MBS Group T8 · Subgroup 13
Plastic And Reconstructive Surgery: MBS items and fees.
All 285 items in subgroup 13 of Group T8, surgical operations, 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.
T8.13 Plastic And Reconstructive Surgery
285 items
| Item | Description | Fee and benefits |
|---|---|---|
| 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 |
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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.