Billing Codes
Medicare Benefits Schedule — Updated Quarterly

MBS Item Tracker

Search 6,000+ Medicare item numbers across all categories including Pathology and Diagnostic Imaging

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Total Items
6045
MBS item numbers
Showing 2351–2400 of 6045 Pg 48/121
Item No. Description Schedule Fee Status
37818
Hypospadias, glanuloplasty incorporating meatal advancement, on a patient 10 years of age or over (H) (Anaes.) (Assist.)
Group T8 · Subheading 7 		$588.25 ≠ CHANGED
Item Number
37818
Schedule Fee
$588.25
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Hypospadias, glanuloplasty incorporating meatal advancement, on a patient 10 years of age or over (H) (Anaes.) (Assist.)
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37819
Hypospadias, glanuloplasty incorporating meatal advancement, on a patient under 10 years of age (H) (Anaes.) (Assist.)
Group T8 · Subheading 7 		$764.70 ≠ CHANGED
Item Number
37819
Schedule Fee
$764.70
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.09.2015
Gov. Change Flags
Fee ≠
Full Description
Hypospadias, glanuloplasty incorporating meatal advancement, on a patient under 10 years of age (H) (Anaes.) (Assist.)
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37821
HYPOSPADIAS, distal, 1 stage repair, on a patient 10 years of age or over. (Anaes.) (Assist.)
Group T8 · Subheading 7 		$997.15 ≠ CHANGED
Item Number
37821
Schedule Fee
$997.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
HYPOSPADIAS, distal, 1 stage repair, on a patient 10 years of age or over. (Anaes.) (Assist.)
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37822
HYPOSPADIAS, distal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.)
Group T8 · Subheading 7 		$1296.35 ≠ CHANGED
Item Number
37822
Schedule Fee
$1296.35
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.09.2015
Gov. Change Flags
Fee ≠
Full Description
HYPOSPADIAS, distal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.)
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37824
HYPOSPADIAS, proximal, 1 stage repair, on a patient 10 years of age or over (Anaes.) (Assist.)
Group T8 · Subheading 7 		$1386.40 ≠ CHANGED
Item Number
37824
Schedule Fee
$1386.40
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
HYPOSPADIAS, proximal, 1 stage repair, on a patient 10 years of age or over (Anaes.) (Assist.)
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37825
HYPOSPADIAS, proximal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.)
Group T8 · Subheading 7 		$1802.25 ≠ CHANGED
Item Number
37825
Schedule Fee
$1802.25
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.09.2015
Gov. Change Flags
Fee ≠
Full Description
HYPOSPADIAS, proximal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.)
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37827
HYPOSPADIAS, staged repair, first stage, on a patient 10 years of age or over (Anaes.) (Assist.)
Group T8 · Subheading 7 		$638.70 ≠ CHANGED
Item Number
37827
Schedule Fee
$638.70
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
HYPOSPADIAS, staged repair, first stage, on a patient 10 years of age or over (Anaes.) (Assist.)
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37828
HYPOSPADIAS, staged repair, first stage, on a patient under 10 years of age (Anaes.) (Assist.)
Group T8 · Subheading 7 		$830.25 ≠ CHANGED
Item Number
37828
Schedule Fee
$830.25
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.09.2015
Gov. Change Flags
Fee ≠
Full Description
HYPOSPADIAS, staged repair, first stage, on a patient under 10 years of age (Anaes.) (Assist.)
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37830
Hypospadias, staged repair, second stage, on a patient 10 years of age or over (H) (Anaes.) (Assist.)
Group T8 · Subheading 7 		$827.50 ≠ CHANGED
Item Number
37830
Schedule Fee
$827.50
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Hypospadias, staged repair, second stage, on a patient 10 years of age or over (H) (Anaes.) (Assist.)
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37831
Hypospadias, staged repair, second stage, on a patient under 10 years of age (H) (Anaes.) (Assist.)
Group T8 · Subheading 7 		$1075.90 ≠ CHANGED
Item Number
37831
Schedule Fee
$1075.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2015
Gov. Change Flags
Fee ≠
Full Description
Hypospadias, staged repair, second stage, on a patient under 10 years of age (H) (Anaes.) (Assist.)
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37833
Hypospadias, repair of urethral fistula, on a patient 10 years of age or over (Anaes.) (Assist.)
Group T8 · Subheading 7 		$394.90 ≠ CHANGED
Item Number
37833
Schedule Fee
$394.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Hypospadias, repair of urethral fistula, on a patient 10 years of age or over (Anaes.) (Assist.)
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37834
Hypospadias, repair of urethral fistula, on a patient under 10 years of age (Anaes.) (Assist.)
Group T8 · Subheading 7 		$513.50 ≠ CHANGED
Item Number
37834
Schedule Fee
$513.50
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.09.2015
Gov. Change Flags
Fee ≠
Full Description
Hypospadias, repair of urethral fistula, on a patient under 10 years of age (Anaes.) (Assist.)
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37836
EPISPADIAS, staged repair, first stage (Anaes.) (Assist.)
Group T8 · Subheading 7 		$831.80 ≠ CHANGED
Item Number
37836
Schedule Fee
$831.80
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
EPISPADIAS, staged repair, first stage (Anaes.) (Assist.)
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37839
EPISPADIAS, staged repair, second stage (Anaes.) (Assist.)
Group T8 · Subheading 7 		$942.65 ≠ CHANGED
Item Number
37839
Schedule Fee
$942.65
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
EPISPADIAS, staged repair, second stage (Anaes.) (Assist.)
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37842
Exstrophy of bladder or epispadias, primary or secondary repair with or without bladder neck tightening, with or without ureteric reimplantation (Anaes.) (Assist.)
Group T8 · Subheading 7 		$1830.15 ≠ CHANGED
Item Number
37842
Schedule Fee
$1830.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Exstrophy of bladder or epispadias, primary or secondary repair with or without bladder neck tightening, with or without ureteric reimplantation (Anaes.) (Assist.)
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37845
Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty, with or without endoscopy (Anaes.) (Assist.)
Group T8 · Subheading 7 		$831.80 ≠ CHANGED
Item Number
37845
Schedule Fee
$831.80
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty, with or without endoscopy (Anaes.) (Assist.)
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37848
Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty with endoscopy and vaginoplasty (Anaes.) (Assist.)
Group T8 · Subheading 7 		$1497.35 ≠ CHANGED
Item Number
37848
Schedule Fee
$1497.35
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty with endoscopy and vaginoplasty (Anaes.) (Assist.)
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37851
Congenital disorder of sexual differentiation, vaginoplasty for, with or without endoscopy (Anaes.) (Assist.)
Group T8 · Subheading 7 		$1109.30 ≠ CHANGED
Item Number
37851
Schedule Fee
$1109.30
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Congenital disorder of sexual differentiation, vaginoplasty for, with or without endoscopy (Anaes.) (Assist.)
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37854
Urethral valve, destruction of, including cystoscopy and urethroscopy (Anaes.)
Group T8 · Subheading 7 		$438.55 ≠ CHANGED
Item Number
37854
Schedule Fee
$438.55
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 7
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Urethral valve, destruction of, including cystoscopy and urethroscopy (Anaes.)
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38200
Right heart catheterisation with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurement by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38254 or 38368 applies (H) (Anaes.)
Group T8 · Subheading 1 		$533.15 ≠ CHANGED
Item Number
38200
Schedule Fee
$533.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Right heart catheterisation with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurement by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38254 or 38368 applies (H) (Anaes.)
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38203
Left heart catheterisation by percutaneous arterial puncture, arteriotomy or percutaneous left ventricular puncture, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38206, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.)
Group T8 · Subheading 1 		$636.25 ≠ CHANGED
Item Number
38203
Schedule Fee
$636.25
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Left heart catheterisation by percutaneous arterial puncture, arteriotomy or percutaneous left ventricular puncture, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38206, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.)
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38206
Right heart catheterisation with left heart catheterisation via the right heart or by another procedure, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38203, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.)
Group T8 · Subheading 1 		$769.15 ≠ CHANGED
Item Number
38206
Schedule Fee
$769.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Right heart catheterisation with left heart catheterisation via the right heart or by another procedure, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38203, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.)
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38209
Cardiac electrophysiological study—up to and including 3 catheter investigation of any one or more of—syncope, atrio‑ventricular conduction, sinus node function or simple ventricular tachycardia studies, other than a service associated with a service to which item 38212 or 38213 applies (H) (Anaes.)
Group T8 · Subheading 1 		$987.65 ≠ CHANGED
Item Number
38209
Schedule Fee
$987.65
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Cardiac electrophysiological study—up to and including 3 catheter investigation of any one or more of—syncope, atrio‑ventricular conduction, sinus node function or simple ventricular tachycardia studies, other than a service associated with a service to which item 38212 or 38213 applies (H) (Anaes.)
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38212
Cardiac electrophysiological study for: (a) the investigation of supraventricular tachycardia involving 4 or more catheters; or (b) complex tachycardia inductions; or (c) multiple catheter mapping; or (d) acute intravenous anti‑arrhythmic drug testing with pre and post drug inductions; or (e) catheter ablation to intentionally induce complete atrioventricular block; or (f) intraoperative mapping; other than a service associated with a service to which item 38209 or 38213 applies (H) (Anaes.)
Group T8 · Subheading 1 		$1642.65 ≠ CHANGED
Item Number
38212
Schedule Fee
$1642.65
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Cardiac electrophysiological study for: (a) the investigation of supraventricular tachycardia involving 4 or more catheters; or (b) complex tachycardia inductions; or (c) multiple catheter mapping; or (d) acute intravenous anti‑arrhythmic drug testing with pre and post drug inductions; or (e) catheter ablation to intentionally induce complete atrioventricular block; or (f) intraoperative mapping; other than a service associated with a service to which item 38209 or 38213 applies (H) (Anaes.)
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38213
Cardiac electrophysiological study, performed either: (a) during insertion of implantable defibrillator; or (b) for defibrillation threshold testing at a different time to implantation; other than a service associated with a service to which item 38209 or 38212 applies (H) (Anaes.)
Group T8 · Subheading 1 		$489.25 ≠ CHANGED
Item Number
38213
Schedule Fee
$489.25
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.1996
Gov. Change Flags
Fee ≠
Full Description
Cardiac electrophysiological study, performed either: (a) during insertion of implantable defibrillator; or (b) for defibrillation threshold testing at a different time to implantation; other than a service associated with a service to which item 38209 or 38212 applies (H) (Anaes.)
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38241
Use of a coronary pressure wire, if the service is: (a) performed during selective coronary angiography, percutaneous angioplasty or transluminal insertion of one or more stents; and (b) to measure fractional flow reserve, non-hyperaemic pressure ratios or coronary flow reserve in intermediate coronary artery or graft lesions (stenosis of 50 to 70%); and (c) to determine whether revascularisation is appropriate, if previous functional imaging: (i) has not been performed; or (ii) has been performed but the results are inconclusive or do not apply to the vessel being interrogated; and (d) performed on one or more coronary vascular territories (H) (Anaes.)
Group T8 · Subheading 1 		$562.10 ≠ CHANGED
Item Number
38241
Schedule Fee
$562.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2006
Gov. Change Flags
Fee ≠
Full Description
Use of a coronary pressure wire, if the service is: (a) performed during selective coronary angiography, percutaneous angioplasty or transluminal insertion of one or more stents; and (b) to measure fractional flow reserve, non-hyperaemic pressure ratios or coronary flow reserve in intermediate coronary artery or graft lesions (stenosis of 50 to 70%); and (c) to determine whether revascularisation is appropriate, if previous functional imaging: (i) has not been performed; or (ii) has been performed but the results are inconclusive or do not apply to the vessel being interrogated; and (d) performed on one or more coronary vascular territories (H) (Anaes.)
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38244
Note: (acute coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into native coronary arteries; and (c) with or without left heart catheterisation, left ventriculography or aortography; and (d) including all associated imaging; other than a service associated with a service to which 38200, 38203, 38206, 38247, 38248, 38249, 38251 or 38252 applies (H) (Anaes.)
Group T8 · Subheading 1 		$1058.20 ≠ CHANGED
Item Number
38244
Schedule Fee
$1058.20
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (acute coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into native coronary arteries; and (c) with or without left heart catheterisation, left ventriculography or aortography; and (d) including all associated imaging; other than a service associated with a service to which 38200, 38203, 38206, 38247, 38248, 38249, 38251 or 38252 applies (H) (Anaes.)
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38247
Note: (acute coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (c) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38248, 38249, 38251 or 38252 applies (H) (Anaes.)
Group T8 · Subheading 1 		$1695.45 ≠ CHANGED
Item Number
38247
Schedule Fee
$1695.45
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (acute coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (c) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38248, 38249, 38251 or 38252 applies (H) (Anaes.)
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38248
Note: (stable coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the of Note: TR.8.3 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38249, 38251 or 38252 applies—applicable each 3 months (H) (Anaes.)
Group T8 · Subheading 1 		$1058.20 ≠ CHANGED
Item Number
38248
Schedule Fee
$1058.20
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (stable coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the of Note: TR.8.3 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38249, 38251 or 38252 applies—applicable each 3 months (H) (Anaes.)
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38249
Note: (stable coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.3 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38251 or 38252 applies—applicable once each 3 months (H) (Anaes.)
Group T8 · Subheading 1 		$1695.45 ≠ CHANGED
Item Number
38249
Schedule Fee
$1695.45
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (stable coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.3 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38251 or 38252 applies—applicable once each 3 months (H) (Anaes.)
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38251
Note: (pre-operative assessment) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38252 applies—applicable once each 12 months (H) (Anaes.)
Group T8 · Subheading 1 		$1058.20 ≠ CHANGED
Item Number
38251
Schedule Fee
$1058.20
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (pre-operative assessment) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38252 applies—applicable once each 12 months (H) (Anaes.)
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38252
Note: (pre-operative assessment - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary and graft angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38251 applies—applicable once each 12 months (H) (Anaes.)
Group T8 · Subheading 1 		$1695.45 ≠ CHANGED
Item Number
38252
Schedule Fee
$1695.45
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (pre-operative assessment - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary and graft angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38251 applies—applicable once each 12 months (H) (Anaes.)
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38254
Right heart catheterisation: (a) performed at the same time as a service to which item 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313 or 38314 applies; and (b) including any of the following (if performed): (i) fluoroscopy; (ii) oximetry; (iii) dye dilution curves; (iv) cardiac output measurement; (v) shunt detection; (vi) exercise stress test (H) (Anaes.)
Group T8 · Subheading 1 		$533.15 ≠ CHANGED
Item Number
38254
Schedule Fee
$533.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Right heart catheterisation: (a) performed at the same time as a service to which item 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313 or 38314 applies; and (b) including any of the following (if performed): (i) fluoroscopy; (ii) oximetry; (iii) dye dilution curves; (iv) cardiac output measurement; (v) shunt detection; (vi) exercise stress test (H) (Anaes.)
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38256
Temporary transvenous pacemaking electrode, insertion of (H) (Anaes.)
Group T8 · Subheading 1 		$319.85 ≠ CHANGED
Item Number
38256
Schedule Fee
$319.85
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.1993
Gov. Change Flags
Fee ≠
Full Description
Temporary transvenous pacemaking electrode, insertion of (H) (Anaes.)
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38270
Balloon valvuloplasty or isolated atrial septostomy, including cardiac catheterisations before and after balloon dilatation (H) (Anaes.) (Assist.)
Group T8 · Subheading 1 		$1091.90 ≠ CHANGED
Item Number
38270
Schedule Fee
$1091.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.05.1997
Gov. Change Flags
Fee ≠
Full Description
Balloon valvuloplasty or isolated atrial septostomy, including cardiac catheterisations before and after balloon dilatation (H) (Anaes.) (Assist.)
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38272
Atrial septal defect or patent foramen closure: (a) for congenital heart disease in a patient with documented evidence of right heart overload or paradoxical embolism; and (b) using a septal occluder or similar device, by transcatheter approach; and (c) including right or left heart catheterisation (or both); other than a service associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 1 		$1091.90 ≠ CHANGED
Item Number
38272
Schedule Fee
$1091.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2005
Gov. Change Flags
Fee ≠
Full Description
Atrial septal defect or patent foramen closure: (a) for congenital heart disease in a patient with documented evidence of right heart overload or paradoxical embolism; and (b) using a septal occluder or similar device, by transcatheter approach; and (c) including right or left heart catheterisation (or both); other than a service associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.)
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38273
Patent ductus arteriosus, transcatheter closure of, including cardiac catheterisation and any imaging associated with the service (Anaes.) (Assist.)
Group T8 · Subheading 1 		$1091.90 ≠ CHANGED
Item Number
38273
Schedule Fee
$1091.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2014
Gov. Change Flags
Fee ≠
Full Description
Patent ductus arteriosus, transcatheter closure of, including cardiac catheterisation and any imaging associated with the service (Anaes.) (Assist.)
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38274
Ventricular septal defect, transcatheter closure of, with cardiac catheterisation, excluding imaging (H) (Anaes.) (Assist.)
Group T8 · Subheading 1 		$894.50 ≠ CHANGED
Item Number
38274
Schedule Fee
$894.50
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2014
Gov. Change Flags
Fee ≠
Full Description
Ventricular septal defect, transcatheter closure of, with cardiac catheterisation, excluding imaging (H) (Anaes.) (Assist.)
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38275
Myocardial biopsy, by cardiac catheterisation (H) (Anaes.)
Group T8 · Subheading 1 		$356.90 ≠ CHANGED
Item Number
38275
Schedule Fee
$356.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.05.1997
Gov. Change Flags
Fee ≠
Full Description
Myocardial biopsy, by cardiac catheterisation (H) (Anaes.)
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38276
Transcatheter occlusion of left atrial appendage, and cardiac catheterisation performed by the same practitioner, for stroke prevention in a patient who has non‑valvular atrial fibrillation, if: (a) the patient is at increased risk of thromboembolism demonstrated by: (i) a prior stroke (whether of an ischaemic or unknown type), transient ischaemic attack or non‑central nervous system systemic embolism; or (ii) at least 2 of the following risk factors: (A) an age of 65 years or more; (B) hypertension; (C) diabetes mellitus; (D) heart failure or left ventricular ejection fraction of 35% or less (or both); (E) vascular disease (prior myocardial infarction, peripheral artery disease or aortic plaque); and (b) the patient has an absolute and permanent contraindication to oral anticoagulation (confirmed by written documentation that is provided by a medical practitioner, independent of the practitioner rendering the service); and (c) the service is not associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 1 		$1091.90 ≠ CHANGED
Item Number
38276
Schedule Fee
$1091.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2017
Gov. Change Flags
Fee ≠
Full Description
Transcatheter occlusion of left atrial appendage, and cardiac catheterisation performed by the same practitioner, for stroke prevention in a patient who has non‑valvular atrial fibrillation, if: (a) the patient is at increased risk of thromboembolism demonstrated by: (i) a prior stroke (whether of an ischaemic or unknown type), transient ischaemic attack or non‑central nervous system systemic embolism; or (ii) at least 2 of the following risk factors: (A) an age of 65 years or more; (B) hypertension; (C) diabetes mellitus; (D) heart failure or left ventricular ejection fraction of 35% or less (or both); (E) vascular disease (prior myocardial infarction, peripheral artery disease or aortic plaque); and (b) the patient has an absolute and permanent contraindication to oral anticoagulation (confirmed by written documentation that is provided by a medical practitioner, independent of the practitioner rendering the service); and (c) the service is not associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.)
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38285
Insertion of implantable ECG loop recorder, by a specialist or consultant physician, for the diagnosis of a primary disorder, including initial programming and testing, if: (a) the patient has recurrent unexplained syncope and does not have a structural heart defect associated with a high risk of sudden cardiac death; and (b) a diagnosis has not been achieved through all other available cardiac investigations; and (c) a neurogenic cause is not suspected (Anaes.)
Group T8 · Subheading 1 		$184.65 ≠ CHANGED
Item Number
38285
Schedule Fee
$184.65
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2004
Gov. Change Flags
Fee ≠
Full Description
Insertion of implantable ECG loop recorder, by a specialist or consultant physician, for the diagnosis of a primary disorder, including initial programming and testing, if: (a) the patient has recurrent unexplained syncope and does not have a structural heart defect associated with a high risk of sudden cardiac death; and (b) a diagnosis has not been achieved through all other available cardiac investigations; and (c) a neurogenic cause is not suspected (Anaes.)
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38286
Removal of implantable ECG loop recorder (Anaes.)
Group T8 · Subheading 1 		$166.30 ≠ CHANGED
Item Number
38286
Schedule Fee
$166.30
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2004
Gov. Change Flags
Fee ≠
Full Description
Removal of implantable ECG loop recorder (Anaes.)
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38287
Ablation of arrhythmia circuit or focus or isolation procedure involving one atrial chamber (H) (Anaes.) (Assist.)
Group T8 · Subheading 2 		$2511.75 ≠ CHANGED
Item Number
38287
Schedule Fee
$2511.75
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.1998
Gov. Change Flags
Fee ≠
Full Description
Ablation of arrhythmia circuit or focus or isolation procedure involving one atrial chamber (H) (Anaes.) (Assist.)
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38288
Implantable loop recorder, insertion of, for diagnosis of atrial fibrillation, if: (a) the patient to whom the service is provided has been diagnosed as having had an embolic stroke of undetermined source; and (b) the bases of the diagnosis included the following: (i) the medical history of the patient; (ii) physical examination; (iii) brain and carotid imaging; (iv) cardiac imaging; (v) surface ECG testing including 24‑hour Holter monitoring; and (c) atrial fibrillation is suspected; and (d) the patient: (i) does not have a permanent indication for oral anticoagulants; or (ii) does not have a permanent oral anticoagulants contraindication; including initial programming and testing (Anaes.)
Group T8 · Subheading 1 		$230.95 ≠ CHANGED
Item Number
38288
Schedule Fee
$230.95
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 1
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.05.2018
Gov. Change Flags
Fee ≠
Full Description
Implantable loop recorder, insertion of, for diagnosis of atrial fibrillation, if: (a) the patient to whom the service is provided has been diagnosed as having had an embolic stroke of undetermined source; and (b) the bases of the diagnosis included the following: (i) the medical history of the patient; (ii) physical examination; (iii) brain and carotid imaging; (iv) cardiac imaging; (v) surface ECG testing including 24‑hour Holter monitoring; and (c) atrial fibrillation is suspected; and (d) the patient: (i) does not have a permanent indication for oral anticoagulants; or (ii) does not have a permanent oral anticoagulants contraindication; including initial programming and testing (Anaes.)
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38290
ABLATION OF ARRHYTHMIA CIRCUITS OR FOCI, or isolation procedure involving both atrial chambers and including curative procedures for atrial fibrillation (Anaes.) (Assist.)
Group T8 · Subheading 2 		$3198.10 ≠ CHANGED
Item Number
38290
Schedule Fee
$3198.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.1998
Gov. Change Flags
Fee ≠
Full Description
ABLATION OF ARRHYTHMIA CIRCUITS OR FOCI, or isolation procedure involving both atrial chambers and including curative procedures for atrial fibrillation (Anaes.) (Assist.)
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38293
Ventricular arrhythmia with mapping and ablation, including all associated electrophysiological studies performed on the same day (H) (Anaes.) (Assist.)
Group T8 · Subheading 2 		$3432.75 ≠ CHANGED
Item Number
38293
Schedule Fee
$3432.75
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.1998
Gov. Change Flags
Fee ≠
Full Description
Ventricular arrhythmia with mapping and ablation, including all associated electrophysiological studies performed on the same day (H) (Anaes.) (Assist.)
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38307
Note: (acute coronary syndrome - 1 coronary territory with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; (ii) transluminal insertion of one or more stents; and (d) performed on one coronary vascular territory; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 3 		$2121.75 ≠ CHANGED
Item Number
38307
Schedule Fee
$2121.75
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 3
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (acute coronary syndrome - 1 coronary territory with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; (ii) transluminal insertion of one or more stents; and (d) performed on one coronary vascular territory; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
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38308
Note: (acute coronary syndrome - 2 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 2 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 3 		$2441.10 ≠ CHANGED
Item Number
38308
Schedule Fee
$2441.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 3
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (acute coronary syndrome - 2 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 2 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
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38309
Percutaneous transluminal rotational atherectomy of one or more coronary arteries, including all associated imaging, if: (a) the target stenosis within at least one coronary artery is heavily calcified and balloon angioplasty with or without stenting is not feasible without rotational artherectomy; and (b) the service is performed in conjunction with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies Applicable only once on each occasion the service is performed (H) (Anaes.) (Assist.)
Group T8 · Subheading 3 		$1438.65 ≠ CHANGED
Item Number
38309
Schedule Fee
$1438.65
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 3
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2005
Gov. Change Flags
Fee ≠
Full Description
Percutaneous transluminal rotational atherectomy of one or more coronary arteries, including all associated imaging, if: (a) the target stenosis within at least one coronary artery is heavily calcified and balloon angioplasty with or without stenting is not feasible without rotational artherectomy; and (b) the service is performed in conjunction with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies Applicable only once on each occasion the service is performed (H) (Anaes.) (Assist.)
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38310
Note: (acute coronary syndrome - 3 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 3 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 3 		$2760.60 ≠ CHANGED
Item Number
38310
Schedule Fee
$2760.60
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 3
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2021
Gov. Change Flags
Fee ≠
Full Description
Note: (acute coronary syndrome - 3 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 3 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
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Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Hypospadias, glanuloplasty incorporating meatal advancement, on a patient 10 years of age or over (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Hypospadias, glanuloplasty incorporating meatal advancement, on a patient under 10 years of age (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
HYPOSPADIAS, distal, 1 stage repair, on a patient 10 years of age or over. (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
HYPOSPADIAS, distal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
HYPOSPADIAS, proximal, 1 stage repair, on a patient 10 years of age or over (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
HYPOSPADIAS, proximal, 1 stage repair, on a patient under 10 years of age (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
HYPOSPADIAS, staged repair, first stage, on a patient 10 years of age or over (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
HYPOSPADIAS, staged repair, first stage, on a patient under 10 years of age (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Hypospadias, staged repair, second stage, on a patient 10 years of age or over (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Hypospadias, staged repair, second stage, on a patient under 10 years of age (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Hypospadias, repair of urethral fistula, on a patient 10 years of age or over (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Hypospadias, repair of urethral fistula, on a patient under 10 years of age (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
EPISPADIAS, staged repair, first stage (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
EPISPADIAS, staged repair, second stage (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Exstrophy of bladder or epispadias, primary or secondary repair with or without bladder neck tightening, with or without ureteric reimplantation (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty, with or without endoscopy (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Congenital disorder of sexual differentiation with urogenital sinus, external genitoplasty with endoscopy and vaginoplasty (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Congenital disorder of sexual differentiation, vaginoplasty for, with or without endoscopy (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Urethral valve, destruction of, including cystoscopy and urethroscopy (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Right heart catheterisation with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurement by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38254 or 38368 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Left heart catheterisation by percutaneous arterial puncture, arteriotomy or percutaneous left ventricular puncture, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38206, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Right heart catheterisation with left heart catheterisation via the right heart or by another procedure, with any one or more of the following: (a) fluoroscopy; (b) oximetry; (c) dye dilution curves; (d) cardiac output measurements by any method; (e) shunt detection; (f) exercise stress test; other than a service associated with a service to which item 38200, 38203, 38244, 38247, 38248, 38249, 38251, 38252 or 38254 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Cardiac electrophysiological study—up to and including 3 catheter investigation of any one or more of—syncope, atrio‑ventricular conduction, sinus node function or simple ventricular tachycardia studies, other than a service associated with a service to which item 38212 or 38213 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Cardiac electrophysiological study for: (a) the investigation of supraventricular tachycardia involving 4 or more catheters; or (b) complex tachycardia inductions; or (c) multiple catheter mapping; or (d) acute intravenous anti‑arrhythmic drug testing with pre and post drug inductions; or (e) catheter ablation to intentionally induce complete atrioventricular block; or (f) intraoperative mapping; other than a service associated with a service to which item 38209 or 38213 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Cardiac electrophysiological study, performed either: (a) during insertion of implantable defibrillator; or (b) for defibrillation threshold testing at a different time to implantation; other than a service associated with a service to which item 38209 or 38212 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Use of a coronary pressure wire, if the service is: (a) performed during selective coronary angiography, percutaneous angioplasty or transluminal insertion of one or more stents; and (b) to measure fractional flow reserve, non-hyperaemic pressure ratios or coronary flow reserve in intermediate coronary artery or graft lesions (stenosis of 50 to 70%); and (c) to determine whether revascularisation is appropriate, if previous functional imaging: (i) has not been performed; or (ii) has been performed but the results are inconclusive or do not apply to the vessel being interrogated; and (d) performed on one or more coronary vascular territories (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (acute coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into native coronary arteries; and (c) with or without left heart catheterisation, left ventriculography or aortography; and (d) including all associated imaging; other than a service associated with a service to which 38200, 38203, 38206, 38247, 38248, 38249, 38251 or 38252 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (acute coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17A; and (b) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (c) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38248, 38249, 38251 or 38252 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (stable coronary syndrome) the service only applies if the patient meets the requirements of the descriptor and the of Note: TR.8.3 and TR.8.5 Selective coronary angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38249, 38251 or 38252 applies—applicable each 3 months (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (stable coronary syndrome - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.3 and TR.8.5 Selective coronary and graft angiography: (a) for a patient who is eligible for the service under clause 5.10.17B; and (b) as part of the management of the patient; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38251 or 38252 applies—applicable once each 3 months (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (pre-operative assessment) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of catheters and injection of opaque material into native coronary arteries; and (d) with or without left heart catheterisation, left ventriculography or aortography; and (e) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38252 applies—applicable once each 12 months (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (pre-operative assessment - graft) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.5 Selective coronary and graft angiography: (a) for a symptomatic patient with valvular or other non-coronary structural heart disease; and (b) as part of the management of the patient for: (i) pre-operative assessment for planning non-coronary cardiac surgery, including by transcatheter approaches; or (ii) evaluation of valvular heart disease or other non-coronary structural heart disease where clinical impression is discordant with non-invasive assessment; and (c) with placement of one or more catheters and injection of opaque material into the native coronary arteries; and (d) if free coronary grafts attached to the aorta or direct internal mammary artery grafts are present—with placement of one or more catheters and injection of opaque material into those grafts (irrespective of the number of grafts); and (e) with or without left heart catheterisation, left ventriculography or aortography; and (f) including all associated imaging; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249 or 38251 applies—applicable once each 12 months (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Right heart catheterisation: (a) performed at the same time as a service to which item 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38310, 38311, 38313 or 38314 applies; and (b) including any of the following (if performed): (i) fluoroscopy; (ii) oximetry; (iii) dye dilution curves; (iv) cardiac output measurement; (v) shunt detection; (vi) exercise stress test (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Temporary transvenous pacemaking electrode, insertion of (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Balloon valvuloplasty or isolated atrial septostomy, including cardiac catheterisations before and after balloon dilatation (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Atrial septal defect or patent foramen closure: (a) for congenital heart disease in a patient with documented evidence of right heart overload or paradoxical embolism; and (b) using a septal occluder or similar device, by transcatheter approach; and (c) including right or left heart catheterisation (or both); other than a service associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Patent ductus arteriosus, transcatheter closure of, including cardiac catheterisation and any imaging associated with the service (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Ventricular septal defect, transcatheter closure of, with cardiac catheterisation, excluding imaging (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Myocardial biopsy, by cardiac catheterisation (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Transcatheter occlusion of left atrial appendage, and cardiac catheterisation performed by the same practitioner, for stroke prevention in a patient who has non‑valvular atrial fibrillation, if: (a) the patient is at increased risk of thromboembolism demonstrated by: (i) a prior stroke (whether of an ischaemic or unknown type), transient ischaemic attack or non‑central nervous system systemic embolism; or (ii) at least 2 of the following risk factors: (A) an age of 65 years or more; (B) hypertension; (C) diabetes mellitus; (D) heart failure or left ventricular ejection fraction of 35% or less (or both); (E) vascular disease (prior myocardial infarction, peripheral artery disease or aortic plaque); and (b) the patient has an absolute and permanent contraindication to oral anticoagulation (confirmed by written documentation that is provided by a medical practitioner, independent of the practitioner rendering the service); and (c) the service is not associated with a service to which item 38200, 38203, 38206 or 38254 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Insertion of implantable ECG loop recorder, by a specialist or consultant physician, for the diagnosis of a primary disorder, including initial programming and testing, if: (a) the patient has recurrent unexplained syncope and does not have a structural heart defect associated with a high risk of sudden cardiac death; and (b) a diagnosis has not been achieved through all other available cardiac investigations; and (c) a neurogenic cause is not suspected (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Removal of implantable ECG loop recorder (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Ablation of arrhythmia circuit or focus or isolation procedure involving one atrial chamber (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Implantable loop recorder, insertion of, for diagnosis of atrial fibrillation, if: (a) the patient to whom the service is provided has been diagnosed as having had an embolic stroke of undetermined source; and (b) the bases of the diagnosis included the following: (i) the medical history of the patient; (ii) physical examination; (iii) brain and carotid imaging; (iv) cardiac imaging; (v) surface ECG testing including 24‑hour Holter monitoring; and (c) atrial fibrillation is suspected; and (d) the patient: (i) does not have a permanent indication for oral anticoagulants; or (ii) does not have a permanent oral anticoagulants contraindication; including initial programming and testing (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
ABLATION OF ARRHYTHMIA CIRCUITS OR FOCI, or isolation procedure involving both atrial chambers and including curative procedures for atrial fibrillation (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Ventricular arrhythmia with mapping and ablation, including all associated electrophysiological studies performed on the same day (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (acute coronary syndrome - 1 coronary territory with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; (ii) transluminal insertion of one or more stents; and (d) performed on one coronary vascular territory; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (acute coronary syndrome - 2 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 2 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Percutaneous transluminal rotational atherectomy of one or more coronary arteries, including all associated imaging, if: (a) the target stenosis within at least one coronary artery is heavily calcified and balloon angioplasty with or without stenting is not feasible without rotational artherectomy; and (b) the service is performed in conjunction with a service to which item 38307, 38308, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies Applicable only once on each occasion the service is performed (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Note: (acute coronary syndrome - 3 coronary territories with selective coronary angiography) the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: TR.8.2 and TR.8.5 Percutaneous coronary intervention: (a) for a patient: (i) eligible for the service under clause 5.10.17A; and (ii) for whom selective coronary angiography has not been completed in the previous 3 months; and (b) including selective coronary angiography and all associated imaging, catheter and contrast; and (c) including either or both: (i) percutaneous angioplasty; and (ii) transluminal insertion of one or more stents; and (d) performed on 3 coronary vascular territories; and (e) excluding aftercare; other than a service associated with a service to which item 38200, 38203, 38206, 38244, 38247, 38248, 38249, 38251, 38252, 38307, 38308, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322 or 38323 applies (H) (Anaes.) (Assist.)
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