Billing Codes
Medicare Benefits Schedule — Updated Quarterly

MBS Item Tracker

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Total Items
6045
MBS item numbers
Showing 3101–3150 of 6045 Pg 63/121
Item No. Description Schedule Fee Status
45535
Autologous fat grafting, bilateral service (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for one or more of the following purposes: (i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage; (ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction; (iii) breast reconstruction in breast cancer patients; (iv) the correction of developmental disorders of the breast; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Up to a total of 4 services, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.)
Group T8 · Subheading 4 		$1323.35 ≠ CHANGED
Item Number
45535
Schedule Fee
$1323.35
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: 01.11.2021
Gov. Change Flags
Fee ≠
Full Description
Autologous fat grafting, bilateral service (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for one or more of the following purposes: (i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage; (ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction; (iii) breast reconstruction in breast cancer patients; (iv) the correction of developmental disorders of the breast; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Up to a total of 4 services, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.)
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45537
Perforator flap, such as a thoracodorsal artery perforator (TDAP) flap or a lateral intercostal artery perforator (LICAP) flap, or similar, raising on a named source vessel, for reconstruction of a partial mastectomy defect, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Group T8 		$941.45 ≠ CHANGED
Item Number
45537
Schedule Fee
$941.45
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
Perforator flap, such as a thoracodorsal artery perforator (TDAP) flap or a lateral intercostal artery perforator (LICAP) flap, or similar, raising on a named source vessel, for reconstruction of a partial mastectomy defect, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
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45538
Perforator flap, such as a deep inferior epigastric perforator (DIEP) flap or similar, raising in preparation for microsurgical transfer of a free flap for post mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Group T8 		$1077.20 ≠ CHANGED
Item Number
45538
Schedule Fee
$1077.20
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
Perforator flap, such as a deep inferior epigastric perforator (DIEP) flap or similar, raising in preparation for microsurgical transfer of a free flap for post mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
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45539
Breast reconstruction (unilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1726.00 ≠ CHANGED
Item Number
45539
Schedule Fee
$1726.00
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 tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
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45540
Breast reconstruction (bilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Group T8 		$3020.35 ≠ CHANGED
Item Number
45540
Schedule Fee
$3020.35
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 tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
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45541
Breast reconstruction (bilateral), following mastectomy, using tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Group T8 		$1284.80 ≠ CHANGED
Item Number
45541
Schedule Fee
$1284.80
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 tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
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45542
Breast reconstruction (unilateral), following mastectomy, using tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$734.15 ≠ CHANGED
Item Number
45542
Schedule Fee
$734.15
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 tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
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45545
Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.)
Group T8 · Subheading 4 		$745.15 ≠ CHANGED
Item Number
45545
Schedule Fee
$745.15
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
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
Full Description
Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.)
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45546
NIPPLE OR AREOLA or both, intradermal colouration of, following breast reconstruction after mastectomy or for congenital absence of nipple
Group T8 · Subheading 4 		$236.80 ≠ CHANGED
Item Number
45546
Schedule Fee
$236.80
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: 01.11.1998
Gov. Change Flags
Fee ≠
Full Description
NIPPLE OR AREOLA or both, intradermal colouration of, following breast reconstruction after mastectomy or for congenital absence of nipple
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45547
Revision of breast prosthesis pocket, if:(a) breast prosthesis or tissue expander has been placed for the purpose of breast reconstruction in the context of breast cancer or for developmental breast abnormality; and(b) the prosthesis or tissue expander has migrated or rotated from its intended position or orientation; and(c) the existing prosthesis is used(H) (Anaes.) (Assist.)
Group T8 		$837.15 ≠ CHANGED
Item Number
45547
Schedule Fee
$837.15
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 breast prosthesis pocket, if:(a) breast prosthesis or tissue expander has been placed for the purpose of breast reconstruction in the context of breast cancer or for developmental breast abnormality; and(b) the prosthesis or tissue expander has migrated or rotated from its intended position or orientation; and(c) the existing prosthesis is used(H) (Anaes.) (Assist.)
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45548
Breast prosthesis, removal of, as an independent procedure (H) (Anaes.)
Group T8 · Subheading 4 		$331.25 ≠ CHANGED
Item Number
45548
Schedule Fee
$331.25
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 prosthesis, removal of, as an independent procedure (H) (Anaes.)
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45551
Breast prosthesis, removal of, with excision of at least half of the fibrous capsule, not with insertion of any prosthesis. The excised specimen must be sent for histopathology and the volume removed must be documented in the histopathology report (Anaes.) (Assist.)
Group T8 · Subheading 4 		$531.10 ≠ CHANGED
Item Number
45551
Schedule Fee
$531.10
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
Breast prosthesis, removal of, with excision of at least half of the fibrous capsule, not with insertion of any prosthesis. The excised specimen must be sent for histopathology and the volume removed must be documented in the histopathology report (Anaes.) (Assist.)
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45553
Breast prosthesis, removal of and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Group T8 · Subheading 4 		$684.15 ≠ CHANGED
Item Number
45553
Schedule Fee
$684.15
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: 01.11.2006
Gov. Change Flags
Fee ≠
Full Description
Breast prosthesis, removal of and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
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45554
Breast prosthesis, removal and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), including excision of at least half of the fibrous capsule or formation of a new pocket, or both, if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) the excised specimen is sent for histopathology and the volume removed is documented in the histopathology report; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Group T8 · Subheading 4 		$837.15 ≠ CHANGED
Item Number
45554
Schedule Fee
$837.15
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 prosthesis, removal and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), including excision of at least half of the fibrous capsule or formation of a new pocket, or both, if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) the excised specimen is sent for histopathology and the volume removed is documented in the histopathology report; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
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45556
Breast ptosis, correction of (unilateral), in the context of breast cancer or developmental abnormality, if photographic evidence (including anterior, left lateral and right lateral views) and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided, other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$916.85 ≠ CHANGED
Item Number
45556
Schedule Fee
$916.85
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: 01.11.2001
Gov. Change Flags
Fee ≠
Full Description
Breast ptosis, correction of (unilateral), in the context of breast cancer or developmental abnormality, if photographic evidence (including anterior, left lateral and right lateral views) and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided, other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side (H) (Anaes.) (Assist.)
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45558
Correction of bilateral breast ptosis by mastopexy, if: (a) at least two‑thirds of the breast tissue, including the nipple, lies inferior to the inframammary fold where the nipple is located at the most dependent, inferior part of the breast contour; and (b) photographic evidence (including anterior, left lateral and right lateral views), with a marker at the level of the inframammary fold, demonstrating the clinical need for this service, is documented in the patient notes Applicable only once per lifetime, other than a service associated with a service to which item 31512, 31513 or 31514 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1375.20 ≠ CHANGED
Item Number
45558
Schedule Fee
$1375.20
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: 01.11.2001
Gov. Change Flags
Fee ≠
Full Description
Correction of bilateral breast ptosis by mastopexy, if: (a) at least two‑thirds of the breast tissue, including the nipple, lies inferior to the inframammary fold where the nipple is located at the most dependent, inferior part of the breast contour; and (b) photographic evidence (including anterior, left lateral and right lateral views), with a marker at the level of the inframammary fold, demonstrating the clinical need for this service, is documented in the patient notes Applicable only once per lifetime, other than a service associated with a service to which item 31512, 31513 or 31514 applies (H) (Anaes.) (Assist.)
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45560
HAIR TRANSPLANTATION for the treatment of alopecia of congenital or traumatic origin or due to disease, excluding male pattern baldness, not being a service to which another item in this Group applies (Anaes.)
Group T8 · Subheading 4 		$566.95 ≠ CHANGED
Item Number
45560
Schedule Fee
$566.95
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
EMSN Cap
%: 35%
Gov. Change Flags
Fee ≠
Full Description
HAIR TRANSPLANTATION for the treatment of alopecia of congenital or traumatic origin or due to disease, excluding male pattern baldness, not being a service to which another item in this Group applies (Anaes.)
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45561
Microvascular anastomosis of artery and/or vein, if considered necessary to salvage a vascularly compromised pedicled or free flap, either during the primary procedure or at a subsequent return to theatre (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$2124.10 ≠ CHANGED
Item Number
45561
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: 01.05.2007
Gov. Change Flags
Fee ≠
Full Description
Microvascular anastomosis of artery and/or vein, if considered necessary to salvage a vascularly compromised pedicled or free flap, either during the primary procedure or at a subsequent return to theatre (H) (Anaes.) (Assist.)
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45562
Free transfer of tissue (microvascular free flap) for non-breast defect involving raising of tissue on vascular pedicle, including direct repair of secondary cutaneous defect (if performed), other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1315.85 ≠ CHANGED
Item Number
45562
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: 01.03.1999
Gov. Change Flags
Fee ≠
Full Description
Free transfer of tissue (microvascular free flap) for non-breast defect involving raising of tissue on vascular pedicle, including direct repair of secondary cutaneous defect (if performed), other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.)
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45563
Neurovascular island flap for restoration of essential sensation in the digits or sole of the foot, or for genital reconstruction, including:(a) direct repair of secondary cutaneous defect (if performed); and(b) formal dissection of the neurovascular pedicle;other than a service performed on simple V-Y flaps or other standard flaps, such as rotation or keystone (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1315.85 ≠ CHANGED
Item Number
45563
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
Neurovascular island flap for restoration of essential sensation in the digits or sole of the foot, or for genital reconstruction, including:(a) direct repair of secondary cutaneous defect (if performed); and(b) formal dissection of the neurovascular pedicle;other than a service performed on simple V-Y flaps or other standard flaps, such as rotation or keystone (H) (Anaes.) (Assist.)
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45564
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$3047.70 ≠ CHANGED
Item Number
45564
Schedule Fee
$3047.70
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: 01.11.1999
Gov. Change Flags
Fee ≠
Full Description
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
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45565
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$2285.90 ≠ CHANGED
Item Number
45565
Schedule Fee
$2285.90
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: 01.11.1999
Gov. Change Flags
Fee ≠
Full Description
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
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45566
Insertion of a temporary prosthetic tissue expander which requires subsequent removal, including all attendances for subsequent expansion injections, other than a service for breast or post-mastectomy tissue expansion (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1282.15 ≠ CHANGED
Item Number
45566
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
Insertion of a temporary prosthetic tissue expander which requires subsequent removal, including all attendances for subsequent expansion injections, other than a service for breast or post-mastectomy tissue expansion (H) (Anaes.) (Assist.)
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45567
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562, 45564 or 45565 applies—single surgeon (H) (Anaes.) (Assist.)
Group T8 		$3515.20 ≠ CHANGED
Item Number
45567
Schedule Fee
$3515.20
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
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562, 45564 or 45565 applies—single surgeon (H) (Anaes.) (Assist.)
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45568
Tissue expander, removal of, including complete excision of fibrous capsule if performed (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$531.10 ≠ CHANGED
Item Number
45568
Schedule Fee
$531.10
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: 01.11.2003
Gov. Change Flags
Fee ≠
Full Description
Tissue expander, removal of, including complete excision of fibrous capsule if performed (H) (Anaes.) (Assist.)
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45571
Closure of abdomen with reconstruction of umbilicus, with or without lipectomy, to be used following the harvest of an autologous flap, being a service associated with a service to which item 45530, 45531, 45562, 45564, 45565, 45567, 46080, 46082, 46084, 46086, 46088 or 46090 applies, including repair of the musculoaponeurotic layer of the abdomen (including insertion of prosthetic mesh if used) (H) (Anaes.) (Assist.)
Group T8 		$1238.75 ≠ CHANGED
Item Number
45571
Schedule Fee
$1238.75
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
Closure of abdomen with reconstruction of umbilicus, with or without lipectomy, to be used following the harvest of an autologous flap, being a service associated with a service to which item 45530, 45531, 45562, 45564, 45565, 45567, 46080, 46082, 46084, 46086, 46088 or 46090 applies, including repair of the musculoaponeurotic layer of the abdomen (including insertion of prosthetic mesh if used) (H) (Anaes.) (Assist.)
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45572
Intra-operative tissue expansion using a prosthetic tissue expander, performed under general anaesthetic or intravenous sedation during an operation, if combined with a service to which another item in Group T8 applies (including expansion injections), not to be used for breast tissue expansion (H) (Anaes.)
Group T8 · Subheading 4 		$349.15 ≠ CHANGED
Item Number
45572
Schedule Fee
$349.15
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
Intra-operative tissue expansion using a prosthetic tissue expander, performed under general anaesthetic or intravenous sedation during an operation, if combined with a service to which another item in Group T8 applies (including expansion injections), not to be used for breast tissue expansion (H) (Anaes.)
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45575
Facial nerve paralysis, free fascia graft for (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$862.05 ≠ CHANGED
Item Number
45575
Schedule Fee
$862.05
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Facial nerve paralysis, free fascia graft for (H) (Anaes.) (Assist.)
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45578
FACIAL NERVE PARALYSIS, muscle transfer for (Anaes.) (Assist.)
Group T8 · Subheading 4 		$998.30 ≠ CHANGED
Item Number
45578
Schedule Fee
$998.30
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
FACIAL NERVE PARALYSIS, muscle transfer for (Anaes.) (Assist.)
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45581
Facial nerve paralysis, excision of tissue for (H) (Anaes.)
Group T8 · Subheading 4 		$331.25 ≠ CHANGED
Item Number
45581
Schedule Fee
$331.25
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
Facial nerve paralysis, excision of tissue for (H) (Anaes.)
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45584
Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), for treatment of post traumatic pseudolipoma, if photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
Group T8 · Subheading 4 		$756.10 ≠ CHANGED
Item Number
45584
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), for treatment of post traumatic pseudolipoma, if photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
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45585
Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), other than a service associated with a service to which item 31525 or 31526 applies, if: (a) the liposuction is for: (i) the treatment of Barraquer-Simons syndrome, lymphoedema or macrodystrophia lipomatosa; or (ii) the reduction of a buffalo hump that is secondary to an endocrine disorder or pharmacological treatment of a medical condition; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (H) (Anaes.)
Group T8 · Subheading 4 		$756.10 ≠ CHANGED
Item Number
45585
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: 19.06.1997
Gov. Change Flags
Fee ≠
Full Description
Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), other than a service associated with a service to which item 31525 or 31526 applies, if: (a) the liposuction is for: (i) the treatment of Barraquer-Simons syndrome, lymphoedema or macrodystrophia lipomatosa; or (ii) the reduction of a buffalo hump that is secondary to an endocrine disorder or pharmacological treatment of a medical condition; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (H) (Anaes.)
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45587
Meloplasty for correction of facial asymmetry if: (a) the asymmetry is secondary to trauma (including previous surgery), a congenital condition or a medical condition (such as facial nerve palsy); and (b) the meloplasty is limited to one side of the face (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1066.25 ≠ CHANGED
Item Number
45587
Schedule Fee
$1066.25
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
Meloplasty for correction of facial asymmetry if: (a) the asymmetry is secondary to trauma (including previous surgery), a congenital condition or a medical condition (such as facial nerve palsy); and (b) the meloplasty is limited to one side of the face (Anaes.) (Assist.)
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45588
Meloplasty (excluding browlifts and chinlift platysmaplasties), bilateral, if: (a) surgery is indicated to correct a functional impairment due to a congenital condition, disease (excluding post-acne scarring) or trauma (other than trauma resulting from previous elective cosmetic surgery); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1599.55 ≠ CHANGED
Item Number
45588
Schedule Fee
$1599.55
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
Meloplasty (excluding browlifts and chinlift platysmaplasties), bilateral, if: (a) surgery is indicated to correct a functional impairment due to a congenital condition, disease (excluding post-acne scarring) or trauma (other than trauma resulting from previous elective cosmetic surgery); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
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45589
Autologous fat grafting (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for either or both of the following purposes: (i) the correction of asymmetry arising from volume and contour defects in craniofacial disorders—up to a total of 4 services if each service is provided at least 3 months after the previous service; (ii) the treatment of burn scar or associated skin graft in the context of scar contracture, contour deformity or neuropathic pain, for patients who have undergone a minimum of 3 months of topical therapies, including silicone and pressure therapy, with an unsatisfactory or minimal level of improvement—up to a total of 4 services per region of the body (upper or lower limbs, trunk, neck or face) if each service provided per region of the body is provided at least 3 months after the previous such service; and (b) both: (i) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes; and (ii) for craniofacial disorders, evidence of diagnosis of the qualifying craniofacial disorder is documented in the patient notes (H) (Anaes.)
Group T8 · Subheading 4 		$756.10 ≠ CHANGED
Item Number
45589
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 (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for either or both of the following purposes: (i) the correction of asymmetry arising from volume and contour defects in craniofacial disorders—up to a total of 4 services if each service is provided at least 3 months after the previous service; (ii) the treatment of burn scar or associated skin graft in the context of scar contracture, contour deformity or neuropathic pain, for patients who have undergone a minimum of 3 months of topical therapies, including silicone and pressure therapy, with an unsatisfactory or minimal level of improvement—up to a total of 4 services per region of the body (upper or lower limbs, trunk, neck or face) if each service provided per region of the body is provided at least 3 months after the previous such service; and (b) both: (i) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes; and (ii) for craniofacial disorders, evidence of diagnosis of the qualifying craniofacial disorder is documented in the patient notes (H) (Anaes.)
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45590
Orbital cavity, reconstruction of wall or floor, with or without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530 or 45594 applies on the same side (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$578.40 ≠ CHANGED
Item Number
45590
Schedule Fee
$578.40
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Orbital cavity, reconstruction of wall or floor, with or without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530 or 45594 applies on the same side (H) (Anaes.) (Assist.)
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45592
Orbital cavity, reconstruction of wall and floor with bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 45594 applies on the same side (H) (Anaes.) (Assist.)
Group T8 		$1018.75 ≠ CHANGED
Item Number
45592
Schedule Fee
$1018.75
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
Orbital cavity, reconstruction of wall and floor with bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 45594 applies on the same side (H) (Anaes.) (Assist.)
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45594
Orbital cavity, exploration of wall or floor without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530, 45590 or 45592 applies on the same side (H) (Anaes.) (Assist.)
Group T8 		$477.45 ≠ CHANGED
Item Number
45594
Schedule Fee
$477.45
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
Orbital cavity, exploration of wall or floor without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530, 45590 or 45592 applies on the same side (H) (Anaes.) (Assist.)
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45596
Hemimaxillectomy (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1077.70 ≠ CHANGED
Item Number
45596
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Hemimaxillectomy (H) (Anaes.) (Assist.)
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45597
Total maxillectomy (bilateral) (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1442.70 ≠ CHANGED
Item Number
45597
Schedule Fee
$1442.70
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: 01.04.1992
Gov. Change Flags
Fee ≠
Full Description
Total maxillectomy (bilateral) (H) (Anaes.) (Assist.)
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45599
Mandible, total resection of, other than a service associated with a service to which item 45608 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$1121.00 ≠ CHANGED
Item Number
45599
Schedule Fee
$1121.00
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
Mandible, total resection of, other than a service associated with a service to which item 45608 applies (H) (Anaes.) (Assist.)
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45602
MANDIBLE, including lower border, OR MAXILLA, sub-total resection of (Anaes.) (Assist.)
Group T8 · Subheading 4 		$837.15 ≠ CHANGED
Item Number
45602
Schedule Fee
$837.15
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
MANDIBLE, including lower border, OR MAXILLA, sub-total resection of (Anaes.) (Assist.)
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45605
MANDIBLE OR MAXILLA, segmental resection of, for tumours or cysts (Anaes.) (Assist.)
Group T8 · Subheading 4 		$703.25 ≠ CHANGED
Item Number
45605
Schedule Fee
$703.25
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
MANDIBLE OR MAXILLA, segmental resection of, for tumours or cysts (Anaes.) (Assist.)
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45608
Mandible, segmental mandibular or maxilla reconstruction with bone graft, not being a service associated with a service to which item 45599 applies (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$990.20 ≠ CHANGED
Item Number
45608
Schedule Fee
$990.20
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Mandible, segmental mandibular or maxilla reconstruction with bone graft, not being a service associated with a service to which item 45599 applies (H) (Anaes.) (Assist.)
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45609
Mandible, maxilla or skull base, reconstruction of, using bony free flap, all osteotomies, shaping, inset and fixation by any means, including all necessary 3 dimensional planning, if performed in conjunction with one or more services covered by items 46060 to 46068 (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$990.20 ≠ CHANGED
Item Number
45609
Schedule Fee
$990.20
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: 01.07.2023
Gov. Change Flags
Fee ≠
Full Description
Mandible, maxilla or skull base, reconstruction of, using bony free flap, all osteotomies, shaping, inset and fixation by any means, including all necessary 3 dimensional planning, if performed in conjunction with one or more services covered by items 46060 to 46068 (H) (Anaes.) (Assist.)
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45611
Mandible, condylectomy of (H) (Anaes.) (Assist.)
Group T8 · Subheading 4 		$567.05 ≠ CHANGED
Item Number
45611
Schedule Fee
$567.05
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: 01.12.1991
Gov. Change Flags
Fee ≠
Full Description
Mandible, condylectomy of (H) (Anaes.) (Assist.)
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45614
Eyelid, reconstruction of a defect (greater than one quarter of the length of the lid) involving all 3 layers of the eyelid, if unable to be closed by direct suture or wedge excision, including all flaps and grafts that may be required (Anaes.) (Assist.)
Group T8 · Subheading 4 		$998.30 ≠ CHANGED
Item Number
45614
Schedule Fee
$998.30
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
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
Full Description
Eyelid, reconstruction of a defect (greater than one quarter of the length of the lid) involving all 3 layers of the eyelid, if unable to be closed by direct suture or wedge excision, including all flaps and grafts that may be required (Anaes.) (Assist.)
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45617
Upper eyelid, reduction of, if: (a) the reduction is for any of the following: (i) history of a demonstrated visual impairment; (ii) intertriginous inflammation of the eyelid; (iii) herniation of orbital fat in exophthalmos; (iv) facial nerve palsy; (v) post‑traumatic scarring; (vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
Group T8 · Subheading 4 		$281.40 ≠ CHANGED
Item Number
45617
Schedule Fee
$281.40
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
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
Full Description
Upper eyelid, reduction of, if: (a) the reduction is for any of the following: (i) history of a demonstrated visual impairment; (ii) intertriginous inflammation of the eyelid; (iii) herniation of orbital fat in exophthalmos; (iv) facial nerve palsy; (v) post‑traumatic scarring; (vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
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45620
Lower eyelid, reduction of, if: (a) the reduction is for: (i) herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring; or (ii) the restoration of symmetry of the contralateral lower eyelid in respect of one of these conditions; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
Group T8 · Subheading 4 		$390.25 ≠ CHANGED
Item Number
45620
Schedule Fee
$390.25
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
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
Full Description
Lower eyelid, reduction of, if: (a) the reduction is for: (i) herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring; or (ii) the restoration of symmetry of the contralateral lower eyelid in respect of one of these conditions; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
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45623
Ptosis of upper eyelid (unilateral), correction of, by: (a) sutured elevation of the tarsal plate on the eyelid retractors (Muller’s or levator muscle or levator aponeurosis); or (b) sutured suspension to the brow/frontalis muscle; Not applicable to a service for repair of mechanical ptosis to which item 45617 applies (Anaes.) (Assist.)
Group T8 · Subheading 4 		$865.35 ≠ CHANGED
Item Number
45623
Schedule Fee
$865.35
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
EMSN Cap
%: 80%
Gov. Change Flags
Fee ≠
Full Description
Ptosis of upper eyelid (unilateral), correction of, by: (a) sutured elevation of the tarsal plate on the eyelid retractors (Muller’s or levator muscle or levator aponeurosis); or (b) sutured suspension to the brow/frontalis muscle; Not applicable to a service for repair of mechanical ptosis to which item 45617 applies (Anaes.) (Assist.)
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Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Autologous fat grafting, bilateral service (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for one or more of the following purposes: (i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage; (ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction; (iii) breast reconstruction in breast cancer patients; (iv) the correction of developmental disorders of the breast; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Up to a total of 4 services, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Perforator flap, such as a thoracodorsal artery perforator (TDAP) flap or a lateral intercostal artery perforator (LICAP) flap, or similar, raising on a named source vessel, for reconstruction of a partial mastectomy defect, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Perforator flap, such as a deep inferior epigastric perforator (DIEP) flap or similar, raising in preparation for microsurgical transfer of a free flap for post mastectomy breast reconstruction, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast reconstruction (unilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast reconstruction (bilateral), following mastectomy, using tissue expansion—insertion of tissue expansion unit and all attendances for subsequent expansion injections, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast reconstruction (bilateral), following mastectomy, using tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast reconstruction (unilateral), following mastectomy, using tissue expansion—removal of tissue expansion unit and insertion of permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
NIPPLE OR AREOLA or both, intradermal colouration of, following breast reconstruction after mastectomy or for congenital absence of nipple
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Revision of breast prosthesis pocket, if:(a) breast prosthesis or tissue expander has been placed for the purpose of breast reconstruction in the context of breast cancer or for developmental breast abnormality; and(b) the prosthesis or tissue expander has migrated or rotated from its intended position or orientation; and(c) the existing prosthesis is used(H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast prosthesis, removal of, as an independent procedure (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast prosthesis, removal of, with excision of at least half of the fibrous capsule, not with insertion of any prosthesis. The excised specimen must be sent for histopathology and the volume removed must be documented in the histopathology report (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast prosthesis, removal of and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast prosthesis, removal and replacement with another prosthesis, following medical complications (for rupture, migration of prosthetic material or symptomatic capsular contracture), including excision of at least half of the fibrous capsule or formation of a new pocket, or both, if: (a) either: (i) it is demonstrated by intra-operative photographs post-removal that removal alone would cause unacceptable deformity; or (ii) the original implant was inserted in the context of breast cancer or developmental abnormality; and (b) the excised specimen is sent for histopathology and the volume removed is documented in the histopathology report; and (c) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Breast ptosis, correction of (unilateral), in the context of breast cancer or developmental abnormality, if photographic evidence (including anterior, left lateral and right lateral views) and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided, other than a service associated with a service to which item 31512, 31513 or 31514 applies on the same side (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Correction of bilateral breast ptosis by mastopexy, if: (a) at least two‑thirds of the breast tissue, including the nipple, lies inferior to the inframammary fold where the nipple is located at the most dependent, inferior part of the breast contour; and (b) photographic evidence (including anterior, left lateral and right lateral views), with a marker at the level of the inframammary fold, demonstrating the clinical need for this service, is documented in the patient notes Applicable only once per lifetime, other than a service associated with a service to which item 31512, 31513 or 31514 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
HAIR TRANSPLANTATION for the treatment of alopecia of congenital or traumatic origin or due to disease, excluding male pattern baldness, not being a service to which another item in this Group applies (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Microvascular anastomosis of artery and/or vein, if considered necessary to salvage a vascularly compromised pedicled or free flap, either during the primary procedure or at a subsequent return to theatre (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Free transfer of tissue (microvascular free flap) for non-breast defect involving raising of tissue on vascular pedicle, including direct repair of secondary cutaneous defect (if performed), other than a service associated with a service to which item 45564, 45565, 45567, 46060, 46062, 46064, 46066, 46068, 46070 or 46072 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Neurovascular island flap for restoration of essential sensation in the digits or sole of the foot, or for genital reconstruction, including:(a) direct repair of secondary cutaneous defect (if performed); and(b) formal dissection of the neurovascular pedicle;other than a service performed on simple V-Y flaps or other standard flaps, such as rotation or keystone (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562 or 45567 applies—conjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Insertion of a temporary prosthetic tissue expander which requires subsequent removal, including all attendances for subsequent expansion injections, other than a service for breast or post-mastectomy tissue expansion (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Free transfer of tissue (reconstructive surgery) for the repair of major tissue defect of the head and neck or other non-breast defect, using microvascular techniques, all necessary elements of the operation including (but not limited to):(a) anastomoses of all required vessels; and(b) raising of tissue on a vascular pedicle; and(c) preparation of recipient vessels; and(d) transfer of tissue; and(e) insetting of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed;other than a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505, 45507, 45562, 45564 or 45565 applies—single surgeon (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Tissue expander, removal of, including complete excision of fibrous capsule if performed (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Closure of abdomen with reconstruction of umbilicus, with or without lipectomy, to be used following the harvest of an autologous flap, being a service associated with a service to which item 45530, 45531, 45562, 45564, 45565, 45567, 46080, 46082, 46084, 46086, 46088 or 46090 applies, including repair of the musculoaponeurotic layer of the abdomen (including insertion of prosthetic mesh if used) (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Intra-operative tissue expansion using a prosthetic tissue expander, performed under general anaesthetic or intravenous sedation during an operation, if combined with a service to which another item in Group T8 applies (including expansion injections), not to be used for breast tissue expansion (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Facial nerve paralysis, free fascia graft for (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
FACIAL NERVE PARALYSIS, muscle transfer for (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Facial nerve paralysis, excision of tissue for (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), for treatment of post traumatic pseudolipoma, if photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), other than a service associated with a service to which item 31525 or 31526 applies, if: (a) the liposuction is for: (i) the treatment of Barraquer-Simons syndrome, lymphoedema or macrodystrophia lipomatosa; or (ii) the reduction of a buffalo hump that is secondary to an endocrine disorder or pharmacological treatment of a medical condition; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Meloplasty for correction of facial asymmetry if: (a) the asymmetry is secondary to trauma (including previous surgery), a congenital condition or a medical condition (such as facial nerve palsy); and (b) the meloplasty is limited to one side of the face (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Meloplasty (excluding browlifts and chinlift platysmaplasties), bilateral, if: (a) surgery is indicated to correct a functional impairment due to a congenital condition, disease (excluding post-acne scarring) or trauma (other than trauma resulting from previous elective cosmetic surgery); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Autologous fat grafting (harvesting, preparation and injection of adipocytes) if: (a) the autologous fat grafting is for either or both of the following purposes: (i) the correction of asymmetry arising from volume and contour defects in craniofacial disorders—up to a total of 4 services if each service is provided at least 3 months after the previous service; (ii) the treatment of burn scar or associated skin graft in the context of scar contracture, contour deformity or neuropathic pain, for patients who have undergone a minimum of 3 months of topical therapies, including silicone and pressure therapy, with an unsatisfactory or minimal level of improvement—up to a total of 4 services per region of the body (upper or lower limbs, trunk, neck or face) if each service provided per region of the body is provided at least 3 months after the previous such service; and (b) both: (i) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes; and (ii) for craniofacial disorders, evidence of diagnosis of the qualifying craniofacial disorder is documented in the patient notes (H) (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Orbital cavity, reconstruction of wall or floor, with or without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530 or 45594 applies on the same side (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Orbital cavity, reconstruction of wall and floor with bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 45594 applies on the same side (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Orbital cavity, exploration of wall or floor without bone graft, cartilage graft or foreign implant, other than a service associated with a service to which item 42530, 45590 or 45592 applies on the same side (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Hemimaxillectomy (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Total maxillectomy (bilateral) (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Mandible, total resection of, other than a service associated with a service to which item 45608 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
MANDIBLE, including lower border, OR MAXILLA, sub-total resection of (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
MANDIBLE OR MAXILLA, segmental resection of, for tumours or cysts (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Mandible, segmental mandibular or maxilla reconstruction with bone graft, not being a service associated with a service to which item 45599 applies (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Mandible, maxilla or skull base, reconstruction of, using bony free flap, all osteotomies, shaping, inset and fixation by any means, including all necessary 3 dimensional planning, if performed in conjunction with one or more services covered by items 46060 to 46068 (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Mandible, condylectomy of (H) (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Eyelid, reconstruction of a defect (greater than one quarter of the length of the lid) involving all 3 layers of the eyelid, if unable to be closed by direct suture or wedge excision, including all flaps and grafts that may be required (Anaes.) (Assist.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Upper eyelid, reduction of, if: (a) the reduction is for any of the following: (i) history of a demonstrated visual impairment; (ii) intertriginous inflammation of the eyelid; (iii) herniation of orbital fat in exophthalmos; (iv) facial nerve palsy; (v) post‑traumatic scarring; (vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Lower eyelid, reduction of, if: (a) the reduction is for: (i) herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring; or (ii) the restoration of symmetry of the contralateral lower eyelid in respect of one of these conditions; and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)
Fee From
01.07.2026
Category
Category 3 — Therapeutic Procedures
Description
Ptosis of upper eyelid (unilateral), correction of, by: (a) sutured elevation of the tarsal plate on the eyelid retractors (Muller’s or levator muscle or levator aponeurosis); or (b) sutured suspension to the brow/frontalis muscle; Not applicable to a service for repair of mechanical ptosis to which item 45617 applies (Anaes.) (Assist.)
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