Billing Codes
Department of Veterans' Affairs — Updated Annually

DVA Medical Fee Schedule

Compare DVA fees against MBS rates for 5,800+ items — essential for practices treating DVA card holders

Side-by-side MBS ↔ DVA comparison →

Total Items
5886
DVA fee schedule items
Showing 3051–3100 of 5886 Pg 62/118
Item No. Description MBS Fee DVA Fee
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.)
$1101.10 $1073.20 ▼
Item Number
45062
Fee Comparison
MBS
$1101.10
→
DVA
$1073.20
-$27.90 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1682.30
Full Description
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.)
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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 $331.70 ▼
Item Number
45200
Fee Comparison
MBS
$340.30
→
DVA
$331.70
-$8.60 (-3%)
Additional DVA Rates
RMFS In-Hosp
$400.20
RMFS Out-Hosp
$464.40
Full Description
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.)
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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 $482.85 ▼
Item Number
45201
Fee Comparison
MBS
$495.40
→
DVA
$482.85
-$12.55 (-3%)
Additional DVA Rates
RMFS In-Hosp
$684.60
RMFS Out-Hosp
$676.00
Full Description
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.)
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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 $482.85 ▼
Item Number
45202
Fee Comparison
MBS
$495.40
→
DVA
$482.85
-$12.55 (-3%)
Additional DVA Rates
RMFS In-Hosp
$678.05
RMFS Out-Hosp
$676.00
Full Description
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.)
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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 $473.65 ▼
Item Number
45203
Fee Comparison
MBS
$485.95
→
DVA
$473.65
-$12.30 (-3%)
Additional DVA Rates
RMFS In-Hosp
$686.55
RMFS Out-Hosp
$663.15
Full Description
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.)
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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 $447.50 ▼
Item Number
45206
Fee Comparison
MBS
$459.15
→
DVA
$447.50
-$11.65 (-3%)
Additional DVA Rates
RMFS In-Hosp
$600.70
RMFS Out-Hosp
$626.50
Full Description
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.)
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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 $447.50 ▼
Item Number
45207
Fee Comparison
MBS
$459.15
→
DVA
$447.50
-$11.65 (-3%)
Additional DVA Rates
RMFS In-Hosp
$586.55
RMFS Out-Hosp
$626.50
Full Description
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.)
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45209
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), first stage of a multistage procedure (H) (Anaes.) (Assist.)
$567.05 $552.70 ▼
Item Number
45209
Fee Comparison
MBS
$567.05
→
DVA
$552.70
-$14.35 (-3%)
Additional DVA Rates
RMFS In-Hosp
$768.35
Full Description
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), first stage of a multistage procedure (H) (Anaes.) (Assist.)
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45212
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), subsequent stage of a multistage procedure (H) (Anaes.) (Assist.)
$281.40 $274.25 ▼
Item Number
45212
Fee Comparison
MBS
$281.40
→
DVA
$274.25
-$7.15 (-3%)
Additional DVA Rates
RMFS In-Hosp
$387.30
Full Description
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), subsequent stage of a multistage procedure (H) (Anaes.) (Assist.)
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45221
DIRECT FLAP REPAIR, small (cross finger or similar), first stage (Anaes.)
$313.15 $305.20 ▼
Item Number
45221
Fee Comparison
MBS
$313.15
→
DVA
$305.20
-$7.95 (-3%)
Additional DVA Rates
RMFS In-Hosp
$434.80
RMFS Out-Hosp
$427.30
Full Description
DIRECT FLAP REPAIR, small (cross finger or similar), first stage (Anaes.)
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45224
DIRECT FLAP REPAIR, small (cross finger or similar), second stage (Anaes.)
$140.70 $137.15 ▼
Item Number
45224
Fee Comparison
MBS
$140.70
→
DVA
$137.15
-$3.55 (-3%)
Additional DVA Rates
RMFS In-Hosp
$240.60
RMFS Out-Hosp
$192.05
Full Description
DIRECT FLAP REPAIR, small (cross finger or similar), second stage (Anaes.)
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45227
Indirect flap or tubed pedicle, formation of (H) (Anaes.) (Assist.)
$533.15 $519.65 ▼
Item Number
45227
Fee Comparison
MBS
$533.15
→
DVA
$519.65
-$13.50 (-3%)
Additional DVA Rates
RMFS In-Hosp
$741.00
Full Description
Indirect flap or tubed pedicle, formation of (H) (Anaes.) (Assist.)
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45230
DIRECT OR INDIRECT FLAP OR TUBED PEDICLE, delay of (Anaes.)
$266.60 $259.85 ▼
Item Number
45230
Fee Comparison
MBS
$266.60
→
DVA
$259.85
-$6.75 (-3%)
Additional DVA Rates
RMFS In-Hosp
$315.20
RMFS Out-Hosp
$363.80
Full Description
DIRECT OR INDIRECT FLAP OR TUBED PEDICLE, delay of (Anaes.)
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45233
Indirect flap or tubed pedicle, preparation of intermediate or final site and attachment to the site (H) (Anaes.) (Assist.)
$567.05 $552.70 ▼
Item Number
45233
Fee Comparison
MBS
$567.05
→
DVA
$552.70
-$14.35 (-3%)
Additional DVA Rates
RMFS In-Hosp
$773.80
Full Description
Indirect flap or tubed pedicle, preparation of intermediate or final site and attachment to the site (H) (Anaes.) (Assist.)
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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 $305.20 ▼
Item Number
45239
Fee Comparison
MBS
$313.15
→
DVA
$305.20
-$7.95 (-3%)
Additional DVA Rates
RMFS In-Hosp
$434.80
RMFS Out-Hosp
$427.30
Full Description
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.)
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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 $331.70 ▼
Item Number
45440
Fee Comparison
MBS
$340.30
→
DVA
$331.70
-$8.60 (-3%)
Additional DVA Rates
RMFS In-Hosp
$464.40
RMFS Out-Hosp
$464.40
Full Description
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.)
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45443
Split 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 $684.20 ▼
Item Number
45443
Fee Comparison
MBS
$702.00
→
DVA
$684.20
-$17.80 (-3%)
Additional DVA Rates
RMFS In-Hosp
$957.90
RMFS Out-Hosp
$957.90
Full Description
Split 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.)
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45451
Full thickness skin graft to one defect, with an average diameter of 5 mm or more (Anaes.) (Assist.)
$567.05 $552.70 ▼
Item Number
45451
Fee Comparison
MBS
$567.05
→
DVA
$552.70
-$14.35 (-3%)
Additional DVA Rates
RMFS In-Hosp
$785.15
RMFS Out-Hosp
$773.80
Full Description
Full thickness skin graft to one defect, with an average diameter of 5 mm or more (Anaes.) (Assist.)
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45496
FLAP, free tissue transfer using microvascular techniques - revision of, by open operation (Anaes.)
$498.05 $485.45 ▼
Item Number
45496
Fee Comparison
MBS
$498.05
→
DVA
$485.45
-$12.60 (-3%)
Additional DVA Rates
RMFS In-Hosp
$690.80
Full Description
FLAP, free tissue transfer using microvascular techniques - revision of, by open operation (Anaes.)
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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 $369.80 ▼
Item Number
45497
Fee Comparison
MBS
$379.40
→
DVA
$369.80
-$9.60 (-3%)
Additional DVA Rates
RMFS In-Hosp
$526.80
Full Description
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.)
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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.)
$1304.95 $1271.90 ▼
Item Number
45500
Fee Comparison
MBS
$1304.95
→
DVA
$1271.90
-$33.05 (-3%)
Additional DVA Rates
RMFS In-Hosp
$2078.55
Full Description
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.)
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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.)
$2124.10 $2070.25 ▼
Item Number
45501
Fee Comparison
MBS
$2124.10
→
DVA
$2070.25
-$53.85 (-3%)
Additional DVA Rates
RMFS In-Hosp
$3144.30
Full Description
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.)
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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.)
$3186.20 $3105.45 ▼
Item Number
45502
Fee Comparison
MBS
$3186.20
→
DVA
$3105.45
-$80.75 (-3%)
Additional DVA Rates
RMFS In-Hosp
$4424.75
Full Description
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.)
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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.)
$2430.10 $2368.50 ▼
Item Number
45503
Fee Comparison
MBS
$2430.10
→
DVA
$2368.50
-$61.60 (-3%)
Additional DVA Rates
RMFS In-Hosp
$3372.90
Full Description
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.)
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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.)
$2124.10 $2070.25 ▼
Item Number
45504
Fee Comparison
MBS
$2124.10
→
DVA
$2070.25
-$53.85 (-3%)
Additional DVA Rates
RMFS In-Hosp
$3809.10
Full Description
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.)
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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.)
$3216.75 $3135.25 ▼
Item Number
45505
Fee Comparison
MBS
$3216.75
→
DVA
$3135.25
-$81.50 (-3%)
Additional DVA Rates
RMFS In-Hosp
$4467.20
Full Description
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.)
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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.)
$1957.50 $1907.90 ▼
Item Number
45507
Fee Comparison
MBS
$1957.50
→
DVA
$1907.90
-$49.60 (-3%)
Additional DVA Rates
RMFS In-Hosp
$2671.20
Full Description
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.)
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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 $256.50 ▼
Item Number
45510
Fee Comparison
MBS
$263.15
→
DVA
$256.50
-$6.65 (-3%)
Additional DVA Rates
RMFS In-Hosp
$359.10
RMFS Out-Hosp
$359.10
Full Description
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.)
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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 $344.95 ▼
Item Number
45512
Fee Comparison
MBS
$353.90
→
DVA
$344.95
-$8.95 (-3%)
Additional DVA Rates
RMFS In-Hosp
$482.05
RMFS Out-Hosp
$482.95
Full Description
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.)
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45515
Scar, 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 non rebatable procedure); and(d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (Anaes.)
$223.25 $217.60 ▼
Item Number
45515
Fee Comparison
MBS
$223.25
→
DVA
$217.60
-$5.65 (-3%)
Additional DVA Rates
RMFS In-Hosp
$310.65
RMFS Out-Hosp
$304.65
Full Description
Scar, 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 non rebatable procedure); and(d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (Anaes.)
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45518
Scar, 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 non‑rebatable procedure); and (d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (H) (Anaes.)
$270.15 $263.30 ▼
Item Number
45518
Fee Comparison
MBS
$270.15
→
DVA
$263.30
-$6.85 (-3%)
Additional DVA Rates
RMFS In-Hosp
$368.70
Full Description
Scar, 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 non‑rebatable procedure); and (d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (H) (Anaes.)
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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.)
$1077.70 $1050.40 ▼
Item Number
45520
Fee Comparison
MBS
$1077.70
→
DVA
$1050.40
-$27.30 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1495.85
Full Description
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.)
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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 $736.95 ▼
Item Number
45522
Fee Comparison
MBS
$756.10
→
DVA
$736.95
-$19.15 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1358.50
Full Description
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.)
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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.)
$1616.70 $1575.75 ▼
Item Number
45523
Fee Comparison
MBS
$1616.70
→
DVA
$1575.75
-$40.95 (-3%)
Additional DVA Rates
RMFS In-Hosp
$2243.90
Full Description
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.)
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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 $865.20 ▼
Item Number
45524
Fee Comparison
MBS
$887.70
→
DVA
$865.20
-$22.50 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1232.20
Full Description
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.)
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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.)
$1282.15 $1249.65 ▼
Item Number
45527
Fee Comparison
MBS
$1282.15
→
DVA
$1249.65
-$32.50 (-3%)
Additional DVA Rates
RMFS In-Hosp
$2234.50
Full Description
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.)
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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.)
$1331.35 $1297.60 ▼
Item Number
45528
Fee Comparison
MBS
$1331.35
→
DVA
$1297.60
-$33.75 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1847.70
Full Description
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.)
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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.)
$2243.65 $2186.80 ▼
Item Number
45529
Fee Comparison
MBS
$2243.65
→
DVA
$2186.80
-$56.85 (-3%)
Additional DVA Rates
RMFS In-Hosp
$3061.70
Full Description
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.)
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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.)
$1315.85 $1282.50 ▼
Item Number
45530
Fee Comparison
MBS
$1315.85
→
DVA
$1282.50
-$33.35 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1826.50
Full Description
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.)
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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.)
$2302.75 $2244.40 ▼
Item Number
45531
Fee Comparison
MBS
$2302.75
→
DVA
$2244.40
-$58.35 (-3%)
Additional DVA Rates
RMFS In-Hosp
$3142.30
Full Description
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.)
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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 $316.00 ▼
Item Number
45532
Fee Comparison
MBS
$324.20
→
DVA
$316.00
-$8.20 (-3%)
Additional DVA Rates
RMFS In-Hosp
$442.50
Full Description
Revision of post-mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
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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 $736.95 ▼
Item Number
45534
Fee Comparison
MBS
$756.10
→
DVA
$736.95
-$19.15 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1031.90
Full Description
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.)
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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.)
$1323.35 $1289.80 ▼
Item Number
45535
Fee Comparison
MBS
$1323.35
→
DVA
$1289.80
-$33.55 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1805.85
Full Description
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.)
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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 $917.60 ▼
Item Number
45537
Fee Comparison
MBS
$941.45
→
DVA
$917.60
-$23.85 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1284.75
Full Description
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.)
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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.)
$1077.20 $1049.90 ▼
Item Number
45538
Fee Comparison
MBS
$1077.20
→
DVA
$1049.90
-$27.30 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1469.95
Full Description
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.)
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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.)
$1726.00 $1682.25 ▼
Item Number
45539
Fee Comparison
MBS
$1726.00
→
DVA
$1682.25
-$43.75 (-3%)
Additional DVA Rates
RMFS In-Hosp
$2896.65
Full Description
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.)
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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.)
$3020.35 $2943.80 ▼
Item Number
45540
Fee Comparison
MBS
$3020.35
→
DVA
$2943.80
-$76.55 (-3%)
Additional DVA Rates
RMFS In-Hosp
$4121.45
Full Description
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.)
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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.)
$1284.80 $1252.25 ▼
Item Number
45541
Fee Comparison
MBS
$1284.80
→
DVA
$1252.25
-$32.55 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1753.20
Full Description
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.)
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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 $715.55 ▼
Item Number
45542
Fee Comparison
MBS
$734.15
→
DVA
$715.55
-$18.60 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1121.55
Full Description
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.)
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45545
Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.)
$745.15 $726.25 ▼
Item Number
45545
Fee Comparison
MBS
$745.15
→
DVA
$726.25
-$18.90 (-3%)
Additional DVA Rates
RMFS In-Hosp
$1016.80
RMFS Out-Hosp
$1016.80
Full Description
Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.)
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MBS Fee
$1101.10
DVA Fee
$1073.20
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$340.30
DVA Fee
$331.70
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$495.40
DVA Fee
$482.85
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$495.40
DVA Fee
$482.85
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$485.95
DVA Fee
$473.65
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$459.15
DVA Fee
$447.50
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$459.15
DVA Fee
$447.50
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$567.05
DVA Fee
$552.70
Category
Category 3 — Therapeutic Procedures
Description
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), first stage of a multistage procedure (H) (Anaes.) (Assist.)
MBS Fee
$281.40
DVA Fee
$274.25
Category
Category 3 — Therapeutic Procedures
Description
Pedicled flap repair (forehead, cross arm, cross leg, abdominal or similar), subsequent stage of a multistage procedure (H) (Anaes.) (Assist.)
MBS Fee
$313.15
DVA Fee
$305.20
Category
Category 3 — Therapeutic Procedures
Description
DIRECT FLAP REPAIR, small (cross finger or similar), first stage (Anaes.)
MBS Fee
$140.70
DVA Fee
$137.15
Category
Category 3 — Therapeutic Procedures
Description
DIRECT FLAP REPAIR, small (cross finger or similar), second stage (Anaes.)
MBS Fee
$533.15
DVA Fee
$519.65
Category
Category 3 — Therapeutic Procedures
Description
Indirect flap or tubed pedicle, formation of (H) (Anaes.) (Assist.)
MBS Fee
$266.60
DVA Fee
$259.85
Category
Category 3 — Therapeutic Procedures
Description
DIRECT OR INDIRECT FLAP OR TUBED PEDICLE, delay of (Anaes.)
MBS Fee
$567.05
DVA Fee
$552.70
Category
Category 3 — Therapeutic Procedures
Description
Indirect flap or tubed pedicle, preparation of intermediate or final site and attachment to the site (H) (Anaes.) (Assist.)
MBS Fee
$313.15
DVA Fee
$305.20
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$340.30
DVA Fee
$331.70
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$702.00
DVA Fee
$684.20
Category
Category 3 — Therapeutic Procedures
Description
Split 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.)
MBS Fee
$567.05
DVA Fee
$552.70
Category
Category 3 — Therapeutic Procedures
Description
Full thickness skin graft to one defect, with an average diameter of 5 mm or more (Anaes.) (Assist.)
MBS Fee
$498.05
DVA Fee
$485.45
Category
Category 3 — Therapeutic Procedures
Description
FLAP, free tissue transfer using microvascular techniques - revision of, by open operation (Anaes.)
MBS Fee
$379.40
DVA Fee
$369.80
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1304.95
DVA Fee
$1271.90
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$2124.10
DVA Fee
$2070.25
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$3186.20
DVA Fee
$3105.45
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$2430.10
DVA Fee
$2368.50
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$2124.10
DVA Fee
$2070.25
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$3216.75
DVA Fee
$3135.25
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1957.50
DVA Fee
$1907.90
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$263.15
DVA Fee
$256.50
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$353.90
DVA Fee
$344.95
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$223.25
DVA Fee
$217.60
Category
Category 3 — Therapeutic Procedures
Description
Scar, 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 non rebatable procedure); and(d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (Anaes.)
MBS Fee
$270.15
DVA Fee
$263.30
Category
Category 3 — Therapeutic Procedures
Description
Scar, 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 non‑rebatable procedure); and (d) sufficient photographic evidence demonstrating the clinical need for the service is included in patient notes (H) (Anaes.)
MBS Fee
$1077.70
DVA Fee
$1050.40
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$756.10
DVA Fee
$736.95
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1616.70
DVA Fee
$1575.75
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$887.70
DVA Fee
$865.20
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1282.15
DVA Fee
$1249.65
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1331.35
DVA Fee
$1297.60
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$2243.65
DVA Fee
$2186.80
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1315.85
DVA Fee
$1282.50
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$2302.75
DVA Fee
$2244.40
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$324.20
DVA Fee
$316.00
Category
Category 3 — Therapeutic Procedures
Description
Revision of post-mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
MBS Fee
$756.10
DVA Fee
$736.95
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1323.35
DVA Fee
$1289.80
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$941.45
DVA Fee
$917.60
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1077.20
DVA Fee
$1049.90
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1726.00
DVA Fee
$1682.25
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$3020.35
DVA Fee
$2943.80
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$1284.80
DVA Fee
$1252.25
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$734.15
DVA Fee
$715.55
Category
Category 3 — Therapeutic Procedures
Description
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.)
MBS Fee
$745.15
DVA Fee
$726.25
Category
Category 3 — Therapeutic Procedures
Description
Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.)
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