifibrotic agent following glaucoma filtering surgery, as an independent procedure (Anaes.) | $63.80 75% benefit $47.85 85% benefit $54.25 |
| 42752 | Insertion of glaucoma drainage device incorporating an extraocular reservoir (H) (Anaes.) (Assist.) | $1,602.00 75% benefit $1,201.50 |
| 42755 | Any of the following:(a) removal of glaucoma drainage device incorporating an extraocular reservoir;(b) insertion or removal of intraluminal stent;(c) tying off of lumenOne eye (H) (Anaes.) (Assist.) | $197.95 75% benefit $148.50 |
| 42758 | Goniotomy for the treatment of primary congenital glaucoma, excluding the minimally invasive implantation of glaucoma drainage devices (Anaes.) (Assist.) | $837.15 75% benefit $627.90 |
| 42761 | Division of anterior or posterior synechiae, as an independent procedure, other than by laser (H) (Anaes.) (Assist.) | $621.20 75% benefit $465.90 |
| 42764 | Iridectomy (including excision of tumour of iris) or iridotomy, as an independent procedure, other than by laser (H) (Anaes.) (Assist.) | $621.20 75% benefit $465.90 |
| 42767 | TUMOUR, INVOLVING CILIARY BODY OR CILIARY BODY AND IRIS, excision of (Anaes.) (Assist.) | $1,304.95 75% benefit $978.75 |
| 42770 | CYCLODESTRUCTIVE procedures for the treatment of intractable glaucoma, treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period (Anaes.) (Assist.) | $352.80 75% benefit $264.60 85% benefit $299.90 |
| 42773 | New 85% benefit on 1 November 2026Detached retina, pneumatic retinopexy for, as an independent procedure (Anaes.) (Assist.) | $1,079.90 75% benefit $809.95 85% benefit $971.40 was $975.40 |
| 42776 | DETACHED RETINA, buckling or resection operation for (Anaes.) (Assist.) | $1,602.00 75% benefit $1,201.50 |
| 42779 | DETACHED RETINA, revision of scleral buckling operation for (Anaes.) (Assist.) | $1,998.20 75% benefit $1,498.65 |
| 42782 | LASER TRABECULOPLASTY, for the treatment of glaucoma. Each treatment to 1 eye, to a maximum of 4 treatments to that eye in a 2 year period (Anaes.) (Assist.) | $539.90 75% benefit $404.95 85% benefit $458.95 |
| 42785 | LASER IRIDOTOMY - each treatment episode to 1 eye, to a maximum of 3 treatments to that eye in a 2 year period (Anaes.) (Assist.) | $422.95 75% benefit $317.25 85% benefit $359.55 |
| 42788 | Laser capsulotomy—each treatment episode to one eye, to a maximum of 2 treatments to that eye in a 2 year period—other than a service associated with a service to which item 42702 applies (Anaes.) (Assist.) | $422.95 75% benefit $317.25 85% benefit $359.55 |
| 42791 | Laser vitreolysis or corticolysis of lens material or fibrinolysis, excluding vitreolysis in the posterior vitreous cavity—each treatment to one eye, to a maximum of 3 treatments to that eye in a 2 year period (Anaes.) (Assist.) | $422.95 75% benefit $317.25 85% benefit $359.55 |
| 42794 | Division of suture by laser following glaucoma filtering surgery, each treatment to one eye, to a maximum of 2 treatments to that eye in a 2 year period (Anaes.) | $81.05 75% benefit $60.80 85% benefit $68.90 |
| 42801 | EPISCLERAL RADIOACTIVE PLAQUE (Ruthenium 106 or Iodine 125), for the treatment of choroidal melanomas, insertion of (Anaes.) (Assist.) | $1,256.45 75% benefit $942.35 |
| 42802 | EPISCLERAL RADIOACTIVE PLAQUE (Ruthenium 106 or Iodine 125), for the treatment of choroidal melanomas, removal of (Anaes.) (Assist.) | $627.95 75% benefit $471.00 |
| 42805 | Tantalum markers, surgical insertion to the sclera to localise the tumour base and to assist in planning radiotherapy of choroidal melanomas—one or more of (H) (Anaes.) | $702.00 75% benefit $526.50 |
| 42808 | Laser iridoplasty | $425.85 75% benefit $319.40 85% benefit $362.00 |
| 42809 | RETINA, photocoagulation of, not being a service associated with photodynamic therapy with verteporfin (Anaes.) (Assist.) | $539.90 75% benefit $404.95 85% benefit $458.95 |
| 42810 | PHOTOTHERAPEUTIC KERATECTOMY, by laser, for corneal scarring or disease, excluding surgery for refractive error (Anaes.) | $679.40 75% benefit $509.55 85% benefit $577.50 |
| 42811 | TRANSPUPILLARY THERMOTHERAPY, for treatment of choroidal and retinal tumours or vascular malformations (Anaes.) | $539.90 75% benefit $404.95 85% benefit $458.95 |
| 42812 | Removal of scleral buckling material, from an eye having undergone previous scleral buckling surgery (Anaes.) | $197.95 75% benefit $148.50 85% benefit $168.30 |
| 42815 | VITREOUS CAVITY, removal of silicone oil or other liquid vitreous substitutes from, during a procedure other than that in which the vitreous substitute is inserted (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 42818 | New 85% benefit on 1 November 2026Retina or ciliary body, cryotherapy to, as an independent procedure, or when performed in conjunction with item 42809 (Anaes.) | $702.00 75% benefit $526.50 85% benefit $596.70 was $597.50 |
| 42821 | OCULAR TRANSILLUMINATION, for the diagnosis and measurement of intraocular tumours (Anaes.) | $108.20 75% benefit $81.15 85% benefit $92.00 |
| 42824 | RETROBULBAR INJECTION OF ALCOHOL OR OTHER DRUG, as an independent procedure | $83.60 75% benefit $62.70 85% benefit $71.10 |
| 42833 | SQUINT, OPERATION FOR, ON 1 OR BOTH EYES, the operation involving a total of 1 OR 2 MUSCLES on a patient aged 15 years or over (Anaes.) (Assist.) | $702.00 75% benefit $526.50 |
| 42836 | SQUINT, OPERATION FOR, ON 1 OR BOTH EYES, the operation involving a total of 1 OR 2 MUSCLES, on a patient aged 14 years or under, or where the patient has had previous squint, retinal or extra ocular operations on the eye or eyes, or on a patient with concurrent thyroid eye disease (Anaes.) (Assist.) | $873.00 75% benefit $654.75 |
| 42839 | SQUINT, OPERATION FOR, ON 1 OR BOTH EYES, the operation involving a total of 3 OR MORE MUSCLES on a patient aged 15 years or over (Anaes.) (Assist.) | $837.15 75% benefit $627.90 |
| 42842 | SQUINT, OPERATION FOR, ON 1 OR BOTH EYES, the operation involving a total of 3 or MORE MUSCLES, on a patient aged 14 years or under, or where the patient has had previous squint, retinal or extra ocular operations on the eye or eyes, or on a patient with concurrent thyroid eye disease (Anaes.) (Assist.) | $1,044.05 75% benefit $783.05 |
| 42845 | READJUSTMENT OF ADJUSTABLE SUTURES, 1 or both eyes, as an independent procedure following an operation for correction of squint (Anaes.) | $226.75 75% benefit $170.10 85% benefit $192.75 |
| 42848 | SQUINT, muscle transplant for (Hummelsheim type, or similar operation) on a patient aged 15 years or over (Anaes.) (Assist.) | $837.15 75% benefit $627.90 |
| 42851 | SQUINT, muscle transplant for (Hummelsheim type, or similar operation) on a patient aged 14 years or under, or where the patient has had previous squint, retinal or extra ocular operations on the eye or eyes, or on a patient with concurrent thyroid eye disease (Anaes.) (Assist.) | $1,044.05 75% benefit $783.05 |
| 42854 | Ruptured medial palpebral ligament or ruptured extra‑ocular muscle, repair of (H) (Anaes.) (Assist.) | $485.95 75% benefit $364.50 |
| 42857 | Resuturing of wound following intraocular procedures with or without excision of prolapsed iris (H) (Anaes.) (Assist.) | $485.95 75% benefit $364.50 |
| 42860 | Eyelid (upper or lower), scleral or Goretex or other non‑autogenous graft to, with recession of the lid retractors (H) (Anaes.) (Assist.) | $1,079.90 75% benefit $809.95 |
| 42863 | New 85% benefit on 1 November 2026Eyelid (upper or lower), recession of, by open operation on and direct release of the lid retractors, one eye (Anaes.) (Assist.) | $927.15 75% benefit $695.40 85% benefit $818.65 was $822.65 |
| 42866 | New 85% benefit on 1 November 2026Entropion or tarsal ectropion, repair of, by tightening, shortening or repair of inferior retractors by open operation across the entire width of the eyelid, excluding when performed in conjunction with closure of the retractors using conjunctival approaches for fat pad reduction or orbital surgery (Anaes.) (Assist.) | $899.85 75% benefit $674.90 85% benefit $791.35 was $795.35 |
| 42869 | EYELID closure in facial nerve paralysis, insertion of foreign implant for (Anaes.) (Assist.) | $657.10 75% benefit $492.85 85% benefit $558.55 |
| 42872 | Direct eyebrow lift in paretic states, or in involutional states, if:(a) vision is obscured as evidenced by the resting of upper lid skin on the eyelashes in straight ahead gaze; and(b) photographic evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) | $288.05 75% benefit $216.05 85% benefit $244.85 |
| 43021 | Photodynamic therapy, one eye, including the infusion of Verteporfin continuously through a peripheral vein, using a non-thermal laser at a wavelength of 689nm, for the treatment of choroidal neovascularisation. | $544.70 75% benefit $408.55 85% benefit $463.00 |
| 43022 | Photodynamic therapy, both eyes, including the infusion of Verteporfin continuously through a peripheral vein, using a non-thermal laser at a wavelength of 689nm, for the treatment of choroidal neovascularisation. | $653.70 75% benefit $490.30 85% benefit $555.65 |
| 43030 | Paracentesis of anterior chamber or vitreous cavity, or both, for either or both of the following:(a) the injection of therapeutic substances;(b) the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes;as an independent procedure of the left eye | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 43032 | Paracentesis of anterior chamber or vitreous cavity, or both, for either or both of the following:(a) the injection of therapeutic substances;(b) the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes;as an independent procedure of the right eye | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 43034 | Paracentesis of anterior chamber or vitreous cavity, or both, for either or both of the following:(a) the injection of therapeutic substances;(b) the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes;as an independent procedure of the left eye, for a patient requiring the administration of anaesthetic by an anaesthetist (Anaes.) | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 43036 | Paracentesis of anterior chamber or vitreous cavity, or both, for either or both of the following:(a) the injection of therapeutic substances;(b) the removal of aqueous or vitreous humours for diagnostic or therapeutic purposes;as an independent procedure of the right eye, for a patient requiring the administration of anaesthetic by an anaesthetist (Anaes.) | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 43038 | Intravitreal injection of therapeutic substances, or the removal of vitreous humour for diagnostic purposes, one or more of, as a procedure associated with other intraocular surgery of the left eye (Anaes.) | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 43040 | Intravitreal injection of therapeutic substances, or the removal of vitreous humour for diagnostic purposes, one or more of, as a procedure associated with other intraocular surgery of the right eye (Anaes.) | $359.95 75% benefit $270.00 85% benefit $306.00 |
| 43050 | Choroidal detachment, repair by external drainage (H) (Anaes.) (Assist.) | $806.95 75% benefit $605.25 |
| 43521 | OPERATION ON SKULL (Anaes.) (Assist.) | $556.05 75% benefit $417.05 |
| 43527 | Operation on sternum, clavicle, rib, metacarpus, carpus, phalanx, metatarsus, tarsus, mandible or maxilla (other than alveolar margins), by open or arthroscopic means, for septic arthritis or osteomyelitis—one approach, inclusive of the adjoining joint (H) (Anaes.) (Assist.) | $426.55 75% benefit $319.95 |
| 43530 | Operation on scapula, ulna, radius, tibia, fibula, humerus or femur, by open or arthroscopic means, for septic arthritis or osteomyelitis—one approach, inclusive of the adjoining joint (H) (Anaes.) (Assist.) | $426.55 75% benefit $319.95 |
| 43533 | Operation on spine or pelvic bones, by open or arthroscopic means, for septic arthritis or osteomyelitis—one approach, inclusive of the adjoining joint (H) (Anaes.) (Assist.) | $703.25 75% benefit $527.45 |
| 43801 | INTESTINAL MALROTATION with or without volvulus, laparotomy for, not involving bowel resection (Anaes.) (Assist.) | $1,145.90 75% benefit $859.45 |
| 43804 | INTESTINAL MALROTATION with or without volvulus, laparotomy for, with bowel resection and anastomosis, with or without formation of stoma (Anaes.) (Assist.) | $1,219.90 75% benefit $914.95 |
| 43805 | UMBILICAL, EPIGASTRIC OR LINEA ALBA HERNIA, repair of, on a patient under 10 years of age (Anaes.) | $426.55 75% benefit $319.95 |
| 43807 | DUODENAL ATRESIA or STENOSIS, duodenoduodenostomy or duodenojejunostomy for (Anaes.) (Assist.) | $1,330.95 75% benefit $998.25 |
| 43810 | JEJUNAL ATRESIA, bowel resection and anastomosis for, with or without tapering (Anaes.) (Assist.) | $1,552.75 75% benefit $1,164.60 |
| 43813 | MECONIUM ILEUS, laparotomy for, complicated by 1 or more of associated volvulus, atresia, intesinal perforation with or without meconium peritonitis (Anaes.) (Assist.) | $1,552.75 75% benefit $1,164.60 |
| 43816 | ILEAL ATRESIA, COLONIC ATRESIA OR MECONIUM ILEUS not being a service associated with a service to which item 43813 applies, laparotomy for (Anaes.) (Assist.) | $1,441.80 75% benefit $1,081.35 |
| 43819 | Agangliosis Coli, laparotomy for, with or without frozen section biopsies and formation of stoma (Anaes.) (Assist.) | $1,164.60 75% benefit $873.45 |
| 43822 | ANORECTAL MALFORMATION, laparotomy and colostomy for (Anaes.) (Assist.) | $1,164.60 75% benefit $873.45 |
| 43825 | NEONATAL ALIMENTARY OBSTRUCTION, laparotomy for, not being a service to which any other item in this Subgroup applies (Anaes.) (Assist.) | $1,330.95 75% benefit $998.25 |
| 43828 | ACUTE NEONATAL NECROTISING ENTEROCOLITIS, laparotomy for, with resection, including any anastomoses or stoma formation (Anaes.) (Assist.) | $1,470.45 75% benefit $1,102.85 |
| 43831 | ACUTE NEONATAL NECROTISING ENTEROCOLITIS where no definitive procedure is possible, laparotomy for (Anaes.) (Assist.) | $1,145.90 75% benefit $859.45 |
| 43832 | Branchial fistula, removal of, on a patient under 10 years of age (Anaes.) (Assist.) | $781.50 75% benefit $586.15 |
| 43834 | BOWEL RESECTION for necrotising enterocolitis stricture or strictures, including any anastomoses or stoma formation (Anaes.) (Assist.) | $1,330.95 75% benefit $998.25 |
| 43835 | STRANGULATED, INCARCERATED OR OBSTRUCTED HERNIA, repair of, without bowel resection, on a patient under 10 years of age (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 43837 | CONGENITAL DIAPHRAGMATIC HERNIA, repair by thoracic or abdominal approach, with diagnosis confirmed in the first 24 hours of life (Anaes.) (Assist.) | $1,663.60 75% benefit $1,247.70 |
| 43838 | Diaphragmatic hernia, congential repair of, by thoracic or abdominal approach, not being a service to which any of items 31569 to 31581 apply, on a patient under 10 years of age (Anaes.) (Assist.) | $1,489.45 75% benefit $1,117.10 |
| 43840 | CONGENITAL DIAPHRAGMATIC HERNIA, repair by thoracic or abdominal approach, diagnosed after the first day of life and before 20 days of age (Anaes.) (Assist.) | $1,441.80 75% benefit $1,081.35 |
| 43841 | Femoral or inguinal hernia or infantile hydrocele, repair of, on a patient under 10 years of age, other than a service to which item 30651 or 43835 applies (H) (Anaes.) (Assist.) | $722.70 75% benefit $542.05 |
| 43843 | OESOPHAGEAL ATRESIA (with or without repair of tracheo-oesophageal fistula), complete correction of, not being a service to which item 43846 applies (Anaes.) (Assist.) | $2,218.25 75% benefit $1,663.70 |
| 43846 | OESOPHAGEAL ATRESIA (with or without repair of tracheo-oesophageal fistula), complete correction of, in infant of birth weight less than 1500 grams (Anaes.) (Assist.) | $2,384.55 75% benefit $1,788.45 |
| 43849 | OESOPHAGEAL ATRESIA, gastrostomy for (Anaes.) (Assist.) | $610.05 75% benefit $457.55 |
| 43852 | OESOPHAGEAL ATRESIA, thoracotomy for, and division of tracheo-oesophageal fistula without anastomosis (Anaes.) (Assist.) | $1,940.85 75% benefit $1,455.65 |
| 43855 | OESOPHAGEAL ATRESIA, delayed primary anastomosis for (Anaes.) (Assist.) | $2,051.95 75% benefit $1,539.00 |
| 43858 | OESOPHAGEAL ATRESIA, cervical oesophagostomy for (Anaes.) (Assist.) | $720.85 75% benefit $540.65 |
| 43861 | CONGENITAL CYSTADENOMATOID MALFORMATION OR CONGENITAL LOBAR EMPHYSEMA, thoracotomy and lung resection for (Anaes.) (Assist.) | $1,996.50 75% benefit $1,497.40 |
| 43864 | GASTROSCHISIS, operation for (Anaes.) (Assist.) | $1,497.35 75% benefit $1,123.05 |
| 43867 | GASTROSCHISIS or Exomphalos, secondary operation for, with removal of silo (Anaes.) (Assist.) | $831.80 75% benefit $623.85 |
| 43870 | EXOMPHALOS containing small bowel only, operation for (Anaes.) (Assist.) | $1,164.60 75% benefit $873.45 |
| 43873 | EXOMPHALOS containing small bowel and other viscera, operation for (Anaes.) (Assist.) | $1,552.75 75% benefit $1,164.60 |
| 43876 | SACROCOCCYGEAL TERATOMA, excision of, by posterior approach (Anaes.) (Assist.) | $1,330.95 75% benefit $998.25 |
| 43879 | SACROCOCCYGEAL TERATOMA, excision of, by combined posterior and abdominal approach (Anaes.) (Assist.) | $1,552.75 75% benefit $1,164.60 |
| 43882 | Cloacal exstrophy, operation for (H) (Anaes.) (Assist.) | $1,996.50 75% benefit $1,497.40 |
| 43900 | TRACHEO-OESOPHAGEAL FISTULA without atresia, division and repair of (Anaes.) (Assist.) | $1,330.95 75% benefit $998.25 |
| 43903 | OESOPHAGEAL ATRESIA or CORROSIVE OESOPHAGEAL STRICTURE, oesophageal replacement for, utilizing gastric tube, jejunum or colon (Anaes.) (Assist.) | $2,218.25 75% benefit $1,663.70 |
| 43906 | OESOPHAGUS, resection of congenital, anastomic or corrosive stricture and anastomosis, not being a service to which item 43903 applies (Anaes.) (Assist.) | $1,940.85 75% benefit $1,455.65 |
| 43909 | TRACHEOMALACIA, aortopexy for (Anaes.) (Assist.) | $1,940.85 75% benefit $1,455.65 |
| 43912 | THORACOTOMY and excision of 1 or more of bronchogenic or enterogenous cyst or mediastinal teratoma (Anaes.) (Assist.) | $1,833.60 75% benefit $1,375.20 |
| 43915 | EVENTRATION, plication of diaphragm for (Anaes.) (Assist.) | $1,386.40 75% benefit $1,039.80 |
| 43930 | HYPERTROPHIC PYLORIC STENOSIS, pyloromyotomy for (Anaes.) (Assist.) | $533.15 75% benefit $399.90 |
| 43933 | IDIOPATHIC INTUSSUSCEPTION, laparotomy and manipulative reduction of (Anaes.) (Assist.) | $624.10 75% benefit $468.10 |
| 43936 | INTUSSUSCEPTION, laparotomy and resection with anastomosis (Anaes.) (Assist.) | $1,164.60 75% benefit $873.45 |
| 43939 | VENTRAL HERNIA following neonatal closure of exomphalos or gastroschisis, repair of (Anaes.) (Assist.) | $887.25 75% benefit $665.45 |
| 43942 | ABDOMINAL WALL VITELLO INTESTINAL REMNANT, excision of (Anaes.) | $277.30 75% benefit $208.00 |
| 43945 | PATENT VITELLO INTESTINAL DUCT, excision of (Anaes.) (Assist.) | $1,164.60 75% benefit $873.45 |
| 43948 | UMBILICAL GRANULOMA, excision of, under general anaesthesia (Anaes.) | $166.45 75% benefit $124.85 |
| 43951 | GASTRO-OESOPHAGEAL REFLUX with or without hiatus hernia, laparotomy and fundoplication for, without gastrostomy (Anaes.) (Assist.) | $1,042.85 75% benefit $782.15 |
| 43954 | GASTRO-OESOPHAGEAL REFLUX with or without hiatus hernia, laparotomy and fundoplication for, with gastrostomy (Anaes.) (Assist.) | $1,275.65 75% benefit $956.75 |
| 43957 | GASTRO-OESOPHAGEAL REFLUX, LAPAROTOMY AND FUNDOPLICATION for, with or without hiatus hernia, in child with neurological disease, with gastrostomy (Anaes.) (Assist.) | $1,386.40 75% benefit $1,039.80 |
| 43960 | ANORECTAL MALFORMATION, perineal anoplasty of (Anaes.) (Assist.) | $487.75 75% benefit $365.85 |
| 43963 | ANORECTAL MALFORMATION, posterior sagittal anorectoplasty of (Anaes.) (Assist.) | $1,940.85 75% benefit $1,455.65 |
| 43966 | ANORECTAL MALFORMATION, posterior sagittal anorectoplasty of, with laparotomy (Anaes.) (Assist.) | $2,218.25 75% benefit $1,663.70 |
| 43969 | PERSISTENT CLOACA, total correction of, with genital repair using posterior sagittal approach, with or without laparotomy (Anaes.) (Assist.) | $3,050.15 75% benefit $2,287.65 |
| 43972 | CHOLEDOCHAL CYST, resection of, with 1 duct anastomosis (Anaes.) (Assist.) | $2,218.25 75% benefit $1,663.70 |
| 43975 | CHOLEDOCHAL CYST, resection of, with 2 duct anastomoses (Anaes.) (Assist.) | $2,606.55 75% benefit $1,954.95 |
| 43978 | BILIARY ATRESIA, portoenterostomy for (Anaes.) (Assist.) | $2,218.25 75% benefit $1,663.70 |
| 43981 | NEPHROBLASTOMA, NEUROBLASTOMA OR OTHER MALIGNANT TUMOUR, laparotomy (exploratory), including associated biopsies, where no other intra-abdominal procedure is performed (Anaes.) (Assist.) | $610.05 75% benefit $457.55 |
| 43984 | NEPHROBLASTOMA, radical nephrectomy for (Anaes.) (Assist.) | $1,552.75 75% benefit $1,164.60 |
| 43987 | NEUROBLASTOMA, radical excision of (Anaes.) (Assist.) | $1,719.20 75% benefit $1,289.40 |
| 43990 | Aganglionosis Coli, definitive resection with pull-through anastomosis, with or without frozen section biopsies, when aganglionic segment extends to sigmoid colon (Anaes.) (Assist.) | $2,107.45 75% benefit $1,580.60 |
| 43993 | Aganglionosis Coli, definitive resection with pull-through anastomosis, with or without frozen section biopsies, when aganglionic segment extends into descending or transverse colon with or without resiting of stoma (Anaes.) (Assist.) | $2,273.75 75% benefit $1,705.35 |
| 43996 | Aganglionosis Coli, total colectomy for total colonic aganglionosis with ileoanal pull-through, with or without side to side ileocolic anastomosis (Anaes.) (Assist.) | $2,551.00 75% benefit $1,913.25 |
| 43999 | Aganglionosis Coli, anal sphincterotomy as an independent procedure for (Anaes.) (Assist.) | $319.00 75% benefit $239.25 |
| 44101 | RECTUM, examination of, on a patient under 2 years of age, under general anaesthesia with full thickness biopsy or removal of polyp or similar lesion (Anaes.) (Assist.) | $399.85 75% benefit $299.90 |
| 44102 | RECTUM, examination of, on a patient 2 years of age or over, under general anaesthesia with full thickness biopsy or removal of polyp or similar lesion (Anaes.) (Assist.) | $307.60 75% benefit $230.70 |
| 44104 | Rectal prolapse, submucosal or perirectal injection for, under general anaesthesia, on a patient under 2 years of age (H) (Anaes.) | $70.25 75% benefit $52.70 |
| 44105 | Rectal prolapse, submucosal or perirectal injection for, under general anaesthesia, on a patient 2 years of age or over (H) (Anaes.) | $53.95 75% benefit $40.50 |
| 44108 | Inguinal hernia, laparoscopic or open repair of, at age less than 12 months (H) (Anaes.) (Assist.) | $722.70 75% benefit $542.05 |
| 44111 | Obstructed or strangulated inguinal hernia, laparoscopic or open repair of, at age less than 12 months, including orchidopexy when performed (H) (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 44114 | Inguinal hernia, laparoscopic or open repair of, at age less than 12 months when orchidopexy also required (H) (Anaes.) (Assist.) | $811.15 75% benefit $608.40 |
| 44130 | Lymphadenectomy, for atypical mycobacterial infection or other granulomatous disease (H) (Anaes.) (Assist.) | $554.50 75% benefit $415.90 |
| 44133 | TORTICOLLIS, open division of sternomastoid muscle for (Anaes.) (Assist.) | $440.10 75% benefit $330.10 |
| 44136 | Ingrown toe nail, operation for, under general anaesthesia (H) (Anaes.) | $202.90 75% benefit $152.20 |
| 44325 | Amputation of hand, transcarpal (H) (Anaes.) (Assist.) | $353.90 75% benefit $265.45 |
| 44328 | Amputation of hand, proximal to wrist radiocarpal joint, through forearm (H) (Anaes.) (Assist.) | $426.55 75% benefit $319.95 |
| 44331 | Amputation at shoulder (H) (Anaes.) (Assist.) | $703.25 75% benefit $527.45 |
| 44334 | Interscapulothoracic amputation (H) (Anaes.) (Assist.) | $1,429.40 75% benefit $1,072.05 |
| 44338 | Amputation of one digit of one foot, distal to metatarsal head, including any of the following (if performed): (a) resection of bone or joint; (b) excision of neuroma; (c) skin cover with homodigital flaps (H) (Anaes.) (Assist.) | $172.40 75% benefit $129.30 |
| 44342 | Amputation of 2 digits of one foot, distal to metatarsal head, including any of the following (if performed): (a) resection of bone or joint; (b) excision of neuroma; (c) skin cover with homodigital flaps (H) (Anaes.) (Assist.) | $263.15 75% benefit $197.40 |
| 44346 | Amputation of 3 digits of one foot, distal to metatarsal head, including any of the following (if performed): (a) resection of bone or joint; (b) excision of neuroma; (c) skin cover with homodigital flaps (H) (Anaes.) (Assist.) | $304.00 75% benefit $228.00 |
| 44350 | Amputation of 4 digits of one foot, distal to metatarsal head, including any of the following (if performed): (a) resection of bone or joint; (b) excision of neuroma; (c) skin cover with homodigital flaps (H) (Anaes.) (Assist.) | $344.95 75% benefit $258.75 |
| 44354 | Amputation of 5 digits of one foot, distal to metatarsal head, including any of the following (if performed): (a) resection of bone or joint; (b) excision of neuroma; (c) skin cover with homodigital flaps (H) (Anaes.) (Assist.) | $394.75 75% benefit $296.10 |
| 44358 | Amputation of one ray of one foot, proximal to the metatarsal head, including any of the following (if performed): (a) resection of bone; (b) excision of neuromas; (c) skin cover or recontouring with homodigital flaps (H) (Anaes.) (Assist.) | $263.15 75% benefit $197.40 |
| 44359 | Amputation of one or more toes of one foot, or amputation at midfoot or hindfoot of one foot, for diabetic or other microvascular disease; (a) including any of the following (if performed): (i) resection of bone; (ii) excision of neuromas; (iii) excision of one or more bones of the foot; (iv) treatment of underlying infection; (v) skin cover or recontouring with homodigital flaps; and (b) excluding aftercare; —applicable only once per foot per occasion on which the service is performed (H) (Anaes.) (Assist.) | $315.85 75% benefit $236.90 |
| 44361 | Amputation of foot, at ankle or hindfoot, including any of the following (if performed): (a) resection of bone; (b) excision of neuromas; (c) skin cover; (H) (Anaes.) (Assist.) | $522.35 75% benefit $391.80 |
| 44364 | Amputation of foot, transtarsal, including any of the following (if performed): (a) resection of bone; (b) excision of neuromas; (c) skin cover; (H) (Anaes.) (Assist.) | $353.90 75% benefit $265.45 |
| 44367 | Amputation through thigh, at knee or below knee (H) (Anaes.) (Assist.) | $624.70 75% benefit $468.55 |
| 44370 | Amputation at hip (H) (Anaes.) (Assist.) | $862.05 75% benefit $646.55 |
| 44373 | Hindquarter, amputation of (H) (Anaes.) (Assist.) | $1,769.45 75% benefit $1,327.10 |
| 44376 | Amputation stump, re‑amputation of, to provide adequate skin and muscle cover (H) (Anaes.) (Assist.) Derived fee: 75% of the original amputation fee | Derived |
| 45000 | Single stage local muscle flap repair, on eyelid, nose, lip, neck, hand, thumb, finger or genitals not in association with any of items 31356 to 31383 (Anaes.) | $647.85 75% benefit $485.90 85% benefit $550.70 |
| 45003 | New 85% benefit on 1 November 2026Single stage local myocutaneous flap repair to one defect, simple and small not in association with any of items 31356 to 31383 (Anaes.) | $720.15 75% benefit $540.15 85% benefit $612.15 was $615.65 |
| 45006 | Single stage large myocutaneous flap repair to one defect (pectoralis major, latissimus dorsi, or similar large muscle), other than a service associated with a service to which any of items 45524 to 45542 apply (H) (Anaes.) (Assist.) | $1,242.00 75% benefit $931.50 |
| 45009 | Single stage local muscle flap repair to 1 defect, simple and small, other than a service associated with a service to which item 30278, 30281 or 41722 applies (H) (Anaes.) (Assist.) | $453.70 75% benefit $340.30 |
| 45012 | Single stage large muscle flap repair to one defect (pectoralis major, gastrocnemius, gracilis or similar large muscle), other than a service associated with a service to which any of items 45524 to 45542 apply (H) (Anaes.) (Assist.) | $931.45 75% benefit $698.60 |
| 45015 | MUSCLE OR MYOCUTANEOUS FLAP, delay of (Anaes.) | $359.95 75% benefit $270.00 |
| 45018 | Dermis, dermofat or fascia graft (other than transfer of fat by injection): (a) if the service is not associated with neurosurgical services for spinal disorders mentioned in any of items 51011 to 51171; and (b) other than a service associated with a service to which item 39615, 39715, 40106 or 40109 applies; and (c) other than a service to which item 38502 applies (H) (Anaes.) (Assist.) | $566.95 75% benefit $425.25 |
| 45019 | Full face chemical peel for severely sun‑damaged skin, if: (a) the damage affects at least 75% of the facial skin surface area; and (b) the damage involves photo-damage (dermatoheliosis); and (c) the photo-damage involves: (i) a solar keratosis load exceeding 30 individual lesions; or (ii) solar lentigines; or (iii) freckling, yellowing or leathering of the skin; or (iv) solar kertoses which have proven refractory to, or recurred following, medical therapies; and (d) at least medium depth peeling agents are used; and (e) the chemical peel is performed in the operating theatre of a hospital by a medical practitioner recognised as a specialist in the specialty of dermatology or plastic surgery. Applicable once only in any 12 month period (Anaes.) | $474.85 75% benefit $356.15 |
| 45021 | Abrasive therapy for severely disfiguring scarring of face resulting from trauma, burns or acne, if sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes—limited to one claim per patient per episode (Anaes.) | $212.30 75% benefit $159.25 85% benefit $180.50 |
| 45025 | CARBON DIOXIDE LASER OR ERBIUM LASER (not including fractional laser therapy) resurfacing of the face or neck for severely disfiguring scarring resulting from trauma, burns or acne - limited to 1 aesthetic area (Anaes.) | $212.30 75% benefit $159.25 85% benefit $180.50 |
| 45026 | CARBON DIOXIDE LASER OR ERBIUM LASER (not including fractional laser therapy) resurfacing of the face or neck for severely disfiguring scarring resulting from trauma, burns or acne - more than 1 aesthetic area (Anaes.) | $477.05 75% benefit $357.80 85% benefit $405.50 |
| 45027 | Vascular anomaly, cauterisation of or injection into, if undertaken in the operating theatre of a hospital (H) (Anaes.) | $144.10 75% benefit $108.10 |
| 45030 | Vascular anomaly, of skin, mucous membrane and/or subcutaneous tissue, small, excision and suture of (Anaes.) | $162.45 75% benefit $121.85 85% benefit $138.10 |
| 45033 | Vascular anomaly, large or involving deeper tissue including facial muscle, excision and suture of (H) (Anaes.) (Assist.) | $294.30 75% benefit $220.75 |
| 45035 | Vascular anomaly, large, deep, and involving major neurovascular structures, excision of, including dissection of muscles, nerves or major vessels (H) (Anaes.) (Assist.) | $840.30 75% benefit $630.25 |
| 45036 | Vascular anomaly, of neck, deep and involving major neurovascular structures, excision of, including dissection of cranial nerves and major vessels (H) (Anaes.) (Assist.) | $1,350.20 75% benefit $1,012.65 |
| 45045 | Vascular anomaly on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals, excision of (Anaes.) | $369.20 75% benefit $276.90 85% benefit $313.85 |
| 45048 | LYMPHOEDEMATOUS tissue or lymphangiectasis, of lower leg and foot, or thigh, or upper arm, or forearm and hand, major excision of (Anaes.) (Assist.) | $927.15 75% benefit $695.40 |
| 45051 | Contour reconstruction by open repair of contour defects, due to deformity, if: (a) contour reconstructive surgery is indicated because the deformity is secondary to congenital absence of tissue or has arisen from trauma (other than trauma from previous cosmetic surgery); and (b) insertion of a non-biological implant is required, other than one or more of the following: (i) insertion of a non-biological implant that is a component of another service specified in Group T8; (ii) injection of liquid or semisolid material; (iii) an oral and maxillofacial implant service to which item 52321 applies; (iv) a service to insert mesh; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 45054 | Limb or chest, decompression escharotomy of (including all incisions), for acute compartment syndrome secondary to burn (H) (Anaes.) (Assist.) | $390.25 75% benefit $292.70 |
| 45060 | Developmental breast abnormality, single stage correction of, if: (a) the correction involves either: (i) bilateral mastopexy for symmetrical tubular breasts; or (ii) surgery on both breasts with a combination of insertion of one or more implants (which must have at least a 10% volume difference), mastopexy or reduction mammaplasty, if there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least 20% in normally shaped breasts, or 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (Anaes.) (Assist.) | $1,521.60 75% benefit $1,141.20 |
| 45061 | Developmental breast abnormality, 2 stage correction of, first stage, involving surgery on both breasts with a combination of insertion of one or more tissue expanders, mastopexy or reduction mammaplasty, if: (a) there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or (ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes. Applicable only once per occasion on which the service is provided (Anaes.) (Assist.) | $1,521.60 75% benefit $1,141.20 |
| 45062 | Developmental breast abnormality, 2 stage correction of, second stage, involving surgery on both breasts with a combination of exchange of one or more tissue expanders for one or more implants (which must have at least a 10% volume difference), mastopexy or reduction mammaplasty, if: (a) there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or (ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes. Applicable only once per occasion on which the service is provided (Anaes.) (Assist.) | $1,101.10 75% benefit $825.85 |
| 45070 | Developmental breast abnormality, single stage correction of, involving surgery on one breast, if: (a) the correction involves either: (i) insertion of an implant with or without mastopexy; or(ii) reduction mammaplasty; and (b) there is a difference in breast volume with the other breast, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or(ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (c) photographic or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (H) (Anaes.) (Assist.) | $1,014.40 75% benefit $760.80 |
| 45071 | Developmental breast abnormality, 2 stage correction of, first stage, involving surgery on one breast with insertion of a tissue expander, if: (a) there is a difference in breast volume with the other breast, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or(ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (H) (Anaes.) (Assist.) | $1,014.40 75% benefit $760.80 |
| 45072 | Developmental breast abnormality, 2 stage correction of, second stage, involving surgery on one breast with exchange of a tissue expander for an implant (which must have at least a 10% volume difference), if: (a) there is a difference in breast volume with the other breast, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or(ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (H) (Anaes.) (Assist.) | $734.05 75% benefit $550.55 |
| 45200 | Single stage local flap, if indicated to repair one defect, simple and small, excluding flap for male pattern baldness and excluding H-flap or double advancement flap not in association with any of items 31356 to 31383 (Anaes.) | $340.30 75% benefit $255.25 85% benefit $289.30 |
| 45201 | Muscle, myocutaneous or skin flap, where clinically indicated to repair one surgical excision made in the removal of a malignant or non-malignant skin lesion (only in association with items 31000, 31001, 31002, 31003, 31004, 31005, 31358, 31359, 31360, 31363, 31364, 31369, 31370, 31371, 31373, 31376, 31378, 31380 or 31383)-may be claimed only once per defect (Anaes.) | $495.40 75% benefit $371.55 85% benefit $421.10 |
| 45202 | Muscle, myocutaneous or skin flap, where clinically indicated to repair one surgical excision made in the removal of a malignant or non-malignant skin lesion in a patient, if the clinical relevance of the procedure is clearly annotated in the patient's record and either: (a) item 45201 applies and additional flap repair is required for the same defect; or (b) item 45201 does not apply and either: (i) the patient has severe pre-existing scarring, severe skin atrophy or sclerodermoid changes; or (ii) the repair is contiguous with a free margin (Anaes.) | $495.40 75% benefit $371.55 85% benefit $421.10 |
| 45203 | Single stage local flap, if indicated to repair one defect, complicated or large, excluding flap for male pattern baldness and excluding H-flap or double advancement flap not in association with any of items 31356 to 31383 (Anaes.) (Assist.) | $485.95 75% benefit $364.50 85% benefit $413.10 |
| 45206 | Single stage local flap if indicated to repair one defect, on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals and excluding H-flap or double advancement flap not in association with any of items 31356 to 31383 (Anaes.) | $459.15 75% benefit $344.40 85% benefit $390.30 |
| 45207 | H-flap or double advancement flap if indicated to repair one defect, on eyelid, eyebrow or forehead not in association with any of items 31356 to 31383 (Anaes.) | $459.15 75% benefit $344.40 85% benefit $390.30 |
| 45209 | Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), first stage of a multistage procedure (H) (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 45212 | Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), subsequent stage of a multistage procedure (H) (Anaes.) (Assist.) | $281.40 75% benefit $211.05 |
| 45221 | DIRECT FLAP REPAIR, small (cross finger or similar), first stage (Anaes.) | $313.15 75% benefit $234.90 85% benefit $266.20 |
| 45224 | DIRECT FLAP REPAIR, small (cross finger or similar), second stage (Anaes.) | $140.70 75% benefit $105.55 85% benefit $119.60 |
| 45227 | Indirect flap or tubed pedicle, formation of (H) (Anaes.) (Assist.) | $533.15 75% benefit $399.90 |
| 45230 | DIRECT OR INDIRECT FLAP OR TUBED PEDICLE, delay of (Anaes.) | $266.60 75% benefit $199.95 85% benefit $226.65 |
| 45233 | Indirect flap or tubed pedicle, preparation of intermediate or final site and attachment to the site (H) (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 45239 | Direct, indirect, free or local flap, revision of, by incision and suture and/or liposuction, applicable once per flap, not being a service associated with a service to which item 45497 applies (Anaes.) | $313.15 75% benefit $234.90 85% benefit $266.20 |
| 45440 | Split thickness skin graft to a small defect that is:(a) less than 40 mm in diameter: (i) on areas below the knee; or(ii) distal to the ulnar styloid; or(iii) on the genital area; or(iv) on areas above the clavicle; or (b) less than 80 mm in diameter on any other part of the body (Anaes.) (Assist.) | $340.30 75% benefit $255.25 85% benefit $289.30 |
| 45443 | New 85% benefit on 1 November 2026Split thickness skin graft to a large defect that is:(a) 40 mm or more in diameter: (i) on areas below the knee; or(ii) distal to the ulnar styloid; or(iii) on the genital area; or(iv) on areas above the clavicle; or (b) 80 mm or more in diameter on any other part of the body (Anaes.) (Assist.) | $702.00 75% benefit $526.50 85% benefit $596.70 was $597.50 |
| 45451 | Full thickness skin graft to one defect, with an average diameter of 5 mm or more (Anaes.) (Assist.) | $567.05 75% benefit $425.30 85% benefit $482.00 |
| 45496 | FLAP, free tissue transfer using microvascular techniques - revision of, by open operation (Anaes.) | $498.05 75% benefit $373.55 |
| 45497 | Flap, free tissue transfer using microvascular techniques or any autologous breast reconstruction, revision of, by liposuction, other than a service associated with a service to which item 45239 applies (H) (Anaes.) | $379.40 75% benefit $284.55 |
| 45500 | Microvascular repair using microsurgical techniques, with restoration of continuity of artery or vein of distal extremity or digit; cannot be claimed by the same provider for both artery and vein (H) (Anaes.) (Assist.) | $1,304.95 75% benefit $978.75 |
| 45501 | Microvascular anastomosis of artery or vein using microsurgical techniques, for replantation or revascularisation of limb or digit, if the limb or digit is devitalised and the repair is critical for restoration of blood supply, other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.) | $2,124.10 75% benefit $1,593.10 |
| 45502 | Microvascular anastomoses of artery and vein using microsurgical techniques, for replantation or revascularisation of limb or digit, if the limb or digit is devitalised and the repair is critical for restoration of blood supply, including anastomoses of all required vessels for that extremity or digit, unless a micro-arterial or micro-venous graft is being used, other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.) | $3,186.20 75% benefit $2,389.65 |
| 45503 | Micro-arterial or micro-venous graft using microsurgical techniques, if the graft is critical for restoration of blood supply, including harvest of graft and suturing of all related anastomoses (not to be claimed in the context of cardiac surgery) (H) (Anaes.) (Assist.) | $2,430.10 75% benefit $1,822.60 |
| 45504 | Microvascular anastomosis of artery, vein or veins, using microsurgical techniques, for free transfer of tissue, including setting in of free flap, other than:(a) a service for the purpose of breast reconstruction; or(b) a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies(H) (Anaes.) (Assist.) | $2,124.10 75% benefit $1,593.10 |
| 45505 | Microvascular anastomoses of artery and vein or veins, using microsurgical techniques, for free transfer of tissue, including setting in of free flap, other than:(a) a service for the purpose of breast reconstruction; or(b) a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies(H) (Anaes.) (Assist.) | $3,216.75 75% benefit $2,412.60 |
| 45507 | Microvascular repair using microsurgical techniques, with restoration of continuity of artery and vein of distal extremity or digit, including anastomoses of all required vessels for that extremity or digit, other than a service associated with a service to which item 45564, 45565 or 45567 applies (H) (Anaes.) (Assist.) | $1,957.50 75% benefit $1,468.15 |
| 45510 | Scar, of face or neck, not more than 3 cm in length, revision of, if:(a) undertaken in the operating theatre of a hospital; or(b) performed by a specialist in the practice of the specialist’s specialty (Anaes.) | $263.15 75% benefit $197.40 85% benefit $223.70 |
| 45512 | SCAR, of face or neck, more than 3 cm in length, revision of, where undertaken in the operating theatre of a hospital, or where performed by a specialist in the practice of his or her specialty (Anaes.) | $353.90 75% benefit $265.45 85% benefit $300.85 |
| 45515 | New wording on 1 November 2026Scar, other than on face or neck, not more than 7 cm in length, revision of, if:(a) the service is: (i) undertaken in the operating theatre of a hospital; or (ii) performed by a specialist in the practice of the specialist’s specialty; and (b) the service is not performed in conjunction with the insertion of breast implants for cosmetic purposes; and (c) the incision made for revision of the scar is not used as an approach for another procedure (including a procedure which does not attract a medicare benefit); and (d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (Anaes.) | $223.25 75% benefit $167.45 85% benefit $189.80 |
| 45518 | New benefit rates and new wording on 1 November 2026Scar, other than on face or neck, more than 7 cm in length, revision of, if:(a) the service is: (i) undertaken in the operating theatre of a hospital; or (ii) performed by a specialist in the practice of the specialist’s specialty; and (b) the service is not performed in conjunction with the insertion of breast implants for cosmetic purposes; and (c) the incision made for revision of the scar is not used as an approach for another procedure (including a procedure which does not attract a medicare benefit); and (d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (Anaes.) | $270.15 75% benefit $202.65 85% benefit $229.65 |
| 45520 | Reduction mammaplasty (unilateral) with surgical repositioning of nipple, in the context of breast cancer or developmental abnormality of the breast, other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side (H) (Anaes.) (Assist.) | $1,077.70 75% benefit $808.30 |
| 45522 | Reduction mammaplasty (unilateral) without surgical repositioning of the nipple:(a) excluding the treatment of gynaecomastia; and(b) not with insertion of any prosthesis;other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side (H) (Anaes.) (Assist.) | $756.10 75% benefit $567.10 |
| 45523 | Reduction mammaplasty (bilateral) with surgical repositioning of the nipple:(a) for patients with macromastia who are experiencing pain in the neck or shoulder region; and(b) not with insertion of any prosthesis;other than a service associated with a service to which item 31512, 31513 or 31514 applies (H) (Anaes.) (Assist.) | $1,616.70 75% benefit $1,212.55 |
| 45524 | Mammaplasty, augmentation (unilateral) in the context of: (a) breast cancer; or (b) developmental abnormality of the breast, if there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or (ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds. Applicable only once per occasion on which the service is provided, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $887.70 75% benefit $665.80 |
| 45527 | Breast reconstruction (unilateral), following mastectomy, using a permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $1,282.15 75% benefit $961.65 |
| 45528 | Mammaplasty, augmentation, bilateral (other than a service to which item 45527 applies), if: (a) reconstructive surgery is indicated because of: (i) developmental malformation of breast tissue (excluding hypomastia); or (ii) disease of or trauma to the breast (other than trauma resulting from previous elective cosmetic surgery); or (iii) amastia secondary to a congenital endocrine disorder; and (b) photographic or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $1,331.35 75% benefit $998.55 |
| 45529 | Breast reconstruction (bilateral), following mastectomy, using permanent prostheses, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $2,243.65 75% benefit $1,682.75 |
| 45530 | Post-mastectomy breast reconstruction, autologous (unilateral), using a large muscle or myocutaneous flap, isolated on its vascular pedicle, excluding repair of muscular aponeurotic layer, other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45006 or 45012 applies (H) (Anaes.) (Assist.) | $1,315.85 75% benefit $986.90 |
| 45531 | Post-mastectomy breast reconstruction, autologous (bilateral), using a large muscle or myocutaneous flap, isolated on its vascular pedicle, excluding repair of muscular aponeurotic layer, other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45006 or 45012 applies (H) (Anaes.) (Assist.) | $2,302.75 75% benefit $1,727.10 |
| 45532 | Revision of post-mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $324.20 75% benefit $243.15 |
| 45534 | Autologous fat grafting, unilateral service (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for one or more of the following purposes: (i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage; (ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction; (iii) breast reconstruction in breast cancer patients; (iv) the correction of developmental disorders of the breast; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Up to a total of 4 services per side (for total treatment of a single breast), other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) | $756.10 75% benefit $567.10 |
| 45535 | Autologous fat grafting, bilateral service (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for one or more of the following purposes: (i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage; (ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction; (iii) breast reconstruction in breast cancer patients; (iv) the correction of developmental disorders of the breast; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Up to a total of 4 services, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) | $1,323.35 75% benefit $992.55 |
| 45537 | Perforator flap, such as a thoracodorsal artery perforator (TDAP) flap or a lateral intercostal artery perforator (LICAP) flap, or similar, raising on a named source vessel, for reconstruction of a partial mastectomy defect, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $941.45 75% benefit $706.10 |
| 45538 | Perforator flap, such as a deep inferior epigastric perforator (DIEP) flap or similar, raising in preparation for microsurgical transfer of a free flap for post mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $1,077.20 75% benefit $807.90 |
| 45539 | Breast reconstruction (unilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $1,726.00 75% benefit $1,294.50 |
| 45540 | Breast reconstruction (bilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $3,020.35 75% benefit $2,265.30 |
| 45541 | Breast reconstruction (bilateral), following mastectomy, using tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $1,284.80 75% benefit $963.60 |
| 45542 | Breast reconstruction (unilateral), following mastectomy, using tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.) | $734.15 75% benefit $550.65 |
| 45545 | New 85% benefit on 1 November 2026Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.) | $745.15 75% benefit $558.90 85% benefit $636.65 was $640.65 |
| 45546 | NIPPLE OR AREOLA or both, intradermal colouration of, following breast reconstruction after mastectomy or for congenital absence of nipple | $236.80 75% benefit $177.60 85% benefit $201.30 |
| 45547 | Revision of breast prosthesis pocket, if:(a) breast prosthesis or tissue expander has been placed for the purpose of breast reconstruction in the context of breast cancer or for developmental breast abnormality; and(b) the prosthesis or tissue expander has migrated or rotated from its intended position or orientation; and(c) the existing prosthesis is used(H) (Anaes.) (Assist.) | $837.15 75% benefit $627.90 |
| 45548 | Breast prosthesis, removal of, as an independent procedure (H) (Anaes.) | $331.25 75% benefit $248.45 |
| 45551 | Breast prosthesis, removal of, with excision of at least half of the fibrous capsule, not with insertion of any prosthesis. The excised specimen must be sent for histopathology and the volume removed must be documented in the histopathology report (Anaes.) (Assist.) | $531.10 75% benefit $398.35 |
| 45553 | Breast prosthesis, removal of and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.) | $684.15 75% benefit $513.15 |
| 45554 | Breast prosthesis, removal and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), including excision of at least half of the fibrous capsule or formation of a new pocket, or both, if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) the excised specimen is sent for histopathology and the volume removed is documented in the histopathology report; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.) | $837.15 75% benefit $627.90 |
| 45556 | Breast ptosis, correction of (unilateral), in the context of breast cancer or developmental abnormality, if photographic evidence (including anterior, left lateral and right lateral views) and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided, other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side (H) (Anaes.) (Assist.) | $916.85 75% benefit $687.65 |
| 45558 | Correction of bilateral breast ptosis by mastopexy, if: (a) at least two‑thirds of the breast tissue, including the nipple, lies inferior to the inframammary fold where the nipple is located at the most dependent, inferior part of the breast contour; and (b) photographic evidence (including anterior, left lateral and right lateral views), with a marker at the level of the inframammary fold, demonstrating the clinical need for this service, is documented in the patient notes Applicable only once per lifetime, other than a service associated with a service to which item 31512, 31513 or 31514 applies (H) (Anaes.) (Assist.) | $1,375.20 75% benefit $1,031.40 |
| 45560 | HAIR TRANSPLANTATION for the treatment of alopecia of congenital or traumatic origin or due to disease, excluding male pattern baldness, not being a service to which another item in this Group applies (Anaes.) | $566.95 75% benefit $425.25 85% benefit $481.95 |
| 45561 | Microvascular anastomosis of artery and/or vein, if considered necessary to salvage a vascularly compromised pedicled or free flap, either during the primary procedure or at a subsequent return to theatre (H) (Anaes.) (Assist.) | $2,124.10 75% benefit $1,593.10 |
| 45562 | Free transfer of tissue (microvascular free flap) for non-breast defect involving raising of tissue on vascular pedicle, including direct repair of secondary cutaneous defect (if performed), other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.) | $1,315.85 75% benefit $986.90 |
| 45563 | Neurovascular island flap for restoration of essential sensation in the digits or sole of the foot, or for genital reconstruction, including:(a) direct repair of secondary cutaneous defect (if performed); and(b) formal dissection of the neurovascular pedicle;other than a service performed on simple V-Y flaps or other standard flaps, such as rotation or keystone (H) (Anaes.) (Assist.) | $1,315.85 75% benefit $986.90 |
| 45564 | Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | $3,047.70 75% benefit $2,285.80 |
| 45565 | Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | $2,285.90 75% benefit $1,714.45 |
| 45566 | Insertion of a temporary prosthetic tissue expander which requires subsequent removal, including all attendances for subsequent expansion injections, other than a service for breast or post-mastectomy tissue expansion (H) (Anaes.) (Assist.) | $1,282.15 75% benefit $961.65 |
| 45567 | Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562, 45564 or 45565 applies—single surgeon (H) (Anaes.) (Assist.) | $3,515.20 75% benefit $2,636.40 |
| 45568 | Tissue expander, removal of, including complete excision of fibrous capsule if performed (H) (Anaes.) (Assist.) | $531.10 75% benefit $398.35 |
| 45571 | Closure of abdomen with reconstruction of umbilicus, with or without lipectomy, to be used following the harvest of an autologous flap, being a service associated with a service to which item 45530, 45531, 45562, 45564, 45565, 45567, 46080, 46082, 46084, 46086, 46088 or 46090 applies, including repair of the musculoaponeurotic layer of the abdomen (including insertion of prosthetic mesh if used) (H) (Anaes.) (Assist.) | $1,238.75 75% benefit $929.10 |
| 45572 | Intra-operative tissue expansion using a prosthetic tissue expander, performed under general anaesthetic or intravenous sedation during an operation, if combined with a service to which another item in Group T8 applies (including expansion injections), not to be used for breast tissue expansion (H) (Anaes.) | $349.15 75% benefit $261.90 |
| 45575 | Facial nerve paralysis, free fascia graft for (H) (Anaes.) (Assist.) | $862.05 75% benefit $646.55 |
| 45578 | FACIAL NERVE PARALYSIS, muscle transfer for (Anaes.) (Assist.) | $998.30 75% benefit $748.75 |
| 45581 | Facial nerve paralysis, excision of tissue for (H) (Anaes.) | $331.25 75% benefit $248.45 |
| 45584 | Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), for treatment of post traumatic pseudolipoma, if photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) | $756.10 75% benefit $567.10 |
| 45585 | Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), other than a service associated with a service to which item 31525 or 31526 applies, if: (a) the liposuction is for: (i) the treatment of Barraquer-Simons syndrome, lymphoedema or macrodystrophia lipomatosa; or (ii) the reduction of a buffalo hump that is secondary to an endocrine disorder or pharmacological treatment of a medical condition; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (H) (Anaes.) | $756.10 75% benefit $567.10 |
| 45587 | Meloplasty for correction of facial asymmetry if: (a) the asymmetry is secondary to trauma (including previous surgery), a congenital condition or a medical condition (such as facial nerve palsy); and (b) the meloplasty is limited to one side of the face (Anaes.) (Assist.) | $1,066.25 75% benefit $799.70 |
| 45588 | Meloplasty (excluding browlifts and chinlift platysmaplasties), bilateral, if: (a) surgery is indicated to correct a functional impairment due to a congenital condition, disease (excluding post-acne scarring) or trauma (other than trauma resulting from previous elective cosmetic surgery); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.) | $1,599.55 75% benefit $1,199.70 |
| 45589 | Autologous fat grafting (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for either or both of the following purposes: (i) the correction of asymmetry arising from volume and contour defects in craniofacial disorders—up to a total of 4 services if each service is provided at least 3 months after the previous service; (ii) the treatment of burn scar or associated skin graft in the context of scar contracture, contour deformity or neuropathic pain, for patients who have undergone a minimum of 3 months of topical therapies, including silicone and pressure therapy, with an unsatisfactory or minimal level of improvement—up to a total of 4 services per region of the body (upper or lower limbs, trunk, neck or face) if each service provided per region of the body is provided at least 3 months after the previous such service; and (b) both: (i) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes; and (ii) for craniofacial disorders, evidence of diagnosis of the qualifying craniofacial disorder is documented in the patient notes (H) (Anaes.) | $756.10 75% benefit $567.10 |
| 45590 | Orbital cavity, reconstruction of wall or floor, with or without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530 or 45594 applies on the same side (H) (Anaes.) (Assist.) | $578.40 75% benefit $433.80 |
| 45592 | Orbital cavity, reconstruction of wall and floor with bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 45594 applies on the same side (H) (Anaes.) (Assist.) | $1,018.75 75% benefit $764.10 |
| 45594 | Orbital cavity, exploration of wall or floor without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530, 45590 or 45592 applies on the same side (H) (Anaes.) (Assist.) | $477.45 75% benefit $358.10 |
| 45596 | Hemimaxillectomy (H) (Anaes.) (Assist.) | $1,077.70 75% benefit $808.30 |
| 45597 | Total maxillectomy (bilateral) (H) (Anaes.) (Assist.) | $1,442.70 75% benefit $1,082.05 |
| 45599 | Mandible, total resection of, other than a service associated with a service to which item 45608 applies (H) (Anaes.) (Assist.) | $1,121.00 75% benefit $840.75 |
| 45602 | MANDIBLE, including lower border, OR MAXILLA, sub-total resection of (Anaes.) (Assist.) | $837.15 75% benefit $627.90 |
| 45605 | MANDIBLE OR MAXILLA, segmental resection of, for tumours or cysts (Anaes.) (Assist.) | $703.25 75% benefit $527.45 |
| 45608 | Mandible, segmental mandibular or maxilla reconstruction with bone graft, not being a service associated with a service to which item 45599 applies (H) (Anaes.) (Assist.) | $990.20 75% benefit $742.65 |
| 45609 | Mandible, maxilla or skull base, reconstruction of, using bony free flap, all osteotomies, shaping, inset and fixation by any means, including all necessary 3 dimensional planning, if performed in conjunction with one or more services covered by items 46060 to 46068 (H) (Anaes.) (Assist.) | $990.20 75% benefit $742.65 |
| 45611 | Mandible, condylectomy of (H) (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 45614 | New 85% benefit on 1 November 2026Eyelid, reconstruction of a defect (greater than one quarter of the length of the lid) involving all 3 layers of the eyelid, if unable to be closed by direct suture or wedge excision, including all flaps and grafts that may be required (Anaes.) (Assist.) | $998.30 75% benefit $748.75 85% benefit $889.80 was $893.80 |
| 45617 | Upper eyelid, reduction of, if: (a) the reduction is for any of the following: (i) history of a demonstrated visual impairment; (ii) intertriginous inflammation of the eyelid; (iii) herniation of orbital fat in exophthalmos; (iv) facial nerve palsy; (v) post‑traumatic scarring; (vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) | $281.40 75% benefit $211.05 85% benefit $239.20 |
| 45620 | Lower eyelid, reduction of, if: (a) the reduction is for: (i) herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring; or (ii) the restoration of symmetry of the contralateral lower eyelid in respect of one of these conditions; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) | $390.25 75% benefit $292.70 85% benefit $331.75 |
| 45623 | New 85% benefit on 1 November 2026Ptosis of upper eyelid (unilateral), correction of, by: (a) sutured elevation of the tarsal plate on the eyelid retractors (Muller’s or levator muscle or levator aponeurosis); or (b) sutured suspension to the brow/frontalis muscle; Not applicable to a service for repair of mechanical ptosis to which item 45617 applies (Anaes.) (Assist.) | $865.35 75% benefit $649.05 85% benefit $756.85 was $760.85 |
| 45624 | New 85% benefit on 1 November 2026Ptosis of upper eyelid, correction of, by: (a) sutured elevation of the tarsal plate on the eyelid retractors (Muller’s or levator muscle or levator aponeurosis); or (b) sutured suspension to the brow/frontalis muscle; if a previous ptosis surgery has been performed on that side (Anaes.) (Assist.) | $1,122.05 75% benefit $841.55 85% benefit $1,013.55 was $1,017.55 |
| 45625 | PTOSIS of eyelid, correction of eyelid height by revision of levator sutures within one week of primary repair by levator resection or advancement, performed in the operating theatre of a hospital (Anaes.) | $224.55 75% benefit $168.45 |
| 45626 | Ectropion or entropion, not caused by trachoma, correction of (unilateral) (Anaes.) | $390.25 75% benefit $292.70 85% benefit $331.75 |
| 45627 | Ectropion or entropion, caused by trachoma, correction of (unilateral) (Anaes.) | $390.25 75% benefit $292.70 85% benefit $331.75 |
| 45629 | Symblepharon, grafting for (H) (Anaes.) (Assist.) | $567.05 75% benefit $425.30 |
| 45632 | Rhinoplasty, partial, involving correction of one or both lateral cartilages, one or both alar cartilages or one or both lateral cartilages and alar cartilages, if: (a) the indication for surgery is: (i) airway obstruction and the patient has a self-reported NOSE Scale score of greater than 45; or (ii) significant acquired, congenital or developmental deformity; and (b) photographic and/or NOSE Scale evidence demonstrating the clinical need for this service is documented in the patient notes (H) (Anaes.) | $612.75 75% benefit $459.60 |
| 45635 | Rhinoplasty, partial, involving correction of bony vault only, if: (a) the indication for surgery is: (i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or (ii) significant acquired, congenital or developmental deformity; and (b) photographic and/or NOSE Scale evidence demonstrating the clinical need for this service is documented in the patient notes (H) (Anaes.) | $703.25 75% benefit $527.45 |
| 45641 | Rhinoplasty, total, including correction of all bony and cartilaginous elements of the external nose, with or without autogenous cartilage or bone graft from a local site (nasal), if: (a) the indication for surgery is: (i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or (ii) significant acquired, congenital or developmental deformity; and (b) photographic and/or NOSE Scale evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) | $1,275.90 75% benefit $956.95 |
| 45644 | Rhinoplasty, total, including correction of all bony and cartilaginous elements of the external nose involving autogenous bone or cartilage graft obtained from distant donor site, including obtaining of graft, if: (a) the indication for surgery is: (i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or (ii) significant acquired, congenital or developmental deformity; and (b) photographic and/or NOSE Scale evidence demonstrating the clinical need for this service is documented in the patient notes; other than a service associated with a service to which item 45718 applies (H) (Anaes.) (Assist.) | $1,531.35 75% benefit $1,148.55 |
| 45645 | CHOANAL ATRESIA, repair of by puncture and dilatation (Anaes.) | $267.60 75% benefit $200.70 |
| 45646 | Choanal atresia, correction by open operation with bone removal (H) (Anaes.) (Assist.) | $1,077.70 75% benefit $808.30 |
| 45650 | Rhinoplasty, revision of, if: (a) the indication for surgery is: (i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or (ii) significant acquired, congenital or developmental deformity; and (b) photographic and/or NOSE Scale evidence demonstrating the clinical need for this service is documented in the patient notes (H) (Anaes.) | $176.85 75% benefit $132.65 |
| 45652 | Rhinophyma of a moderate or severe degree, carbon dioxide laser or erbium laser excision - ablation of (Anaes.) | $426.55 75% benefit $319.95 85% benefit $362.60 |
| 45653 | RHINOPHYMA, shaving of (Anaes.) | $426.55 75% benefit $319.95 85% benefit $362.60 |
| 45656 | COMPOSITE GRAFT (Chondrocutaneous or chondromucosal) to nose, ear or eyelid (Anaes.) (Assist.) | $601.15 75% benefit $450.90 85% benefit $511.00 |
| 45658 | Correction of a congenital deformity of the ear if: (a) the congenital deformity is not related to a prominent ear; and (b) the deformity has been clinically diagnosed as a constricted ear, Stahl's ear, or a similar congenital deformity; and (c) photographic evidence demonstrating the clinical need for this service is documented in the patient notes. (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 45659 | Correction of a congenital deformity of the ear if: (a) the patient is less than 18 years of age; and (b) the deformity is characterised by an absence of the antihelical fold and/or large scapha and/or large concha; and (c) photographic evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 45660 | External ear, complex total reconstruction of, using costal cartilage grafts to form a framework, including the harvesting and sculpturing of the cartilage and its insertion, for congenital absence, microtia or post-traumatic loss of entire or substantial portion of pinna (first stage) - performed by a specialist in the practice of the specialist’s specialty (H) (Anaes.) (Assist.) | $3,445.50 75% benefit $2,584.15 |
| 45661 | External ear, complex total reconstruction of, elevation of costal cartilage framework using cartilage previously stored in abdominal wall, including the use of local skin and fascia flaps and skin graft to cover cartilage (second stage) - performed by a specialist in the practice of the specialist’s specialty (H) (Anaes.) (Assist.) | $1,531.35 75% benefit $1,148.55 |
| 45665 | Lip, eyelid or ear, full thickness wedge excision of, with repair by direct sutures, excluding eyelid wedge when performed in conjunction with a cosmetic eyelid procedure (Anaes.) | $390.25 75% benefit $292.70 85% benefit $331.75 |
| 45668 | VERMILIONECTOMY, by surgical excision (Anaes.) | $390.25 75% benefit $292.70 85% benefit $331.75 |
| 45669 | Vermilionectomy for biopsy-confirmed cellular atypia, using carbon dioxide laser or erbium laser excision - ablation (Anaes.) | $390.25 75% benefit $292.70 85% benefit $331.75 |
| 45671 | Lip or eyelid reconstruction, single stage or first stage of a two-stage flap reconstruction of a defect involving all 3 layers of tissue, if the flap is switched from the opposing lip or eyelid respectively (H) (Anaes.) (Assist.) | $998.30 75% benefit $748.75 |
| 45674 | Lip or eyelid reconstruction, second stage of a two-stage flap reconstruction, division of the pedicle and inset of flap and closure of the donor (H) (Anaes.) | $290.40 75% benefit $217.80 |
| 45675 | MACROCHEILIA or macroglossia, operation for (Anaes.) (Assist.) | $578.40 75% benefit $433.80 |
| 45676 | MACROSTOMIA, operation for (Anaes.) (Assist.) | $688.60 75% benefit $516.45 |
| 45677 | Cleft lip, unilateral—primary repair of nasolabial complex, one stage, without anterior palate repair (H) (Anaes.) (Assist.) | $683.30 75% benefit $512.50 |
| 45680 | Cleft lip, unilateral—primary repair of nasolabial complex, one stage, with anterior palate repair (H) (Anaes.) (Assist.) | $891.15 75% benefit $668.40 |
| 45683 | Cleft lip, bilateral—primary repair of nasolabial complex, one stage, without anterior palate repair (H) (Anaes.) (Assist.) | $989.95 75% benefit $742.50 |
| 45686 | Cleft lip, bilateral—primary repair of nasolabial complex, one stage, with anterior palate repair (H) (Anaes.) (Assist.) | $1,168.45 75% benefit $876.35 |
| 45689 | CLEFT LIP, lip adhesion procedure, unilateral or bilateral (Anaes.) (Assist.) | $313.35 75% benefit $235.05 |
| 45692 | Cleft lip, partial revision, including minor flap revision alignment and adjustment, including revision of minor whistle deformity if performed (H) (Anaes.) | $359.95 75% benefit $270.00 |
| 45695 | CLEFT LIP, total revision, including major flap revision, muscle reconstruction and revision of major whistle deformity (Anaes.) (Assist.) | $585.05 75% benefit $438.80 |
| 45698 | CLEFT LIP, primary columella lengthening procedure, bilateral (Anaes.) | $549.05 75% benefit $411.80 |
| 45701 | CLEFT LIP RECONSTRUCTION using full thickness flap (Abbe or similar), first stage (Anaes.) (Assist.) | $990.20 75% benefit $742.65 |
| 45704 | Cleft lip reconstruction using full thickness flap (Abbe or similar), second stage (H) (Anaes.) | $359.95 75% benefit $270.00 |
| 45707 | CLEFT PALATE, primary repair (Anaes.) (Assist.) | $935.85 75% benefit $701.90 |
| 45710 | CLEFT PALATE, secondary repair, closure of fistula using local flaps (Anaes.) | $585.05 75% benefit $438.80 |
| 45713 | CLEFT PALATE, secondary repair, lengthening procedure (Anaes.) (Assist.) | $666.20 75% benefit $499.65 |
| 45714 | Oro-nasal fistula, repair of, including a local flap for closure (H) (Anaes.) (Assist.) | $935.85 75% benefit $701.90 |
| 45716 | VELO-PHARYNGEAL INCOMPETENCE, pharyngeal flap for, or pharyngoplasty for (Anaes.) | $935.85 75% benefit $701.90 |
| 45717 | Alveolar cleft (congenital), unilateral, bone grafting of, including local flap closure of associated oro-nasal fistulae and ridge augmentation, other than a service associated with a service to which item 45718 applies (H) (Anaes.) (Assist.) | $1,407.50 75% benefit $1,055.65 |
| 45718 | Face, contour restoration of one region, for the correction of deformity using autogenous bone or cartilage, if the deformity:(a) is secondary to congenital absence of tissue; or(b) has arisen from:(i) trauma (other than from previous cosmetic surgery); or(ii) a diagnosed pathological process;other than a service associated with a service to which item 45644 or 45717 (alveolar bone grafting) applies (H) (Anaes.) (Assist.) | $1,531.35 75% benefit $1,148.55 |
| 45761 | Genioplasty, including transposition of nerves and vessels and bone grafts taken from the same site, if: (a) the deformity: (i) is secondary to congenital absence of tissue; or(ii) is the result of a diagnosed craniofacial disorder; or(iii) has arisen from trauma (other than from previous cosmetic surgery) or a diagnosed pathological process; and (b) for a craniofacial disorder—evidence of diagnosis of the disorder is documented in the patient notes; and (c) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (H) (Anaes.) (Assist.) | $896.05 75% benefit $672.05 |
| 45767 | Hypertelorism, correction of, using intracranial approach (H) (Anaes.) (Assist.) | $3,006.20 75% benefit $2,254.65 |
| 45773 | Syndromic orbital dystopia, such as Treacher Collins Syndrome, bilateral facial or periorbital reconstruction, with bone grafts from a distant site (H) (Anaes.) (Assist.) | $2,098.65 75% benefit $1,574.00 |
| 45776 | ORBITAL DYSTOPIA (UNILATERAL), CORRECTION OF, with total repositioning of 1 orbit, intracranial (Anaes.) (Assist.) | $2,098.65 75% benefit $1,574.00 |
| 45779 | ORBITAL DYSTOPIA (UNILATERAL), CORRECTION OF, with total repositioning of 1 orbit, extracranial (Anaes.) (Assist.) | $1,542.95 75% benefit $1,157.25 |
| 45782 | Fronto-orbital advancement (H) (Anaes.) (Assist.) | $1,179.70 75% benefit $884.80 |
| 45785 | Cranial vault reconstruction for single suture synostosis (H) (Anaes.) (Assist.) | $1,996.55 75% benefit $1,497.45 |
| 45788 | Glenoid fossa, construction of, from bone and cartilage graft, and creation of condyle and ascending ramus of mandible, in hemifacial microsomia, not including harvesting of graft material (H) (Anaes.) (Assist.) | $1,973.85 75% benefit $1,480.40 |
| 45791 | Absent condyle and ascending ramus in craniofacial microsomia, construction of, not including harvesting of graft material (H) (Anaes.) (Assist.) | $1,066.25 75% benefit $799.70 |
| 45794 | Osseo‑integration procedure, first stage, implantation of fixture, following congenital absence, tumour or trauma, other than a service associated with a service to which item 41603 applies (Anaes.) | $603.15 75% benefit $452.40 85% benefit $512.70 |
| 45797 | Osseo‑integration procedure, second stage, fixation of transcutaneous abutment, following congenital absence, tumour or trauma, other than a service associated with a service to which item 41603 applies (Anaes.) | $223.25 75% benefit $167.45 85% benefit $189.80 |
| 45801 | Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), in the oral cavity, removal from mucosa or submucosal tissues, if the removal is by surgical excision and suture (Anaes.) | $161.55 75% benefit $121.20 85% benefit $137.35 |
| 45807 | TUMOUR, CYST (other than a cyst associated with a tooth or tooth fragment unless it has been established by radiological examination that there is a minimum of 5mm separation between the cyst lining and tooth structure or where a tumour or cyst has been proven by positive histopathology), ULCER OR SCAR (other than a scar removed during the surgical approach at an operation), in the oral and maxillofacial region, removal of, not being a service to which another item in this Subgroup applies, involving muscle, bone, or other deep tissue (Anaes.) | $295.10 75% benefit $221.35 85% benefit $250.85 |
| 45809 | Tumour or deep cyst (other than a cyst associated with a tooth or tooth fragment unless it has been established by radiological examination that there is a minimum of 5mm separation between the cyst lining and tooth structure or if a tumour or cyst has been proven by positive histopathology), in the oral and maxillofacial region, removal of, requiring wide excision, other than a service to which another item in this Subgroup applies (H) (Anaes.) (Assist.) | $444.65 75% benefit $333.50 |
| 45811 | Tumour, in the oral and maxillofacial region, removal of, from soft tissue (including muscle, fascia and connective tissue), extensive excision of, without skin or mucosal graft (H) (Anaes.) (Assist.) | $601.15 75% benefit $450.90 |
| 45813 | Tumour, in the oral and maxillofacial region, removal of, from soft tissue (including muscle, fascia and connective tissue), extensive excision of, with skin or mucosal graft (H) (Anaes.) (Assist.) | $703.25 75% benefit $527.45 |
| 45815 | Operation on:(a) mandible or maxilla (other than alveolar margins) for chronic osteomyelitis with radiological and laboratory evidence of osteomyelitis; or(b) mandible or maxilla for necrosis of the jaw from any cause including medication or radiation that requires debridement of the alveolar bone or beyond (Anaes.) (Assist.) | $426.55 75% benefit $319.95 85% benefit $362.60 |
| 45823 | Arch bars or similar, one or more, that were inserted for dental fixation purposes to the maxilla or mandible, removal of, requiring general anaesthesia, if the service is undertaken in the operating theatre of a hospital (H) (Anaes.) | $130.35 75% benefit $97.80 |
| 45825 | MANDIBULAR OR PALATAL EXOSTOSIS, excision of (Anaes.) (Assist.) | $405.00 75% benefit $303.75 85% benefit $344.25 |
| 45827 | Mylohyoid ridge, reduction of (H) (Anaes.) (Assist.) | $387.05 75% benefit $290.30 |
| 45829 | MAXILLARY TUBEROSITY, reduction of (Anaes.) | $295.30 75% benefit $221.50 85% benefit $251.05 |
| 45831 | Papillary hyperplasia of the palate, surgical reduction of—cannot be claimed more than once per occasion of service (H) (Anaes.) (Assist.) | $387.05 75% benefit $290.30 |
| 45837 | New 85% benefit on 1 November 2026VESTIBULOPLASTY, submucosal or open, including excision of muscle and skin or mucosal graft when performed - unilateral or bilateral (Anaes.) (Assist.) | $702.00 75% benefit $526.50 85% benefit $596.70 was $597.50 |
| 45841 | ALVEOLAR RIDGE AUGMENTATION with bone or alloplast or both - unilateral (Anaes.) (Assist.) | $566.95 75% benefit $425.25 85% benefit $481.95 |
| 45845 | Osseo-integration procedure, intra-oral implantation of titanium or similar fixture to facilitate restoration of the dentition following:(a) resection of part of the maxilla or mandible for a benign or a malignant tumour; or(b) segmental loss from trauma or congenital absence of a segment of the maxilla or mandible (multiple adjacent teeth)Fixture must be placed at site of the missing segment following appropriate reconstructive procedures (Anaes.) | $603.15 75% benefit $452.40 85% benefit $512.70 |
| 45847 | Osseo-integration procedure, fixation of transmucosal abutment to fixtures that are placed following:(a) resection of part of the maxilla or mandible for a benign or a malignant tumour; or(b) segmental loss from trauma or congenital absence of a segment of the maxilla or mandible (multiple adjacent teeth)Fixture must be placed at site of the missing segment following appropriate reconstructive procedures (Anaes.) | $223.25 75% benefit $167.45 85% benefit $189.80 |
| 45849 | Maxillary sinus, allograft, bone graft or both, to floor of maxillary sinus following elevation of mucosal lining (sinus lift procedure), unilateral (H) (Anaes.) (Assist.) | $695.30 75% benefit $521.50 |
| 45851 | Temporomandibular joint, manipulation of, as an independent procedure performed in the operating theatre of a hospital, other than a service associated with a service to which any other item in this Group applies (H) (Anaes.) | $171.20 75% benefit $128.40 |
| 45855 | Temporomandibular joint, arthroscopy of, with or without biopsy, other than a service associated with another arthroscopic procedure of that joint (H) (Anaes.) (Assist.) | $347.75 75% benefit $260.85 |
| 45857 | Temporomandibular joint, arthroscopy of, removal of loose bodies, debridement, or lysis and lavage or biopsy (including repositioning of meniscus where indicated)—one or more such procedures of that joint, other than a service associated with any other arthroscopic or open procedure of the temporomandibular joint (H) (Anaes.) (Assist.) | $782.60 75% benefit $586.95 |
| 45865 | ARTHROCENTESIS, irrigation of temporomandibular joint after insertion of 2 cannuli into the appropriate joint space(s) (Anaes.) (Assist.) | $347.75 75% benefit $260.85 85% benefit $295.60 |
| 45871 | Temporomandibular joint, open surgical exploration of, with meniscus, capsular and condylar head surgery, with or without microsurgical techniques (H) (Anaes.) (Assist.) | $1,602.00 75% benefit $1,201.50 |
| 45873 | Temporomandibular joint, surgery of, involving procedures to which item 45871 applies and also involving the use of tissue flaps, or cartilage graft, or allograft implants, with or without microsurgical techniques (H) (Anaes.) (Assist.) | $1,800.15 75% benefit $1,350.15 |
| 45874 | Temporomandibular joint, including condylar head and glenoid fossa, total alloplastic replacement (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 45882 | The treatment of a premalignant lesion of the oral mucosa by a treatment using cryotherapy, diathermy or carbon dioxide laser. | $51.50 75% benefit $38.65 85% benefit $43.80 |
| 45888 | Removal of a deep foreign body using interventional imaging techniques (H) (Anaes.) (Assist.) | $495.00 75% benefit $371.25 |
| 45891 | New 85% benefit on 1 November 2026Repair to one defect using temporalis muscle by a single stage local flap (Anaes.) (Assist.) | $721.10 75% benefit $540.85 85% benefit $612.95 was $616.60 |
| 45894 | Grafting (mucosa or split skin), in the oral cavity of a mucosal defect (Anaes.) | $245.00 75% benefit $183.75 85% benefit $208.25 |
| 45939 | Cryosurgery of the peripheral branches of the trigeminal nerve for pain relief (H) (Anaes.) (Assist.) | $535.05 75% benefit $401.30 |
| 46050 | Perforator flap, raising on a named source vessel, for pedicled transfer for head or neck or other non-breast reconstruction (H) (Anaes.) (Assist.) | $941.45 75% benefit $706.10 |
| 46052 | Perforator Flap, such as anterolateral thigh flap or similar, raising in preparation for microsurgical transfer of a free flap for head or neck or other non-breast reconstruction (H) (Anaes.) (Assist.) | $297.15 75% benefit $222.90 |
| 46060 | Free transfer of tissue with a vascularised bone component (including chimeric/composite flap), for the repair of major defect of the head or neck or other non-breast defect, all necessary elements of the operation, including (but not limited to):(a) anastomoses of all required vessels using microvascular techniques; and(b) harvesting of flap (including osteotomies); and(c) raising of tissue on a vascular pedicle; and(d) preparation of recipient vessels; and(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than the following:(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesSingle surgeon (H) (Anaes.) (Assist.) | $3,186.20 75% benefit $2,389.65 |
| 46062 | Free transfer of tissue with a vascularised bone component (including chimeric/composite flap), for the repair of major defect of the head or neck or other non-breast defect, all necessary elements of the operation, including (but not limited to):(a) anastomoses of all required vessels using microvascular techniques; and(b) harvesting of flap (including osteotomies); and(c) raising of tissue on a vascular pedicle; and(d) preparation of recipient vessels; and(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than the following:(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesConjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | $3,047.70 75% benefit $2,285.80 |
| 46064 | Free transfer of tissue with a vascularised bone component (including chimeric/composite flap), for the repair of major defect of the head or neck or other non-breast defect, all necessary elements of the operation, including (but not limited to):(a) anastomoses of all required vessels using microvascular techniques; and(b) harvesting of flap (including osteotomies); and(c) raising of tissue on a vascular pedicle; and(d) preparation of recipient vessels; and(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than the following:(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesConjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | $2,285.90 75% benefit $1,714.45 |
| 46066 | Double free flap, including one free transfer of tissue with a vascularized bone component, for the repair of major defect of the head or neck or other non-breast defect, all necessary elements of the operation, including (but not limited to):(a) anastomoses of all required vessels using microvascular techniques; and(b) harvesting of flap (including osteotomies); and(c) raising of tissue on a vascular pedicle; and(d) preparation of recipient vessels; and(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than the following:(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesConjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | $4,571.50 75% benefit $3,428.65 |
| 46068 | Double free flap, including one free transfer of tissue with a vascularized bone component, for the repair of major defect of the head or neck or other non-breast defect, all necessary elements of the operation, including (but not limited to):(a) anastomoses of all required vessels using microvascular techniques; and(b) harvesting of flap (including osteotomies); and(c) raising of tissue on a vascular pedicle; and(d) preparation of recipient vessels; and(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than the following:(g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base;(h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesConjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | $3,428.85 75% benefit $2,571.65 |
| 46070 | Double free flap, including 2 free transfers of tissue (reconstructive surgery) for the repair of major tissue defect, involving anastomoses of all required vessels using microvascular techniques, all necessary elements of the operation, including (but not limited to):(a) raising each flap of tissue on a separate vascular pedicle; and(b) preparation of recipient vessels; and(c) transfer of tissue; and(d) inset of tissue at recipient site; and(e) direct repair of secondary cutaneous defect, if performed;other than a service:(f) performed in the context of breast reconstruction; or(g) associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesConjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | $4,571.50 75% benefit $3,428.65 |
| 46072 | Double free flap, including 2 free transfers of tissue (reconstructive surgery) for the repair of major tissue defect, involving anastomoses of all required vessels using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) raising each flap of tissue on a separate vascular pedicle; and(b) preparation of recipient vessels; and(c) transfer of tissue; and(d) inset of tissue at recipient site; and(e) direct repair of secondary cutaneous defect, if performed;other than a service:(f) performed in the context of breast reconstruction; or(g) associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesConjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | $3,428.85 75% benefit $2,571.65 |
| 46080 | Post-mastectomy breast reconstruction, autologous, single surgeon (unilateral) using a myocutaneous or perforator flap, by microsurgical transfer:(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but(b) excluding repair of muscular aponeurotic layer;other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies (H) (Anaes.) (Assist.) | $3,515.20 75% benefit $2,636.40 |
| 46082 | Post-mastectomy breast reconstruction, autologous, single surgeon (bilateral) using a myocutaneous or perforator flap, by microsurgical transfer:(a) including anastomoses of arteries and veins (including repair of secondary skin defect); but(b) excluding repair of muscular aponeurotic layer;other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies (H) (Anaes.) (Assist.) | $6,151.55 75% benefit $4,613.70 |
| 46084 | Post-mastectomy breast reconstruction, autologous, conjoint surgery (unilateral) using a myocutaneous or perforator flap, by microsurgical transfer:(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but(b) excluding repair of muscular aponeurotic layer;other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | $3,047.70 75% benefit $2,285.80 |
| 46086 | Post-mastectomy breast reconstruction, autologous, conjoint surgery (unilateral) using a myocutaneous or perforator flap, by microsurgical transfer:(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but(b) excluding repair of muscular aponeurotic layer;other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | $2,285.90 75% benefit $1,714.45 |
| 46088 | Post-mastectomy breast reconstruction, autologous, conjoint surgery (bilateral) using a myocutaneous or perforator flap, by microsurgical transfer:(a) including anastomosis of artery and one or more veins (including repair of secondary skin defect); but(b) excluding repair of muscular aponeurotic layer;other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | $5,333.40 75% benefit $4,000.05 |
| 46090 | Post-mastectomy breast reconstruction, autologous, conjoint surgery (bilateral) using a myocutaneous or perforator flap, by microsurgical transfer:(a) including anastomoses of arteries and veins (including repair of secondary skin defect); but(b) excluding repair of muscular aponeurotic layer;other than a service associated with a service to which item 30166, 30169, 30175, 30177 or 30179 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | $4,000.20 75% benefit $3,000.15 |
| 46092 | Lower pole coverage of reconstructive breast prosthesis, following mastectomy, using muscle or fascia turnover flap or autologous dermal flaps, if the service is performed in combination with a service to which item 31522, 31523, 31528, 31529, 45527, 45539 or 45542 applies (H) (Anaes.) (Assist.) | $485.95 75% benefit $364.50 |
| 46094 | Lower pole coverage or complete implant coverage of reconstructive breast prosthesis, following mastectomy, using allograft or synthetic products (H) (Anaes.) (Assist.) | $359.05 75% benefit $269.30 |
| 46100 | Excision of burnt tissue, or definitive burn wound closure, if: (a) the area of burn excised involves more than 1% of hands, face or anterior neck; and(b) the service is performed in conjunction with a service (the co-claimed service) to which any of items 46101 to 46111, 46113 to 46123 and 46125 to 46135 apply; other than a service to which item 46112, 46124 or 46136 applies Derived fee: 40% of the fee for the co-claimed service | Derived |
| 46101 | Excision of burnt tissue, if the area of burn excised involves not more than 1% of the total body surface (Anaes.) (Assist.) | $404.00 75% benefit $303.00 85% benefit $343.40 |
| 46102 | Excision of burnt tissue, if the area of burn excised involves more than 1% but less than 3% of the total body surface (H) (Anaes.) (Assist.) | $641.30 75% benefit $481.00 |
| 46103 | Excision of burnt tissue, if the area of burn excised involves 3% or more but less than 10% of the total body surface (H) (Anaes.) (Assist.) | $703.35 75% benefit $527.55 |
| 46104 | Excision of burnt tissue, if the area of burn excised involves 10% or more but less than 20% of the total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $1,073.10 75% benefit $804.85 |
| 46105 | Excision of burnt tissue, if the area of burn excised involves 20% or more but less than 30% of total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $1,443.15 75% benefit $1,082.40 |
| 46106 | Excision of burnt tissue, if the area of burn excised involves 30% or more but less than 40% of total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $1,813.90 75% benefit $1,360.45 |
| 46107 | Excision of burnt tissue, if the area of burn excised involves 40% or more but less than 50% of total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $2,184.00 75% benefit $1,638.00 |
| 46108 | Excision of burnt tissue, if the area of burn excised involves 50% or more but less than 60% of total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $2,553.45 75% benefit $1,915.10 |
| 46109 | Excision of burnt tissue, if the area of burn excised involves 60% or more but less than 70% of total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $2,923.60 75% benefit $2,192.70 |
| 46110 | Excision of burnt tissue, if the area of burn excised involves 70% or more but less than 80% of total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $3,331.00 75% benefit $2,498.25 |
| 46111 | Excision of burnt tissue, if the area of burn excised involves 80% or more of total body surface, excluding aftercare (H) (Anaes.) (Assist.) | $3,730.50 75% benefit $2,797.90 |
| 46112 | Excision of burnt tissue, if the area of burn excised involves whole of face (excluding ears)—may be claimed with any one of items 46101 to 46111, based on the percentage total body surface (excluding the face), excluding aftercare (H) (Anaes.) (Assist.) | $2,059.45 75% benefit $1,544.60 |
| 46113 | Excised burn wound closure, or closure of skin defect secondary to burns contracture release, to an area of less than 1% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure, or autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure, if the total area being treated in the procedure is: (A) for a patient aged less than 15 years—at least 10% of total body surface; or(B) for a patient aged 15 years or over—at least 20% of total body surface; or (iii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound (H) (Anaes.) (Assist.) | $404.00 75% benefit $303.00 |
| 46114 | Excised burn wound closure, or closure of skin defect secondary to burns contracture release, to an area of at least 1% but less than 3% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure, or autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure, if the total area being treated in the procedure is: (A) for a patient aged less than 15 years—at least 10% of total body surface; or(B) for a patient aged 15 years or over—at least 20% of total body surface; or (iii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound (H) (Anaes.) (Assist.) | $641.30 75% benefit $481.00 |
| 46115 | Excised burn wound closure or closure of skin defect secondary to burns contracture release, to an area of at least 3% but less than 10% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure, or autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure, if the total area being treated in the procedure is: (A) for a patient aged less than 15 years—at least 10% of total body surface; or(B) for a patient aged 15 years or over—at least 20% of total body surface; or (iii) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound (H) (Anaes.) (Assist.) | $703.35 75% benefit $527.55 |
| 46116 | Excised burn wound closure or closure of skin defect secondary to burns contracture release, to an area of at least 10% but less than 20% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision or contracture release; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) for a patient aged less than 15 years—autologous skin cell suspension for definitive closure, or autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iii) for a patient aged 15 years or over—autologous skin cell suspension for definitive closure, or autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure, if the total area being treated in the procedure is at least 20% of total body surface; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $1,073.10 75% benefit $804.85 |
| 46117 | Excised burn wound closure, to an area of at least 20% but less than 30% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $1,443.15 75% benefit $1,082.40 |
| 46118 | Excised burn wound closure, to an area of at least 30% but less than 40% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $1,813.90 75% benefit $1,360.45 |
| 46119 | Excised burn wound closure, to an area of at least 40% but less than 50% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $2,184.00 75% benefit $1,638.00 |
| 46120 | Excised burn wound closure, to an area of at least 50% but less than 60% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and (b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $2,553.45 75% benefit $1,915.10 |
| 46121 | Excised burn wound closure, to an area of at least 60% but less than 70% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $2,923.60 75% benefit $2,192.70 |
| 46122 | Excised burn wound closure, to an area of at least 70% but less than 80% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and (b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $3,331.00 75% benefit $2,498.25 |
| 46123 | Excised burn wound closure, to an area of at least 80% of total body surface, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $3,730.50 75% benefit $2,797.90 |
| 46124 | Excised burn wound closure of whole of face, if the service: (a) is performed at the same time as the procedure for the primary burn wound excision; and(b) involves: (i) autologous skin grafting for definitive closure; or(ii) autologous skin cell suspension for definitive closure; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting for definitive closure; or(iv) allogenic skin grafting, or biosynthetic skin substitutes, to temporize the excised wound; excluding aftercare (H) (Anaes.) (Assist.) | $2,059.45 75% benefit $1,544.60 |
| 46125 | Non-excisional debridement of superficial or mid-dermal partial thickness burns, if the area of burn involves less than 1% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements) (Anaes.) (Assist.) | $404.00 75% benefit $303.00 85% benefit $343.40 |
| 46126 | Non‑excisional debridement of superficial or mid‑dermal partial thickness burns, if the area of burn involves 1% or more but less than 3% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements) (H) (Anaes.) (Assist.) | $641.30 75% benefit $481.00 |
| 46127 | Non-excisional debridement of superficial or mid-dermal partial thickness burns, if the area of burn involves 3% or more but less than 10% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements) (H) (Anaes.) (Assist.) | $888.35 75% benefit $666.30 |
| 46128 | Non-excisional debridement of superficial or mid-dermal partial thickness burns, if the area of burn involves 10% or more but less than 30% of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements), excluding aftercare (H) (Anaes.) (Assist.) | $1,628.55 75% benefit $1,221.45 |
| 46129 | Non-excisional debridement of superficial or mid-dermal partial thickness burns, if the area of burn involves 30% or more of total body surface, and application of skin substitute (skin allograft or biosynthetic epidermal replacements), excluding aftercare (H) (Anaes.) (Assist.) | $2,980.30 75% benefit $2,235.25 |
| 46130 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, to an area involving less than 1% of total body surface, if the service: (a) is provided following a previous procedure that used non‑autologous temporary wound closure or simple dressings; and(b) involves: (i) autologous tissue (split skin graft or other); or(ii) autologous skin cell suspension, or autologous skin cell suspension in conjunction with autologous skin grafting, if the total area being treated in the procedure is: (A) for a patient aged less than 15 years—at least 10% of total body surface; or(B) for a patient aged 15 years or over—at least 20% of total body surface (H) (Anaes.) (Assist.) | $404.00 75% benefit $303.00 |
| 46131 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, to an area involving at least 1% but less than 3% of total body surface, if the service: (a) is provided following a previous procedure that used non‑autologous temporary wound closure or simple dressings; and(b) involves: (i) autologous tissue (split skin graft or other); or(ii) autologous skin cell suspension, or autologous skin cell suspension in conjunction with autologous skin grafting, if the total area being treated in the procedure is: (A) for a patient aged less than 15 years—at least 10% of total body surface; or(B) for a patient aged 15 years or over—at least 20% of total body surface (H) (Anaes.) (Assist.) | $641.30 75% benefit $481.00 |
| 46132 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, to an area involving at least 3% but less than 10% of total body surface, if the service: (a) is provided following a previous procedure that used non‑autologous temporary wound closure or simple dressings; and(b) involves: (i) autologous tissue (split skin graft or other); or(ii) autologous skin cell suspension, or autologous skin cell suspension in conjunction with autologous skin grafting, if the total area being treated in the procedure is: (A) for a patient aged less than 15 years—at least 10% of total body surface; or(B) for a patient aged 15 years or over—at least 20% of total body surface (H) (Anaes.) (Assist.) | $703.35 75% benefit $527.55 |
| 46133 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis or secondary to release of burns scar contracture, to an area involving at least 10% but less than 20% of total body surface, if the service: (a) is provided following a previous procedure that used non‑autologous temporary wound closure or simple dressings; and(b) involves: (i) autologous tissue (split skin graft or other); or(ii) for a patient aged less than 15 years—autologous skin cell suspension, or autologous skin cell suspension in conjunction with autologous skin grafting; or(iii) for a patient aged 15 years or over—autologous skin cell suspension, or autologous skin cell suspension in conjunction with autologous skin grafting, if the total area being treated in the procedure is at least 20% of total body surface; (excluding aftercare) (H) (Anaes.) (Assist.) | $1,073.10 75% benefit $804.85 |
| 46134 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis, to an area involving at least 20% but less than 30% of total body surface, if the service: (a) is provided following a previous procedure that used non‑autologous temporary wound closure; and(b) involves: (i) autologous tissue (split skin graft or other); or(ii) autologous skin cell suspension; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting; (excluding aftercare) (H) (Anaes.) (Assist.) | $2,374.90 75% benefit $1,781.20 |
| 46135 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis, to an area involving at least 30% of total body surface, if the service: (a) is provided following a previous procedure that used non‑autologous temporary wound closure; and(b) involves: (i) autologous tissue (split skin graft or other); or(ii) autologous skin cell suspension; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting; (excluding aftercare) (H) (Anaes.) (Assist.) | $3,730.50 75% benefit $2,797.90 |
| 46136 | Definitive burn wound closure, or closure of skin defect secondary to necrotising fasciitis, of whole face, if the service: (a) is provided following a previous procedure that used non‑autologous temporary wound closure; and(b) involves: (i) autologous tissue (split skin graft or other); or(ii) autologous skin cell suspension; or(iii) autologous skin cell suspension in conjunction with autologous skin grafting; (excluding aftercare) (H) (Anaes.) (Assist.) | $2,059.45 75% benefit $1,544.60 |
| 46140 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is less than 1% of total body surface, including direct repair if performed (Anaes.) (Assist.) | $308.10 75% benefit $231.10 85% benefit $261.90 |
| 46141 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is 1% or more but less than 3% of total body surface (H) (Anaes.) (Assist.) | $462.25 75% benefit $346.70 |
| 46142 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is 3% or more but less than 10% of total body surface (H) (Anaes.) (Assist.) | $554.55 75% benefit $415.95 |
| 46143 | Burns contracture, release of, by excision or incision of scar, if the defect resulting from surgery is 10% or more but less than 20% of total body surface (H) (Anaes.) (Assist.) | $718.85 75% benefit $539.15 |
| 46150 | Mandible or maxilla, procedure for advancement, retrusion or alteration of tilt, by osteotomy in standard planes, including fixation by any means (including application of distractors if used)—one service per patient on the same occasion (H) (Anaes.) (Assist.) | $1,591.65 75% benefit $1,193.75 |
| 46151 | Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | $1,735.45 75% benefit $1,301.60 |
| 46152 | Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | $1,301.60 75% benefit $976.20 |
| 46153 | Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | $2,169.10 75% benefit $1,626.85 |
| 46154 | Maxilla, procedure for reshaping arch of, by complex segmental osteotomies, including fixation by any means (including application of distractors if used), one service per patient on the same occasion (H) (Anaes.) (Assist.) | $1,816.50 75% benefit $1,362.40 |
| 46155 | Mandible, procedure for reshaping arch of, by complex segmental osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used), one service per patient on the same occasion (H) (Anaes.) (Assist.) | $1,816.50 75% benefit $1,362.40 |
| 46156 | Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | $2,073.75 75% benefit $1,555.35 |
| 46157 | Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | $1,555.30 75% benefit $1,166.50 |
| 46158 | Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H) (Anaes.) (Assist.) | $2,592.15 75% benefit $1,944.15 |
| 46159 | Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.) | $2,293.35 75% benefit $1,720.05 |
| 46160 | Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.) | $1,720.00 75% benefit $1,290.00 |
| 46161 | Midfacial osteotomies, Le Fort II or Le Fort III—single surgeon (H) (Anaes.) (Assist.) | $2,866.65 75% benefit $2,150.00 |
| 46170 | Decompression of thoracic outlet, primary, for thoracic outlet syndrome, using any approach, including (if performed) division of scalene muscles, cervical rib and/or first rib resection (H) (Anaes.) (Assist.) | $1,197.00 75% benefit $897.75 |
| 46171 | Decompression of thoracic outlet, repeat (revision) procedure, for thoracic outlet syndrome, using any approach, including (if performed) division of scalene muscles, cervical rib and/or first rib resection (H) (Anaes.) (Assist.) | $2,034.75 75% benefit $1,526.10 |
| 46172 | Removal or debulking of brachial plexus tumour, involving intraneural dissection, either supraclavicular or infraclavicular dissection (H) (Anaes.) (Assist.) | $2,992.25 75% benefit $2,244.20 |
| 46173 | Removal or debulking of brachial plexus tumour, involving intraneural dissection, both supraclavicular and infraclavicular dissection (H) (Anaes.) (Assist.) | $4,189.15 75% benefit $3,141.90 |
| 46174 | Exploration of the brachial plexus, either supraclavicular or infraclavicular, including any neurolyses performed and intraoperative neurophysiological recordings, but excluding reconstruction of elements(H) (Anaes.) (Assist.) | $2,992.25 75% benefit $2,244.20 |
| 46175 | Exploration of the brachial plexus, both supraclavicular and infraclavicular, including any neurolyses performed and intraoperative neurophysiological recordings, but excluding reconstruction of elements(H) (Anaes.) (Assist.) | $4,787.55 75% benefit $3,590.70 |
| 46176 | Exploration of the brachial plexus, posterior subscapular approach, all necessary elements of the operation including (but not limited to):(a) resection of the first rib and/or second rib; and(b) vertebral laminectomies or facetectomies, if performed; and(c) any neurolyses performed; and(d) intraoperative neurophysiological recordings;excluding the following:(e) reconstruction of elements of the plexus;(f) spinal instrumentation(H) (Anaes.) (Assist.) | $1,197.00 75% benefit $897.75 |
| 46177 | Reconstruction of deficit of the brachial plexus, single cord or trunk, by any appropriate method, single surgeon (H) (Anaes.) (Assist.) | $2,034.75 75% benefit $1,526.10 |
| 46178 | Reconstruction of deficit of the brachial plexus, single cord or trunk, by any appropriate method, conjoint surgery, principal surgeon (H) (Anaes.) (Assist.) | $2,034.75 75% benefit $1,526.10 |
| 46179 | Reconstruction of deficit of the brachial plexus, single cord or trunk, by any appropriate method, conjoint surgery, conjoint surgeon (H) (Anaes.) (Assist.) | $1,693.60 75% benefit $1,270.20 |
| 46180 | Reconstruction of deficit of the brachial plexus, more than a single cord or trunk, but less than the whole plexus, by any appropriate method, single surgeon (H) (Anaes.) (Assist.) | $2,992.25 75% benefit $2,244.20 |
| 46181 | Reconstruction of deficit of the brachial plexus, more than a single cord or trunk, but less than the whole plexus, by any appropriate method, conjoint surgery, principal surgeon (H) (Anaes.) (Assist.) | $2,992.25 75% benefit $2,244.20 |
| 46182 | Reconstruction of deficit of the brachial plexus, more than a single cord or trunk, but less than the whole plexus, by any appropriate method, conjoint surgery, conjoint surgeon (H) (Anaes.) (Assist.) | $2,495.50 75% benefit $1,871.65 |
| 46183 | Reconstruction of deficit of the brachial plexus, whole plexus, by any appropriate method, single surgeon (H) (Anaes.) (Assist.) | $3,590.65 75% benefit $2,693.00 |
| 46184 | Reconstruction of deficit of the brachial plexus, whole plexus, by any appropriate method, conjoint surgery, principal surgeon (H) (Anaes.) (Assist.) | $3,590.65 75% benefit $2,693.00 |
| 46185 | Reconstruction of deficit of the brachial plexus, whole plexus, by any appropriate method, conjoint surgery, conjoint surgeon (H) (Anaes.) (Assist.) | $2,992.25 75% benefit $2,244.20 |
| 46300 | Arthrodesis of interphalangeal or metacarpophalangeal joint of hand, including either or both of the following (if performed): (a) joint debridement; (b) synovectomy —one joint (H) (Anaes.) (Assist.) | $486.00 75% benefit $364.50 |
| 46303 | Arthrodesis of carpometacarpal joint of hand, including either or both of the following (if performed): (a) joint debridement; (b) synovectomy —one joint (H) (Anaes.) (Assist.) | $630.20 75% benefit $472.65 |
| 46308 | Volar plate or soft tissue interposition arthroplasty of interphalangeal or metacarpophalangeal joint of hand, including either or both of the following (if performed): (a) realignment procedures; (b) tendon transfer; —one joint (H) (Anaes.) (Assist.) | $630.15 75% benefit $472.65 |
| 46309 | Prosthetic replacement arthroplasty or hemiarthroplasty of interphalangeal or metacarpophalangeal joint of hand, including any of the following (if performed): (a) ligament reconstruction; (b) ligament realignment; (c) synovectomy; (d) tendon transfer —one joint (H) (Anaes.) (Assist.) | $630.15 75% benefit $472.65 |
| 46312 | Prosthetic replacement arthroplasty or hemiarthroplasty of interphalangeal or metacarpophalangeal joint of hand, including any of the following (if performed): (a) ligament reconstruction; (b) ligament realignment; (c) synovectomy; (d) tendon transfer —2 joints of one hand (H) (Anaes.) (Assist.) | $810.25 75% benefit $607.70 |
| 46315 | Prosthetic replacement arthroplasty or hemiarthroplasty of interphalangeal or metacarpophalangeal joint of hand, including any of the following (if performed): (a) ligament reconstruction; (b) ligament realignment; (c) synovectomy; (d) tendon transfer —3 joints of one hand (H) (Anaes.) (Assist.) | $1,080.35 75% benefit $810.30 |
| 46318 | Prosthetic replacement arthroplasty or hemiarthroplasty of interphalangeal or metacarpophalangeal joint of hand, including any of the following (if performed): (a) ligament reconstruction; (b) ligament realignment; (c) synovectomy; (d) tendon transfer —4 joints of one hand (H) (Anaes.) (Assist.) | $1,350.40 75% benefit $1,012.80 |
| 46321 | Prosthetic replacement arthroplasty or hemiarthroplasty of interphalangeal or metacarpophalangeal joint of hand, including any of the following (if performed): (a) ligament reconstruction; (b) ligament realignment; (c) synovectomy; (d) tendon transfer; —5 joints of one hand (H) (Anaes.) (Assist.) | $1,620.45 75% benefit $1,215.35 |
| 46322 | Revision of prosthetic replacement arthroplasty or hemiarthroplasty of interphalangeal or metacarpal joint of hand, including any of the following (if performed): (a) bone grafting; (b) ligament reconstruction; (c) ligament realignment; (d) synovectomy; (e) tendon or ligament reconstruction; (f) tendon transfer; —one joint (H) (Anaes.) (Assist.) | $945.30 75% benefit $709.00 |
| 46324 | Prosthetic interpositional replacement of carpometacarpal joint, including either or both of the following (if performed): (a) ligament and tendon transfers; (b) rebalancing procedures (H) (Anaes.) (Assist.) | $1,102.65 75% benefit $827.00 |
| 46325 | Excisional arthroplasty of carpometacarpal joint, including any of the following (if performed): (a) ligament and tendon transfers; (b) realignment procedures; (c) excision of adjacent trapezoid (H) (Anaes.) (Assist.) | $1,102.65 75% benefit $827.00 |
| 46330 | Ligamentous or capsular repair or reconstruction of interphalangeal or metacarpophalangeal joint of hand, including any of the following (if performed): (a) arthrotomy; (b) joint stabilisation; (c) synovectomy; —one joint (H) (Anaes.) (Assist.) | $414.20 75% benefit $310.65 |
| 46333 | Ligamentous or capsular repair or reconstruction of interphalangeal or metacarpophalangeal joint of hand with graft, using graft or implant, including any of the following (if performed): (a) arthrotomy; (b) harvest of graft; (c) joint stabilisation; (d) synovectomy; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 apply—one joint (H) (Anaes.) (Assist.) | $675.10 75% benefit $506.35 |
| 46335 | Synovectomy of digital extensor tendons of hand, distal to wrist, for diagnosed inflammatory arthritis, including any of the following (if performed): (a) reconstruction of extensor retinaculum; (b) removal of tendon nodules; (c) tenolysis; (d) tenoplasty; other than a service associated with: (e) a service to which item 39330 applies; or (f) a service to which item 30023 applies that is performed at the same site Applicable once per hand per occasion on which the service is performed (H) (Anaes.) (Assist.) | $558.00 75% benefit $418.50 |
| 46336 | Synovectomy of interphalangeal, metacarpophalangeal or carpometacarpal joint of hand, including any of the following (if performed): (a) capsulectomy; (b) debridement; (c) ligament or tendon realignment (or both); other than a service combined with a service to which item 46495 applies—one joint (H) (Anaes.) (Assist.) | $315.15 75% benefit $236.40 |
| 46339 | Synovectomy of digital flexor tendons at wrist level, for diagnosed inflammatory arthritis, including either or both of the following (if performed): (a) tenolysis; (b) release of median nerve and carpal tunnel; other than a service associated with: (c) a service to which item 39330 or 39331 applies; or (d) a service to which item 30023 applies that is performed at the same site Applicable once per wrist per occasion on which the service is performed (H) (Anaes.) (Assist.) | $558.00 75% benefit $418.50 |
| 46340 | Synovectomy of wrist flexor or extensor tendons of hand or wrist, for diagnosed inflammatory tenosynovitis, including any of the following (if performed): (a) reconstruction of flexor or extensor retinaculum; (b) removal of tendon nodules; (c) tenolysis; (d) tenoplasty; other than a service associated with: (e) a service to which item 39330 applies; or (f) if this service is performed on the wrist flexor tendons—a service to which item 39331 applies; or (g) a service to which item 30023 applies that is performed at the same site —one or more compartments per limb (H) (Anaes.) (Assist.) | $474.30 75% benefit $355.75 |
| 46341 | Synovectomy of wrist flexor or extensor tendons of hand or wrist, for non-inflammatory tenosynovitis or post traumatic synovitis, including any of the following (if performed): (a) reconstruction of flexor or extensor retinaculum; (b) removal of tendon nodules; (c) tenolysis; (d) tenoplasty; other than a service associated with: (e) a service to which item 39330 applies; or (f) if this service is performed on the wrist flexor tendons—a service to which item 39331 applies; or (g) a service to which item 30023 applies that is performed at the same site —one or more compartments per limb (H) (Anaes.) (Assist.) | $304.20 75% benefit $228.15 |
| 46342 | Synovectomy of distal radioulnar or carpometacarpal joint of hand—one or more joints (H) (Anaes.) (Assist.) | $558.00 75% benefit $418.50 |
| 46345 | Resection arthroplasty of distal radioulnar joint of hand, partial or complete, including any of the following (if performed): (a) ligament or tendon reconstruction; (b) joint stabilisation; (c) synovectomy (H) (Anaes.) (Assist.) | $675.10 75% benefit $506.35 |
| 46348 | Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed): (a) removal of intratendinous nodules; (b) tenolysis; (c) tenoplasty; other than a service associated with: (d) a service to which item 30023 applies that is performed at the same site; or (e) a service to which item 46363 applies that is performed on the same ray —one ray (H) (Anaes.) (Assist.) | $292.55 75% benefit $219.45 |
| 46351 | Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed): (a) removal of intratendinous nodules; (b) tenolysis; (c) tenoplasty; other than a service associated with: (d) a service to which item 30023 applies that is performed at the same site; or (e) a service to which item 46363 applies that is performed on one of the same rays —2 rays of one hand (H) (Anaes.) (Assist.) | $436.60 75% benefit $327.45 |
| 46354 | Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed): (a) removal of intratendinous nodules; (b) tenolysis; (c) tenoplasty; other than a service associated with: (d) a service to which item 30023 applies that is performed at the same site; or (e) a service to which item 46363 applies that is performed on one of the same rays —3 rays of one hand (H) (Anaes.) (Assist.) | $585.15 75% benefit $438.90 |
| 46357 | Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed): (a) removal of intratendinous nodules; (b) tenolysis; (c) tenoplasty; other than a service associated with: (d) a service to which item 30023 applies that is performed at the same site; or (e) a service to which item 46363 applies that is performed on one of the same rays —4 rays of one hand (H) (Anaes.) (Assist.) | $729.20 75% benefit $546.90 |
| 46360 | Flexor tenosynovectomy of hand, distal to lumbrical origin, including any of the following (if performed): (a) removal of intratendinous nodules; (b) tenolysis; (c) tenoplasty; other than a service associated with: (d) a service to which item 30023 applies that is performed at the same site; or (e) a service to which item 46363 applies that is performed on one of the same rays —5 rays of one hand (H) (Anaes.) (Assist.) | $877.75 75% benefit $658.35 |
| 46363 | Trigger finger release, for stenosing tenosynovitis, including either or both of the following (if performed): (a) synovectomy; (b) synovial biopsy; —one ray (Anaes.) (Assist.) | $252.00 75% benefit $189.00 85% benefit $214.20 |
| 46364 | Digital sympathectomy of hand, using microsurgical techniques, other than a service associated with: (a) a service to which item 46363 applies; or (b) a service to which item 30023 applies that is performed at the same site —one digit or palmer arch (or both) or radial or ulnar artery (or both) (H) (Anaes.) (Assist.) | $558.00 75% benefit $418.50 |
| 46365 | Excision of rheumatoid nodules of hand —one lesion (Anaes.) (Assist.) | $315.15 75% benefit $236.40 85% benefit $267.90 |
| 46367 | De Quervain's release, including any of the following (if performed): (a) synovectomy of extensor pollicis brevis; (b) synovectomy of abductor pollicis longus tendons; (c) retinaculum reconstruction; other than a service associated with a service to which item 46339 applies (Anaes.) (Assist.) | $475.85 75% benefit $356.90 85% benefit $404.50 |
| 46370 | Percutaneous fasciotomy for Dupuytren’s contracture, by needle or chemical method, including either or both of the following (if performed): (a) immediate or delayed manipulation; (b) local or regional nerve block; —one ray (Anaes.) (Assist.) | $153.15 75% benefit $114.90 85% benefit $130.20 |
| 46372 | Fasciectomy for Dupuytren’s contracture, including dissection of nerves (if performed)—one ray (H) (Anaes.) (Assist.) | $512.20 75% benefit $384.15 |
| 46375 | Fasciectomy for Dupuytren’s contracture, including dissection of nerves (if performed)—2 rays (H) (Anaes.) (Assist.) | $607.65 75% benefit $455.75 |
| 46378 | Fasciectomy for Dupuytren’s contracture, including dissection of nerves (if performed)—3 rays (H) (Anaes.) (Assist.) | $810.25 75% benefit $607.70 |
| 46379 | Fasciectomy for Dupuytren’s contracture, including dissection of nerves (if performed)—4 rays (H) (Anaes.) (Assist.) | $1,020.70 75% benefit $765.55 |
| 46380 | Fasciectomy for Dupuytren’s contracture, including dissection of nerves (if performed)—5 rays (H) (Anaes.) (Assist.) | $1,286.15 75% benefit $964.65 |
| 46381 | Release of interphalangeal joint of hand, by open procedure, when performed in conjunction with an operation for Dupuytren’s contracture—one joint (H) (Anaes.) (Assist.) | $360.00 75% benefit $270.00 |
| 46384 | Z-plasty or similar local flap procedure, when performed in conjunction with an operation for Dupuytren’s contracture, including raising, transfer in-setting and suturing of both components (flaps)—one Z-plasty or local flap procedure (H) (Anaes.) (Assist.) | $360.00 75% benefit $270.00 |
| 46387 | Fasciectomy for recurrence of Dupuytren’s contracture, including either or both of the following (if performed): (a) dissection of nerves; (b) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—one ray (H) (Anaes.) (Assist.) | $742.75 75% benefit $557.10 |
| 46390 | Fasciectomy for recurrence of Dupuytren’s contracture, including either or both of the following (if performed): (a) dissection of nerves; (b) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—2 rays (H) (Anaes.) (Assist.) | $990.55 75% benefit $742.95 |
| 46393 | Fasciectomy for recurrence of Dupuytren’s contracture, including either or both of the following (if performed): (a) dissection of nerves; (b) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—3 rays (H) (Anaes.) (Assist.) | $1,147.80 75% benefit $860.85 |
| 46394 | Fasciectomy for recurrence of Dupuytren’s contracture, including either or both of the following (if performed): (a) dissection of nerves; (b) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—4 rays (H) (Anaes.) (Assist.) | $1,430.35 75% benefit $1,072.80 |
| 46395 | Fasciectomy for recurrence of Dupuytren’s contracture, including either or both of the following (if performed): (a) dissection of nerves; (b) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—5 rays (H) (Anaes.) (Assist.) | $1,782.40 75% benefit $1,336.80 |
| 46399 | Osteotomy of phalanx or metacarpal of hand, with internal fixation—one bone (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 46401 | Operative treatment of non-union of phalanx or metacarpal of hand, including internal fixation (if performed) (H) (Anaes.) (Assist.) | $497.40 75% benefit $373.05 |
| 46408 | Reconstruction of tendon of hand or wrist, by tendon graft, including either or both of the following (if performed): (a) harvest of graft; (b) tenolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $828.20 75% benefit $621.15 |
| 46411 | Reconstruction of complete flexor tendon pulley of hand or wrist, with graft, including harvest of graft (if performed)—one pulley (H) (Anaes.) (Assist.) | $486.05 75% benefit $364.55 |
| 46414 | Insertion of artificial tendon prosthesis in preparation for grafting of tendon of hand or wrist, including tenolysis (if performed), other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $630.05 75% benefit $472.55 |
| 46417 | Transfer of tendon of hand or wrist, for restoration of hand or digit motion, including harvest of donor motor unit (if performed)—one transfer (H) (Anaes.) (Assist.) | $585.15 75% benefit $438.90 |
| 46420 | Primary repair of extensor tendon of hand or wrist—one tendon (Anaes.) (Assist.) | $244.85 75% benefit $183.65 85% benefit $208.15 |
| 46423 | Delayed repair of extensor tendon of hand or wrist, including tenolysis (if performed), other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $391.60 75% benefit $293.70 |
| 46426 | Primary repair of flexor tendon of hand or wrist, proximal to A1 pulley—one tendon (H) (Anaes.) (Assist.) | $405.05 75% benefit $303.80 |
| 46432 | Primary repair of flexor tendon of hand, distal to A1 pulley, other than a service to repair a tendon of a digit if 2 tendons of the same digit have been repaired during the same procedure—one tendon (H) (Anaes.) (Assist.) | $675.35 75% benefit $506.55 |
| 46434 | Delayed repair of flexor tendon of hand or wrist, including tenolysis (if performed), other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $581.85 75% benefit $436.40 |
| 46438 | Closed pin fixation of mallet finger (H) (Anaes.) | $162.05 75% benefit $121.55 |
| 46441 | Open reduction of mallet finger, including any of the following (if performed): (a) joint release; (b) pin fixation; (c) tenolysis (H) (Anaes.) (Assist.) | $391.60 75% benefit $293.70 |
| 46442 | MALLET FINGER with intra articular fracture involving more than one third of base of terminal phalanx - open reduction (Anaes.) (Assist.) | $336.20 75% benefit $252.15 |
| 46444 | Reconstruction of Boutonniere or swan neck deformity of hand, including either or both of the following (if performed): (a) tendon graft harvest; (b) tendon transfer —one joint (H) (Anaes.) (Assist.) | $585.15 75% benefit $438.90 |
| 46450 | Tenolysis of extensor tendon of hand or wrist, following tendon injury or graft, other than a service: (a) for acute, traumatic injury; or (b) associated with a service to which item 30023 applies that is performed at the same site; —one ray (H) (Anaes.) | $270.15 75% benefit $202.65 |
| 46453 | Tenolysis of flexor tendon of hand or wrist, following tendon injury, repair or graft, other than a service: (a) for acute, traumatic injury; or (b) associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $450.15 75% benefit $337.65 |
| 46456 | Percutaneous tenotomy of digit of hand (Anaes.) | $117.00 75% benefit $87.75 85% benefit $99.45 |
| 46464 | Amputation of a supernumerary complete digit of hand (H) (Anaes.) (Assist.) | $270.15 75% benefit $202.65 |
| 46465 | Amputation of digit of hand, distal to metacarpal head, including any of the following (if performed): (a) excision of neuroma; (b) resection of bone; (c) skin cover with local flaps —one ray (H) (Anaes.) (Assist.) | $270.15 75% benefit $202.65 |
| 46468 | Amputation of digit of hand, distal to metacarpal head, including any of the following (if performed): (a) excision of neuroma; (b) resection of bone; (c) skin cover with local flaps —2 rays (H) (Anaes.) (Assist.) | $472.60 75% benefit $354.45 |
| 46471 | Amputation of digit of hand, distal to metacarpal head, including any of the following (if performed): (a) excision of neuroma; (b) resection of bone; (c) skin cover with local flaps —3 rays (H) (Anaes.) (Assist.) | $675.10 75% benefit $506.35 |
| 46474 | Amputation of digit of hand, distal to metacarpal head, including any of the following (if performed): (a) excision of neuroma; (b) resection of bone; (c) skin cover with local flaps —4 rays (H) (Anaes.) (Assist.) | $877.75 75% benefit $658.35 |
| 46477 | Amputation of digit of hand, distal to metacarpal head, including any of the following (if performed): (a) excision of neuroma; (b) resection of bone; (c) skin cover with local flaps —5 rays (H) (Anaes.) (Assist.) | $1,080.35 75% benefit $810.30 |
| 46480 | Amputation of ray of hand, proximal to metacarpal head, including any of the following (if performed): (a) excision of neuroma; (b) recontouring; (c) resection of bone; (d) skin cover with local flaps —one ray (H) (Anaes.) (Assist.) | $450.15 75% benefit $337.65 |
| 46483 | Revision of amputation stump of hand to provide adequate cover, including any of the following (if performed): (a) bone shortening; (b) excision of nail bed remnants; (c) excision of neuroma (H) (Anaes.) (Assist.) | $360.00 75% benefit $270.00 |
| 46486 | Accurate reconstruction of acute nail bed laceration using magnification (H) (Anaes.) | $270.15 75% benefit $202.65 |
| 46489 | Secondary reconstruction of nail bed deformity using magnification, including removal of nail (if performed), other than a service associated with a service to which item 46513 or 45451 applies (H) (Anaes.) (Assist.) | $315.15 75% benefit $236.40 |
| 46492 | Surgical correction of contracture of joint of hand, flexor or extensor tendon, involving tissues deeper than skin and subcutaneous tissue—one joint (H) (Anaes.) (Assist.) | $432.15 75% benefit $324.15 |
| 46493 | Resection of boss of metacarpal base of hand, including either or both of the following (if performed): (a) excision of ganglion; (b) synovectomy (H) (Anaes.) (Assist.) | $394.45 75% benefit $295.85 |
| 46495 | Complete excision of one or more ganglia or mucous cysts of interphalangeal, metacarpophalangeal or carpometacarpal joint of hand, including any of the following (if performed): (a) arthrotomy; (b) osteophyte resections (c) synovectomy other than a service associated with a service to which item 30107 or 46336 applies—one joint (H) (Anaes.) (Assist.) | $243.20 75% benefit $182.40 |
| 46498 | Excision of ganglion of flexor tendon sheath of hand, including any of the following (if performed): (a) flexor tenosynovectomy; (b) sheath excision; (c) skin closure by any method; other than a service associated with: (d) a service to which item 30107 applies; or (e) a service to which item 46363 applies that is performed on the same ray (Anaes.) (Assist.) | $263.15 75% benefit $197.40 85% benefit $223.70 |
| 46500 | Excision of ganglion of dorsal wrist joint of hand, including any of the following (if performed): (a) arthrotomy; (b) capsular or ligament repair (or both); (c) synovectomy other than a service associated with a service to which item 30107 applies (Anaes.) (Assist.) | $315.15 75% benefit $236.40 85% benefit $267.90 |
| 46501 | Excision of ganglion of volar wrist joint of hand, including any of the following (if performed): (a) arthrotomy; (b) capsular or ligament repair (or both); (c) synovectomy; other than a service associated with a service to which item 30107 or 46325 applies (Anaes.) (Assist.) | $394.05 75% benefit $295.55 85% benefit $334.95 |
| 46502 | Excision of recurrent ganglion of dorsal wrist joint of hand, including any of the following (if performed): (a) arthrotomy; (b) capsular or ligament repair (or both); (c) synovectomy (H) (Anaes.) (Assist.) | $472.65 75% benefit $354.50 |
| 46503 | Excision of recurrent ganglion of volar wrist joint of hand, including any of the following (if performed): (a) arthrotomy; (b) capsular or ligament repair (or both); (c) synovectomy; other than a service associated with a service to which item 30107 applies (H) (Anaes.) (Assist.) | $452.90 75% benefit $339.70 |
| 46504 | Neurovascular island flap, heterodigital, for pulp re-innervation and soft tissue cover (H) (Anaes.) (Assist.) | $1,323.25 75% benefit $992.45 |
| 46507 | Transposition or transfer of digit or ray on vascular pedicle of hand, including any of the following (if performed): (a) nerve transfer; (b) skin closure, by any means; (c) rebalancing procedures (H) (Anaes.) (Assist.) | $1,795.30 75% benefit $1,346.50 |
| 46510 | Surgical reduction of enlarged elements resulting from macrodactyly, including any of the following (if performed): (a) nerve transfer; (b) skin closure, by any means; (c) rebalancing procedures —one digit (H) (Anaes.) (Assist.) | $420.05 75% benefit $315.05 |
| 46513 | Removal of nail of finger or thumb—one nail (Anaes.) | $67.60 75% benefit $50.70 85% benefit $57.50 |
| 46519 | Drainage of midpalmar, thenar or hypothenar spaces or dorsum of hand, excluding aftercare (Anaes.) (Assist.) | $169.00 75% benefit $126.75 85% benefit $143.65 |
| 46522 | Open operation and drainage of infection for flexor tendon sheath of finger or thumb, including either or both of the following (if performed): (a) synovectomy; (b) tenolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—one digit (H) (Anaes.) (Assist.) | $504.15 75% benefit $378.15 |
| 46525 | Incision for pulp space infection of hand: (a) other than a service: (i) to which another item in this Group applies; or (ii) associated with a service to which item 30023 applies that is performed at the same site; and (b) excluding aftercare (H) (Anaes.) | $67.60 75% benefit $50.70 |
| 46528 | Wedge resection for ingrowing nail of finger or thumb: (a) including each of the following: (i) excision and partial ablation of germinal matrix; (ii) removal of segment of nail; (iii) removal of ungual fold; and (b) including phenolisation (if performed) (Anaes.) | $202.90 75% benefit $152.20 85% benefit $172.50 |
| 46531 | Partial resection of ingrowing nail of finger or thumb, including phenolisation (Anaes.) | $101.95 75% benefit $76.50 85% benefit $86.70 |
| 46534 | Complete ablation of nail germinal matrix (H) (Anaes.) (Assist.) | $281.85 75% benefit $211.40 |
| 47000 | Mandible, treatment of dislocation of, by closed reduction, requiring general anaesthesia or intravenous sedation, if performed in the operating theatre of a hospital (H) (Anaes.) | $84.65 75% benefit $63.50 |
| 47003 | Treatment of dislocation of clavicle, by closed reduction (Anaes.) | $101.45 75% benefit $76.10 85% benefit $86.25 |
| 47007 | Repair of acromioclavicular or sternoclavicular joint dislocation (acute or chronic), by open, mini-open or arthroscopic technique, including either or both of the following (if performed): (a) ligament augmentation; (b) tendon transfers (H) (Anaes.) (Assist.) | $422.60 75% benefit $316.95 |
| 47009 | Treatment of dislocation of shoulder, requiring general anaesthesia, other than a service to which item 47012 applies (H) (Anaes.) | $202.90 75% benefit $152.20 |
| 47012 | Treatment of dislocation of shoulder, requiring general anaesthesia, by open reduction (H) (Anaes.) (Assist.) | $405.55 75% benefit $304.20 |
| 47015 | Treatment of dislocation of shoulder, not requiring general anaesthesia | $101.45 75% benefit $76.10 85% benefit $86.25 |
| 47018 | Treatment of dislocation of elbow, by closed reduction (Anaes.) | $236.50 75% benefit $177.40 85% benefit $201.05 |
| 47021 | Treatment of dislocation of elbow, by open reduction (H) (Anaes.) (Assist.) | $315.50 75% benefit $236.65 |
| 47024 | Treatment of dislocation of distal or proximal radioulnar joint, by closed reduction, other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of treating fracture or dislocation in the same region (Anaes.) | $236.50 75% benefit $177.40 85% benefit $201.05 |
| 47027 | Treatment of dislocation of distal or proximal radioulnar joint, by open reduction, including either or both of the following (if performed): (a) styloid fracture; (b) triangular fibrocartilage complex repair; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of treating fracture or dislocation in the same region (H) (Anaes.) (Assist.) | $777.65 75% benefit $583.25 |
| 47030 | Treatment of dislocation of carpus, carpus on radius and ulna or carpometacarpal joint, by closed reduction (Anaes.) | $236.50 75% benefit $177.40 85% benefit $201.05 |
| 47033 | Treatment of dislocation of carpus, carpus on radius and ulna or carpometacarpal joint, by open reduction, including ligament repair (if performed) (H) (Anaes.) (Assist.) | $777.65 75% benefit $583.25 |
| 47042 | Treatment of dislocation of interphalangeal or metacarpophalangeal joint, by closed reduction (Anaes.) | $135.05 75% benefit $101.30 85% benefit $114.80 |
| 47045 | Treatment of dislocation of interphalangeal or metacarpophalangeal joint, by open reduction, including any of the following (if performed): (a) arthrotomy; (b) capsule repair; (c) ligament repair; (d) volar plate repair (H) (Anaes.) (Assist.) | $504.45 75% benefit $378.35 |
| 47047 | Treatment of dislocation of prosthetic hip, by closed reduction (Anaes.) (Assist.) | $388.75 75% benefit $291.60 85% benefit $330.45 |
| 47049 | Treatment of dislocation of prosthetic hip, by open reduction (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 47052 | Treatment of dislocation of native hip, by closed reduction (Anaes.) (Assist.) | $505.35 75% benefit $379.05 85% benefit $429.55 |
| 47053 | Treatment of dislocation of native hip, by open reduction, with internal fixation (if performed) (H) (Anaes.) (Assist.) | $673.65 75% benefit $505.25 |
| 47054 | Treatment of dislocation of knee, by closed reduction, including application of external fixator (if performed) (H) (Anaes.) (Assist.) | $388.75 75% benefit $291.60 |
| 47057 | Treatment of dislocation of patella, by closed reduction (Anaes.) | $152.05 75% benefit $114.05 85% benefit $129.25 |
| 47060 | Treatment of dislocation of patella, by open reduction (H) (Anaes.) (Assist.) | $202.90 75% benefit $152.20 |
| 47063 | Treatment of dislocation of ankle or tarsus, by closed reduction (Anaes.) (Assist.) | $304.20 75% benefit $228.15 85% benefit $258.60 |
| 47066 | Treatment of dislocation of ankle or tarsus, by open reduction, including any of the following (if performed): (a) arthrotomy; (b) capsule repair; (c) removal of loose fragments or intervening soft tissue; (d) washout of joint (H) (Anaes.) (Assist.) | $405.55 75% benefit $304.20 |
| 47069 | Treatment of dislocation of toe, by closed reduction—one toe (Anaes.) | $84.65 75% benefit $63.50 85% benefit $72.00 |
| 47301 | Treatment of fracture of middle or proximal phalanx, by closed reduction, requiring anaesthesia—one bone (Anaes.) | $103.90 75% benefit $77.95 85% benefit $88.35 |
| 47304 | Treatment of fracture of metacarpal, by closed reduction, requiring anaesthesia—one bone (H) (Anaes.) | $118.35 75% benefit $88.80 |
| 47307 | Treatment of fracture of phalanx or metacarpal, by closed reduction, including percutaneous K‑wire fixation (if performed)—one bone (H) (Anaes.) (Assist.) | $239.35 75% benefit $179.55 |
| 47310 | Treatment of fracture of phalanx or metacarpal, by open reduction, with internal fixation (H) (Anaes.) (Assist.) | $394.95 75% benefit $296.25 |
| 47313 | Treatment of intra-articular fracture of phalanx or metacarpal, by closed reduction, including: (a) percutaneous K-wire fixation; and (b) external or dynamic fixation (if performed) (H) (Anaes.) (Assist.) | $383.05 75% benefit $287.30 |
| 47316 | Treatment of intra‑articular fracture of phalanx or metacarpal, by open reduction with fixation, other than a service provided on the same occasion as a service to which item 47319 applies (H) (Anaes.) (Assist.) | $760.00 75% benefit $570.00 |
| 47319 | Treatment of intra-articular fracture of proximal end of middle phalanx, by open reduction, with fixation, other than a service provided on the same occasion as a service to which item 47316 applies (H) (Anaes.) (Assist.) | $777.95 75% benefit $583.50 |
| 47348 | Treatment of fracture of carpus (excluding scaphoid), by cast immobilisation, other than a service associated with a service to which item 47351 applies (Anaes.) | $112.45 75% benefit $84.35 85% benefit $95.60 |
| 47351 | Treatment of fracture of carpus (excluding scaphoid), by open reduction, with internal fixation (H) (Anaes.) (Assist.) | $281.85 75% benefit $211.40 |
| 47354 | Treatment of fracture of carpal scaphoid, by cast immobilisation, other than a service associated with a service to which item 47357 applies (Anaes.) | $202.90 75% benefit $152.20 85% benefit $172.50 |
| 47357 | Treatment of fracture of carpal scaphoid, by reduction, with fixation by any means (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 47361 | Treatment of fracture of distal end of radius or ulna (or both), by cast immobilisation, other than a service associated with a service to which item 47362, 47364, 47367, 47370 or 47373 applies | $157.75 75% benefit $118.35 85% benefit $134.10 |
| 47362 | Treatment of fracture of distal end of radius or ulna (or both), by closed reduction, requiring general or major regional anaesthesia, but excluding local infiltration, other than a service associated with a service to which item 47361, 47364, 47367, 47370 or 47373 applies (Anaes.) | $236.50 75% benefit $177.40 85% benefit $201.05 |
| 47364 | Treatment of fracture of distal end of radius or ulna (not involving joint surface), by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.) | $335.15 75% benefit $251.40 |
| 47367 | Treatment of fracture of distal end of radius, by closed reduction with percutaneous fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.) | $267.60 75% benefit $200.70 |
| 47370 | Treatment of intra‑articular fracture of distal end of radius, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.) | $485.90 75% benefit $364.45 |
| 47373 | Treatment of intra‑articular fracture of distal end of ulna, by open reduction with fixation, other than a service associated with a service to which item 47361 or 47362 applies (H) (Anaes.) (Assist.) | $347.15 75% benefit $260.40 |
| 47381 | Treatment of fracture of shaft of radius or ulna, by closed reduction (H) (Anaes.) | $304.20 75% benefit $228.15 |
| 47384 | Treatment of fracture of shaft of radius or ulna, by open reduction with internal fixation (H) (Anaes.) (Assist.) | $405.55 75% benefit $304.20 |
| 47385 | Treatment of: (a) fracture of shaft of radius or ulna; and (b) dislocation of distal radio-ulnar joint or proximal radio-humeral joint (Galeazzi or Monteggia injury); by closed reduction (H) (Anaes.) (Assist.) | $349.20 75% benefit $261.90 |
| 47386 | Treatment of: (a) fracture of shaft of radius or ulna; and (b) dislocation of distal radio-ulnar joint or proximal radio-humeral joint (Galeazzi or Monteggia injury); by open reduction, with internal fixation, including reduction of dislocation (if performed) (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 47387 | Treatment of fracture of distal or shaft of radius or ulna (or both), by cast immobilisation, other than a service to which item 47390 or 47393 applies (Anaes.) (Assist.) | $326.70 75% benefit $245.05 85% benefit $277.70 |
| 47390 | Treatment of fracture of shafts of radius and ulna, by closed reduction (H) (Anaes.) | $490.20 75% benefit $367.65 |
| 47393 | Treatment of fracture of shafts of radius and ulna, by open reduction, with internal fixation (H) (Anaes.) (Assist.) | $653.55 75% benefit $490.20 |
| 47396 | Treatment of fracture of olecranon, by closed reduction (Anaes.) | $225.25 75% benefit $168.95 85% benefit $191.50 |
| 47399 | Treatment of fracture of olecranon, by open reduction (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 47402 | Treatment of fracture of olecranon, with excision of olecranon fragment and reimplantation of tendon (H) (Anaes.) (Assist.) | $337.90 75% benefit $253.45 |
| 47405 | Treatment of fracture of head or neck of radius, by closed reduction (Anaes.) | $225.25 75% benefit $168.95 85% benefit $191.50 |
| 47408 | Treatment of fracture of head or neck of radius, by open reduction, including internal fixation and excision (if performed) (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 47411 | Treatment of fracture of tuberosity of humerus, other than a service to which item 47417 applies (Anaes.) | $135.05 75% benefit $101.30 85% benefit $114.80 |
| 47414 | Treatment of fracture of tuberosity of humerus, by open reduction (H) (Anaes.) | $270.50 75% benefit $202.90 |
| 47417 | Treatment of fracture of tuberosity of humerus and associated dislocation of shoulder, by closed reduction (Anaes.) (Assist.) | $315.50 75% benefit $236.65 85% benefit $268.20 |
| 47420 | Treatment of fracture of tuberosity of humerus and associated dislocation of shoulder, by open reduction (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 47423 | Humerus, proximal, treatment of fracture of, other than a service to which item 47426, 47429 or 47432 applies (Anaes.) | $259.10 75% benefit $194.35 85% benefit $220.25 |
| 47426 | Humerus, proximal, treatment of fracture of, by closed reduction (H) (Anaes.) | $388.75 75% benefit $291.60 |
| 47429 | Humerus, proximal, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 47432 | Humerus, proximal, treatment of intra‑articular fracture of, by open reduction (H) (Anaes.) (Assist.) | $647.80 75% benefit $485.85 |
| 47435 | Humerus, proximal, treatment of fracture of, and associated dislocation of shoulder, by closed reduction (H) (Anaes.) (Assist.) | $495.80 75% benefit $371.85 |
| 47438 | Humerus, proximal, treatment of fracture of, and associated dislocation of shoulder, by open reduction (H) (Anaes.) (Assist.) | $788.90 75% benefit $591.70 |
| 47441 | Humerus, proximal, treatment of intra-articular fracture of, and associated dislocation of shoulder, by open reduction (H) (Anaes.) (Assist.) | $985.95 75% benefit $739.50 |
| 47444 | Humerus, shaft of, treatment of fracture of, other than a service to which item 47447 or 47450 applies (Anaes.) | $270.50 75% benefit $202.90 85% benefit $229.95 |
| 47447 | Humerus, shaft of, treatment of fracture of, by closed reduction (H) (Anaes.) | $405.55 75% benefit $304.20 |
| 47450 | Humerus, shaft of, treatment of fracture of, by internal or external fixation (H) (Anaes.) (Assist.) | $540.90 75% benefit $405.70 |
| 47451 | Humerus, shaft of, treatment of fracture of, by intramedullary fixation (H) (Anaes.) (Assist.) | $652.05 75% benefit $489.05 |
| 47453 | Humerus, distal, (supracondylar or condylar), treatment of fracture of, other than a service to which item 47456 or 47459 applies (Anaes.) (Assist.) | $315.50 75% benefit $236.65 85% benefit $268.20 |
| 47456 | Humerus, distal (supracondylar or condylar), treatment of fracture of, by closed reduction (H) (Anaes.) (Assist.) | $473.40 75% benefit $355.05 |
| 47459 | Humerus, distal (supracondylar or condylar), treatment of fracture of, by open reduction (H) (Anaes.) (Assist.) | $631.10 75% benefit $473.35 |
| 47462 | Clavicle, treatment of fracture of, other than a service to which item 47465 applies (Anaes.) | $135.05 75% benefit $101.30 85% benefit $114.80 |
| 47465 | Clavicle, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 47466 | Sternum, treatment of fracture of, other than a service to which item 47467 applies (Anaes.) | $135.05 75% benefit $101.30 85% benefit $114.80 |
| 47467 | Sternum, treatment of fracture of, by open reduction (H) (Anaes.) | $270.50 75% benefit $202.90 |
| 47468 | Scapula, neck or glenoid region of, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 47471 | RIBS (one or more), treatment of fracture of - each attendance | $51.50 75% benefit $38.65 85% benefit $43.80 |
| 47474 | PELVIC RING, treatment of fracture of, not involving disruption of pelvic ring or acetabulum | $225.25 75% benefit $168.95 85% benefit $191.50 |
| 47477 | Pelvic ring, treatment of fracture of, with disruption of pelvic ring or acetabulum (H) | $281.85 75% benefit $211.40 |
| 47480 | PELVIC RING, treatment of fracture of, requiring traction (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 47483 | PELVIC RING, treatment of fracture of, requiring control by external fixation (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 47486 | Treatment of fracture of anterior pelvic ring or sacroiliac joint disruption (or both), by open reduction, with internal fixation (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 47489 | Treatment of fracture of posterior pelvic ring or sacroiliac joint disruption (or both), by open reduction, with internal fixation (H) (Anaes.) (Assist.) | $1,690.25 75% benefit $1,267.70 |
| 47491 | Combined anterior and posterior pelvic ring disruption, including sacroiliac joint disruption, treatment of fracture by open reduction and internal fixation of both anterior and posterior ring segments (H) (Anaes.) (Assist.) | $1,859.15 75% benefit $1,394.40 |
| 47495 | Treatment of fracture of acetabulum and associated dislocation of hip, including the application and management of traction (if performed), excluding aftercare (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 47498 | Treatment of isolated posterior wall fracture of acetabulum and associated dislocation of hip, by open reduction, with internal fixation, including the application and management of traction (if performed) (H) (Anaes.) (Assist.) | $845.00 75% benefit $633.75 |
| 47501 | Treatment of anterior or posterior column fracture of acetabulum, by open reduction, with internal fixation, including any of the following (if performed): (a) capsular stabilisation; (b) capsulotomy; (c) osteotomy (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 47511 | Treatment of combined column T-Type, transverse, anterior column or posterior hemitransverse fractures of acetabulum, by open reduction, with internal fixation, performed through single or dual approach (including fixation of the posterior wall fracture), including any of the following (if performed): (a) capsular stabilisation; (b) capsulotomy; (c) osteotomy (H) (Anaes.) (Assist.) | $1,690.25 75% benefit $1,267.70 |
| 47514 | Treatment of posterior wall fracture of acetabulum and associated femoral head fracture, by open reduction, with internal fixation (H) (Anaes.) (Assist.) | $985.95 75% benefit $739.50 |
| 47516 | FEMUR, treatment of fracture of, by closed reduction or traction (Anaes.) (Assist.) | $518.25 75% benefit $388.70 85% benefit $440.55 |
| 47519 | FEMUR, treatment of trochanteric or subcapital fracture of, by internal fixation (H) (Anaes.) (Assist.) | $1,036.70 75% benefit $777.55 |
| 47528 | FEMUR, treatment of fracture of, by internal fixation or external fixation (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 47531 | FEMUR, treatment of fracture of shaft, by intramedullary fixation and cross fixation (H) (Anaes.) (Assist.) | $1,149.35 75% benefit $862.05 |
| 47534 | Femur, condylar region of, treatment of intra‑articular (T‑shaped condylar) fracture of, requiring internal fixation, with or without internal fixation of one or more osteochondral fragments (H) (Anaes.) (Assist.) | $1,295.85 75% benefit $971.90 |
| 47537 | Femur, condylar region of, treatment of fracture of, requiring internal fixation of one or more osteochondral fragments, other than a service associated with a service to which item 47534 applies (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 47540 | Hip spica or shoulder spica, application of, as an independent procedure (H) (Anaes.) | $259.10 75% benefit $194.35 |
| 47543 | Tibia, plateau of, treatment of medial or lateral fracture of, other than a service to which item 47546 or 47549 applies (Anaes.) | $270.50 75% benefit $202.90 85% benefit $229.95 |
| 47546 | Tibia, plateau of, treatment of medial or lateral fracture of, by closed reduction (H) (Anaes.) | $405.55 75% benefit $304.20 |
| 47549 | Treatment of medial or lateral fracture of plateau of tibia, by open reduction, with internal fixation, including any of the following (if performed): (a) arthroscopy; (b) arthrotomy; (c) meniscal repair (H) (Anaes.) (Assist.) | $644.25 75% benefit $483.20 |
| 47552 | Tibia, plateau of, treatment of both medial and lateral fractures of, other than a service to which item 47555 or 47558 applies (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 47555 | Tibia, plateau of, treatment of both medial and lateral fractures of, by closed reduction (H) (Anaes.) | $676.10 75% benefit $507.10 |
| 47558 | Treatment of medial and lateral fractures of tibia, by open reduction, with internal fixation, including any of the following (if performed): (a) arthroscopy; (b) arthrotomy; (c) meniscal repair (H) (Anaes.) (Assist.) | $1,194.45 75% benefit $895.85 |
| 47559 | Treatment of medial or lateral (or both) fracture of plateau of tibia, with application of a bridging external fixator to the plateau (H) (Anaes.) (Assist.) | $914.80 75% benefit $686.10 |
| 47561 | Treatment of fracture of shaft of tibia, by cast immobilisation, other than a service to which item 47570 or 47573 applies (Anaes.) | $326.70 75% benefit $245.05 85% benefit $277.70 |
| 47565 | Tibia, shaft of, treatment of fracture of, by internal fixation or external fixation (H) (Anaes.) (Assist.) | $852.65 75% benefit $639.50 |
| 47566 | Tibia, shaft of, treatment of fracture of, by intramedullary fixation and cross fixation (H) (Anaes.) (Assist.) | $1,086.90 75% benefit $815.20 |
| 47568 | Closed reduction of proximal tibia, distal tibia or shaft of tibia, with or without treatment of fibular fracture (H) (Anaes.) (Assist.) | $490.20 75% benefit $367.65 |
| 47570 | Tibia, shaft of, treatment of fracture of, by open reduction, with or without treatment of fibular fracture (H) (Anaes.) (Assist.) | $653.55 75% benefit $490.20 |
| 47573 | Treatment of proximal or distal intra-articular fracture of shaft of tibia, by open reduction, with or without treatment of fibular fracture, including any of the following (if performed): (a) arthroscopy; (b) arthrotomy; (c) capsule repair; (d) removal of intervening soft tissue; (e) removal of loose fragments; (f) washout of joint; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of treating a medial malleolus fracture of the distal tibia (H) (Anaes.) (Assist.) | $816.95 75% benefit $612.75 |
| 47577 | Treatment of fracture of fibula proximal to ankle, by open reduction, with internal fixation, including any of the following (if performed): (a) internal fixation; (b) arthrotomy; (c) capsule repair; (d) removal of loose fragments or intervening soft tissue; (e) washout of joint (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 47579 | Treatment of fracture of patella, other than a service to which item 47582 or 47585 applies (Anaes.) | $191.60 75% benefit $143.70 85% benefit $162.90 |
| 47582 | Treatment of fracture of patella, with internal fixation, including bone grafting (if performed), other than a service associated with a service to which item 47579 or 47585 applies (H) (Anaes.) (Assist.) | $507.25 75% benefit $380.45 |
| 47585 | Treatment of proximal or distal fracture of patella, by open reduction, with internal fixation, including any of the following (if performed): (a) arthrotomy; (b) excision of patellar pole, with reattachment of tendon; (c) removal of loose fragments; (d) repair of quadriceps or patellar tendon (or both); (e) stabilisation of patello-femoral joint (H) (Anaes.) (Assist.) | $524.40 75% benefit $393.30 |
| 47588 | Knee joint, treatment of fracture of, by internal fixation of intra‑articular fractures of femoral condylar or tibial articular surfaces and requiring repair or reconstruction of one or more ligaments (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 47591 | Knee joint, treatment of fracture of, by internal fixation of intra‑articular fractures of femoral condylar and tibial articular surfaces and requiring repair or reconstruction of one or more ligaments (H) (Anaes.) (Assist.) | $1,915.75 75% benefit $1,436.85 |
| 47592 | Repair or reconstruction (or both) of acute traumatic chondral injury to the distal femoral or proximal tibial articular surfaces of the knee, when chondral or osteochondral implants or transfers are utilised (H) (Anaes.) (Assist.) | $390.20 75% benefit $292.65 |
| 47593 | Repair or reconstruction (or both) of acute traumatic chondral injury to the distal femoral and proximal tibial articular surfaces of the knee, using chondral or osteochondral implants or transfers (H) (Anaes.) (Assist.) | $955.05 75% benefit $716.30 |
| 47595 | Treatment of fracture of ankle joint, hindfoot, midfoot, metatarsals or toes, by non-surgical management—one leg (Anaes.) | $192.85 75% benefit $144.65 85% benefit $163.95 |
| 47597 | Treatment of fracture of ankle joint, by closed reduction (Anaes.) (Assist.) | $388.75 75% benefit $291.60 85% benefit $330.45 |
| 47600 | Treatment of fracture of ankle joint: (a) by internal fixation of the malleolus, fibula or diastasis; and (b) including any of the following (if performed): (i) arthrotomy; (ii) capsule repair; (iii) removal of loose fragments or intervening soft tissue; (iv) washout of joint (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 47603 | Treatment of fracture of ankle joint: (a) by internal fixation of 2 or more of the malleolus, fibula, diastasis and medial tissue interposition; and (b) including any of the following (if performed): (i) arthrotomy; (ii) capsule repair; (iii) removal of loose fragments or intervening soft tissue; (iv) washout of joint (H) (Anaes.) (Assist.) | $852.65 75% benefit $639.50 |
| 47612 | Treatment of intra-articular fracture of hindfoot, by closed reduction, with or without dislocation—one foot (H) (Anaes.) (Assist.) | $490.20 75% benefit $367.65 |
| 47615 | Treatment of fracture of hindfoot, by open reduction, with or without dislocation, including any of the following (if performed): (a) arthrotomy; (b) capsule repair; (c) removal of loose fragments or intervening soft tissue; (d) washout of joint; —one hindfoot bone (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 47618 | Treatment of intra-articular fracture of hindfoot, by open reduction, with or without dislocation, including any of the following (if performed): (a) arthrotomy; (b) capsule repair; (c) removal of loose fragments or intervening soft tissue; (d) washout of joint —one hindfoot bone (H) (Anaes.) (Assist.) | $704.25 75% benefit $528.20 |
| 47621 | Treatment of intra-articular fracture of midfoot, by closed reduction, with or without dislocation—one foot (H) (Anaes.) (Assist.) | $490.20 75% benefit $367.65 |
| 47624 | Treatment of fracture of tarso-metatarsal, by open reduction, with or without dislocation, including any of the following (if performed): (a) arthrotomy; (b) capsule or ligament repair; (c) removal of loose fragments or intervening soft tissue; (d) washout of joint —one joint (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 47630 | Treatment of fracture of cuneiform, by open reduction, with or without dislocation, including any of the following (if performed): (a) arthrotomy; (b) capsule or ligament repair; (c) removal of loose fragments or intervening soft tissue; (d) washout of joint; —one bone (H) (Anaes.) (Assist.) | $405.55 75% benefit $304.20 |
| 47637 | Treatment of fractures of metatarsal, by closed reduction—one or more metatarsals of one foot (Anaes.) (Assist.) | $229.60 75% benefit $172.20 85% benefit $195.20 |
| 47639 | Treatment of fracture of metatarsal, by open reduction, including removal of loose fragments or intervening soft tissue (if performed)—one metatarsal of one foot (H) (Anaes.) (Assist.) | $270.50 75% benefit $202.90 |
| 47648 | Treatment of fracture of metatarsal, by open reduction, including removal of loose fragments or intervening soft tissue (if performed)—2 metatarsals of one foot (H) (Anaes.) (Assist.) | $360.35 75% benefit $270.30 |
| 47657 | Treatment of fracture of metatarsal, by open reduction, including removal of loose fragments or intervening soft tissue (if performed)—3 or more metatarsals of one foot (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 47663 | Treatment of fracture of phalanx of toe, by closed reduction—one toe (Anaes.) | $169.00 75% benefit $126.75 85% benefit $143.65 |
| 47666 | Treatment of fracture or dislocation of phalanx of great toe, by open reduction, including any of the following (if performed): (a) arthrotomy; (b) capsule repair; (c) removal of loose fragments; (d) removal of intervening soft tissue; (e) washout of joint; — one great toe (H) (Anaes.) | $281.85 75% benefit $211.40 |
| 47672 | Treatment of fracture or dislocation of phalanx of toe, by open reduction, including any of the following (if performed): (a) arthrotomy; (b) capsule repair; (c) removal of loose fragments; (d) removal of intervening soft tissue; (e) washout of joint; —one toe (other than great toe) of one foot (H) (Anaes.) | $135.05 75% benefit $101.30 |
| 47678 | Treatment of fracture or dislocation of phalanx of toe, by open reduction, including any of the following (if performed): (a) arthrotomy; (b) capsule repair; (c) removal of loose fragments; (d) removal of intervening soft tissue; (e) washout of joint; —2 or more toes (other than great toe) of one foot (H) (Anaes.) | $202.90 75% benefit $152.20 |
| 47735 | Nasal bones, treatment of fracture of, other than a service to which item 47738 or 47741 applies—each attendance | $51.55 75% benefit $38.70 85% benefit $43.85 |
| 47738 | Nasal bones, treatment of fracture of, by reduction (Anaes.) | $281.85 75% benefit $211.40 85% benefit $239.60 |
| 47741 | Nasal bones, treatment of fracture of, by open reduction involving osteotomies (H) (Anaes.) (Assist.) | $574.95 75% benefit $431.25 |
| 47753 | Maxilla or mandible, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.) | $486.65 75% benefit $365.00 |
| 47762 | Zygomatic arch, treatment of fracture of, requiring surgical reduction by a temporal, intra-oral or other approach, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $285.85 75% benefit $214.40 |
| 47765 | Zygomaticomaxillary complex/malar, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at one or more sites (H) (Anaes.) (Assist.) | $537.80 75% benefit $403.35 |
| 47766 | Naso-orbital-ethmoidal complex, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at one or more sites (H) (Anaes.) (Assist.) | $719.35 75% benefit $539.55 |
| 47786 | Maxilla, treatment of fracture of, requiring open reduction and internal fixation involving one or more plates (H) (Anaes.) (Assist.) | $860.25 75% benefit $645.20 |
| 47789 | Mandible, treatment of fracture of, requiring open reduction and internal fixation involving one or more plates (H) (Anaes.) (Assist.) | $860.25 75% benefit $645.20 |
| 47790 | Tendon, large, lengthening of, as an independent procedure (H) (Anaes.) (Assist.) | $337.90 75% benefit $253.45 |
| 47791 | Tenosynovectomy, not being a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $315.50 75% benefit $236.65 |
| 47792 | Joint stabilisation procedure of acromioclavicular joint or sternoclavicular joint, including any of the following (if performed): (a) arthrotomy; (b) osteotomy, with or without fixation; (c) local tendon transfer; (d) local tendon lengthening or release; (e) ligament repair; (f) joint debridement; not being a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 47795 | Joint stabilisation procedure of scapulothoracic joint, other than a service associated with a service to which another item in this Group (other than item 38828 or 48406) applies (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 47900 | Injection into, or aspiration of, unicameral bone cyst (Anaes.) | $202.90 75% benefit $152.20 85% benefit $172.50 |
| 47903 | Epicondylitis, open operation for (H) (Anaes.) | $281.85 75% benefit $211.40 |
| 47904 | Digital nail of toe, removal of, not being a service to which item 47906 applies (Anaes.) | $67.60 75% benefit $50.70 85% benefit $57.50 |
| 47906 | Digital nail of toe, removal of, in the operating theatre of a hospital (H) (Anaes.) | $135.05 75% benefit $101.30 |
| 47915 | Wedge resection for ingrowing nail of toe: (a) including each of the following: (i) removal of segment of nail; (ii) removal of ungual fold; (iii) excision and partial ablation of germinal matrix and portion of nail bed; and (b) including phenolisation (if performed) (Anaes.) (Assist.) | $202.90 75% benefit $152.20 85% benefit $172.50 |
| 47916 | Partial resection for ingrowing nail of toe, including phenolisation (Anaes.) | $101.95 75% benefit $76.50 85% benefit $86.70 |
| 47918 | Complete ablation of nail germinal matrix: (a) including each of the following: (i) removal of segment of nail; (ii) removal of ungual fold; (iii) excision and ablation of germinal matrix and portion of nail bed; and (b) including phenolisation (if performed) (Anaes.) (Assist.) | $281.85 75% benefit $211.40 85% benefit $239.60 |
| 47921 | Orthopaedic pin or wire, insertion of, as an independent procedure (Anaes.) | $135.05 75% benefit $101.30 85% benefit $114.80 |
| 47924 | Removal of one or more buried wires, pins or screws (inserted for internal fixation purposes), with incision, other than a service associated with a service to which item 47927 or 47929 applies—one bone (Anaes.) | $45.10 75% benefit $33.85 85% benefit $38.35 |
| 47927 | Removal of one or more buried wires, pins or screws (inserted for internal fixation purposes)—one bone (H) (Anaes.) | $169.00 75% benefit $126.75 |
| 47929 | Removal of fixation elements (including plate, rod or nail and associated wires, pins, screws or external fixation), other than a service associated with a service to which item 47924 or 47927 applies—one bone (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 47953 | Repair of distal biceps brachii tendon, by any method, performed as an independent procedure (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 47954 | Repair of traumatic tear or rupture of tendon, other than a service associated with: (a) a service to which item 39330 applies; or (b) a service to which another item in this Schedule applies if the service described in the other item is for the purpose of repairing peripheral nerve items in the same region (Anaes.) (Assist.) | $450.65 75% benefit $338.00 85% benefit $383.10 |
| 47955 | Repair of gluteal or rectus femoris tendon, by open or arthroscopic means, when performed as an independent procedure, including either or both of the following (if performed): (a) bursectomy; (b) preparation of greater trochanter; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the hip (H) (Anaes.) (Assist.) | $779.90 75% benefit $584.95 |
| 47956 | Repair of proximal hamstring tendon, performed as an independent procedure, other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the hip (H) (Anaes.) (Assist.) | $1,169.85 75% benefit $877.40 |
| 47960 | TENOTOMY, SUBCUTANEOUS, not being a service to which another item in this Group applies (Anaes.) | $157.75 75% benefit $118.35 85% benefit $134.10 |
| 47964 | Iliopsoas tenotomy, by open or arthroscopic means, when performed as an independent procedure, other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the hip (H) (Anaes.) (Assist.) | $259.10 75% benefit $194.35 |
| 47967 | Restoration of shoulder or elbow function by major muscle tendon transfer, including associated dissection of neurovascular pedicle, excluding micro-anastomosis and biceps tenodesis—one transfer (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 47968 | Open tenotomy of one or more tendons of shoulder, with or without tenoplasty, to restore shoulder function, other than a service to which another item in this Group applies—applicable once per joint per occasion on which this service is performed (Anaes.) | $259.10 75% benefit $194.35 85% benefit $220.25 |
| 47970 | Open tenotomy of one or more tendons of scapula, with or without tenoplasty, to restore scapula function, other than a service to which another item in this Group applies—applicable once per joint per occasion on which this service is performed (H) (Anaes.) | $259.10 75% benefit $194.35 |
| 47973 | Open tenotomy of one or more tendons of elbow, with or without tenoplasty, to restore elbow function, other than a service to which another item in this Group applies—applicable once per joint per occasion on which this service is performed (H) (Anaes.) | $259.10 75% benefit $194.35 |
| 47975 | Forearm or calf, decompression fasciotomy of, for acute compartment syndrome, requiring excision of muscle and deep tissue (H) (Anaes.) (Assist.) | $441.85 75% benefit $331.40 |
| 47978 | Forearm or calf, decompression fasciotomy of, for chronic compartment syndrome, requiring excision of muscle and deep tissue (H) (Anaes.) | $268.45 75% benefit $201.35 |
| 47981 | Forearm, calf or interosseous muscle space of hand, decompression fasciotomy of, other than a service to which another item in this Group applies (Anaes.) | $180.15 75% benefit $135.15 85% benefit $153.15 |
| 47982 | Forage (Drill decompression), of neck or head of femur, or both (H) (Anaes.) (Assist.) | $436.80 75% benefit $327.60 |
| 47983 | Stabilisation of slipped capital femoral epiphysis, by internal fixation (H) (Anaes.) (Assist.) | $1,036.70 75% benefit $777.55 |
| 47984 | Open subcapital realignment of slipped capital femoral epiphysis, other than a service associated with a service to which item 48427 applies (H) (Anaes.) (Assist.) | $1,036.70 75% benefit $777.55 |
| 48245 | Harvesting and insertion of bone graft (autograft) via separate incisions and at separate surgical fields (H) (Anaes.) (Assist.) | $374.35 75% benefit $280.80 |
| 48248 | Harvesting and insertion of bone graft (autograft) via separate incisions, including internal fixation of the graft or fusion fixation (or both) (H) (Anaes.) (Assist.) | $579.75 75% benefit $434.85 |
| 48251 | Harvesting and insertion of osteochondral graft (autograft) via separate incisions at the same joint or joint complex (H) (Anaes.) (Assist.) | $477.10 75% benefit $357.85 |
| 48254 | Harvesting and insertion of pedicled bone flap (autograft), including internal fixation of the bone flap (if performed), other than a service associated with a service to which item 45562, 45504 or 45505 applies (H) (Anaes.) (Assist.) | $1,093.05 75% benefit $819.80 |
| 48257 | Preparation and insertion of metallic, cortical or other graft substitute (allograft), where substitute is structural cortico-cancellous bone or structural bone (or both), including internal fixation (if performed) (H) (Anaes.) (Assist.) | $477.10 75% benefit $357.85 |
| 48400 | Operation on foot: (a) with either or both of the following: (i) osteotomy of phalanx or metatarsal for correction of deformity; (ii) excision of accessory bone or sesamoid bone; and (b) including any of the following (if performed): (i) removal of bone; (ii) excision of surrounding osteophytes; (iii) synovectomy; (iv) joint release; —one bone (H) (Anaes.) (Assist.) | $394.45 75% benefit $295.85 |
| 48403 | Osteotomy of phalanx of first toe or metatarsal, for correction of deformity, with internal fixation, including any of the following (if performed): (a) removal of bone; (b) excision of surrounding osteophytes; (c) synovectomy; (d) joint release; —one bone (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 48406 | Osteotomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, for correction of deformity, including any of the following (if performed): (a) removal of bone; (b) excision of surrounding osteophytes; (c) synovectomy; (d) joint release; other than a service to which item 38365, 38467, 38477, 38484, 38485, 38490, 38493, 38499, 38502, 38510, 38512, 38513, 38515, 38516, 38517, 38519, 38550, 38553, 38554, 38555, 38557, 38670, 38703, 38742 or 38764 applies—one bone (H) (Anaes.) (Assist.) | $394.45 75% benefit $295.85 |
| 48409 | Osteotomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, for correction of deformity, with internal fixation, including any of the following (if performed): (a) removal of bone; (b) excision of surrounding osteophytes; (c) synovectomy; (d) joint release; other than a service to which item 38365, 38467, 38477, 38484, 38485, 38490, 38493, 38499, 38502, 38510, 38512, 38513, 38515, 38516, 38517, 38519, 38550, 38553, 38554, 38555, 38557, 38670, 38703, 38742 or 38764 applies—one bone (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 48412 | Osteotomy of humerus, without internal fixation (H) (Anaes.) (Assist.) | $754.85 75% benefit $566.15 |
| 48415 | Osteotomy of humerus, with internal fixation (H) (Anaes.) (Assist.) | $957.80 75% benefit $718.35 |
| 48419 | Osteotomy of distal tibia, for correction of deformity, without internal or external fixation, including any of the following (if performed): (a) excision of surrounding osteophytes; (b) release of joint; (c) removal of bone; (d) synovectomy; —one bone (H) (Anaes.) (Assist.) | $754.85 75% benefit $566.15 |
| 48420 | Osteotomy of distal tibia, for correction of deformity, with internal or external fixation by any method, including any of the following (if performed): (a) excision of surrounding osteophytes; (b) release of joint; (c) removal of bone; (d) synovectomy; —one bone (H) (Anaes.) (Assist.) | $957.80 75% benefit $718.35 |
| 48421 | Osteotomy of proximal tibia, to alter lower limb alignment or rotation (or both), with internal or external fixation (or both) (H) (Anaes.) (Assist.) | $1,100.10 75% benefit $825.10 |
| 48422 | Osteotomy of distal femur, to alter lower limb alignment or rotation (or both), with internal or external fixation (or both) (H) (Anaes.) (Assist.) | $1,093.05 75% benefit $819.80 |
| 48423 | Osteotomy of pelvis, in a patient aged 18 years or over, including any of the following (if performed): (a) associated intra-articular procedures; (b) bone grafting; (c) internal fixation (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 48424 | Osteotomy of pelvis, in a patient aged less than 18 years, with application of hip spica, including internal fixation (if performed), other than a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 48426 | Osteotomy of femur, in a patient aged 18 years or over, including either or both of the following (if performed): (a) bone grafting; (b) internal fixation (H) (Anaes.) (Assist.) | $1,093.05 75% benefit $819.80 |
| 48427 | Osteotomy of femur, in a patient aged less than 18 years, including internal fixation (if performed), other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $1,093.05 75% benefit $819.80 |
| 48430 | Excision of one or more osteophytes of the foot or ankle, or simple removal of bunion, including any of the following (if performed): (a) capsulotomy; (b) excision of surrounding osteophytes; (c) release of ligaments; (d) removal of one or more associated bursae or ganglia; (e) removal of bone; (f) synovectomy; —each incision (H) (Anaes.) (Assist.) | $321.15 75% benefit $240.90 |
| 48433 | Treatment of non-union or malunion, with preservation of the joint, for ankle or hindfoot fracture, with internal or external fixation by any method, including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) excision of surrounding osteophytes; (d) osteotomy; (e) release of joint; (f) removal of bone; (g) removal of hardware; (h) synovectomy; —one bone (H) (Anaes.) (Assist.) | $1,278.95 75% benefit $959.25 |
| 48435 | Treatment of non-union or malunion, with preservation of the joint, for midfoot or forefoot fracture, with internal or external fixation by any method, including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) excision of surrounding osteophytes; (d) osteotomy; (e) release of joint; (f) removal of bone; (g) removal of hardware; (h) synovectomy; —one bone (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 48436 | Excision of one or more exostoses of the hand, distal to the wrist, including any of the following (if performed): (a) excision of surrounding osteophytes; (b) release of ligaments; (c) removal of one or more associated bursae or ganglia; (d) removal of bone; (e) synovectomy; other than a service associated with a service to which another item in this Schedule applies that: (f) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and (g) is performed on the same joint or bone; —each incision (H) (Anaes.) (Assist.) | $321.15 75% benefit $240.90 |
| 48438 | Excision of one or more exostoses in the wrist including any of the following (if performed): (a) capsulotomy; (b) excision of surrounding osteophytes; (c) release of ligaments; (d) removal of one or more associated bursae or ganglia; (e) removal of bone; (f) synovectomy; other than: (g) a service to which 48436 applies; or (h) a service associated with a service to which another item in this Schedule applies that: (i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and (ii) is performed on the same joint or bone; —each incision (H) (Anaes.) (Assist.) | $321.15 75% benefit $240.90 |
| 48440 | Excision of one or more exostoses in the arm or shoulder, including the radius, ulna, humerus, acromion, clavicle, or scapula, including any of the following (if performed): (a) capsulotomy; (b) excision of surrounding osteophytes; (c) release of ligaments; (d) removal of one or more associated bursae or ganglia; (e) removal of bone; (f) synovectomy; other than: (g) a service to which 48438 applies; or (h) a service associated with a service to which another item in this Schedule applies that: (i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and (ii) is performed on the same joint or bone; —each incision (H) (Anaes.) (Assist.) | $321.15 75% benefit $240.90 |
| 48442 | Excision of one or more exostoses in the hip, including pelvis and femur, including any of following (if performed): (a) capsulotomy; (b) excision of surrounding osteophytes; (c) release of ligaments; (d) removal of one or more associated bursae or ganglia; (e) removal of bone; (f) synovectomy; other than: (g) a service to which 48444 applies; or (h) a service associated with a service to which another item in this Schedule applies that: (i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and (ii) is performed on the same joint or bone; —each incision (H) (Anaes.) (Assist.) | $321.15 75% benefit $240.90 |
| 48444 | Excision of one or more exostoses in the knee, tibia or fibula, including any of following (if performed): (a) capsulotomy; (b) excision of surrounding osteophytes; (c) release of ligaments; (d) removal of one or more associated bursae or ganglia; (e) removal of bone; (f) synovectomy; other than: (g) a service to which item 48430 applies; or (h) a service associated with a service to which another item in this Schedule applies that: (i) is an arthroscopic procedure, arthrodesis, arthroplasty or osteotomy, or involves the removal of hardware; and (ii) is performed on the same joint or bone; —each incision (H) (Anaes.) (Assist.) | $321.15 75% benefit $240.90 |
| 48446 | Treatment of non-union or malunion of fracture of pelvis, including bone graft, and including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) osteotomy; (d) removal of hardware; (e) internal fixation; other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone —one bone (H) (Anaes.) (Assist.) | $1,444.30 75% benefit $1,083.25 |
| 48448 | Treatment of non-union or malunion of fracture of femur, including bone graft, and including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) osteotomy; (d) removal of hardware; (e) internal fixation; other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone —one bone (H) (Anaes.) (Assist.) | $1,444.30 75% benefit $1,083.25 |
| 48450 | Treatment of non-union or malunion of fracture of tibia or fibula, proximal to ankle, including bone graft, and including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) osteotomy; (d) removal of hardware; (e) internal fixation; other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone —one bone (H) (Anaes.) (Assist.) | $1,309.00 75% benefit $981.75 |
| 48452 | Treatment of non-union or malunion of fracture of humerus, including bone graft, and including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) osteotomy; (d) removal of hardware; (e) internal fixation; other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone —one bone (H) (Anaes.) (Assist.) | $1,309.00 75% benefit $981.75 |
| 48454 | Treatment of non-union or malunion of fracture of radius, ulna, or carpus including bone graft, and including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) osteotomy; (d) removal of hardware; (e) internal fixation; other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone —one bone (H) (Anaes.) (Assist.) | $970.95 75% benefit $728.25 |
| 48456 | Treatment of non-union or malunion of fracture of hand, distal to wrist, including bone graft, and including any of the following (if performed): (a) arthrotomy; (b) debridement; (c) osteotomy; (d) removal of hardware; (e) internal fixation; other than a service associated with a service to which item 48245, 48248, 48251, 48254, 48257 or 47929 applies that is performed on the same bone —one bone (H) (Anaes.) (Assist.) | $970.95 75% benefit $728.25 |
| 48507 | Epiphysiodesis of a long bone, in a patient less than 18 years of age (H) (Anaes.) (Assist.) | $438.30 75% benefit $328.75 |
| 48509 | Hemiepiphysiodesis, partial growth plate arrest using internal fixation, in a patient less than 18 years of age (H) (Anaes.) (Assist.) | $394.45 75% benefit $295.85 |
| 48512 | Epiphysiolysis, release of focal growth plate closure, in a patient less than 18 years of age (H) (Anaes.) (Assist.) | $1,070.55 75% benefit $802.95 |
| 48900 | Shoulder, excision of coraco‑acromial ligament or removal of calcium deposit from cuff or both (H) (Anaes.) (Assist.) | $337.90 75% benefit $253.45 |
| 48903 | Shoulder, decompression of subacromial space by acromioplasty, excision of coraco‑acromial ligament and distal clavicle, or any combination (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 48906 | Shoulder, repair of rotator cuff, including excision of coraco‑acromial ligament or removal of calcium deposit from cuff, or both—other than a service associated with a service to which item 48900 applies (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 48909 | Shoulder, repair of rotator cuff, including decompression of subacromial space by acromioplasty, excision of coraco‑acromial ligament and distal clavicle, or any combination, other than a service associated with a service to which item 48903 applies (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 48915 | Shoulder, hemi‑arthroplasty of (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 48918 | Anatomic or reverse total shoulder replacement, including any of the following (if performed): (a) associated rotator cuff repair; (b) biceps tenodesis; (c) tuberosity osteotomy; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the shoulder region by open or arthroscopic means (H) (Anaes.) (Assist.) | $1,803.15 75% benefit $1,352.40 |
| 48919 | Anatomic or reverse total shoulder replacement with bone graft, including any of the following (if performed): (a) associated rotator cuff repair; (b) biceps tenodesis; (c) tuberosity osteotomy; other than a service associated with: (d) a service to which another item in this Schedule applies that is performed on the shoulder region by open or arthroscopic means; or (e) a service to which item 48245, 48248, 48251, 48254 or 48257 applies that is performed on the same joint (H) (Anaes.) (Assist.) | $2,041.70 75% benefit $1,531.30 |
| 48921 | Shoulder, total replacement arthroplasty, revision of (H) (Anaes.) (Assist.) | $1,859.15 75% benefit $1,394.40 |
| 48924 | Revision of total shoulder replacement, including either or both of the following (if performed): (a) bone graft to humerus; (b) bone graft to scapula (H) (Anaes.) (Assist.) | $2,141.05 75% benefit $1,605.80 |
| 48925 | Arthroplasty of shoulder, other than: (a) a service to which another item applies; or (b) a service associated with a service to which any of items 48900 to 48909, 48948, 48951, or 48960 applies that is performed on the same joint (H) (Anaes.) (Assist.) | $840.80 75% benefit $630.60 |
| 48927 | Shoulder prosthesis, removal of (H) (Anaes.) (Assist.) | $439.30 75% benefit $329.50 |
| 48932 | Arthroplasty of acromioclavicular joint or sternoclavicular joint, other than: (a) a service to which another item applies; or (b) a service associated with a service to which another item in this Schedule applies that is performed on the same joint by arthroscopic means —one joint (H) (Anaes.) (Assist.) | $840.80 75% benefit $630.60 |
| 48939 | Shoulder, arthrodesis of, with synovectomy if performed (H) (Anaes.) (Assist.) | $1,295.85 75% benefit $971.90 |
| 48942 | Arthrodesis of shoulder, with bone grafting or internal fixation, including either or both of the following (if performed): (a) removal of prosthesis; (b) synovectomy; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $1,690.25 75% benefit $1,267.70 |
| 48943 | Arthrodesis of acromioclavicular or sternoclavicular joint, including either or both of the following (if performed): (a) joint debridement; (b) synovectomy; —one joint (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 48944 | Arthrodesis of scapulothoracic joint, including either or both of the following (if performed): (a) joint debridement; (b) synovectomy; —one joint (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 48945 | SHOULDER, diagnostic arthroscopy of (including biopsy) - not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.) | $326.70 75% benefit $245.05 |
| 48948 | SHOULDER, arthroscopic surgery of, involving any 1 or more of: removal of loose bodies; decompression of calcium deposit; debridement of labrum, synovium or rotator cuff; or chondroplasty - not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 48951 | SHOULDER, arthroscopic division of coraco-acromial ligament including acromioplasty - not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.) | $1,070.55 75% benefit $802.95 |
| 48952 | Surgery of acromioclavicular joint or sternoclavicular joint, by arthroscopic means, including any of the following (if performed): (a) cartilage treatment; (b) removal of loose bodies; (c) synovectomy; (d) excision of joint osteophytes; other than a service associated with a service to which another item in this Group applies that is performed on the same joint by arthroscopic means (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 48953 | Surgery of scapulothoracic joint, by arthroscopic means, including any of the following (if performed): (a) cartilage treatment; (b) removal of loose bodies; (c) synovectomy; (d) excision of joint osteophytes; other than a service associated with a service to which another item in this Group applies that is performed on the same joint by arthroscopic means (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 48954 | Synovectomy of shoulder, performed as an independent procedure, including release of contracture (if performed), other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the shoulder region by arthroscopic means (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 48958 | Joint stabilisation procedure for multi-directional instability of shoulder, anterior or posterior repair, by open or arthroscopic means, including labral repair or reattachment (if performed), excluding bone grafting and removal of hardware, other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the shoulder region by arthroscopic means (H) (Anaes.) (Assist.) | $1,295.85 75% benefit $971.90 |
| 48959 | Latarjet procedure by open or arthroscopic means, including any of the following (if performed) but excluding removal of hardware: (a) labral repair or reattachment; (b) bone grafting; (c) tendon transfer; other than a service associated with a service to which another item in this Schedule applies that is performed on the shoulder region by arthroscopic means (H) (Anaes.) (Assist.) | $1,809.60 75% benefit $1,357.20 |
| 48960 | SHOULDER, reconstruction or repair of, including repair of rotator cuff by arthroscopic, arthroscopic assisted or mini open means; arthroscopic acromioplasty; or resection of acromioclavicular joint by separate approach when performed - not being a service associated with any other procedure of the shoulder region (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 48972 | Tenodesis of biceps, by open or arthroscopic means, performed as an independent procedure (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 48980 | Excision of heterotopic ossification, myositis ossificans or post-traumatic ossification in the shoulder girdle (H) (Anaes.) (Assist.) | $957.80 75% benefit $718.35 |
| 48983 | Excision of heterotopic ossification, myositis ossificans or post-traumatic ossification in the elbow (H) (Anaes.) (Assist.) | $702.40 75% benefit $526.80 |
| 48986 | Excision of heterotopic ossification, myositis ossificans or post-traumatic ossification in the forearm (H) (Anaes.) (Assist.) | $957.80 75% benefit $718.35 |
| 49100 | ELBOW, arthrotomy of, involving 1 or more of lavage, removal of loose body or division of contracture (H) (Anaes.) (Assist.) | $394.45 75% benefit $295.85 |
| 49104 | Repair of one or more ligaments of the elbow, for acute instability—within 6 weeks after the time of injury (H) (Anaes.) (Assist.) | $633.80 75% benefit $475.35 |
| 49105 | Stabilisation of one or more ligaments of the elbow, for chronic instability, including harvesting of tendon graft—6 weeks or more after the time of injury (H) (Anaes.) (Assist.) | $929.60 75% benefit $697.20 |
| 49106 | Elbow, arthrodesis of, with synovectomy if performed (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 49109 | ELBOW, total synovectomy of (H) (Anaes.) (Assist.) | $845.00 75% benefit $633.75 |
| 49112 | Radial head replacement of elbow, other than a service associated with a service to which item 49115 applies (H) (Anaes.) (Assist.) | $845.00 75% benefit $633.75 |
| 49113 | Removal of radial head prosthesis (H) (Anaes.) (Assist.) | $840.80 75% benefit $630.60 |
| 49114 | Revision of radial head replacement (H) (Anaes.) (Assist.) | $840.80 75% benefit $630.60 |
| 49115 | Total or hemi humeral arthroplasty of elbow, excluding isolated radial head replacement and ligament stabilisation procedures, other than a service associated with a service to which item 49112 applies (H) (Anaes.) (Assist.) | $1,352.05 75% benefit $1,014.05 |
| 49116 | ELBOW, total replacement arthroplasty of, revision procedure, including removal of prosthesis (H) (Anaes.) (Assist.) | $1,784.70 75% benefit $1,338.55 |
| 49117 | Revision of total replacement arthroplasty of elbow, including bone grafting and removal of prosthesis (H) (Anaes.) (Assist.) | $2,141.65 75% benefit $1,606.25 |
| 49118 | ELBOW, diagnostic arthroscopy of, including biopsy and lavage, not being a service associated with any other arthroscopic procedure of the elbow (H) (Anaes.) (Assist.) | $326.70 75% benefit $245.05 |
| 49121 | Surgery of the elbow, by arthroscopic means, including any of the following (if performed): (a) chondroplasty; (b) drilling of defect; (c) osteoplasty; (d) removal of loose bodies; (e) release of contracture or adhesions; (f) treatment of epicondylitis; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of an arthroscopic procedure of the elbow (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 49124 | Excision of olecranon bursa, including bony prominence, other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of an arthroscopic procedure of the elbow (H) (Anaes.) (Assist.) | $444.65 75% benefit $333.50 |
| 49127 | Elbow joint, arthroplasty of, other than a service to which another item applies (H) (Anaes.) (Assist.) | $840.80 75% benefit $630.60 |
| 49200 | Wrist, arthrodesis of, with synovectomy if performed, with or without internal fixation of the radiocarpal joint (H) (Anaes.) (Assist.) | $980.25 75% benefit $735.20 |
| 49203 | Limited fusion of wrist, with or without bone graft, including each of the following: (a) ligament or tendon transfers; (b) partial or total excision of one or more carpal bones; (c) rebalancing procedures; (d) synovectomy (H) (Anaes.) (Assist.) | $928.50 75% benefit $696.40 |
| 49206 | Proximal row carpectomy of wrist, including either or both of the following (if performed): (a) styloidectomy; (b) synovectomy (H) (Anaes.) (Assist.) | $676.10 75% benefit $507.10 |
| 49209 | Prosthetic replacement of wrist or distal radioulnar joint, including either or both of the following (if performed): (a) ligament realignment; (b) tendon realignment (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 49210 | Revision of total replacement arthroplasty of wrist or distal radioulnar joint, including any of the following (if performed): (a) ligament rebalancing; (b) removal of prosthesis; (c) tendon rebalancing (H) (Anaes.) (Assist.) | $1,190.10 75% benefit $892.60 |
| 49212 | Arthrotomy of wrist or distal radioulnar joint, including any of the following (if performed): (a) joint debridement; (b) removal of loose bodies; (c) synovectomy (H) (Anaes.) (Assist.) | $281.85 75% benefit $211.40 |
| 49213 | Sauve-Kapandji procedure of distal radioulnar joint, including any of the following (if performed): a) radioulnar fusion; b) osteotomy; c) soft tissue reconstruction (H) (Anaes.) (Assist.) | $1,008.40 75% benefit $756.30 |
| 49215 | Reconstruction of single or multiple ligaments or capsules of wrist, including any of the following (if performed): (a) arthrotomy; (b) ligament harvesting and grafting; (c) synovectomy; (d) tendon harvesting and grafting; (e) insertion of synthetic ligament substitute (H) (Anaes.) (Assist.) | $777.65 75% benefit $583.25 |
| 49218 | Wrist, diagnostic arthroscopy of, including radiocarpal or midcarpal joints, or both (including biopsy)—other than a service associated with another arthroscopic procedure of the wrist joint (H) (Anaes.) (Assist.) | $326.70 75% benefit $245.05 |
| 49219 | Diagnosis of carpometacarpal joint of thumb or joint of digit, by arthroscopic means, including biopsy (if performed) (H) (Anaes.) (Assist.) | $326.70 75% benefit $245.05 |
| 49220 | Treatment of carpometacarpal joint of thumb or joint of digit, by arthroscopic means—one joint (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 49221 | Treatment of wrist, by arthroscopic means, including any of the following (if performed): (a) drilling of defect; (b) removal of loose bodies; (c) release of adhesions; (d) synovectomy; (e) debridement; (f) resection of dorsal or volar ganglia; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing an arthroscopic procedure of the wrist joint (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 49224 | Osteoplasty of wrist, by arthroscopic means, including either or both of the following (if performed): (a) excision of the distal ulna; (b) total synovectomy; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing an arthroscopic procedure of the wrist joint—2 or more distinct areas (H) (Anaes.) (Assist.) | $845.00 75% benefit $633.75 |
| 49227 | Treatment of wrist by one of the following: (a) pinning of osteochondral fragment, by arthroscopic means; (b) stabilisation procedure for ligamentous disruption; (c) partial wrist fusion or carpectomy, by arthroscopic means; (d) fracture management; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing an arthroscopic procedure of the wrist joint (H) (Anaes.) (Assist.) | $845.00 75% benefit $633.75 |
| 49230 | Total, hemi or interpositional prosthetic replacement of carpal bone of wrist, including any of the following (if performed): (a) ligament and tendon rebalancing procedures; (b) limited wrist fusions; (c) limited bone grafting (H) (Anaes.) (Assist.) | $1,102.65 75% benefit $827.00 |
| 49233 | Excisional arthroplasty of single (or part of) carpal bone of wrist, when transfers of ligaments or tendons, or rebalancing procedures, are not required, including any of the following (if performed): (a) radial styloidectomy; (b) ulnar styloidectomy; (c) proximal hamate; (d) partial scaphoid; other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a distal radioulnar joint reconstruction, a proximal row carpectomy or a limited wrist fusion—applicable once for a single operation (H) (Anaes.) (Assist.) | $464.20 75% benefit $348.15 |
| 49236 | Stabilisation of soft tissue of distal radioulnar joint, with or without ligament or tendon grafting, including either or both of the following (if performed): (a) graft harvest; (b) triangular fibrocartilage complex repair or reconstruction (H) (Anaes.) (Assist.) | $699.95 75% benefit $525.00 |
| 49239 | Excision of pisiform or hook of hamate or sesamoid bone of hand, including release of ulnar nerve (if performed) (H) (Anaes.) (Assist.) | $348.15 75% benefit $261.15 |
| 49300 | Sacro-iliac joint—arthrodesis of (H) (Anaes.) (Assist.) | $623.95 75% benefit $468.00 |
| 49303 | Arthrotomy of hip, by open procedure, including any of the following (if performed): (a) lavage; (b) drainage; (c) biopsy (H) (Anaes.) (Assist.) | $653.55 75% benefit $490.20 |
| 49306 | Hip, arthrodesis of, with synovectomy if performed (H) (Anaes.) (Assist.) | $1,295.85 75% benefit $971.90 |
| 49309 | Arthrectomy or excision arthroplasty (Girdlestone) of hip, other than a service performed: (a) for the purpose of implant removal; or (b) as stage 1 of a 2-stage procedure (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 49315 | Hip, arthroplasty of, unipolar or bipolar (H) (Anaes.) (Assist.) | $1,014.15 75% benefit $760.65 |
| 49318 | Total arthroplasty of hip, including minor bone grafting (if performed), other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 49319 | Bilateral total arthroplasty of hip, including minor bone grafting (if performed), other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $2,771.25 75% benefit $2,078.45 |
| 49321 | Complex primary arthroplasty of hip, with internal fixation, including either or both of the following (if performed): (a) structural bone graft; (b) insertion of synthetic substitutes or metal augments; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $1,915.75 75% benefit $1,436.85 |
| 49360 | Diagnostic arthroscopy of hip, other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing a procedure of the hip joint by arthroscopic means (H) (Anaes.) (Assist.) | $411.75 75% benefit $308.85 |
| 49363 | Diagnostic arthroscopy of hip, with synovial biopsy, other than a service associated with a service to which another item in this Schedule applies that is performed on the hip joint by arthroscopic means (H) (Anaes.) (Assist.) | $495.70 75% benefit $371.80 |
| 49366 | Treatment of hip, by arthroscopic means, including any procedures to treat bone or soft tissue in the same area (if performed), other than a service associated with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing: (a) a procedure of the hip joint by arthroscopic means; or (b) surgery for femoroacetabular impingement (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 49372 | Revision arthroplasty of hip, with exchange of head or liner (or both) (H) (Anaes.) (Assist.) | $1,104.05 75% benefit $828.05 |
| 49374 | Revision arthroplasty of hip, with exchange of head and acetabular shell or cup, including minor bone grafting (if performed) (H) (Anaes.) (Assist.) | $2,050.45 75% benefit $1,537.85 |
| 49376 | Revision arthroplasty of hip, with exchange of head and acetabular shell or cup, including major bone grafting (if performed) (H) (Anaes.) (Assist.) | $2,523.70 75% benefit $1,892.80 |
| 49378 | Revision arthroplasty of hip, with revision of femoral component (if there is no requirement for femoral osteotomy), including minor bone grafting (if performed) (H) (Anaes.) (Assist.) | $2,208.05 75% benefit $1,656.05 |
| 49380 | Revision arthroplasty of hip, with revision of femoral and acetabular components (if femoral osteotomy is not required), including minor bone grafting (if performed) (H) (Anaes.) (Assist.) | $2,681.35 75% benefit $2,011.05 |
| 49382 | Revision arthroplasty of hip, with revision of femoral and acetabular components (if femoral osteotomy is not required), including major bone grafting (H) (Anaes.) (Assist.) | $3,470.05 75% benefit $2,602.55 |
| 49384 | Revision arthroplasty of hip, for pelvic discontinuity, with revision of acetabular component (H) (Anaes.) (Assist.) | $4,100.90 75% benefit $3,075.70 |
| 49386 | Revision arthroplasty of hip, with revision of femoral component with femoral osteotomy, including minor bone grafting (if performed) (H) (Anaes.) (Assist.) | $2,839.15 75% benefit $2,129.40 |
| 49388 | Revision arthroplasty of hip, including: (a) revision of both of the following: (i) femoral component with femoral osteotomy; (ii) acetabular component; and (b) minor bone grafting (if performed) (H) (Anaes.) (Assist.) | $3,312.30 75% benefit $2,484.25 |
| 49390 | Revision arthroplasty of hip, including: (a) revision of both of the following: (i) femoral component with femoral osteotomy; (ii) acetabular component; and (b) major bone grafting (H) (Anaes.) (Assist.) | $3,943.25 75% benefit $2,957.45 |
| 49392 | Revision arthroplasty of hip, including: (a) either: (i) revision of femoral component with femoral osteotomy; or (ii) proximal femoral replacement; and (b) revision of acetabular component for pelvic discontinuity (H) (Anaes.) (Assist.) | $5,520.50 75% benefit $4,140.40 |
| 49394 | Revision arthroplasty of hip, including: (a) replacement of proximal femur; and (b) revision of the acetabular component; and (c) bone grafting (if performed) (H) (Anaes.) (Assist.) | $4,731.80 75% benefit $3,548.85 |
| 49396 | Revision arthroplasty of hip, including: (a) removal of prosthesis as stage 1 of a 2-stage revision arthroplasty or as a definitive stage procedure; and (b) insertion of temporary prosthesis (if performed) (H) (Anaes.) (Assist.) | $3,154.55 75% benefit $2,365.95 |
| 49398 | Revision arthroplasty of hip, including: (a) revision of femoral component for periprosthetic fracture; and (b) internal fixation; and (c) bone grafting (if performed) (H) (Anaes.) (Assist.) | $2,365.95 75% benefit $1,774.50 |
| 49500 | Knee, arthrotomy of, involving one or more of capsular release, biopsy or lavage, or removal of loose body or foreign body (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 49503 | Arthrotomy of knee, including one of the following: (a) meniscal surgery; (b) repair of collateral or cruciate ligament; (c) patellectomy; (d) single transfer of ligament or tendon; (e) repair or replacement of chondral or osteochondral surface (excluding prosthetic replacement); other than a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $586.00 75% benefit $439.50 |
| 49506 | Arthrotomy of knee, including 2 or more of the following: (a) meniscal surgery; (b) repair of collateral or cruciate ligament; (c) patellectomy; (d) single transfer of ligament or tendon; (e) repair or replacement of chondral or osteochondral surface (excluding prosthetic replacement); other than a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $879.05 75% benefit $659.30 |
| 49509 | Total synovectomy of knee, by open procedure, other than a service performed in association with a service to which another item in this Schedule applies if the service described in the other item is for the purpose of performing an arthroplasty (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 49512 | Primary or revision arthrodesis of knee, including arthrodesis (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 49515 | Removal of cemented or uncemented knee prosthesis, performed as the first stage of a 2-stage procedure; including: (a) removal of associated cement; and (b) insertion of spacer (if required) (H) (Anaes.) (Assist.) | $1,014.15 75% benefit $760.65 |
| 49516 | Bilateral unicompartmental arthroplasty of femur and proximal tibia of knee (H) (Anaes.) (Assist.) | $2,526.80 75% benefit $1,895.10 |
| 49517 | Unicompartmental arthroplasty of femur and proximal tibia of knee (H) (Anaes.) (Assist.) | $1,443.90 75% benefit $1,082.95 |
| 49518 | Total arthroplasty of knee, including either or both of the following (if performed): (a) revision of patello-femoral joint replacement to total knee replacement; (b) patellar resurfacing; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 49519 | Bilateral total arthroplasty of knee, including patellar resurfacing, other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $2,771.25 75% benefit $2,078.45 |
| 49521 | Complex primary arthroplasty of knee, using revision femoral or tibial components, including either or both of the following (if performed): (a) ligament reconstruction; (b) patellar resurfacing; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $1,915.75 75% benefit $1,436.85 |
| 49524 | Complex primary arthroplasty of knee: (a) using revision femoral and tibial components; or (b) using revision femoral or tibial components including anatomic specific allograft of femur or tibia; including either or both of the following (if performed): (c) ligament reconstruction; (d) patellar resurfacing; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $2,253.75 75% benefit $1,690.35 |
| 49525 | Revision of uni-compartmental arthroplasty of the knee, with femoral or tibial components (or both) with uni-compartmental implants, other than a service associated with a service to which: (a) item 48245, 48248, 48251, 48254 or 48257 applies; or (b) another item in this Group applies if the service described in the other item is for the purpose of performing surgery on a knee (H) (Anaes.) (Assist.) | $1,915.75 75% benefit $1,436.85 |
| 49527 | Minor revision of total or partial arthroplasty of knee, including either or both of the following: (a) exchange of polyethylene component (including uni); (b) insertion of patellar component; other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 49530 | Revision of total or partial arthroplasty of knee, with exchange of femoral or tibial component: (a) excluding revision of unicompartmental with unicompartmental implants; and (b) including patellar resurfacing (if performed); other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $2,366.50 75% benefit $1,774.90 |
| 49533 | Revision of total or partial arthroplasty of knee, with exchange of femoral and tibial components, excluding revision of unicompartmental with unicompartmental implants, including patellar resurfacing (if performed), other than a service associated with a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $3,043.10 75% benefit $2,282.35 |
| 49534 | Arthroplasty of patella and trochlea of patello-femoral joint of knee, performed as a primary procedure (H) (Anaes.) (Assist.) | $870.50 75% benefit $652.90 |
| 49536 | Either: (a) repair of cruciate ligaments of knee; or (b) repair or reconstruction of collateral ligaments of knee; by open or arthroscopic means, including either or both of the following (if performed): (c) graft harvest; (d) intraarticular knee surgery; other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the knee by arthroscopic means (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 49542 | Reconstruction of anterior or posterior cruciate ligament of knee, by open or arthroscopic means, including any of the following (if performed): (a) graft harvest; (b) donor site repair; (c) meniscal repair; (d) collateral ligament repair; (e) extra-articular tenodesis; (f) any other associated intra-articular surgery; other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the knee by arthroscopic means (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 49544 | Reconstruction of 2 or more cruciate or collateral ligaments of knee, by open or arthroscopic means, including any of the following (if performed): (a) ligament repair; (b) graft harvest donor site repair; (c) meniscal repair; (d) any other associated intra-articular surgery; other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the knee by arthroscopic means (H) (Anaes.) (Assist.) | $1,836.40 75% benefit $1,377.30 |
| 49548 | Knee, revision of patello-femoral stabilisation (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 49551 | Knee, revision of procedures to which item 49536 or 49542 applies (H) (Anaes.) (Assist.) | $1,577.30 75% benefit $1,183.00 |
| 49554 | Revision of total replacement of knee, by anatomic specific allograft of tibia or femur, other than a service to which item 48245, 48248, 48251, 48254 or 48257 applies (H) (Anaes.) (Assist.) | $2,253.75 75% benefit $1,690.35 |
| 49564 | Stabilisation of patellofemoral joint of knee, by combined open and arthroscopic means, including either or both of the following (if performed): (a) medial soft tissue reconstruction and tendon transfer; (b) tibial tuberosity transfer with bone graft and internal fixation; other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the knee by arthroscopic means (H) (Anaes.) (Assist.) | $1,100.10 75% benefit $825.10 |
| 49565 | Reconstruction of patellofemoral joint of knee, by combined open and arthroscopic means, including: (a) both of the following: (i) medial soft tissue reconstruction; (ii) tibial tuberosity transfer; and (b) any of the following (if performed): (i) bone graft; (ii) internal fixation; (iii) trochleoplasty; other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the knee by arthroscopic means (H) (Anaes.) (Assist.) | $1,578.80 75% benefit $1,184.10 |
| 49569 | Knee, mobilisation for post-traumatic stiffness, by multiple muscle or tendon release (quadricepsplasty) (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 49570 | Diagnosis of knee, by arthroscopic means, when the pre-procedure diagnosis is undetermined, including either or both of the following (if performed): (a) biopsy; (b) lavage (H) (Anaes.) (Assist.) | $326.70 75% benefit $245.05 |
| 49572 | Partial meniscectomy of knee, by arthroscopic means, for atraumatic meniscus tear, other than a service to which another item of this Schedule applies if the service described in the other item is for the purpose of treating osteoarthritis (H) (Anaes.) (Assist.) | $795.05 75% benefit $596.30 |
| 49574 | Removal of loose bodies of knee, by arthroscopic means—one or more bodies (H) (Anaes.) (Assist.) | $795.05 75% benefit $596.30 |
| 49576 | Repair of chondral lesion of knee, by arthroscopic means, including either or both of the following (if performed): (a) microfracture; (b) microdrilling; other than a service performed in combination with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing chondral or osteochondral grafts (H) (Anaes.) (Assist.) | $795.05 75% benefit $596.30 |
| 49578 | Release of soft tissue, lateral release or osteoplasty of knee, by arthroscopic means, other than a service performed in combination with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of stabilising the patellofemoral joint of the knee (H) (Anaes.) (Assist.) | $795.05 75% benefit $596.30 |
| 49580 | Partial meniscectomy of knee, by arthroscopic means, for traumatic meniscus tear (H) (Anaes.) (Assist.) | $795.05 75% benefit $596.30 |
| 49582 | Meniscal repair of knee, by arthroscopic means (H) (Anaes.) (Assist.) | $928.30 75% benefit $696.25 |
| 49584 | Chondral, osteochondral or meniscal graft of knee, by arthroscopic means (H) (Anaes.) (Assist.) | $928.30 75% benefit $696.25 |
| 49586 | Synovectomy of knee, by arthroscopic means, for neoplasia or inflammatory arthropathy, other than a service to which another item of this Schedule applies if the service described in the other item is for the purpose of treating uncomplicated osteoarthritis (H) (Anaes.) (Assist.) | $928.30 75% benefit $696.25 |
| 49590 | Excision of ganglion, cyst or bursa of knee, by open or arthroscopic means, performed as an independent procedure, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $444.65 75% benefit $333.50 |
| 49592 | Excision of heterotopic ossification, myositis ossificans or post-traumatic ossification in the hip, including pelvis and proximal femur (H) (Anaes.) (Assist.) | $1,366.30 75% benefit $1,024.75 |
| 49594 | Excision of heterotopic ossification, myositis ossificans or post-traumatic ossification in the knee, including distal femur, proximal fibula and proximal tibia (H) (Anaes.) (Assist.) | $1,093.05 75% benefit $819.80 |
| 49596 | Excision of heterotopic ossification, myositis ossificans or post-traumatic ossification in the lower leg, other than a service to which item 49594 applies (H) (Anaes.) (Assist.) | $819.85 75% benefit $614.90 |
| 49703 | Surgery of ankle joint, by arthroscopic means, including any of the following (if performed): (a) cartilage treatment; (b) removal of loose bodies; (c) synovectomy; (d) excision of joint osteophytes; other than a service associated with a service to which another item in this Group applies if the service described in the other item is for the purpose of performing a procedure on the ankle by arthroscopic means (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 49706 | Arthrotomy of joint of ankle, including removal of loose bodies and joint debridement, including release of joint contracture (if performed) (H) (Anaes.) (Assist.) | $394.45 75% benefit $295.85 |
| 49709 | Stabilisation of ligament of ankle or subtalar joint (or both), including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) joint debridement; —one ligament complex, each incision (H) (Anaes.) (Assist.) | $845.00 75% benefit $633.75 |
| 49712 | Arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint (H) (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 49715 | Total replacement of ankle, with prosthetic replacement of ankle joint, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint (H) (Anaes.) (Assist.) | $1,352.05 75% benefit $1,014.05 |
| 49716 | Revision of total ankle replacement: (a) including either: (i) exchange of tibial or talar components (or both) or plastic inserts; or (ii) removal of tibial or talar components (or both) and plastic inserts; and (b) including any of the following (if performed): (i) insertion of cement spacer for infection; (ii) capsulotomy; (iii) joint release; (iv) neurolysis; (v) debridement of cysts; (vi) synovectomy; (vii) joint debridement other than a service associated with a service to which item 30023 applies (H) (Anaes.) (Assist.) | $1,784.70 75% benefit $1,338.55 |
| 49717 | Revision of total ankle replacement: (a) including either: (i) exchange of tibial and talar components; or (ii) removal of tibial and talar components and conversion to ankle arthrodesis; and (b) including both of the following (iii) internal or external fixation, by any means; (iv) major bone grafting; and (c) including any of the following (if performed): (i) capsulotomy; (ii) joint release; (iii) neurolysis; (iv) debridement and extensive grafting of cysts; (v) synovectomy; (vi) joint debridement; other than a service associated with a service to which item 30023, 48245, 48248, 48251, 48254 or 48257 applies that is performed at the same site (H) (Anaes.) (Assist.) | $2,141.65 75% benefit $1,606.25 |
| 49718 | Primary repair of major tendon of ankle, by any method, including either or both of the following (if performed): (a) synovial biopsy; (b) synovectomy —one tendon (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 49724 | Reconstruction of major tendon of ankle, by any method, including any of the following (if performed): (a) synovial biopsy; (b) synovectomy; (c) adjacent tendon transfer; (d) turn down flaps; other than a service associated with a service to which item 49718 applies (H) (Anaes.) (Assist.) | $788.90 75% benefit $591.70 |
| 49727 | Lengthening of major tendon of ankle, including either or both of the following (if performed): (a) synovial biopsy; (b) synovectomy (H) (Anaes.) (Assist.) | $337.90 75% benefit $253.45 |
| 49728 | Lengthening of Achilles’ tendon, by any method, with gastro-soleus lengthening for the correction of equinous deformity, including either or both of the following (if performed): (a) synovial biopsy; (b) synovectomy; other than a service associated with a service to which item 49727 applies (H) (Anaes.) (Assist.) | $675.95 75% benefit $507.00 |
| 49730 | Surgery of joint of hindfoot (other than ankle) or first metatarsophalangeal joint, by arthroscopic means, including any of the following (if performed): (a) cartilage treatment; (b) removal of loose bodies; (c) synovectomy; (d) excision of joint osteophytes; other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the ankle by arthroscopic means—one joint (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 49732 | Endoscopy of large tendons of foot, including any of the following (if performed): (a) debridement of tendon and sheath; (b) removal of loose bodies; (c) synovectomy; (d) excision of tendon impingement; other than a service associated with a service to which item 49718 or 49724 applies (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 49734 | Arthrotomy of hindfoot, midfoot or metatarsophalangeal joint, including: (a) removal of loose bodies; and (b) either or both of the following: (i) joint debridement; (ii) release of joint contracture; —each incision (H) (Anaes.) (Assist.) | $394.45 75% benefit $295.85 |
| 49736 | Transfer of major tendon of foot and ankle, including: (a) split or whole transfer to contralateral side of foot; and (b) passage of posterior or anterior tendon to, or through, interosseous membrane; and (c) any of the following (if performed): (i) synovial biopsy; (ii) synovectomy; (iii) tendon lengthening; (iv) insetting of tendon (H) (Anaes.) (Assist.) | $788.90 75% benefit $591.70 |
| 49738 | Stabilisation of ligament of talonavicular or metatarsophalangeal joint, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 49740 | Revision of arthrodesis of ankle, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint; (e) removal of hardware; (f) neurolysis; (g) osteotomy of non-union or malunion; other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $1,690.35 75% benefit $1,267.80 |
| 49742 | Arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint (H) (Anaes.) (Assist.) | $1,595.70 75% benefit $1,196.80 |
| 49744 | Revision of arthrodesis of extended ankle and hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint; (e) removal of hardware; (f) neurolysis; (g) osteotomy of non-union or malunion; other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $2,393.60 75% benefit $1,795.20 |
| 49760 | Arthroereisis of subtalar joint, including any of the following (if performed): (a) capsulotomy; (b) synovectomy; (c) joint debridement (H) (Anaes.) (Assist.) | $422.60 75% benefit $316.95 |
| 49761 | Stabilisation of metatarsophalangeal joint at metatarsal, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —one metatarsal (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 49762 | Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —2 metatarsals (H) (Anaes.) (Assist.) | $929.60 75% benefit $697.20 |
| 49763 | Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —3 metatarsals (H) (Anaes.) (Assist.) | $1,084.60 75% benefit $813.45 |
| 49764 | Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —4 metatarsals (H) (Anaes.) (Assist.) | $1,239.45 75% benefit $929.60 |
| 49765 | Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —5 metatarsals (H) (Anaes.) (Assist.) | $1,394.50 75% benefit $1,045.90 |
| 49766 | Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —6 metatarsals (H) (Anaes.) (Assist.) | $1,549.35 75% benefit $1,162.05 |
| 49767 | Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —7 metatarsals (H) (Anaes.) (Assist.) | $1,704.35 75% benefit $1,278.30 |
| 49768 | Stabilisation of metatarsophalangeal joint at metatarsals, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) osteotomy, with or without fixation; (e) local tendon transfer; (f) local tendon lengthening or release; (g) ligament repair; (h) joint debridement; —8 metatarsals (H) (Anaes.) (Assist.) | $1,859.20 75% benefit $1,394.40 |
| 49769 | Unilateral correction of hallux valgus or varus deformity, by osteotomy of first metatarsal and proximal phalanx of first toe, with internal fixation of both bones, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $1,084.60 75% benefit $813.45 |
| 49770 | Bilateral correction of hallux valgus or varus deformity, by osteotomy of first metatarsal and proximal phalanx of first toe, with internal fixation of both bones, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $1,802.75 75% benefit $1,352.10 |
| 49771 | Synovectomy of major tendon of ankle, for extensive synovitis by any method, including any of the following (if performed): (a) tenolysis; (b) debridement of ligament or tendon (or both); (c) release of ligament or tendon (or both); (d) excision of tubercule or osteophyte; (e) reconstruction of tendon retinaculum; (f) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—each incision (H) (Anaes.) (Assist.) | $444.65 75% benefit $333.50 |
| 49772 | Excision of rheumatoid nodules or gouty tophi, excluding aftercare, including any of the following (if performed): (a) capsulotomy; (b) debridement of ligament or tendon (or both); (c) release of ligament or tendon (or both); (d) excision of tubercle or osteophyte; —each incision (H) (Anaes.) (Assist.) | $392.45 75% benefit $294.35 |
| 49773 | Revision of excision of intermetatarsal or digital neuroma, including any of the following (if performed): (a) release of tissues; (b) excision of bursae; (c) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—one web space (H) (Anaes.) (Assist.) | $486.40 75% benefit $364.80 |
| 49774 | Release of tarsal tunnel, including any of the following (if performed): (a) release of ligaments; (b) synovectomy; (c) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—one foot (H) (Anaes.) (Assist.) | $331.25 75% benefit $248.45 |
| 49775 | Revision of release of tarsal tunnel, including any of the following (if performed): (a) release of ligaments; (b) synovectomy; (c) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—one foot (H) (Anaes.) (Assist.) | $447.25 75% benefit $335.45 |
| 49776 | Revision of arthrodesis of joint of hindfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint; (e) removal of hardware; (f) neurolysis; (g) osteotomy of non‑union or malunion; other than a service associated with a service to which item 30023 applies that is performed at the same site—may only be claimed once per joint (H) (Anaes.) (Assist.) | $1,406.85 75% benefit $1,055.15 |
| 49777 | Arthrodesis of joint of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint; —one joint (H) (Anaes.) (Assist.) | $833.00 75% benefit $624.75 |
| 49778 | Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joints; —2 joints (H) (Anaes.) (Assist.) | $1,249.50 75% benefit $937.15 |
| 49779 | Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joints; —3 joints (H) (Anaes.) (Assist.) | $1,457.70 75% benefit $1,093.30 |
| 49780 | Arthrodesis of joints of midfoot, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joints; —4 joints (H) (Anaes.) (Assist.) | $1,665.85 75% benefit $1,249.40 |
| 49781 | Revision of arthrodesis of joint of midfoot, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of ostephytes at joint; (e) removal of hardware; (f) osteotomy of non-union or malunion; —one joint (H) (Anaes.) (Assist.) | $1,249.50 75% benefit $937.15 |
| 49782 | Revision of total ankle replacement, including: (a) bone grafting of perioperative cysts to the tibia or talus (or both); and (b) retention of implants; and (c) any of the following (if performed): (i) capsulotomy; (ii) joint release; (iii) neurolysis; (iv) debridement and grafting of cysts; (v) synovectomy; (vi) joint debridement; other than a service associated with a service to which item 30023 applies that is performed at the same site (H) (Anaes.) (Assist.) | $676.75 75% benefit $507.60 |
| 49783 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement; —3 joints (H) (Anaes.) (Assist.) | $907.55 75% benefit $680.70 |
| 49784 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement; —4 joints (H) (Anaes.) (Assist.) | $1,037.20 75% benefit $777.90 |
| 49785 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement; —5 joints (H) (Anaes.) (Assist.) | $1,166.70 75% benefit $875.05 |
| 49786 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement; —6 joints (H) (Anaes.) (Assist.) | $1,296.25 75% benefit $972.20 |
| 49787 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement; —7 joints (H) (Anaes.) (Assist.) | $1,425.80 75% benefit $1,069.35 |
| 49788 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joints, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement; —8 joints (H) (Anaes.) (Assist.) | $1,555.35 75% benefit $1,166.55 |
| 49789 | Bilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint (H) (Anaes.) (Assist.) | $1,337.80 75% benefit $1,003.35 |
| 49790 | Revision of arthrodesis of first metatarsophalangeal joint, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of exostosis at joint; (e) removal of hardware; (f) osteotomy of non-union or malunion (H) (Anaes.) (Assist.) | $1,162.00 75% benefit $871.50 |
| 49791 | Arthrodesis of hallux interphalangeal or lesser metatarsophalangeal joint, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joint (H) (Anaes.) (Assist.) | $526.85 75% benefit $395.15 |
| 49792 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) joint release; (d) synovectomy; (e) removal of osteophytes at joints; —one or 2 toes (H) (Anaes.) (Assist.) | $591.75 75% benefit $443.85 |
| 49793 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) joint release; (d) synovectomy; (e) removal of osteophytes at joints; —3 toes (H) (Anaes.) (Assist.) | $690.35 75% benefit $517.80 |
| 49794 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) joint release; (d) synovectomy; (e) removal of osteophytes at joints; —4 toes (H) (Anaes.) (Assist.) | $788.95 75% benefit $591.75 |
| 49795 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) joint release; (d) synovectomy; (e) removal of osteophytes at joints; —5 toes (H) (Anaes.) (Assist.) | $887.60 75% benefit $665.70 |
| 49796 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) joint release; (d) synovectomy; (e) removal of osteophytes at joints; —6 toes (H) (Anaes.) (Assist.) | $986.25 75% benefit $739.70 |
| 49797 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) joint release; (d) synovectomy; (e) removal of osteophytes at joints; —7 toes (H) (Anaes.) (Assist.) | $1,084.85 75% benefit $813.65 |
| 49798 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal joint (or both) of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) joint release; (d) synovectomy; (e) removal of osteophytes at joints; —8 toes (H) (Anaes.) (Assist.) | $1,183.50 75% benefit $887.65 |
| 49800 | Primary repair of flexor or extensor tendon of foot, including either or both of the following (if performed): (a) synovial biopsy; (b) synovectomy; —one toe (H) (Anaes.) (Assist.) | $157.75 75% benefit $118.35 |
| 49803 | Secondary repair of flexor or extensor tendon of foot, including either or both of the following (if performed): (a) synovial biopsy; (b) synovectomy; —one toe (H) (Anaes.) (Assist.) | $202.90 75% benefit $152.20 |
| 49806 | Subcutaneous tenotomy of foot, by small percutaneous incisions—one or more tendons (Anaes.) | $157.75 75% benefit $118.35 85% benefit $134.10 |
| 49809 | Open tenotomy or lengthening of foot, by open incision, with or without tenoplasty, including either or both of the following (if performed): (a) synovial biopsy; (b) synovectomy; —one toe (H) (Anaes.) (Assist.) | $259.10 75% benefit $194.35 |
| 49812 | Advancement of tendon or ligament transfer of foot, including: (a) side to side transfer, harvesting and transfer for ligament or minor foot tendon reconstruction; and (b) either or both of the following (if performed): (i) synovial biopsy; (ii) synovectomy; —one major tendon or toe (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 49814 | Reconstruction of major tendon of ankle, by any method, including: (a) osteotomy of hindfoot, with internal fixation; and (b) lengthening of major tendon of ankle; and (c) any of the following (if performed): (i) synovial biopsy; (ii) synovectomy; (iii) adjacent tendon transfer; (iv) turn down flaps; other than a service associated with a service to which item 49718 applies (H) (Anaes.) (Assist.) | $1,183.35 75% benefit $887.55 |
| 49815 | Triple arthrodesis of hindfoot joints, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joints (H) (Anaes.) (Assist.) | $1,641.35 75% benefit $1,231.05 |
| 49818 | Release of plantar fascia, including excision of calcaneal spur (if performed) (H) (Anaes.) (Assist.) | $326.70 75% benefit $245.05 |
| 49821 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joint, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement —one joint (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 49824 | Excisional or interpositional arthroplasty of metatarsophalangeal or tarsometatarsal joint, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) local tendon transfer; (e) joint debridement; —2 joints (H) (Anaes.) (Assist.) | $907.20 75% benefit $680.40 |
| 49827 | Unilateral correction of hallux valgus or varus deformity of the foot, by local tendon transfer, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 49830 | Bilateral correction of hallux valgus or varus deformity of the foot, by local tendon transfer, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $985.95 75% benefit $739.50 |
| 49833 | Unilateral correction of hallux valgus or varus deformity of the foot, by osteotomy of first metatarsal, without internal fixation, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 49836 | Bilateral correction of hallux valgus or varus deformity of the foot by osteotomy of first metatarsal, without internal fixation, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $1,070.55 75% benefit $802.95 |
| 49837 | Unilateral correction of hallux valgus or varus deformity of the foot, by osteotomy of first metatarsal, with internal fixation, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $774.75 75% benefit $581.10 |
| 49838 | Bilateral correction of hallux valgus or varus deformity of the foot by osteotomy of first metatarsal, with internal fixation or arthrodesis of first metatarsophalangeal joint, including any of the following (if performed): (a) exostectomy; (b) removal of bursae; (c) synovectomy; (d) capsule repair; (e) capsule or tendon release or transfer (H) (Anaes.) (Assist.) | $1,337.80 75% benefit $1,003.35 |
| 49839 | Total replacement of first metatarsophalangeal joint, with replacement of both joint surfaces, including any of the following (if performed): (a) capsulotomy; (b) synovectomy; (c) joint debridement (H) (Anaes.) (Assist.) | $619.75 75% benefit $464.85 |
| 49845 | Unilateral arthrodesis of first metatarsophalangeal joint, by open or arthroscopic means, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joints (H) (Anaes.) (Assist.) | $774.75 75% benefit $581.10 |
| 49851 | Arthrodesis, osteotomy or interpositional arthroplasty of proximal or distal (or both) joints of lesser toe, including any of the following (if performed): (a) internal fixation, by any method; (b) capsulotomy; (c) tendon lengthening; (d) joint release; (e) synovectomy; (f) removal of osteophytes at joints; —one toe (H) (Anaes.) (Assist.) | $518.25 75% benefit $388.70 |
| 49854 | Radical plantar fasciotomy or fasciectomy, with extensive incision into foot and excision of fascia, including excision of calcaneal spur (if performed), other than a service associated with a service to which 49818 applies (H) (Anaes.) (Assist.) | $450.65 75% benefit $338.00 |
| 49857 | Hemi joint replacement of first or lesser metatarsophalangeal joint, including any of the following (if performed): (a) capsulotomy; (b) synovectomy; (c) joint debridement (H) (Anaes.) (Assist.) | $416.85 75% benefit $312.65 |
| 49860 | Synovectomy of metatarsophalangeal joints, including any of the following (if performed): (a) capsulotomy; (b) debridement; (c) release of ligament or tendon (or both); —one or more joints on one foot (H) (Anaes.) (Assist.) | $389.35 75% benefit $292.05 |
| 49866 | Excision of intermetatarsal or digital neuroma, including any of the following (if performed): (a) release of metatarsal or digital ligament; (b) excision of bursae; (c) neurolysis; other than a service associated with a service to which item 30023 applies that is performed at the same site—one web space (H) (Anaes.) (Assist.) | $360.35 75% benefit $270.30 |
| 49878 | Talipes equinovarus, calcaneo valgus or metatarsus varus, treatment by cast, splint or manipulation—each attendance (Anaes.) | $67.60 75% benefit $50.70 85% benefit $57.50 |
| 49881 | Complete excision of one or more ganglia or bursae: (a) including excision of bony prominence or mucinous cyst of interphalangeal or metatarsophalangeal joint and surrounding tissues; and (b) including any of the following (if performed): (i) arthrotomy; (ii) synovectomy; (iii) osteophyte resections; (iv) neurolysis; (v) skin closure, by any local method; other than a service associated with a service to which item 30023 applies that is performed at the same site—each incision (H) (Anaes.) (Assist.) | $263.15 75% benefit $197.40 |
| 49884 | Complete excision of one or more ganglia or bursae: (a) including excision of bony prominence or mucinous cyst of ankle, hindoot or midfoot joint and surrounding tissues; and (b) including any of the following (if performed): (i) arthrotomy; (ii) synovectomy; (iii) osteophyte resections; (iv) neurolysis; (v) capsular or ligament repair; (vi) skin closure, by any method; other than a service associated with a service to which item 30023 applies that is performed at the same site—each incision (H) (Anaes.) (Assist.) | $444.65 75% benefit $333.50 |
| 49887 | Revision of complete excision of one or more ganglia or bursae: (a) including excision of bony prominence or mucinous cyst of interphalangeal or metatarsophalangeal joint and surrounding tissues; and (b) including any of the following (if performed): (i) arthrotomy; (ii) synovectomy; (iii) osteophyte resections; (iv) neurolysis; (v) skin closure, by any method; other than a service associated with: (c) a service to which item 49881 applies; or (d) a service to which item 30023 applies that is performed at the same site —each incision (H) (Anaes.) (Assist.) | $355.45 75% benefit $266.60 |
| 49890 | Revision of complete excision of one or more ganglia or bursae: (a) including excision of bony prominence or mucinous cyst of ankle, hindfoot or midfoot joint and surrounding tissues; and (b) including any of the following (if performed): (i) arthrotomy; (ii) synovectomy; (iii) osteophyte resections; (iv) neurolysis; (v) capsular or ligament repair; (vi) skin closure, by any method; other than a service associated with: (c) a service to which item 49884 applies; or (d) a service to which item 30023 applies that is performed at the same site —each incision (H) (Anaes.) (Assist.) | $600.20 75% benefit $450.15 |
| 50107 | Stabilisation of joint of hip, by open means, including any of the following (if performed): (a) repair of capsule; (b) labrum; (c) capsulorraphy; (d) repair of ligament; (e) internal fixation; other than a service associated with a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $563.40 75% benefit $422.55 |
| 50112 | Cicatricial flexion or extension contraction of joint, correction of, involving tissues deeper than skin and subcutaneous tissue, other than a service to which another item in this Group applies (H) (Anaes.) (Assist.) | $432.15 75% benefit $324.15 |
| 50115 | Manipulation of one or more joints, excluding spine, other than a service associated with a service to which another item in this Group applies (H) (Anaes.) | $171.20 75% benefit $128.40 |
| 50118 | Arthrodesis of joint of hindfoot, by any method, with internal or external fixation by any method, including any of the following (if performed): (a) capsulotomy; (b) joint release; (c) synovectomy; (d) removal of osteophytes at joints; —one joint (H) (Anaes.) (Assist.) | $937.80 75% benefit $703.35 |
| 50130 | Joint or joints, application of external fixator to, other than for treatment of fractures (H) (Anaes.) (Assist.) | $373.80 75% benefit $280.35 |
| 50200 | Core needle biopsy of aggressive or potentially malignant bone or soft tissue tumour, excluding aftercare, if the service has not already applied to the patient twice in the preceding 12 months for a service provided by the same provider (Anaes.) | $225.25 75% benefit $168.95 85% benefit $191.50 |
| 50201 | Incisional biopsy of aggressive or potentially malignant bone or soft tissue tumour, excluding aftercare, if the service has not already applied to the patient twice in the preceding 12 months for a service provided by the same provider (Anaes.) (Assist.) | $394.35 75% benefit $295.80 85% benefit $335.20 |
| 50203 | Intralesional or marginal excision of bone or soft tissue tumour (H) (Anaes.) (Assist.) | $495.80 75% benefit $371.85 |
| 50206 | Intralesional or marginal excision of bone tumour, with at least one of the following: (a) autograft; (b) allograft; (c) cementation (H) (Anaes.) (Assist.) | $732.50 75% benefit $549.40 |
| 50209 | Intralesional or marginal excision of bone tumour, with at least 2 of the following: (a) autograft; (b) allograft; (c) cementation (H) (Anaes.) (Assist.) | $901.55 75% benefit $676.20 |
| 50212 | Wide excision of malignant or aggressive bone or soft tissue tumour (or both), affecting a limb, trunk or scapula (H) (Anaes.) (Assist.) | $1,971.90 75% benefit $1,478.95 |
| 50215 | Wide excision of malignant or aggressive bone or soft tissue tumour (or both), with intercalary reconstruction of bone by prosthesis, allograft or autograft (H) (Anaes.) (Assist.) | $2,479.05 75% benefit $1,859.30 |
| 50218 | Wide excision of malignant or aggressive bone or soft tissue tumour (or both), with reconstruction, replacement or arthrodesis of adjacent joint, by prosthesis, allograft or autograft (H) (Anaes.) (Assist.) | $3,267.90 75% benefit $2,450.95 |
| 50221 | Wide excision of malignant or aggressive bone or soft tissue tumour (or both) of pelvis, sacrum or spine, without reconstruction (H) (Anaes.) (Assist.) | $3,042.30 75% benefit $2,281.75 |
| 50224 | Wide excision of malignant or aggressive bone or soft tissue tumour (or both) of pelvis, sacrum or spine, with reconstruction of bone defect, or one or more joints, by any technique (H) (Anaes.) (Assist.) | $3,380.40 75% benefit $2,535.30 |
| 50233 | Treatment of malignant or aggressive bone or soft tissue tumour (or both) by hindquarter or forequarter amputation (H) (Anaes.) (Assist.) | $2,591.70 75% benefit $1,943.80 |
| 50236 | Treatment of malignant or aggressive bone or soft tissue tumour (or both), by hip disarticulation, shoulder disarticulation or amputation through the proximal one third of the femur (H) (Anaes.) (Assist.) | $2,028.35 75% benefit $1,521.30 |
| 50239 | Treatment of malignant or aggressive bone or soft tissue tumour (or both), by amputation, other than a service associated with a service to which item 50233 or 50236 applies (H) (Anaes.) (Assist.) | $1,352.05 75% benefit $1,014.05 |
| 50242 | Revision of endoprosthetic replacement, if item 50218 or 50224, or an item that describes a service substantially similar to either of those items, applied to the initial procedure: (a) including any of the following: (i) rebushing; (ii) patella resurfacing; (iii) polyethylene exchange or similar; and (b) excluding removal of prosthetic from bone (H) (Anaes.) (Assist.) | $1,014.15 75% benefit $760.65 |
| 50245 | Revision of reconstructive procedure, if item 50215, 50218 or 50224, or an item that describes a service substantially similar to any of those items, applied to the initial procedure, by any technique or combination of techniques (H) (Anaes.) (Assist.) | $3,042.55 75% benefit $2,281.95 |
| 50300 | Gradual correction of joint deformity, with application of external fixator (H) (Anaes.) (Assist.) | $1,385.60 75% benefit $1,039.20 |
| 50303 | Limb lengthening, by gradual distraction, with application of external fixator or intra-medullary device (H) (Anaes.) (Assist.) | $1,891.80 75% benefit $1,418.85 |
| 50306 | Bipolar limb lengthening: (a) with application of external fixator or intra-medullary device; and (b) by any of the following: (i) gradual distraction; (ii) bone transport; (iii) fixator extension, to correct for an adjacent joint deformity (H) (Anaes.) (Assist.) | $2,953.75 75% benefit $2,215.35 |
| 50309 | Ring fixator or similar device, adjustment of, with or without insertion or removal of fixation pins, performed under general anaesthesia, other than a service to which item 50303 or 50306 applies (H) (Anaes.) (Assist.) | $365.15 75% benefit $273.90 |
| 50310 | Major adjustment of ring fixator or similar device, other than a service associated with a service to which item 50303, 50306, or 50309 applies | $52.25 75% benefit $39.20 85% benefit $44.45 |
| 50312 | Synovectomy or debridement, and microfracture, of ankle joint for osteochondral large defect greater than 1.5cm2, by arthroscopic or open means, including any of the following (if performed): (a) capsulotomy; (b) debridement or release of ligament; (c) debridement or release of tendon; other than a service associated with a service to which any of the following apply: (d) item 49703; (e) another item in this Schedule if the service described in the other item is for the purpose of performing an arthroscopic procedure of the ankle (H) (Anaes.) (Assist.) | $900.30 75% benefit $675.25 |
| 50321 | Release of soft tissue of talipes equinovarus, by open means (H) (Anaes.) (Assist.) | $1,111.70 75% benefit $833.80 |
| 50324 | Revision of release of soft tissue of talipes equinovarus, by open means (H) (Anaes.) (Assist.) | $1,584.90 75% benefit $1,188.70 |
| 50330 | Post‑operative manipulation, and change of plaster, of vertical, congenital talipes equinovarus or talus, other than a service to which item 50321 or 50324 applies (H) (Anaes.) | $273.70 75% benefit $205.30 |
| 50333 | Excision of tarsal coalition, with interposition of muscle, fat graft or similar graft, including any of the following (if performed): (a) capsulotomy; (b) synovectomy; (c) excision of osteophytes; —one coalition (H) (Anaes.) (Assist.) | $738.20 75% benefit $553.65 |
| 50335 | Treatment of vertical, congenital talus, by percutaneous or open stabilisation of talonavicular joint and Achilles’ tenotomy (H) (Anaes.) (Assist.) | $738.20 75% benefit $553.65 |
| 50336 | Talus, vertical, congenital, combined anterior and posterior reconstruction (H) (Anaes.) (Assist.) | $1,103.55 75% benefit $827.70 |
| 50339 | Tibialis anterior or tibialis posterior tendon transfer (split or whole) (H) (Anaes.) (Assist.) | $706.75 75% benefit $530.10 |
| 50345 | Hyperextension deformity of toe, release incorporating V‑Y plasty of skin, lengthening of extensor tendons and release of capsule contracture (H) (Anaes.) (Assist.) | $414.90 75% benefit $311.20 |
| 50348 | Knee, deformity of, post‑operative manipulation and change of plaster, performed under general anaesthesia (H) (Anaes.) | $273.70 75% benefit $205.30 |
| 50351 | Treatment of developmental dislocation of hip, by open reduction, including application of hip spica (H) (Anaes.) (Assist.) | $1,911.75 75% benefit $1,433.85 |
| 50352 | Treatment of developmental dysplasia of hip, including supervision of initial application of splint, harness or cast, other than a service to which another item in this Group applies (Anaes.) | $67.60 75% benefit $50.70 85% benefit $57.50 |
| 50354 | Resection and fixation of congenital pseudarthrosis of tibia (H) (Anaes.) (Assist.) | $1,568.00 75% benefit $1,176.00 |
| 50357 | Transfer of tendon of rectus femoris or medial or lateral hamstring (H) (Anaes.) (Assist.) | $672.10 75% benefit $504.10 |
| 50360 | Combined medial and lateral hamstring tendon transfer (H) (Anaes.) (Assist.) | $779.90 75% benefit $584.95 |
| 50369 | Unilateral posterior release of knee contracture, with multiple tendon lengthening or tenotomies, including release of joint capsule (if performed), other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of knee replacement (H) (Anaes.) (Assist.) | $779.90 75% benefit $584.95 |
| 50372 | Bilateral posterior release of knee contracture, with multiple tendon lengthening or tenotomies, including release of joint capsule (if performed), other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of knee replacement (H) (Anaes.) (Assist.) | $1,369.00 75% benefit $1,026.75 |
| 50375 | Unilateral medial release of hip contracture, with lengthening or division of the adductors and psoas, including division of obturator nerve (if performed) (H) (Anaes.) (Assist.) | $597.40 75% benefit $448.05 |
| 50378 | Bilateral medial release of hip contracture, with lengthening or division of adductors and psoas, including division of obturator nerve (if performed) (H) (Anaes.) (Assist.) | $1,045.50 75% benefit $784.15 |
| 50381 | Unilateral anterior release of hip contracture, with lengthening or division of hip flexors and psoas, including division of joint capsule (if performed) (H) (Anaes.) (Assist.) | $779.90 75% benefit $584.95 |
| 50384 | Bilateral anterior release of hip contracture, with lengthening or division of hip flexors and psoas, including division of joint capsule (if performed) (H) (Anaes.) (Assist.) | $1,369.00 75% benefit $1,026.75 |
| 50390 | Application of cast under general anaesthesia, for patient with perthes, cerebral palsy, or other neuromuscular conditions, affecting hips or knees (H) (Anaes.) | $273.70 75% benefit $205.30 |
| 50393 | Acetabular shelf procedure, other than a service associated with a service to which another item of this Schedule applies if the service in the other item is for the purpose of performing arthroplasty on the hip (H) (Anaes.) (Assist.) | $1,012.20 75% benefit $759.15 |
| 50394 | Multiple peri-acetabular osteotomy, including internal fixation (if performed) (H) (Anaes.) (Assist.) | $3,324.25 75% benefit $2,493.20 |
| 50395 | Osteotomy and distillation of greater trochanter, with internal fixation (H) (Anaes.) (Assist.) | $1,093.05 75% benefit $819.80 |
| 50396 | Amputation of congenital abnormalities or duplication of digits of the hand or foot, including any of the following (if performed): (a) splitting of phalanx or phalanges; (b) ligament reconstruction; (c) joint reconstruction (H) (Anaes.) (Assist.) | $556.10 75% benefit $417.10 |
| 50399 | Forearm, radial aplasia or dysplasia (radial club hand), centralisation or radialisation of (H) (Anaes.) (Assist.) | $1,103.55 75% benefit $827.70 |
| 50411 | Lower limb deficiency, treatment of congenital deficiency of the femur by resection of the distal femur and proximal tibia followed by knee fusion (H) (Anaes.) (Assist.) | $1,568.00 75% benefit $1,176.00 |
| 50414 | Lower limb deficiency, treatment of congenital deficiency of the femur by resection of the distal femur and proximal tibia followed by knee fusion and rotationplasty (H) (Anaes.) (Assist.) | $2,115.70 75% benefit $1,586.80 |
| 50417 | Lower limb deficiency, treatment of congenital deficiency of the tibia by reconstruction of the knee, involving transfer of fibula or tibia, and repair of quadriceps mechanism (H) (Anaes.) (Assist.) | $1,568.00 75% benefit $1,176.00 |
| 50420 | Patella, congenital dislocation of, reconstruction of the quadriceps (H) (Anaes.) (Assist.) | $1,294.25 75% benefit $970.70 |
| 50423 | Tibia, fibula or both, congenital deficiency of, transfer of the fibula to tibia, with internal fixation (H) (Anaes.) (Assist.) | $1,194.75 75% benefit $896.10 |
| 50426 | Removal of one or more lesions from bone, for osteochondroma occurring solitary or in association with hereditary multiple exotoses, with histological examination—one approach (H) (Anaes.) (Assist.) | $556.10 75% benefit $417.10 |
| 50428 | Percutaneous drilling of osteochondritis dessicans or other osteochondral lesion, for a patient: (a) with open growth plates; or (b) less than 18 years of age (H) (Anaes.) (Assist.) | $928.30 75% benefit $696.25 |
| 50450 | Unilateral single event multilevel surgery, for a patient less than 18 years of age with hemiplegic cerebral palsy, comprising 3 or more of the following: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; (b) correction of muscle imbalance by transfer of a tendon or tendons; (c) correction of femoral torsion by rotational osteotomy of the femur; (d) correction of tibial torsion by rotational osteotomy of the tibia; (e) correction of joint instability by varus derotation osteotomy of the femur, subtalar arthrodesis with synovectomy if performed, or os calcis lengthening; conjoint surgery, principal specialist surgeon, including fluoroscopy and aftercare (H) (Anaes.) (Assist.) | $1,468.50 75% benefit $1,101.40 |
| 50451 | Unilateral single event multilevel surgery, for a patient less than 18 years of age with hemiplegic cerebral palsy, comprising 3 or more of the following: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; (b) correction of muscle imbalance by transfer of a tendon or tendons; (c) correction of femoral torsion by rotational osteotomy of the femur; (d) correction of tibial torsion by rotational osteotomy of the tibia; (e) correction of joint instability by varus derotation osteotomy of the femur, subtalar arthrodesis with synovectomy if performed, or os calcis lengthening; conjoint surgery, conjoint specialist surgeon, including fluoroscopy and excluding aftercare (H) (Anaes.) (Assist.) | $1,468.50 75% benefit $1,101.40 |
| 50455 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, that comprises: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; conjoint surgery, principal specialist surgeon, including fluoroscopy and aftercare (H) (Anaes.) (Assist.) | $1,663.05 75% benefit $1,247.30 |
| 50456 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, that comprises: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; conjoint surgery, conjoint specialist surgeon, including fluoroscopy and excluding aftercare (H) (Anaes.) (Assist.) | $1,663.05 75% benefit $1,247.30 |
| 50460 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, that comprises bilateral soft tissue surgery and bilateral femoral osteotomies, with: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of torsional abnormality of the femur by rotational osteotomy and internal fixation; conjoint surgery, principal specialist surgeon, including fluoroscopy and aftercare (H) (Anaes.) (Assist.) | $2,482.85 75% benefit $1,862.15 |
| 50461 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, that comprises bilateral soft tissue surgery and bilateral femoral osteotomies, with: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of torsional abnormality of the femur by rotational osteotomy and internal fixation; conjoint surgery, conjoint specialist surgeon, including fluoroscopy and excluding aftercare (H) (Anaes.) (Assist.) | $2,482.85 75% benefit $1,862.15 |
| 50465 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, that comprises bilateral soft tissue surgery, bilateral femoral osteotomies and bilateral tibial osteotomies, with: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of abnormal torsion of the femur by rotational osteotomy with internal fixation; and (d) correction of abnormal torsion of the tibia by rotational osteotomy with internal fixation; conjoint surgery, principal specialist surgeon, including fluoroscopy and aftercare (H) (Anaes.) (Assist.) | $3,497.10 75% benefit $2,622.85 |
| 50466 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, that comprises bilateral soft tissue surgery, bilateral femoral osteotomies and bilateral tibial osteotomies, with: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of abnormal torsion of the femur by rotational osteotomy with internal fixation; and (d) correction of abnormal torsion of the tibia by rotational osteotomy with internal fixation; conjoint surgery, conjoint specialist surgeon, including fluoroscopy and excluding aftercare (H) (Anaes.) (Assist.) | $3,497.10 75% benefit $2,622.85 |
| 50470 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with cerebral palsy, that comprises bilateral soft tissue surgery, bilateral femoral osteotomies, bilateral tibial osteotomies and bilateral foot stabilisation, with: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of abnormal torsion of the femur by rotational osteotomy with internal fixation; and (d) correction of abnormal torsion of the tibia by rotational osteotomy with internal fixation; and (e) correction of bilateral pes valgus by os calcis lengthening or subtalar fusion; conjoint surgery, principal specialist surgeon, including fluoroscopy and aftercare (H) (Anaes.) (Assist.) | $4,435.20 75% benefit $3,326.40 |
| 50471 | Bilateral single event multilevel surgery, for a patient less than 18 years of age with cerebral palsy, that comprises bilateral soft tissue surgery, bilateral femoral osteotomies, bilateral tibial osteotomies and bilateral foot stabilisation, with: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of abnormal torsion of the femur by rotational osteotomy with internal fixation; and (d) correction of abnormal torsion of the tibia by rotational osteotomy with internal fixation; and (e) correction of bilateral pes valgus by os calcis lengthening or subtalar fusion; conjoint surgery, conjoint specialist surgeon, including fluoroscopy and excluding aftercare (H) (Anaes.) (Assist.) | $4,435.20 75% benefit $3,326.40 |
| 50475 | Single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, for the correction of crouch gait, including: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of flexion deformity at the knee by extension osteotomy of the distal femur including internal fixation; and (d) correction of patella alta and quadriceps insufficiency by patella tendon shortening or reconstruction; and (e) correction of tibial torsion by rotational osteotomy of the tibia with internal fixation; and (f) correction of foot instability by os calcis lengthening or subtalar fusion; conjoint surgery, principal specialist surgeon, including fluoroscopy and aftercare (H) (Anaes.) (Assist.) | $5,117.80 75% benefit $3,838.35 |
| 50476 | Single event multilevel surgery, for a patient less than 18 years of age with diplegic cerebral palsy, for the correction of crouch gait including: (a) lengthening of a contracted muscle tendon unit or units by tendon lengthening, muscle recession, fractional lengthening or intramuscular lengthening; and (b) correction of muscle imbalance by transfer of a tendon or tendons; and (c) correction of flexion deformity at the knee by extension osteotomy of the distal femur including internal fixation; and (d) correction of patella alta and quadriceps insufficiency by patella tendon shortening or reconstruction; and (e) correction of tibial torsion by rotational osteotomy of the tibia with internal fixation; and (f) correction of foot instability by os calcis lengthening or subtalar fusion; conjoint surgery, conjoint specialist surgeon, including fluoroscopy and excluding aftercare (H) (Anaes.) (Assist.) | $5,117.80 75% benefit $3,838.35 |
| 50508 | Treatment of fracture of distal end of radius or ulna (or both), by closed reduction, for a patient with open growth plates (Anaes.) | $473.00 75% benefit $354.75 85% benefit $402.05 |
| 50512 | Treatment of fracture of distal end of radius or ulna (or both), by open or closed reduction, with internal fixation, for a patient with open growth plates (H) (Anaes.) (Assist.) | $631.15 75% benefit $473.40 |
| 50524 | Radius or ulna, shaft of, with open growth plate, treatment of fracture of, in conjunction with dislocation of distal radio‑ulnar joint or proximal radio‑humeral joint (Galeazzi or Monteggia injury), by closed reduction (H) (Anaes.) (Assist.) | $489.00 75% benefit $366.75 |
| 50528 | Radius or ulna, shaft of, with open growth plate, treatment of fracture of, in conjunction with dislocation of distal radio‑ulnar joint or proximal radio‑humeral joint (Galeazzi or Monteggia injury), by reduction with or without internal fixation by open or percutaneous means (H) (Anaes.) (Assist.) | $788.75 75% benefit $591.60 |
| 50532 | Treatment of fracture of shafts of radius or ulna (or both), by closed reduction, for a patient with open growth plate (H) (Anaes.) | $686.30 75% benefit $514.75 |
| 50536 | Treatment of fracture of shafts of radius or ulna (or both), by open or closed reduction, with internal fixation, for a patient with open growth plate (H) (Anaes.) (Assist.) | $915.00 75% benefit $686.25 |
| 50540 | Olecranon, with open growth plate, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.) | $631.15 75% benefit $473.40 |
| 50544 | Radius, with open growth plate, treatment of fracture of head or neck of, by closed reduction of (H) (Anaes.) | $315.50 75% benefit $236.65 |
| 50548 | Radius, with open growth plate, treatment of fracture of head or neck of, by reduction with or without internal fixation by open or percutaneous means (H) (Anaes.) (Assist.) | $631.15 75% benefit $473.40 |
| 50552 | Humerus, proximal, with open growth plate, treatment of fracture of, by closed reduction (H) (Anaes.) | $544.30 75% benefit $408.25 |
| 50556 | Treatment of fracture of proximal humerus, by open or closed reduction, with internal fixation, for a patient with open growth plate (H) (Anaes.) (Assist.) | $725.55 75% benefit $544.20 |
| 50560 | Humerus, shaft of, with open growth plate, treatment of fracture of, by closed reduction (H) (Anaes.) | $567.85 75% benefit $425.90 |
| 50564 | Treatment of fracture of shaft of humerus, by open or closed reduction, with internal or external fixation, for a patient with open growth plate (H) (Anaes.) (Assist.) | $757.20 75% benefit $567.90 |
| 50568 | Humerus, with open growth plate, supracondylar or condylar, treatment of fracture of, by closed reduction (H) (Anaes.) | $662.65 75% benefit $497.00 |
| 50572 | Humerus, with open growth plate, supracondylar or condylar, treatment of fracture of, by reduction with or without internal fixation by open or percutaneous means (H) (Anaes.) (Assist.) | $883.50 75% benefit $662.65 |
| 50576 | Treatment of fracture of femur, by closed reduction or traction, including application of hip spica (if performed), for a patient with open growth plate (H) (Anaes.) (Assist.) | $725.55 75% benefit $544.20 |
| 50580 | Tibia, with open growth plate, plateau or condyles, medial or lateral, treatment of fracture of, by reduction with or without internal fixation by open or percutaneous means (H) (Anaes.) (Assist.) | $757.20 75% benefit $567.90 |
| 50584 | Tibia, distal, with open growth plate, treatment of fracture of, by reduction with or without internal fixation by open or percutaneous means (H) (Anaes.) (Assist.) | $725.55 75% benefit $544.20 |
| 50588 | Tibia and fibula, with open growth plates, treatment of fracture of, by internal fixation (H) (Anaes.) (Assist.) | $946.40 75% benefit $709.80 |
| 50592 | Treatment of fracture of shaft of femur, by open or closed reduction, with internal or external fixation, for a patient with open growth plate (H) (Anaes.) (Assist.) | $1,149.35 75% benefit $862.05 |
| 50596 | Treatment of fracture of shaft of tibia, by open or closed reduction, including casting, for a patient with open growth plate (H) (Anaes.) (Assist.) | $359.25 75% benefit $269.45 |
| 50600 | Scoliosis or kyphosis, in a child, manipulation of deformity and application of a localiser cast, under general anaesthesia, in a hospital (H) (Anaes.) (Assist.) | $520.35 75% benefit $390.30 |
| 50604 | Scoliosis or kyphosis, in a child or adolescent, spinal fusion for (without instrumentation) (H) (Anaes.) (Assist.) | $2,208.25 75% benefit $1,656.20 |
| 50608 | Scoliosis or kyphosis, in a child or adolescent, treatment by segmental instrumentation and fusion of the spine, other than a service to which any of items 51011 to 51171 apply (H) (Anaes.) (Assist.) | $4,101.70 75% benefit $3,076.30 |
| 50612 | Scoliosis or kyphosis, in a child or adolescent, with spinal deformity, treatment by segmental instrumentation, utilising separate anterior and posterior approaches, other than a service to which any of items 51011 to 51171 apply (H) (Anaes.) (Assist.) | $5,834.35 75% benefit $4,375.80 |
| 50616 | Scoliosis, in a child or adolescent, re-exploration for adjustment or removal of segmental instrumentation used for correction of spine deformity (H) (Anaes.) (Assist.) | $741.30 75% benefit $556.00 |
| 50620 | Scoliosis, in a child or adolescent, revision of failed scoliosis surgery, involving more than one of osteotomy, fusion, removal of instrumentation or instrumentation, other than a service to which any of items 51011 to 51171 apply (H) (Anaes.) (Assist.) | $4,101.70 75% benefit $3,076.30 |
| 50624 | Scoliosis, in a child or adolescent, anterior correction of, with fusion and segmental fixation (Dwyer, Zielke or similar) - not more than 4 levels (H) (Anaes.) (Assist.) | $4,101.70 75% benefit $3,076.30 |
| 50628 | Scoliosis, in a child or adolescent, anterior correction of, with fusion and segmental fixation (Dwyer, Zielke or similar)—more than 4 levels (H) (Anaes.) (Assist.) | $5,066.80 75% benefit $3,800.10 |
| 50632 | Scoliosis or kyphosis, in a child or adolescent, requiring segmental instrumentation and fusion of the spine down to and including the pelvis or sacrum, other than a service to which any of items 51011 to 51171 apply (H) (Anaes.) (Assist.) | $4,259.45 75% benefit $3,194.60 |
| 50636 | Scoliosis, in a child or adolescent, requiring anterior decompression of the spinal cord with vertebral resection and instrumentation in the presence of spinal cord involvement, other than a service to which any of items 51011 to 51171 apply (H) (Anaes.) (Assist.) | $4,732.70 75% benefit $3,549.55 |
| 50640 | Scoliosis, in a child or adolescent, congenital, resection and fusion of abnormal vertebra via an anterior or posterior approach, other than a service to which any of items 51011 to 51171 apply (H) (Anaes.) (Assist.) | $2,616.15 75% benefit $1,962.15 |
| 50644 | Spine, bone graft to, for a child or adolescent, associated with surgery for correction of scoliosis or kyphosis or both (H) (Anaes.) (Assist.) | $2,524.15 75% benefit $1,893.15 |
| 50654 | Examination or closed reduction (or both) of hip under anaesthesia for a patient under the age of 18 years, including any of the following (if performed): (a) diagnostic injection; (b) arthrography; (c) application or reapplication of a hip spica (H) (Anaes.) (Assist.) | $594.40 75% benefit $445.80 |
| 50950 | Unresectable primary malignant tumour of the liver, destruction of, by percutaneous ablation (including any associated imaging services), other than a service associated with a service to which item 30419 or 50952 applies (H) (Anaes.) | $978.00 75% benefit $733.50 |
| 50952 | Unresectable primary malignant tumour of the liver, destruction of, by open or laparoscopic ablation (including any associated imaging services), if a multi‑disciplinary team has assessed that percutaneous ablation cannot be performed or is not practical because of one or more of the following clinical circumstances: (a) percutaneous access cannot be achieved; (b) vital organs or tissues are at risk of damage from the percutaneous ablation procedure; (c) resection of one part of the liver is possible, however there is at least one primary liver tumour in an unresectable portion of the liver that is suitable for ablation; other than a service associated with a service to which item 30419 or 50950 applies (H) (Anaes.) | $978.00 75% benefit $733.50 |
| 51011 | Direct spinal decompression or exposure (via a partial or a total laminectomy or a partial vertebrectomy), or a posterior spinal release, one motion segment, not being a service associated with a service to which item 51012, 51013, 51014 or 51015 applies (H) (Anaes.) (Assist.) | $1,718.15 75% benefit $1,288.65 |
| 51012 | Direct spinal decompression or exposure (via a partial or a total laminectomy or a partial vertebrectomy), or a posterior spinal release, 2 motion segments, not being a service associated with a service to which item 51011, 51013, 51014 or 51015 applies (H) (Anaes.) (Assist.) | $2,290.65 75% benefit $1,718.00 |
| 51013 | Direct spinal decompression or exposure (via a partial or a total laminectomy or a partial vertebrectomy), or a posterior spinal release, 3 motion segments, not being a service associated with a service to which item 51011, 51012, 51014 or 51015 applies (H) (Anaes.) (Assist.) | $2,863.30 75% benefit $2,147.50 |
| 51014 | Direct spinal decompression or exposure (via a partial or a total laminectomy or a partial vertebrectomy), or a posterior spinal release, 4 motion segments, not being a service associated with a service to which item 51011, 51012, 51013 or 51015 applies (H) (Anaes.) (Assist.) | $3,435.95 75% benefit $2,577.00 |
| 51015 | Direct spinal decompression or exposure (via a partial or a total laminectomy or a partial vertebrectomy), or a posterior spinal release, more than 4 motion segments, not being a service associated with a service to which item 51011, 51012, 51013 or 51014 applies (H) (Anaes.) (Assist.) | $4,008.65 75% benefit $3,006.50 |
| 51020 | Simple fixation of part of one vertebra (not motion segment) including pars interarticularis, spinous process or pedicle, or simple interspinous wiring between 2 adjacent vertebral levels, not being a service associated with: (a) interspinous dynamic stabilisation devices; or (b) a service to which item 51021, 51022, 51023, 51024, 51025 or 51026 applies (Anaes.) (Assist.) | $916.20 75% benefit $687.15 |
| 51021 | Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, one motion segment, excluding vertebral body tethering for the treatment of scoliosis and not being a service associated with a service to which item 51020, 51022, 51023, 51024, 51025 or 51026 applies (H) (Anaes.) (Assist.) | $1,533.50 75% benefit $1,150.15 |
| 51022 | Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 2 motion segments, excluding vertebral body tethering for the treatment of scoliosis and not being a service associated with a service to which item 51020, 51021, 51023, 51024, 51025 or 51026 applies (H) (Anaes.) (Assist.) | $1,907.60 75% benefit $1,430.70 |
| 51023 | Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 3 or 4 motion segments, excluding vertebral body tethering for the treatment of scoliosis and not being a service associated with a service to which item 51020, 51021, 51022, 51024, 51025 or 51026 applies (H) (Anaes.) (Assist.) | $2,270.10 75% benefit $1,702.60 |
| 51024 | Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 5 or 6 motion segments, excluding vertebral body tethering for the treatment of scoliosis and not being a service associated with a service to which item 51020, 51021, 51022, 51023, 51025 or 51026 applies (H) (Anaes.) (Assist.) | $2,620.70 75% benefit $1,965.55 |
| 51025 | Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, 7 to 12 motion segments, excluding vertebral body tethering for the treatment of scoliosis and not being a service associated with a service to which item 51020, 51021, 51022, 51023, 51024 or 51026 applies (H) (Anaes.) (Assist.) | $3,063.05 75% benefit $2,297.30 |
| 51026 | Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, more than 12 motion segments, excluding vertebral body tethering for the treatment of scoliosis and not being a service associated with a service to which item 51020, 51021, 51022, 51023, 51024 or 51025 applies (H) (Anaes.) (Assist.) | $3,353.65 75% benefit $2,515.25 |
| 51031 | Spine, posterior and/or posterolateral bone graft to, one motion segment, not being a service associated with a service to which item 51032, 51033, 51034, 51035 or 51036 applies (Anaes.) (Assist.) | $1,126.80 75% benefit $845.10 |
| 51032 | Spine, posterior and/or posterolateral bone graft to, 2 motion segments, not being a service associated with a service to which item 51031, 51033, 51034, 51035 or 51036 applies (Anaes.) (Assist.) | $1,352.20 75% benefit $1,014.15 |
| 51033 | Spine, posterior and/or posterolateral bone graft to, 3 motion segments, not being a service associated with a service to which item 51031, 51032, 51034, 51035 or 51036 applies (Anaes.) (Assist.) | $1,577.65 75% benefit $1,183.25 |
| 51034 | Spine, posterior and/or posterolateral bone graft to, 4 to 7 motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51035 or 51036 applies (Anaes.) (Assist.) | $1,690.25 75% benefit $1,267.70 |
| 51035 | Spine, posterior and/or posterolateral bone graft to, 8 to 11 motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51034 or 51036 applies (Anaes.) (Assist.) | $1,803.00 75% benefit $1,352.25 |
| 51036 | Spine, posterior and/or posterolateral bone graft to, 12 or more motion segments, not being a service associated with a service to which item 51031, 51032, 51033, 51034 or 51035 applies (Anaes.) (Assist.) | $1,915.60 75% benefit $1,436.70 |
| 51041 | Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), one motion segment, not being a service associated with a service to which item 51042, 51043, 51044 or 51045 applies (Anaes.) (Assist.) | $1,295.85 75% benefit $971.90 |
| 51042 | Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 2 motion segments, not being a service associated with a service to which item 51041, 51043, 51044 or 51045 applies (Anaes.) (Assist.) | $1,814.30 75% benefit $1,360.75 |
| 51043 | Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 3 motion segments, not being a service associated with a service to which item 51041, 51042, 51044 or 51045 applies (Anaes.) (Assist.) | $2,267.85 75% benefit $1,700.90 |
| 51044 | Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 4 motion segments, not being a service associated with a service to which item 51041, 51042, 51043 or 51045 applies (Anaes.) (Assist.) | $2,462.20 75% benefit $1,846.65 |
| 51045 | Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), 5 or more motion segments, not being a service associated with a service to which item 51041, 51042, 51043 or 51044 applies (Anaes.) (Assist.) | $2,591.75 75% benefit $1,943.85 |
| 51051 | Pedicle subtraction osteotomy, one vertebra, not being a service associated with a service to which item 51052, 51053, 51054, 51055, 51056, 51057, 51058 or 51059 applies (Anaes.) (Assist.) | $2,214.25 75% benefit $1,660.70 |
| 51052 | Pedicle subtraction osteotomy, 2 vertebrae, not being a service associated with a service to which item 51051, 51053, 51054, 51055, 51056, 51057, 51058 or 51059 applies (Anaes.) (Assist.) | $2,693.05 75% benefit $2,019.80 |
| 51053 | Vertebral column resection osteotomy performed through single posterior approach, one vertebra, not being a service associated with a service to which item 51051, 51052, 51054, 51055, 51056, 51057, 51058 or 51059 applies (Anaes.) (Assist.) | $3,064.00 75% benefit $2,298.00 |
| 51054 | Vertebral body, piecemeal or subtotal excision of (where piecemeal or subtotal excision is defined as removal of more than 50% of the vertebral body), one vertebra, not being a service associated with: (a) anterior column fusion when at the same motion segment; or (b) a service to which item 51051, 51052, 51053, 51055, 51056, 51057, 51058 or 51059 applies (Anaes.) (Assist.) | $1,633.70 75% benefit $1,225.30 |
| 51055 | Vertebral body, piecemeal or subtotal excision of (where piecemeal or subtotal excision is defined as removal of more than 50% of the vertebral body), 2 vertebrae, not being a service associated with: (a) anterior column fusion when at the same motion segment; or (b) a service to which item 51051, 51052, 51053, 51054, 51056, 51057, 51058 or 51059 applies (Anaes.) (Assist.) | $2,450.65 75% benefit $1,838.00 |
| 51056 | Vertebral body, piecemeal or subtotal excision of (where piecemeal or subtotal excision is defined as removal of more than 50% of the vertebral body), 3 or more vertebrae, not being a service associated with: (a) anterior column fusion when at the same motion segment; or (b) a service to which item 51051, 51052, 51053, 51054, 51055, 51057, 51058 or 51059 applies (Anaes.) (Assist.) | $2,859.00 75% benefit $2,144.25 |
| 51057 | Vertebral body, en bloc excision of (complete spondylectomy), one vertebra, not being a service associated with: (a) anterior column fusion when at the same motion segment; or (b) a service to which item 51051, 51052, 51053, 51054, 51055, 51056, 51058 or 51059 applies (Anaes.) (Assist.) | $2,872.55 75% benefit $2,154.45 |
| 51058 | Vertebral body, en bloc excision of (complete spondylectomy), 2 vertebrae, not being a service associated with: (a) anterior column fusion when at the same motion segment; or (b) a service to which item 51051, 51052, 51053, 51054, 51055, 51056, 51057 or 51059 applies (Anaes.) (Assist.) | $3,232.20 75% benefit $2,424.15 |
| 51059 | Vertebral body, en bloc excision of (complete spondylectomy), 3 or more vertebrae, not being a service associated with: (a) anterior column fusion when at the same motion segment; or (b) a service to which item 51051, 51052, 51053, 51054, 51055, 51056, 51057 or 51058 applies (Anaes.) (Assist.) | $3,949.85 75% benefit $2,962.40 |
| 51061 | Spinal fusion, anterior and posterior, including spinal instrumentation at one motion segment, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51062, 51063, 51064, 51065 or 51066 applies (Anaes.) (Assist.) | $3,392.80 75% benefit $2,544.60 |
| 51062 | Spinal fusion, anterior and posterior, including spinal instrumentation at 2 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51063, 51064, 51065 or 51066 applies (Anaes.) (Assist.) | $4,397.80 75% benefit $3,298.35 |
| 51063 | Spinal fusion, anterior and posterior, including spinal instrumentation at 3 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51064, 51065 or 51066 applies (Anaes.) (Assist.) | $5,326.60 75% benefit $3,994.95 |
| 51064 | Spinal fusion, anterior and posterior, including spinal instrumentation at 4 to 7 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51063, 51065 or 51066 applies (Anaes.) (Assist.) | $5,928.00 75% benefit $4,446.00 |
| 51065 | Spinal fusion, anterior and posterior, including spinal instrumentation at 8 to 11 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51063, 51064 or 51066 applies (Anaes.) (Assist.) | $6,556.45 75% benefit $4,917.35 |
| 51066 | Spinal fusion, anterior and posterior, including spinal instrumentation at 12 or more motion segments, posterior and/or posterolateral bone graft, and anterior column fusion not being a service associated with a service to which item 51061, 51062, 51063, 51064 or 51065 applies (Anaes.) (Assist.) | $6,903.20 75% benefit $5,177.40 |
| 51071 | Removal of intradural lesion, or primary extradural tumour or lesion, where the pathology is confirmed by histology - not including removal of synovial or juxtafacet cyst and not being a service associated with a service to which item 51072 or 51073 applies (H) (Anaes.) (Assist.) | $2,992.25 75% benefit $2,244.20 |
| 51072 | Craniocervical junction lesion, transoral approach for, not being a service associated with a service to which item 51071 or 51073 applies (Anaes.) (Assist.) | $3,111.95 75% benefit $2,334.00 |
| 51073 | Removal of intramedullary tumour or arteriovenous malformation, not being a service associated with a service to which item 51071 or 51072 applies (Anaes.) (Assist.) | $3,949.85 75% benefit $2,962.40 |
| 51102 | Thoracoplasty in combination with thoracic scoliosis correction—3 or more ribs (Anaes.) (Assist.) | $1,416.50 75% benefit $1,062.40 |
| 51103 | Odontoid screw fixation (Anaes.) (Assist.) | $2,489.25 75% benefit $1,866.95 |
| 51110 | Spine, treatment of fracture, dislocation or fracture‑dislocation, with immobilisation by calipers or halo, not including application of skull tongs or calipers as part of operative positioning (H) (Anaes.) | $901.55 75% benefit $676.20 |
| 51111 | Skull calipers or halo, insertion of, as an independent procedure (Anaes.) | $383.20 75% benefit $287.40 |
| 51112 | Plaster jacket, application of, as an independent procedure (Anaes.) | $259.10 75% benefit $194.35 85% benefit $220.25 |
| 51113 | Halo, application of, in addition to spinal fusion for scoliosis, or other conditions (Anaes.) | $287.35 75% benefit $215.55 |
| 51114 | Halo thoracic orthosis—application of both halo and thoracic jacket (Anaes.) | $507.25 75% benefit $380.45 |
| 51115 | Halo‑femoral traction, as an independent procedure (H) (Anaes.) | $507.25 75% benefit $380.45 |
| 51120 | Bone graft, harvesting of autogenous graft, via separate incision or via subcutaneous approach, in conjunction with spinal fusion, other than for the purposes of bone graft obtained from the cervical, thoracic, lumbar or sacral spine (Anaes.) | $281.85 75% benefit $211.40 |
| 51130 | Lumbar artificial intervertebral total disc replacement, at one motion segment only, including removal of disc and marginal osteophytes: (a) for a patient who: (i) has not had prior spinal fusion surgery at the same lumbar level; and (ii) does not have vertebral osteoporosis; and (iii) has failed conservative therapy; and (b) not being a service associated with a service to which item 51011, 51012, 51013, 51014 or 51015 applies (Anaes.) (Assist.) | $2,146.80 75% benefit $1,610.10 |
| 51131 | Cervical artificial intervertebral total disc replacement, at one motion segment only, including removal of disc and marginal osteophytes, for a patient who: (a) has not had prior spinal surgery at the same cervical level; and (b) is skeletally mature; and (c) has symptomatic degenerative disc disease with radiculopathy; and (d) does not have vertebral osteoporosis; and (e) has failed conservative therapy (Anaes.) (Assist.) | $1,295.85 75% benefit $971.90 |
| 51140 | Previous spinal fusion, re-exploration for, involving adjustment or removal of instrumentation up to 3 motion segments, not being a service associated with a service to which item 51141 applies (Anaes.) (Assist.) | $529.55 75% benefit $397.20 |
| 51141 | Previous spinal fusion, re-exploration for, involving adjustment or removal of instrumentation more than 3 motion segments, not being a service associated with a service to which item 51140 applies (Anaes.) (Assist.) | $979.80 75% benefit $734.85 |
| 51145 | Wound debridement or excision for post operative infection or haematoma following spinal surgery (Anaes.) (Assist.) | $529.55 75% benefit $397.20 |
| 51150 | Coccyx, excision of (Anaes.) (Assist.) | $533.15 75% benefit $399.90 |
| 51160 | Anterior exposure of thoracic or lumbar spine, one motion segment, not being a service to which item 51165 applies (Anaes.) (Assist.) | $1,376.45 75% benefit $1,032.35 |
| 51165 | Anterior exposure of thoracic or lumbar spine, more than one motion segment, excluding vertebral body tethering for the treatment of scoliosis and not being a service to which item 51160 applies (H) (Anaes.) (Assist.) | $1,735.55 75% benefit $1,301.70 |
| 51170 | Syringomyelia or hydromyelia, craniotomy for, with or without duraplasty, intradural dissection, plugging of obex or local cerebrospinal fluid shunt (Anaes.) (Assist.) | $2,614.75 75% benefit $1,961.10 |
| 51171 | Syringomyelia or hydromyelia, treatment by direct cerebrospinal fluid shunt (for example, syringosubarachnoid shunt, syringopleural shunt or syringoperitoneal shunt) (Anaes.) (Assist.) | $1,098.05 75% benefit $823.55 |
T9 Assistance At Operations
7 items
| Item | Description | Fee and benefits |
|---|---|---|
| 51300 | Assistance at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee does not exceed $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee does not exceed $668.25 | $103.25 75% benefit $77.45 85% benefit $87.80 |
| 51303 | Assistance at any operation mentioned in an item in Group T8 that includes “(Assist.)” for which the fee exceeds $668.25 or at a series or combination of operations mentioned in an item in Group T8 that include “(Assist.)” for which the aggregate fee exceeds $668.25 Derived fee: one fifth of the established fee for the operation or combination of operations | Derived |
| 51306 | Assistance at a birth involving Caesarean section (H) | $149.25 75% benefit $111.95 |
| 51309 | Assistance at a series or combination of operations that include “(Assist.)” and assistance at a birth involving Caesarean section (H) Derived fee: one fifth of the established fee for the operation or combination of operations (the fee for item 16520 being the Schedule fee for the Caesarean section component in the calculation of the established fee) | Derived |
| 51312 | Assistance at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615 and 16627 (H) Derived fee: One fifth of the established fee for the procedure or combination of procedures | Derived |
| 51315 | Assistance at cataract and intraocular lens surgery covered by item 42698, 42701, 42702, 42704 or 42707, when performed in association with services covered by item 42551 to 42569, 42653, 42656, 42725, 42746, 42749, 42752, 42776 or 42779 (H) | $326.05 75% benefit $244.55 |
| 51318 | Assistance at cataract and intraocular lens surgery, if patient has: (a) total loss of vision, including no potential for central vision, in the fellow eye; or (b) one of the following in the fellow eye: (i) vitreous loss; (ii) rupture of posterior capsule; (iii) loss of nuclear material into the vitreous; (iv) intraocular haemorrhage; (v) intraocular infection (endophthalmitis); (vi) cystoid macular oedema; (vii) corneal decompensation; (viii) retinal detachment; or (c) pseudo exfoliation, subluxed lens, iridodonesis, phacodonesis, retinal detachment, corneal scarring, pre‑existing uveitis, bound down miosed pupil, nanophthalmos, spherophakia, Marfan’s syndrome, homocysteinuria or previous blunt trauma causing intraocular damage (H) | $215.20 75% benefit $161.40 |
Check the item before you claim.
An eligibility check tests the patient and each MBS item against Medicare’s rules, so a ‘no’ comes back with the reason before the claim goes in.