Billing Codes — Australian Health Schedule Tracker

Showing 4201–4250 of 6045 Pg 85/121

	Item No.	Description	Category	Schedule Fee	100% Benefit	Status
	53403	MANDIBLE, treatment of fracture of, not requiring splinting Group O9	Category 4 — Oral & Maxillofacial Services	$188.95	—	≠ CHANGED
Item Number 53403 Schedule Fee $188.95 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 MANDIBLE, treatment of fracture of, not requiring splinting Sign in to watch this code → Get an email alert when this item changes
	53406	Maxilla, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$486.65	—	≠ CHANGED
Item Number 53406 Schedule Fee $486.65 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Maxilla, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53409	Mandible, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$486.65	—	≠ CHANGED
Item Number 53409 Schedule Fee $486.65 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53410	ZYGOMATIC BONE, treatment of fracture of, not requiring surgical reduction Group O9	Category 4 — Oral & Maxillofacial Services	$102.50	—	≠ CHANGED
Item Number 53410 Schedule Fee $102.50 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 ZYGOMATIC BONE, treatment of fracture of, not requiring surgical reduction Sign in to watch this code → Get an email alert when this item changes
	53411	Zygomatic bone, treatment of fracture of, requiring surgical reduction, by temporal, intra‑oral or other approach (H) (Anaes.) Group O9	Category 4 — Oral & Maxillofacial Services	$285.85	—	≠ CHANGED
Item Number 53411 Schedule Fee $285.85 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Zygomatic bone, treatment of fracture of, requiring surgical reduction, by temporal, intra‑oral or other approach (H) (Anaes.) Sign in to watch this code → Get an email alert when this item changes
	53412	Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at one site (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$469.30	—	≠ CHANGED
Item Number 53412 Schedule Fee $469.30 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at one site (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53413	Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 2 sites (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$574.95	—	≠ CHANGED
Item Number 53413 Schedule Fee $574.95 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 2 sites (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53414	Zygomatic bone, treatment of, requiring surgical reduction and involving internal or external fixation or both at 3 sites (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$660.50	—	≠ CHANGED
Item Number 53414 Schedule Fee $660.50 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Zygomatic bone, treatment of, requiring surgical reduction and involving internal or external fixation or both at 3 sites (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53415	Maxilla, treatment of fracture of, requiring open reduction (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$521.45	—	≠ CHANGED
Item Number 53415 Schedule Fee $521.45 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Maxilla, treatment of fracture of, requiring open reduction (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53416	Mandible, treatment of fracture of, requiring open reduction (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$521.45	—	≠ CHANGED
Item Number 53416 Schedule Fee $521.45 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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, treatment of fracture of, requiring open reduction (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53418	Maxilla, treatment of fracture of, requiring open reduction and internal fixation not involving a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$677.90	—	≠ CHANGED
Item Number 53418 Schedule Fee $677.90 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Maxilla, treatment of fracture of, requiring open reduction and internal fixation not involving a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53419	Mandible, treatment of fracture of, requiring open reduction and internal fixation not involving a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$677.90	—	≠ CHANGED
Item Number 53419 Schedule Fee $677.90 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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, treatment of fracture of, requiring open reduction and internal fixation not involving a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53422	Maxilla, treatment of fracture of, requiring open reduction and internal fixation involving a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$860.25	—	≠ CHANGED
Item Number 53422 Schedule Fee $860.25 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Maxilla, treatment of fracture of, requiring open reduction and internal fixation involving a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53423	Mandible, treatment of fracture of, requiring open reduction and internal fixation involving a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$860.25	—	≠ CHANGED
Item Number 53423 Schedule Fee $860.25 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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, treatment of fracture of, requiring open reduction and internal fixation involving a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53424	Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$738.00	—	≠ CHANGED
Item Number 53424 Schedule Fee $738.00 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53425	Mandible, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$738.00	—	≠ CHANGED
Item Number 53425 Schedule Fee $738.00 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53427	Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$1008.10	—	≠ CHANGED
Item Number 53427 Schedule Fee $1008.10 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53429	Mandible, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of a plate (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$1008.10	—	≠ CHANGED
Item Number 53429 Schedule Fee $1008.10 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of a plate (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53439	MANDIBLE, treatment of a closed fracture of, involving a joint surface (Anaes.) Group O9	Category 4 — Oral & Maxillofacial Services	$285.85	—	≠ CHANGED
Item Number 53439 Schedule Fee $285.85 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 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 MANDIBLE, treatment of a closed fracture of, involving a joint surface (Anaes.) Sign in to watch this code → Get an email alert when this item changes
	53453	Orbital cavity, reconstruction of a wall or floor with or without foreign implant (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$578.40	—	≠ CHANGED
Item Number 53453 Schedule Fee $578.40 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 Type Codes Item: S Fee: N Benefit: A Effective Dates Fee from: 01.07.2026 Item from: 01.11.1992 Gov. Change Flags Fee ≠ Full Description Orbital cavity, reconstruction of a wall or floor with or without foreign implant (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53455	Orbital cavity, bone or cartilage graft to orbital wall or floor including reduction of prolapsed or entrapped orbital contents (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$679.35	—	≠ CHANGED
Item Number 53455 Schedule Fee $679.35 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 Type Codes Item: S Fee: N Benefit: A Effective Dates Fee from: 01.07.2026 Item from: 01.11.1992 Gov. Change Flags Fee ≠ Full Description Orbital cavity, bone or cartilage graft to orbital wall or floor including reduction of prolapsed or entrapped orbital contents (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53458	NASAL BONES, treatment of fracture of, not being a service to which item 53459 or 53460 applies Group O9	Category 4 — Oral & Maxillofacial Services	$51.55	—	≠ CHANGED
Item Number 53458 Schedule Fee $51.55 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.05.1997 Gov. Change Flags Fee ≠ Full Description NASAL BONES, treatment of fracture of, not being a service to which item 53459 or 53460 applies Sign in to watch this code → Get an email alert when this item changes
	53459	NASAL BONES, treatment of fracture of, by reduction (Anaes.) Group O9	Category 4 — Oral & Maxillofacial Services	$281.85	—	≠ CHANGED
Item Number 53459 Schedule Fee $281.85 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.05.1997 Gov. Change Flags Fee ≠ Full Description NASAL BONES, treatment of fracture of, by reduction (Anaes.) Sign in to watch this code → Get an email alert when this item changes
	53460	Nasal bones, treatment of fractures of, by open reduction involving osteotomies (H) (Anaes.) (Assist.) Group O9	Category 4 — Oral & Maxillofacial Services	$574.95	—	≠ CHANGED
Item Number 53460 Schedule Fee $574.95 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O9 Type Codes Item: S Fee: N Benefit: A Effective Dates Fee from: 01.07.2026 Item from: 01.05.1997 Gov. Change Flags Fee ≠ Full Description Nasal bones, treatment of fractures of, by open reduction involving osteotomies (H) (Anaes.) (Assist.) Sign in to watch this code → Get an email alert when this item changes
	53700	(Note. Where an anaesthetic combines a regional nerve block with a general anaesthetic for an operative procedure, benefits will be paid only under the anaesthetic item relevant to the operation. The items in this Group are to be used in the practice of oral and maxillofacial surgery and are not to be used for dental procedures (eg. restorative dentistry or dental extraction.)) TRIGEMINAL NERVE, primary division of, injection of an anaesthetic agent Group O11	Category 4 — Oral & Maxillofacial Services	$149.45	—	≠ CHANGED
Item Number 53700 Schedule Fee $149.45 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O11 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.11.2000 Gov. Change Flags Fee ≠ Full Description (Note. Where an anaesthetic combines a regional nerve block with a general anaesthetic for an operative procedure, benefits will be paid only under the anaesthetic item relevant to the operation. The items in this Group are to be used in the practice of oral and maxillofacial surgery and are not to be used for dental procedures (eg. restorative dentistry or dental extraction.)) TRIGEMINAL NERVE, primary division of, injection of an anaesthetic agent Sign in to watch this code → Get an email alert when this item changes
	53702	TRIGEMINAL NERVE, peripheral branch of, injection of an anaesthetic agent Group O11	Category 4 — Oral & Maxillofacial Services	$74.85	—	≠ CHANGED
Item Number 53702 Schedule Fee $74.85 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O11 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.11.2000 Gov. Change Flags Fee ≠ Full Description TRIGEMINAL NERVE, peripheral branch of, injection of an anaesthetic agent Sign in to watch this code → Get an email alert when this item changes
	53704	FACIAL NERVE, injection of an anaesthetic agent Group O11	Category 4 — Oral & Maxillofacial Services	$45.10	—	≠ CHANGED
Item Number 53704 Schedule Fee $45.10 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O11 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.11.2000 Gov. Change Flags Fee ≠ Full Description FACIAL NERVE, injection of an anaesthetic agent Sign in to watch this code → Get an email alert when this item changes
	53706	NERVE BRANCH, destruction by a neurolytic agent, not being a service to which any other item in this Group applies Group O11	Category 4 — Oral & Maxillofacial Services	$149.45	—	≠ CHANGED
Item Number 53706 Schedule Fee $149.45 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O11 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.11.2000 Gov. Change Flags Fee ≠ Full Description NERVE BRANCH, destruction by a neurolytic agent, not being a service to which any other item in this Group applies Sign in to watch this code → Get an email alert when this item changes
	54001	Video attendance (other than a second or subsequent attendance in a single course of treatment) by an approved dental practitioner in the practice of oral and maxillofacial surgery, if the patient is referred to the approved dental practitioner Group O1	Category 4 — Oral & Maxillofacial Services	$102.35	—	≠ CHANGED
Item Number 54001 Schedule Fee $102.35 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O1 Type Codes Item: D Fee: N Benefit: B Effective Dates Fee from: 01.07.2026 Item from: 22.05.2020 EMSN Cap Max: $500.00 %: 300% Gov. Change Flags Fee ≠ Full Description Video attendance (other than a second or subsequent attendance in a single course of treatment) by an approved dental practitioner in the practice of oral and maxillofacial surgery, if the patient is referred to the approved dental practitioner Sign in to watch this code → Get an email alert when this item changes
	54002	Video attendance by an approved dental practitioner in the practice of oral and maxillofacial surgery, each attendance after the first in a single course of treatment, if the patient is referred to the approved dental practitioner Group O1	Category 4 — Oral & Maxillofacial Services	$51.50	—	≠ CHANGED
Item Number 54002 Schedule Fee $51.50 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O1 Type Codes Item: D Fee: N Benefit: B Effective Dates Fee from: 01.07.2026 Item from: 22.05.2020 EMSN Cap Max: $500.00 %: 300% Gov. Change Flags Fee ≠ Full Description Video attendance by an approved dental practitioner in the practice of oral and maxillofacial surgery, each attendance after the first in a single course of treatment, if the patient is referred to the approved dental practitioner Sign in to watch this code → Get an email alert when this item changes
	54004	Phone attendance by an approved dental practitioner in the practice of oral and maxillofacial surgery, each attendance after the first in a single course of treatment, if the patient is referred to the approved dental practitioner Group O1	Category 4 — Oral & Maxillofacial Services	$51.50	—	≠ CHANGED
Item Number 54004 Schedule Fee $51.50 Category Category 4 — Oral & Maxillofacial Services Group / Subheading Group O1 Type Codes Item: D Fee: N Benefit: B Effective Dates Fee from: 01.07.2026 Item from: 22.05.2020 EMSN Cap Max: $500.00 %: 300% Gov. Change Flags Fee ≠ Full Description Phone attendance by an approved dental practitioner in the practice of oral and maxillofacial surgery, each attendance after the first in a single course of treatment, if the patient is referred to the approved dental practitioner Sign in to watch this code → Get an email alert when this item changes
	55028	Head, ultrasound scan of (R) Group I1	Category 5 — Diagnostic Imaging	$128.60	—	≠ CHANGED
Item Number 55028 Schedule Fee $128.60 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Head, ultrasound scan of (R) Sign in to watch this code → Get an email alert when this item changes
	55029	Head, ultrasound scan of (NR) Group I1	Category 5 — Diagnostic Imaging	$44.55	—	≠ CHANGED
Item Number 55029 Schedule Fee $44.55 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Head, ultrasound scan of (NR) Sign in to watch this code → Get an email alert when this item changes
	55030	Orbital contents, ultrasound scan of (R) Group I1	Category 5 — Diagnostic Imaging	$128.60	—	≠ CHANGED
Item Number 55030 Schedule Fee $128.60 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Orbital contents, ultrasound scan of (R) Sign in to watch this code → Get an email alert when this item changes
	55031	Orbital contents, ultrasound scan of (NR) Group I1	Category 5 — Diagnostic Imaging	$44.55	—	≠ CHANGED
Item Number 55031 Schedule Fee $44.55 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Orbital contents, ultrasound scan of (NR) Sign in to watch this code → Get an email alert when this item changes
	55032	Neck, one or more structures of, ultrasound scan of (R) Group I1	Category 5 — Diagnostic Imaging	$128.60	—	≠ CHANGED
Item Number 55032 Schedule Fee $128.60 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Neck, one or more structures of, ultrasound scan of (R) Sign in to watch this code → Get an email alert when this item changes
	55033	Neck, one or more structures of, ultrasound scan of (NR) Group I1	Category 5 — Diagnostic Imaging	$44.55	—	≠ CHANGED
Item Number 55033 Schedule Fee $44.55 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Neck, one or more structures of, ultrasound scan of (NR) Sign in to watch this code → Get an email alert when this item changes
	55036	Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if: (a) the service is not solely a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra; and(b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R) Group I1	Category 5 — Diagnostic Imaging	$131.00	—	≠ CHANGED
Item Number 55036 Schedule Fee $131.00 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if: (a) the service is not solely a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra; and(b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R) Sign in to watch this code → Get an email alert when this item changes
	55037	Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if the service is not solely a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra (NR) Group I1	Category 5 — Diagnostic Imaging	$44.55	—	≠ CHANGED
Item Number 55037 Schedule Fee $44.55 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if the service is not solely a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra (NR) Sign in to watch this code → Get an email alert when this item changes
	55038	Urinary tract, ultrasound scan of, if: (a) the service is not solely a transrectal ultrasonic examination of any of the following: (i) prostate gland; (ii) bladder base; (iii) urethra; and (b) within 24 hours of the service, a service mentioned in item 55036 or 55065 is not performed on the same patient by the providing practitioner (R) Group I1	Category 5 — Diagnostic Imaging	$128.60	—	≠ CHANGED
Item Number 55038 Schedule Fee $128.60 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Urinary tract, ultrasound scan of, if: (a) the service is not solely a transrectal ultrasonic examination of any of the following: (i) prostate gland; (ii) bladder base; (iii) urethra; and (b) within 24 hours of the service, a service mentioned in item 55036 or 55065 is not performed on the same patient by the providing practitioner (R) Sign in to watch this code → Get an email alert when this item changes
	55039	Urinary tract, ultrasound scan of, if the service is not solely a transrectal ultrasonic examination of any of the following: (a) prostate gland; (b) bladder base; (c) urethra (NR) Group I1	Category 5 — Diagnostic Imaging	$44.55	—	≠ CHANGED
Item Number 55039 Schedule Fee $44.55 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Urinary tract, ultrasound scan of, if the service is not solely a transrectal ultrasonic examination of any of the following: (a) prostate gland; (b) bladder base; (c) urethra (NR) Sign in to watch this code → Get an email alert when this item changes
	55048	Scrotum, ultrasound scan of (R) Group I1	Category 5 — Diagnostic Imaging	$129.00	—	≠ CHANGED
Item Number 55048 Schedule Fee $129.00 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Scrotum, ultrasound scan of (R) Sign in to watch this code → Get an email alert when this item changes
	55049	Scrotum, ultrasound scan of (NR) Group I1	Category 5 — Diagnostic Imaging	$44.55	—	≠ CHANGED
Item Number 55049 Schedule Fee $44.55 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 Gov. Change Flags Fee ≠ Full Description Scrotum, ultrasound scan of (NR) Sign in to watch this code → Get an email alert when this item changes
	55054	Ultrasonic cross-sectional echography, in conjunction with a surgical procedure (other than a procedure to which item 55848 or 55850 applies) using interventional techniques, not being a service associated with a service to which any other item in this Group applies (R) Group I1	Category 5 — Diagnostic Imaging	$128.60	—	≠ CHANGED
Item Number 55054 Schedule Fee $128.60 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.1993 EMSN Cap %: 80% Gov. Change Flags Fee ≠ Full Description Ultrasonic cross-sectional echography, in conjunction with a surgical procedure (other than a procedure to which item 55848 or 55850 applies) using interventional techniques, not being a service associated with a service to which any other item in this Group applies (R) Sign in to watch this code → Get an email alert when this item changes
	55065	Pelvis, ultrasound scan of, by any or all approaches, if:(a) the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following: prostate gland; bladder base; urethra; and (b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R) Group I1	Category 5 — Diagnostic Imaging	$115.80	—	≠ CHANGED
Item Number 55065 Schedule Fee $115.80 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.2014 Gov. Change Flags Fee ≠ Full Description Pelvis, ultrasound scan of, by any or all approaches, if:(a) the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following: prostate gland; bladder base; urethra; and (b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R) Sign in to watch this code → Get an email alert when this item changes
	55066	Breasts, both, ultrasound scan, in conjunction with a surgical procedure using interventional techniques, if:(a) the request for the scan indicates that an ultrasound-guided breast intervention be performed; and(b) the service is not performed in conjunction with a service to which any other item in this Group applies (other than item 55070, 55071, 55073, 55076, 55079 or 55812) (R) Group I1	Category 5 — Diagnostic Imaging	$257.00	—	≠ CHANGED
Item Number 55066 Schedule Fee $257.00 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.05.2020 Gov. Change Flags Fee ≠ Descriptor ≠ Full Description Breasts, both, ultrasound scan, in conjunction with a surgical procedure using interventional techniques, if:(a) the request for the scan indicates that an ultrasound-guided breast intervention be performed; and(b) the service is not performed in conjunction with a service to which any other item in this Group applies (other than item 55070, 55071, 55073, 55076, 55079 or 55812) (R) Sign in to watch this code → Get an email alert when this item changes
	55068	Pelvis, ultrasound scan of, by any or all approaches, if the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra (NR) Group I1	Category 5 — Diagnostic Imaging	$41.15	—	≠ CHANGED
Item Number 55068 Schedule Fee $41.15 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.07.2014 Gov. Change Flags Fee ≠ Full Description Pelvis, ultrasound scan of, by any or all approaches, if the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following:(i) prostate gland;(ii) bladder base;(iii) urethra (NR) Sign in to watch this code → Get an email alert when this item changes
	55070	Breast, one, ultrasound scan of (R) Group I1	Category 5 — Diagnostic Imaging	$115.80	—	≠ CHANGED
Item Number 55070 Schedule Fee $115.80 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.02.2000 Gov. Change Flags Fee ≠ Full Description Breast, one, ultrasound scan of (R) Sign in to watch this code → Get an email alert when this item changes
	55071	Breast, one, ultrasound scan, in conjunction with a surgical procedure using interventional techniques, if:(a) the request for the scan indicates that an ultrasound-guided breast intervention be performed; and(b) the service is not performed in conjunction with a service to which any other item in this Group applies (other than item 55066, 55070, 55073, 55076, 55079 or 55812) (R) Group I1	Category 5 — Diagnostic Imaging	$244.25	—	≠ CHANGED
Item Number 55071 Schedule Fee $244.25 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.05.2020 Gov. Change Flags Fee ≠ Descriptor ≠ Full Description Breast, one, ultrasound scan, in conjunction with a surgical procedure using interventional techniques, if:(a) the request for the scan indicates that an ultrasound-guided breast intervention be performed; and(b) the service is not performed in conjunction with a service to which any other item in this Group applies (other than item 55066, 55070, 55073, 55076, 55079 or 55812) (R) Sign in to watch this code → Get an email alert when this item changes
	55073	Breast, one, ultrasound scan of (NR) Group I1	Category 5 — Diagnostic Imaging	$40.05	—	≠ CHANGED
Item Number 55073 Schedule Fee $40.05 Category Category 5 — Diagnostic Imaging Group / Subheading Group I1 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2026 Item from: 01.02.2000 Gov. Change Flags Fee ≠ Full Description Breast, one, ultrasound scan of (NR) Sign in to watch this code → Get an email alert when this item changes

Fee From

01.07.2026

Category