Group O4: Plastic & Reconstructive
47 items with their schedule fees and Medicare benefits.
| Item | Fee | 75% | Out of hospital |
|---|---|---|---|
| 52300Surgical repair of a single skin or mucous membrane defect using a local flap technique, performed under anaesthesia with surgical assistance. | $340.30 | $255.25 | $289.30 (85%) |
| 52303Repair of one oral/facial defect using a single-stage local flap with buccal fat pad graft under anaesthesia. | $485.95 | $364.50 | — |
| 52306Surgical repair of a single skin defect using a single-stage local flap with temporalis muscle transfer, including anaesthesia and surgical assistance. | $721.10 | $540.85 | — |
| 52309Surgical grafting of a granulating wound with mucosa or split skin, including anaesthesia. | $245.00 | $183.75 | $208.25 (85%) |
| 52312Free grafting of mucosa, split skin or connective tissue to repair one defect, including elective dissection, anaesthesia and surgical assistance. | $340.30 | $255.25 | $289.30 (85%) |
| 52315Full-thickness skin or mucosal graft to a single defect, including anaesthesia and surgical assistance. | $567.05 | $425.30 | $482.00 (85%) |
| 52318Harvesting of small quantity autogenous bone graft through separate incision, performed with another O3-O9 group procedure under anaesthesia. | $169.00 | $126.75 | — |
| 52319Harvesting autogenous bone graft via separate incision in large quantity when associated with another bone/joint surgery (Groups O3–O9), under anaesthesia. | $281.85 | $211.40 | — |
| 52321Insertion of a non-biological foreign implant to correct contour deformity from pathological conditions, excluding cases covered by item 52624. | $567.05 | $425.30 | — |
| 52324Direct flap repair using tongue tissue, first stage procedure performed under anaesthesia with surgical assistance. | $567.05 | $425.30 | — |
| 52327Surgical repair of a defect using a tongue flap as the second stage of a multi-stage procedure, performed under anaesthesia. | $281.40 | $211.05 | — |
| 52330Surgical closure of a palatal defect or oro-nasal fistula, including associated services covered under related items, requiring anaesthesia and surgical assistance. | $935.85 | $701.90 | — |
| 52333Surgical repair of primary cleft palate, including anaesthesia and surgical assistance. | $935.85 | $701.90 | — |
| 52336Surgical repair of a cleft palate fistula using local flaps, including anaesthesia and surgical assistance. | $585.05 | $438.80 | — |
| 52337Surgical grafting and plastic closure of unilateral congenital alveolar cleft with oro-nasal fistula repair and ridge augmentation, including anaesthesia and assistance. | $1,279.65 | $959.75 | — |
| 52339Secondary surgical repair or lengthening of cleft palate, including anaesthesia and surgical assistance. | $666.20 | $499.65 | — |
| 52342Surgical removal or reshaping of one side of the lower or upper jaw, including nerve and blood vessel repositioning and bone grafting from the same site, with anaesthesia and assistance. | $1,157.15 | $867.90 | — |
| 52345Surgical correction of upper or lower jaw bone (one side) involving bone reshaping or removal, nerve/vessel repositioning, bone grafting from the same site, and internal fixation, with anesthesia and surgical assistance. | $1,304.95 | $978.75 | — |
| 52348Bilateral surgical cutting or removal of lower or upper jaw bone with nerve and vessel repositioning and bone grafting from the same site, including anaesthesia and assistance. | $1,474.65 | $1,106.00 | — |
| 52351Bilateral jaw bone surgery involving cutting or removing bone, nerve and vessel relocation, bone grafting from the same site, and fixation with wires, screws, plates or pins. | $1,656.15 | $1,242.15 | — |
| 52354Surgical correction of the mandible or maxilla involving 3 or more bone procedures on one jaw, including nerve/vessel repositioning and bone grafts from the same site, with anaesthesia and assistance. | $1,678.95 | $1,259.25 | — |
| 52357Surgical correction of the mandible or maxilla involving three or more bone procedures on one jaw, including nerve/vessel relocation, bone grafting, and fixation stabilisation. | $1,890.15 | $1,417.65 | — |
| 52360Surgical correction of upper and lower jaw bones involving 2 procedures on each jaw, including nerve/vessel relocation and bone grafts from the same site, under anaesthesia with assistance. | $1,928.20 | $1,446.15 | — |
| 52363Surgical reshaping of both upper and lower jaw bones using 2 procedures per jaw, including nerve/vessel relocation, bone grafting from the same site, and internal fixation. | $2,169.10 | $1,626.85 | — |
| 52366Complex bilateral jaw surgery involving multiple osteotomies/osteectomies (3+ on one jaw, 2+ on the other), including genioplasty, nerve/vessel transposition, and bone grafting from the same site. | $2,121.25 | $1,590.95 | — |
| 52369Complex bilateral jaw surgery involving multiple osteotomies/osteectomies (3+ on one jaw, 2+ on the other), including genioplasty, nerve/vessel transposition, bone grafting and fixation. | $2,385.10 | $1,788.85 | — |
| 52372Complex bilateral jaw surgery involving 3+ procedures on each jaw, including genioplasty, nerve/vessel transposition, and bone grafts from the same site. | $2,314.30 | $1,735.75 | — |
| 52375Complex bilateral jaw surgery involving multiple osteotomies/osteectomies (3+ per jaw), genioplasty, nerve/vessel transposition, bone grafts, and fixation stabilisation. | $2,592.15 | $1,944.15 | — |
| 52378Surgical reshaping of the chin with nerve and vessel repositioning, using bone grafts harvested from the same surgical site. | $896.05 | $672.05 | — |
| 52379Surgical reconstruction of one facial region using the patient's own bone or cartilage graft, including anaesthesia and surgical assistance. | $1,531.35 | $1,148.55 | — |
| 52380Surgical correction of midface deformities using Le Fort II or modified Le Fort III osteotomies with nerve/vessel transposition and bone grafts from the same site. | $2,607.55 | $1,955.70 | — |
| 52382Surgical correction of midface deformity using Le Fort II or modified Le Fort III osteotomies with nerve/vessel transposition, bone grafting, and fixation, requiring anaesthesia and surgical assistance. | $3,125.85 | $2,344.40 | — |
| 52420Surgical fixation of the mandible using intermaxillary wiring to stabilize jaw fractures or alignment issues, excluding cases where wiring is used for weight management. | $288.60 | $216.45 | — |
| 52424Surgical placement of skin, fatty tissue, or fascia graft in the oral and maxillofacial region under anaesthesia with assistance. | $566.95 | $425.25 | — |
| 52430Microsurgical repair of blood vessels in the mouth and jaw area, or restoration of arterial or venous continuity in fingers, hands, or feet, including anaesthesia and assistance. | $1,304.95 | $978.75 | — |
| 52440Surgical repair of unilateral cleft lip in one stage without involving the palate, including anaesthesia and surgical assistance. | $647.85 | $485.90 | — |
| 52442Primary surgical repair of unilateral cleft lip with anterior palate involvement completed in one stage, including anaesthesia and surgical assistance. | $810.05 | $607.55 | — |
| 52444Surgical repair of bilateral cleft lip in one stage without palate repair, including anaesthesia and surgical assistance. | $899.85 | $674.90 | — |
| 52446Surgical repair of bilateral cleft lip and anterior palate in a single stage procedure, including anaesthesia and surgical assistance. | $1,062.30 | $796.75 | — |
| 52450Surgical revision of partial cleft lip with minor flap realignment, adjustment, and correction of minor whistle deformity under anaesthesia. | $359.95 | $270.00 | — |
| 52452Surgical revision of cleft lip with major flap work, muscle repair, and correction of whistle deformity, requiring anaesthesia and surgical assistance. | $585.05 | $438.80 | — |
| 52456First-stage reconstruction of cleft lip using a full thickness flap (Abbe or similar technique) under anaesthesia with surgical assistance. | $990.20 | $742.65 | — |
| 52458Surgical reconstruction of cleft lip using a full-thickness flap technique (such as Abbe flap) as a second-stage procedure, including anaesthesia. | $359.95 | $270.00 | — |
| 52460Surgical repair of velopharyngeal incompetence by pharyngeal flap or pharyngoplasty under anaesthesia. | $935.85 | $701.90 | — |
| 52480Surgical grafting using composite tissue (cartilage with skin or mucosa) to reconstruct the nose, ear, or eyelid, performed under anaesthesia with surgical assistance. | $601.15 | $450.90 | — |
| 52482Surgical correction of enlarged lips or tongue, including anaesthesia and surgical assistance. | $578.40 | $433.80 | — |
| 52484Surgical correction of macrostomia (abnormally large mouth opening) under anaesthesia with surgical assistance. | $688.60 | $516.45 | — |