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 3051–3100 of 6045 Pg 62/121
Item No. Description Schedule Fee Status
45035
Vascular anomaly, large, deep, and involving major neurovascular structures, excision of, including dissection of muscles, nerves or major vessels (H) (Anaes.) (Assist.)
Group T8 · Subheading 1 		$840.30 ≠ CHANGED
Item Number
45035
Schedule Fee
$840.30
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: 01.11.1994
Gov. Change Flags
Fee ≠
Full Description
Vascular anomaly, large, deep, and involving major neurovascular structures, excision of, including dissection of muscles, nerves or major vessels (H) (Anaes.) (Assist.)
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45036
Vascular anomaly, of neck, deep and involving major neurovascular structures, excision of, including dissection of cranial nerves and major vessels (H) (Anaes.) (Assist.)
Group T8 · Subheading 1 		$1350.20 ≠ CHANGED
Item Number
45036
Schedule Fee
$1350.20
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Vascular anomaly, of neck, deep and involving major neurovascular structures, excision of, including dissection of cranial nerves and major vessels (H) (Anaes.) (Assist.)
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45045
Vascular anomaly on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals, excision of (Anaes.)
Group T8 · Subheading 1 		$369.20 ≠ CHANGED
Item Number
45045
Schedule Fee
$369.20
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Vascular anomaly on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals, excision of (Anaes.)
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45048
LYMPHOEDEMATOUS tissue or lymphangiectasis, of lower leg and foot, or thigh, or upper arm, or forearm and hand, major excision of (Anaes.) (Assist.)
Group T8 · Subheading 1 		$927.15 ≠ CHANGED
Item Number
45048
Schedule Fee
$927.15
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
LYMPHOEDEMATOUS tissue or lymphangiectasis, of lower leg and foot, or thigh, or upper arm, or forearm and hand, major excision of (Anaes.) (Assist.)
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45051
Contour reconstruction by open repair of contour defects, due to deformity, if: (a) contour reconstructive surgery is indicated because the deformity is secondary to congenital absence of tissue or has arisen from trauma (other than trauma from previous cosmetic surgery); and (b) insertion of a non-biological implant is required, other than one or more of the following: (i) insertion of a non-biological implant that is a component of another service specified in Group T8; (ii) injection of liquid or semisolid material; (iii) an oral and maxillofacial implant service to which item 52321 applies; (iv) a service to insert mesh; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Group T8 · Subheading 1 		$567.05 ≠ CHANGED
Item Number
45051
Schedule Fee
$567.05
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
Contour reconstruction by open repair of contour defects, due to deformity, if: (a) contour reconstructive surgery is indicated because the deformity is secondary to congenital absence of tissue or has arisen from trauma (other than trauma from previous cosmetic surgery); and (b) insertion of a non-biological implant is required, other than one or more of the following: (i) insertion of a non-biological implant that is a component of another service specified in Group T8; (ii) injection of liquid or semisolid material; (iii) an oral and maxillofacial implant service to which item 52321 applies; (iv) a service to insert mesh; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
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45054
Limb or chest, decompression escharotomy of (including all incisions), for acute compartment syndrome secondary to burn (H) (Anaes.) (Assist.)
Group T8 · Subheading 1 		$390.25 ≠ CHANGED
Item Number
45054
Schedule Fee
$390.25
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: 01.11.1999
Gov. Change Flags
Fee ≠
Full Description
Limb or chest, decompression escharotomy of (including all incisions), for acute compartment syndrome secondary to burn (H) (Anaes.) (Assist.)
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45060
Developmental breast abnormality, single stage correction of, if: (a) the correction involves either: (i) bilateral mastopexy for symmetrical tubular breasts; or (ii) surgery on both breasts with a combination of insertion of one or more implants (which must have at least a 10% volume difference), mastopexy or reduction mammaplasty, if there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least 20% in normally shaped breasts, or 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (Anaes.) (Assist.)
Group T8 · Subheading 1 		$1521.60 ≠ CHANGED
Item Number
45060
Schedule Fee
$1521.60
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: 01.11.2018
Gov. Change Flags
Fee ≠
Full Description
Developmental breast abnormality, single stage correction of, if: (a) the correction involves either: (i) bilateral mastopexy for symmetrical tubular breasts; or (ii) surgery on both breasts with a combination of insertion of one or more implants (which must have at least a 10% volume difference), mastopexy or reduction mammaplasty, if there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least 20% in normally shaped breasts, or 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (Anaes.) (Assist.)
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45061
Developmental breast abnormality, 2 stage correction of, first stage, involving surgery on both breasts with a combination of insertion of one or more tissue expanders, mastopexy or reduction mammaplasty, if: (a) there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or (ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes. Applicable only once per occasion on which the service is provided (Anaes.) (Assist.)
Group T8 · Subheading 1 		$1521.60 ≠ CHANGED
Item Number
45061
Schedule Fee
$1521.60
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: 01.11.2018
Gov. Change Flags
Fee ≠
Full Description
Developmental breast abnormality, 2 stage correction of, first stage, involving surgery on both breasts with a combination of insertion of one or more tissue expanders, mastopexy or reduction mammaplasty, if: (a) there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or (ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes. Applicable only once per occasion on which the service is provided (Anaes.) (Assist.)
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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.)
Group T8 · Subheading 1 		$1101.10 ≠ CHANGED
Item Number
45062
Schedule Fee
$1101.10
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: 01.11.2018
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$340.30 ≠ CHANGED
Item Number
45200
Schedule Fee
$340.30
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$495.40 ≠ CHANGED
Item Number
45201
Schedule Fee
$495.40
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2016
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$495.40 ≠ CHANGED
Item Number
45202
Schedule Fee
$495.40
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2016
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$485.95 ≠ CHANGED
Item Number
45203
Schedule Fee
$485.95
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$459.15 ≠ CHANGED
Item Number
45206
Schedule Fee
$459.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$459.15 ≠ CHANGED
Item Number
45207
Schedule Fee
$459.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2006
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$567.05 ≠ CHANGED
Item Number
45209
Schedule Fee
$567.05
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: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$281.40 ≠ CHANGED
Item Number
45212
Schedule Fee
$281.40
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: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$313.15 ≠ CHANGED
Item Number
45221
Schedule Fee
$313.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$140.70 ≠ CHANGED
Item Number
45224
Schedule Fee
$140.70
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$533.15 ≠ CHANGED
Item Number
45227
Schedule Fee
$533.15
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: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$266.60 ≠ CHANGED
Item Number
45230
Schedule Fee
$266.60
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$567.05 ≠ CHANGED
Item Number
45233
Schedule Fee
$567.05
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: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 2 		$313.15 ≠ CHANGED
Item Number
45239
Schedule Fee
$313.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 2
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 		$340.30 ≠ CHANGED
Item Number
45440
Schedule Fee
$340.30
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2023
Gov. Change Flags
Fee ≠
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.)
Group T8 		$702.00 ≠ CHANGED
Item Number
45443
Schedule Fee
$702.00
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2023
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 3 		$567.05 ≠ CHANGED
Item Number
45451
Schedule Fee
$567.05
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 3
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$498.05 ≠ CHANGED
Item Number
45496
Schedule Fee
$498.05
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.05.2000
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$379.40 ≠ CHANGED
Item Number
45497
Schedule Fee
$379.40
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.05.2000
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$1304.95 ≠ CHANGED
Item Number
45500
Schedule Fee
$1304.95
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$2124.10 ≠ CHANGED
Item Number
45501
Schedule Fee
$2124.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.03.1999
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$3186.20 ≠ CHANGED
Item Number
45502
Schedule Fee
$3186.20
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$2430.10 ≠ CHANGED
Item Number
45503
Schedule Fee
$2430.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$2124.10 ≠ CHANGED
Item Number
45504
Schedule Fee
$2124.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.03.1999
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$3216.75 ≠ CHANGED
Item Number
45505
Schedule Fee
$3216.75
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.03.1999
Gov. Change Flags
Fee ≠
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.)
Group T8 		$1957.50 ≠ CHANGED
Item Number
45507
Schedule Fee
$1957.50
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2023
Gov. Change Flags
Fee ≠
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.)
Group T8 		$263.15 ≠ CHANGED
Item Number
45510
Schedule Fee
$263.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2023
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$353.90 ≠ CHANGED
Item Number
45512
Schedule Fee
$353.90
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$223.25 ≠ CHANGED
Item Number
45515
Schedule Fee
$223.25
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: C
Effective Dates
Fee from: 01.07.2026
Item from: 01.12.1991
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$270.15 ≠ CHANGED
Item Number
45518
Schedule Fee
$270.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$1077.70 ≠ CHANGED
Item Number
45520
Schedule Fee
$1077.70
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$756.10 ≠ CHANGED
Item Number
45522
Schedule Fee
$756.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$1616.70 ≠ CHANGED
Item Number
45523
Schedule Fee
$1616.70
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2018
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$887.70 ≠ CHANGED
Item Number
45524
Schedule Fee
$887.70
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$1282.15 ≠ CHANGED
Item Number
45527
Schedule Fee
$1282.15
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 · Subheading 4 		$1331.35 ≠ CHANGED
Item Number
45528
Schedule Fee
$1331.35
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 19.06.1997
Gov. Change Flags
Fee ≠
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.)
Group T8 		$2243.65 ≠ CHANGED
Item Number
45529
Schedule Fee
$2243.65
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2023
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$1315.85 ≠ CHANGED
Item Number
45530
Schedule Fee
$1315.85
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
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
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.)
Group T8 		$2302.75 ≠ CHANGED
Item Number
45531
Schedule Fee
$2302.75
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2023
Gov. Change Flags
Fee ≠
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.)
Group T8 		$324.20 ≠ CHANGED
Item Number
45532
Schedule Fee
$324.20
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.07.2023
Gov. Change Flags
Fee ≠
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.)
Group T8 · Subheading 4 		$756.10 ≠ CHANGED
Item Number
45534
Schedule Fee
$756.10
Category
Category 3 — Therapeutic Procedures
Group / Subheading
Group T8 · Sub 4
Type Codes
Item: S
Fee: N
Benefit: A
Effective Dates
Fee from: 01.07.2026
Item from: 01.11.2021
Gov. Change Flags
Fee ≠
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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Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Vascular anomaly, large, deep, and involving major neurovascular structures, excision of, including dissection of muscles, nerves or major vessels (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Vascular anomaly, of neck, deep and involving major neurovascular structures, excision of, including dissection of cranial nerves and major vessels (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Vascular anomaly on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals, excision of (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
LYMPHOEDEMATOUS tissue or lymphangiectasis, of lower leg and foot, or thigh, or upper arm, or forearm and hand, major excision of (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Contour reconstruction by open repair of contour defects, due to deformity, if: (a) contour reconstructive surgery is indicated because the deformity is secondary to congenital absence of tissue or has arisen from trauma (other than trauma from previous cosmetic surgery); and (b) insertion of a non-biological implant is required, other than one or more of the following: (i) insertion of a non-biological implant that is a component of another service specified in Group T8; (ii) injection of liquid or semisolid material; (iii) an oral and maxillofacial implant service to which item 52321 applies; (iv) a service to insert mesh; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Limb or chest, decompression escharotomy of (including all incisions), for acute compartment syndrome secondary to burn (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Developmental breast abnormality, single stage correction of, if: (a) the correction involves either: (i) bilateral mastopexy for symmetrical tubular breasts; or (ii) surgery on both breasts with a combination of insertion of one or more implants (which must have at least a 10% volume difference), mastopexy or reduction mammaplasty, if there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least 20% in normally shaped breasts, or 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Developmental breast abnormality, 2 stage correction of, first stage, involving surgery on both breasts with a combination of insertion of one or more tissue expanders, mastopexy or reduction mammaplasty, if: (a) there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or (ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes. Applicable only once per occasion on which the service is provided (Anaes.) (Assist.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
DIRECT FLAP REPAIR, small (cross finger or similar), first stage (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
DIRECT FLAP REPAIR, small (cross finger or similar), second stage (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Indirect flap or tubed pedicle, formation of (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
DIRECT OR INDIRECT FLAP OR TUBED PEDICLE, delay of (Anaes.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Full thickness skin graft to one defect, with an average diameter of 5 mm or more (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
FLAP, free tissue transfer using microvascular techniques - revision of, by open operation (Anaes.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
Fee From
01.07.2026
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.)
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