Group T8: Surgical Operations
2,632 items with their schedule fees and Medicare benefits; showing 43849–45653.
| Item | Fee | 75% | Out of hospital |
|---|---|---|---|
| 43849Anaesthetic services for assisting with gastrostomy procedure in patients with oesophageal atresia. | $610.05 | $457.55 | — |
| 43852Surgical repair of oesophageal atresia via thoracotomy with division of tracheo-oesophageal fistula, without anastomosis (anaesthesia and assistance included). | $1,940.85 | $1,455.65 | — |
| 43855Anaesthetic assistance for delayed primary anastomosis in oesophageal atresia repair. | $2,051.95 | $1,539.00 | — |
| 43858Anaesthetic assistance for cervical oesophagostomy performed to manage oesophageal atresia. | $720.85 | $540.65 | — |
| 43861Anaesthetic assistance for thoracotomy and lung resection in patients with congenital cystadenomatoid malformation or congenital lobar emphysema. | $1,996.50 | $1,497.40 | — |
| 43864Anaesthetic and surgical assistant services for operative repair of gastroschisis (congenital abdominal wall defect where bowel protrudes through the umbilicus). | $1,497.35 | $1,123.05 | — |
| 43867Secondary operation to remove a silo in gastroschisis or exomphalos repair, with anaesthesia and surgical assistance. | $831.80 | $623.85 | — |
| 43870Surgical repair of exomphalos (abdominal wall defect) containing only small bowel, with anaesthesia and surgical assistance. | $1,164.60 | $873.45 | — |
| 43873Surgical repair of exomphalos (abdominal wall defect) containing small bowel and other organs, including anaesthesia and surgical assistance. | $1,552.75 | $1,164.60 | — |
| 43876Excision of sacrococcygeal teratoma via posterior surgical approach, including anaesthesia and surgical assistance. | $1,330.95 | $998.25 | — |
| 43879Surgical excision of sacrococcygeal teratoma using combined posterior and abdominal approach, including anaesthesia and surgical assistance. | $1,552.75 | $1,164.60 | — |
| 43882Surgical repair of cloacal exstrophy, including anesthesia and surgical assistance. | $1,996.50 | $1,497.40 | — |
| 43900Surgical repair of a tracheo-oesophageal fistula (without atresia) including anaesthesia and surgical assistance. | $1,330.95 | $998.25 | — |
| 43903Surgical repair of oesophageal atresia or corrosive stricture using gastric tube, jejunum or colon graft, including anaesthesia and surgical assistance. | $2,218.25 | $1,663.70 | — |
| 43906Surgical resection and reconstruction of congenital, anastomotic, or corrosive oesophageal strictures, excluding cases covered by item 43903. | $1,940.85 | $1,455.65 | — |
| 43909Anaesthetic assistance for aortopexy surgery to treat tracheomalacia (airway collapse). | $1,940.85 | $1,455.65 | — |
| 43912Surgical removal of one or more bronchogenic, enterogenous cysts or mediastinal teratomas via thoracotomy, including anaesthesia and surgical assistance. | $1,833.60 | $1,375.20 | — |
| 43915Anaesthetic assistance for surgical plication (folding and fixation) of an eventrated diaphragm to restore normal position and function. | $1,386.40 | $1,039.80 | — |
| 43930Anaesthetic assistance during pyloromyotomy surgery for hypertrophic pyloric stenosis. | $533.15 | $399.90 | — |
| 43933Surgical correction of idiopathic intussusception via laparotomy with manual reduction under anaesthesia, with surgical assistance. | $624.10 | $468.10 | — |
| 43936Surgical repair of intussusception via laparotomy with bowel resection and reconnection, including anaesthesia and assistance. | $1,164.60 | $873.45 | — |
| 43939Repair of ventral hernia that develops after neonatal closure of exomphalos or gastroschisis, with anaesthesia and surgical assistance. | $887.25 | $665.45 | — |
| 43942Surgical excision of an abdominal wall vitello-intestinal duct remnant under anaesthesia. | $277.30 | $208.00 | — |
| 43945Surgical excision of a patent vitellointestinal duct (remnant of fetal connection between small intestine and umbilicus) under anaesthesia with surgical assistance. | $1,164.60 | $873.45 | — |
| 43948Removal of umbilical granuloma (tissue growth at navel) under general anaesthesia. | $166.45 | $124.85 | — |
| 43951Surgical repair of gastro-oesophageal reflux disease or hiatus hernia via laparotomy with fundoplication, excluding gastrostomy; assistant surgeon item. | $1,042.85 | $782.15 | — |
| 43954Surgical repair of gastro-oesophageal reflux disease or hiatus hernia via laparotomy with fundoplication and gastrostomy creation, with anaesthetist assistance. | $1,275.65 | $956.75 | — |
| 43957Laparotomy with fundoplication and gastrostomy for gastro-oesophageal reflux in a child with neurological disease, with anaesthesia assistance. | $1,386.40 | $1,039.80 | — |
| 43960Surgical repair of anorectal malformation via perineal anoplasty under anaesthesia, with surgical assistance. | $487.75 | $365.85 | — |
| 43963Surgical reconstruction of the rectum and anus for anorectal malformation using posterior sagittal approach, including anaesthesia and assistance. | $1,940.85 | $1,455.65 | — |
| 43966Surgical reconstruction of an anorectal malformation using a posterior sagittal approach with abdominal exploration, including anaesthesia and surgical assistance. | $2,218.25 | $1,663.70 | — |
| 43969Surgical correction of persistent cloaca including genital repair via posterior sagittal approach, with optional laparotomy; includes anaesthesia and assistance. | $3,050.15 | $2,287.65 | — |
| 43972Surgical resection of a choledochal cyst with single duct anastomosis, including anaesthesia and surgical assistance. | $2,218.25 | $1,663.70 | — |
| 43975Surgical resection of a choledochal cyst with reconstruction of 2 bile duct anastomoses, including anaesthesia and surgical assistance. | $2,606.55 | $1,954.95 | — |
| 43978Anaesthesia or assistance for portoenterostomy surgery to treat biliary atresia. | $2,218.25 | $1,663.70 | — |
| 43981Exploratory abdominal surgery with biopsies for suspected nephroblastoma, neuroblastoma or other malignant tumour, when no other intra-abdominal procedure is performed. | $610.05 | $457.55 | — |
| 43984Anaesthetic assistance for radical nephrectomy in a patient with nephroblastoma (Wilms tumour). | $1,552.75 | $1,164.60 | — |
| 43987Anaesthetist or assistant service for radical surgical excision of neuroblastoma. | $1,719.20 | $1,289.40 | — |
| 43990Surgical resection of aganglionic bowel segment extending to sigmoid colon with pull-through anastomosis, including frozen section biopsies if needed, with anaesthesia and assistance. | $2,107.45 | $1,580.60 | — |
| 43993Surgical resection of the aganglionic bowel segment in Hirschsprung's disease with pull-through anastomosis when disease extends into the descending or transverse colon, including frozen section biopsies and stoma revision if needed. | $2,273.75 | $1,705.35 | — |
| 43996Surgical removal of entire colon due to total aganglionosis, with ileoanal pull-through reconstruction, with or without ileocolic anastomosis; includes anaesthesia and assistance. | $2,551.00 | $1,913.25 | — |
| 43999Anaesthetic or assistant services for anal sphincterotomy as an independent procedure in patients with aganglionosis coli (Hirschsprung disease). | $319.00 | $239.25 | — |
| 44101Examination of the rectum under general anaesthesia in children under 2 years, including full-thickness biopsy or polyp removal, with anaesthetic support. | $399.85 | $299.90 | — |
| 44102Examination of the rectum under general anaesthesia in patients aged 2+, including full-thickness biopsy or polyp/lesion removal, with anaesthetist and assistant. | $307.60 | $230.70 | — |
| 44104Submucosal or perirectal injection treatment for rectal prolapse in children under 2 years, performed under general anaesthesia. | $70.25 | $52.70 | — |
| 44105Submucosal or perirectal injection treatment for rectal prolapse in patients aged 2 years or over, performed under general anaesthesia. | $53.95 | $40.50 | — |
| 44108Surgical repair of inguinal hernia in infants under 12 months using laparoscopic or open approach, including anaesthesia and surgical assistance. | $722.70 | $542.05 | — |
| 44111Surgical repair of obstructed or strangulated inguinal hernia in infants under 12 months, performed laparoscopically or openly, including testicular fixation if needed. | $811.15 | $608.40 | — |
| 44114Laparoscopic or open repair of inguinal hernia in infants under 12 months old when orchidopexy is also needed. | $811.15 | $608.40 | — |
| 44130Surgical removal of lymph nodes affected by atypical mycobacterial infection or other granulomatous disease, with anaesthesia and surgical assistance. | $554.50 | $415.90 | — |
| 44133Surgical division of the sternomastoid muscle under general anaesthesia to treat torticollis, with assistance. | $440.10 | $330.10 | — |
| 44136Surgical removal of ingrown toenail performed under general anaesthesia. | $202.90 | $152.20 | — |
| 44325Surgical amputation of the hand at or above the wrist level, including anaesthesia and surgical assistance. | $353.90 | $265.45 | — |
| 44328Surgical amputation of the hand and proximal forearm with anaesthesia and surgical assistance. | $426.55 | $319.95 | — |
| 44331Surgical amputation of the arm at the shoulder joint, including anaesthesia and surgical assistance. | $703.25 | $527.45 | — |
| 44334Anaesthetic service and surgical assistance for interscapulothoracic amputation (removal of arm, shoulder blade, and associated chest wall structures). | $1,429.40 | $1,072.05 | — |
| 44338Surgical removal of one foot digit distal to the metatarsal head, including bone/joint resection, neuroma excision, or skin flap coverage. | $172.40 | $129.30 | — |
| 44342Surgical amputation of 2 toes on one foot below the metatarsal head, with optional bone resection, neuroma removal, or flap coverage. | $263.15 | $197.40 | — |
| 44346Surgical removal of 3 digits from one foot below the metatarsal head, including bone/joint resection, neuroma excision, or flap coverage as needed. | $304.00 | $228.00 | — |
| 44350Surgical amputation of 4 digits on one foot below the metatarsal head, with optional bone resection, neuroma removal, or skin flap coverage. | $344.95 | $258.75 | — |
| 44354Surgical amputation of five toes on one foot at or beyond the metatarsal heads, with optional bone resection, neuroma removal, or local flap coverage. | $394.75 | $296.10 | — |
| 44358Surgical removal of one toe including bone resection, neuroma excision, or skin flap reconstruction as needed, with anaesthesia and surgical assistance. | $263.15 | $197.40 | — |
| 44359Amputation of one or more toes or midfoot/hindfoot of one foot for diabetic or microvascular disease, including bone resection, neuroma excision, infection treatment, and flap reconstruction; once per foot per occasion. | $315.85 | $236.90 | — |
| 44361Surgical amputation of the foot at ankle or hindfoot level, including bone resection, neuroma excision, and skin grafting as needed. | $522.35 | $391.80 | — |
| 44364Surgical removal of part or all of the foot at the tarsal level, including bone resection, neuroma excision, and skin grafting as needed. | $353.90 | $265.45 | — |
| 44367Anaesthesia assistance for amputation through the thigh, at the knee, or below the knee. | $624.70 | $468.55 | — |
| 44370Assistant for anaesthetist during hip disarticulation amputation surgery. | $862.05 | $646.55 | — |
| 44373Anaesthetic and surgical assistance for hindquarter amputation (removal of leg at hip level). | $1,769.45 | $1,327.10 | — |
| 44376Re-amputation of an amputation stump to achieve adequate skin and muscle coverage, performed under anaesthesia with surgical assistance. | — | — | — |
| 45000Surgical repair of a single-stage local muscle flap on eyelid, nose, lip, neck, hand, thumb, finger or genitals when not performed with other listed plastic procedures, including anaesthesia. | $647.85 | $485.90 | $550.70 (85%) |
| 45003Repair of one small, simple skin defect using a local myocutaneous flap in a single stage, under anaesthesia, when not combined with other flap procedures. | $720.15 | $540.15 | $615.65 (85%) |
| 45006Surgical repair of a single large skin and muscle defect using pectoralis major, latissimus dorsi, or similar flap, excluding cases managed under items 45524–45542. | $1,242.00 | $931.50 | — |
| 45009Repair of a small, simple defect using a single-stage local muscle flap, excluding cases covered by items 30278, 30281, or 41722. | $453.70 | $340.30 | — |
| 45012Surgical repair of a large single muscle flap (such as pectoralis major or gastrocnemius) to cover one tissue defect, excluding flaps used with breast reconstruction or other specified procedures. | $931.45 | $698.60 | — |
| 45015Surgical delay procedure for a muscle or myocutaneous flap under anaesthesia to improve blood supply before transfer to a recipient site. | $359.95 | $270.00 | — |
| 45018Dermis, dermofat or fascia graft placement excluding neurosurgical spinal procedures and certain reconstructive services; requires anaesthesia and assistance. | $566.95 | $425.25 | — |
| 45019Full-face chemical peel for severe photo-damaged skin affecting ≥75% of face with solar keratosis load >30 lesions or solar lentigines/freckling/leathering, using medium-depth or deeper agents, performed once per 12 months in hospital theatre by derm… | $474.85 | $356.15 | — |
| 45021Abrasive therapy for severe facial scarring from trauma, burns, or acne, with photographic evidence required; limited to one treatment per patient per episode under anaesthesia. | $212.30 | $159.25 | $180.50 (85%) |
| 45025Laser resurfacing of face or neck using CO2 or erbium laser for severe scarring from trauma, burns or acne, limited to one aesthetic area. | $212.30 | $159.25 | $180.50 (85%) |
| 45026CO2 or erbium laser resurfacing of face or neck for severe disfiguring scars from trauma, burns or acne affecting multiple aesthetic areas, under anaesthesia. | $477.05 | $357.80 | $405.50 (85%) |
| 45027Cauterisation or injection treatment of vascular anomalies performed in a hospital operating theatre under anaesthesia. | $144.10 | $108.10 | — |
| 45030Excision and suturing of small vascular anomalies of skin, mucous membrane, or subcutaneous tissue under anaesthesia. | $162.45 | $121.85 | $138.10 (85%) |
| 45033Surgical excision and suturing of a large vascular anomaly or one involving deeper tissue and facial muscle, requiring anaesthesia and surgical assistance. | $294.30 | $220.75 | — |
| 45035Surgical excision of a large, deep vascular anomaly involving major neurovascular structures, including dissection of muscles, nerves or vessels, with anaesthesia and surgical assistance. | $840.30 | $630.25 | — |
| 45036Surgical excision of a deep neck vascular anomaly involving major nerves and vessels, requiring careful dissection; includes anaesthesia and surgical assistance. | $1,350.20 | $1,012.65 | — |
| 45045Surgical excision of a vascular anomaly on the eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals under anaesthesia. | $369.20 | $276.90 | $313.85 (85%) |
| 45048Major surgical excision of lymphoedematous tissue or lymphangiectasis in the lower leg, foot, thigh, upper arm, or forearm/hand, including anaesthesia and assistance. | $927.15 | $695.40 | — |
| 45051Open contour reconstruction using non-biological implants for deformity from congenital tissue absence or trauma (excluding cosmetic surgery trauma), with documented clinical imaging evidence. | $567.05 | $425.30 | — |
| 45054Emergency surgical incisions to relieve pressure in burned limbs or chest affected by acute compartment syndrome, including anesthesia and assistance. | $390.25 | $292.70 | — |
| 45060Single-stage surgical correction of developmental breast abnormality involving bilateral mastopexy for tubular breasts or bilateral procedures combining implants, mastopexy or reduction with documented volume difference of at least 20% (10% for tubul… | $1,521.60 | $1,141.20 | — |
| 45061First-stage surgical correction of developmental breast asymmetry involving tissue expanders, lift, or reduction on both breasts when volume difference is ≥20% (normal) or ≥10% (tubular/abnormal fold), with documented imaging evidence. | $1,521.60 | $1,141.20 | — |
| 45062Second-stage surgical correction of developmental breast abnormality involving bilateral implant exchange, mastopexy, or reduction for volume asymmetry of ≥20% (normal) or ≥10% (tubular/abnormal folds), with documented imaging evidence. | $1,101.10 | $825.85 | — |
| 45070Single-stage surgical correction of developmental breast abnormality (implant insertion with/without mastopexy or reduction mammaplasty) on one breast when volume difference from other breast is ≥20% (normal) or ≥10% (tubular/abnormal folds), with do… | $1,014.40 | $760.80 | — |
| 45071First-stage surgical correction of developmental breast abnormality with tissue expander insertion for one breast when volume difference is ≥20% (normal breasts) or ≥10% (tubular/abnormal fold breasts), with documented imaging evidence. | $1,014.40 | $760.80 | — |
| 45072Second-stage breast reconstruction surgery replacing a tissue expander with an implant (≥10% volume difference) for developmental abnormality, where breast volume difference is ≥20% (normal) or ≥10% (tubular/abnormal fold), with documented volumetric… | $734.05 | $550.55 | — |
| 45200Repair of a single small skin defect using a simple local flap procedure, excluding scalp hair loss treatment and certain complex flap types. | $340.30 | $255.25 | $289.30 (85%) |
| 45201Surgical flap reconstruction (muscle, myocutaneous or skin) to repair defects from malignant or non-malignant skin lesion removal, claimable once per defect when performed with specified excision items. | $495.40 | $371.55 | $421.10 (85%) |
| 45202Flap repair of a skin lesion excision site when clinically indicated due to defect size, severe scarring, skin atrophy, or proximity to free margins, with clinical justification documented. | $495.40 | $371.55 | $421.10 (85%) |
| 45203Repair of one complicated or large skin defect using a single-stage local flap, excluding baldness treatment and certain flap types, with anaesthesia and assistance. | $485.95 | $364.50 | $413.10 (85%) |
| 45206Local flap repair of a single defect on the eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals, excluding H-flaps or double advancement flaps when performed independently. | $459.15 | $344.40 | $390.30 (85%) |
| 45207Surgical repair of a single eyelid, eyebrow or forehead defect using H-flap or double advancement flap technique, performed independently (not with other listed procedures); includes anaesthesia. | $459.15 | $344.40 | $390.30 (85%) |
| 45209Surgical repair using a pedicled flap from forehead, arm, leg or abdomen as the first stage of a multistage reconstructive procedure, including anaesthesia and assistant. | $567.05 | $425.30 | — |
| 45212Subsequent stage of a multistage pedicled flap repair (forehead, cross arm, cross leg, abdominal) to reconstruct tissue defects, requiring anaesthesia and surgical assistance. | $281.40 | $211.05 | — |
| 45221Surgical repair of a small direct flap (such as cross-finger flap) as the first stage of reconstruction, including anaesthesia. | $313.15 | $234.90 | $266.20 (85%) |
| 45224Second-stage repair of a small direct flap (such as cross-finger) under anaesthesia to complete flap transfer and integration. | $140.70 | $105.55 | $119.60 (85%) |
| 45227Formation of an indirect flap or tubed pedicle graft, requiring anaesthesia and surgical assistance. | $533.15 | $399.90 | — |
| 45230Surgical delay procedure for a direct or indirect flap or tubed pedicle to improve blood supply before final transfer, including anaesthesia. | $266.60 | $199.95 | $226.65 (85%) |
| 45233Surgical preparation and attachment of an indirect flap or tubed pedicle to an intermediate or final recipient site, including anaesthesia and assistance. | $567.05 | $425.30 | — |
| 45239Revision of a direct, indirect, free or local flap using incision, suture and/or liposuction, once per flap, excluding cases associated with item 45497. | $313.15 | $234.90 | $266.20 (85%) |
| 45440Split thickness skin graft to small defects (under 40mm on extremities/neck/genitals or under 80mm elsewhere) including anaesthesia and assistance. | $340.30 | $255.25 | $289.30 (85%) |
| 45443Split thickness skin graft to a large defect (≥40mm on lower leg/distal forearm/genitals/above clavicle, or ≥80mm elsewhere), including anaesthesia and assistance. | $702.00 | $526.50 | $597.50 (85%) |
| 45451Full-thickness skin graft applied to a single skin defect measuring 5 mm or larger in diameter, including anaesthesia and assistance. | $567.05 | $425.30 | $482.00 (85%) |
| 45496Revision of a free tissue transfer using microvascular techniques by open operation, including anaesthesia. | $498.05 | $373.55 | — |
| 45497Revision of free tissue transfer flap or autologous breast reconstruction using liposuction techniques under anaesthesia, excluding cases covered by item 45239. | $379.40 | $284.55 | — |
| 45500Microsurgical repair of blood vessels (artery or vein) in the hand, foot or digits to restore blood flow; provider can claim for either artery or vein repair per service, not both. | $1,304.95 | $978.75 | — |
| 45501Microsurgical repair of artery or vein to restore blood supply to a devitalised limb or digit through replantation or revascularisation. | $2,124.10 | $1,593.10 | — |
| 45502Microsurgical repair of arteries and veins to restore blood supply to a devitalised limb or digit through replantation or revascularisation, including all necessary vessel anastomoses for that extremity. | $3,186.20 | $2,389.65 | — |
| 45503Microsurgical micro-arterial or micro-venous graft to restore critical blood supply, including graft harvest and all anastomoses, excluding cardiac surgery. | $2,430.10 | $1,822.60 | — |
| 45504Microsurgical reconnection of blood vessels for free tissue transfer, excluding breast reconstruction and certain other specified procedures. | $2,124.10 | $1,593.10 | — |
| 45505Microsurgical reconnection of blood vessels for free tissue transfer using microsurgical techniques, excluding breast reconstruction and certain other specified procedures. | $3,216.75 | $2,412.60 | — |
| 45507Microsurgical repair of arteries and veins in the distal arm, hand, leg or foot to restore blood flow, including all necessary vessel connections, excluding cases already covered by replantation or revascularisation items. | $1,957.50 | $1,468.15 | — |
| 45510Revision of facial or neck scar (≤3 cm) performed in a hospital operating theatre or by an anaesthetist specialist in their practice. | $263.15 | $197.40 | $223.70 (85%) |
| 45512Surgical revision of facial or neck scars longer than 3 cm, performed in a hospital operating theatre or by a specialist. | $353.90 | $265.45 | $300.85 (85%) |
| 45515Revision of non-facial/neck scars ≤7 cm, performed in hospital operating theatre or by specialist, with photographic evidence of clinical need; excludes cosmetic breast implants and combined procedures. | $223.25 | $167.45 | $189.80 (85%) |
| 45518Surgical revision of scars over 7cm on body (excluding face/neck) in hospital or by specialist, with required clinical photographs and excluding cosmetic breast implant cases. | $270.15 | $202.65 | — |
| 45520Surgical reduction of one breast with nipple repositioning for breast cancer or developmental abnormality, excluding cases already covered by items 31512, 31513, or 31514 on the same side. | $1,077.70 | $808.30 | — |
| 45522Surgical reduction of breast tissue on one side without moving the nipple or implant insertion, excluding male breast reduction, not performed with related procedures on the same side. | $756.10 | $567.10 | — |
| 45523Surgical reduction of both breasts with nipple repositioning for patients with macromastia causing neck or shoulder pain, without implants. | $1,616.70 | $1,212.55 | — |
| 45524One-sided breast augmentation for cancer reconstruction or developmental abnormality with at least 20% volume difference (or 10% for tubular/abnormal breasts), performed once per occasion unless combined with other reconstructive procedures. | $887.70 | $665.80 | — |
| 45527Surgical reconstruction of one breast after mastectomy using a permanent implant, excluding cases covered by items 45006 or 45012. | $1,282.15 | $961.65 | — |
| 45528Bilateral breast augmentation surgery for reconstructive purposes due to developmental malformation, disease, trauma, or congenital endocrine disorder, with documented clinical evidence. | $1,331.35 | $998.55 | — |
| 45529Bilateral breast reconstruction using permanent implants after mastectomy, excluding cases already covered by items 45006 or 45012. | $2,243.65 | $1,682.75 | — |
| 45530Surgical reconstruction of one breast after mastectomy using a transferred muscle or muscle-and-skin flap with preserved blood supply, excluding concurrent repair of muscle layers. | $1,315.85 | $986.90 | — |
| 45531Bilateral breast reconstruction after mastectomy using autologous muscle or myocutaneous flap with isolated vascular pedicle, excluding muscular aponeurotic layer repair. | $2,302.75 | $1,727.10 | — |
| 45532Surgical revision of reconstructed breast tissue following mastectomy, excluding cases already covered under items 45006 or 45012. | $324.20 | $243.15 | — |
| 45534Unilateral autologous fat grafting (harvesting, preparation, injection) for breast reconstruction or defect correction following cancer treatment, developmental disorders, or to prepare thin/irradiated skin; up to 4 services per breast with documente… | $756.10 | $567.10 | — |
| 45535Bilateral autologous fat grafting for breast reconstruction or correction following cancer treatment, developmental disorders, or significant asymmetry (≥20%), limited to 4 services total with documented imaging evidence of clinical need. | $1,323.35 | $992.55 | — |
| 45537Reconstruction of partial mastectomy defect using a perforator flap (such as TDAP or LICAP) based on a named source vessel, excluding cases already covered by items 45006 or 45012. | $941.45 | $706.10 | — |
| 45538Surgical raising of a perforator flap (such as DIEP) for microsurgical transfer during breast reconstruction after mastectomy, excluding cases already covered by related items. | $1,077.20 | $807.90 | — |
| 45539Insertion of tissue expander for unilateral breast reconstruction after mastectomy, including all expansion injections, excluding cases with implant placement or revision surgery. | $1,726.00 | $1,294.50 | — |
| 45540Bilateral breast reconstruction using tissue expanders after mastectomy, including insertion and all expansion injections. | $3,020.35 | $2,265.30 | — |
| 45541Bilateral breast reconstruction using permanent prosthesis implants after removal of tissue expanders, excluding cases covered by items 45006 or 45012. | $1,284.80 | $963.60 | — |
| 45542Removal of breast tissue expander and insertion of permanent implant after unilateral mastectomy, excluding cases covered by items 45006 or 45012. | $734.15 | $550.65 | — |
| 45545Surgical reconstruction of the nipple and/or areola using any technique, including anaesthesia and surgical assistance. | $745.15 | $558.90 | $640.65 (85%) |
| 45546Intradermal tattooing to restore color to the nipple or areola after breast reconstruction following mastectomy or for congenital absence of nipple. | $236.80 | $177.60 | $201.30 (85%) |
| 45547Surgical revision to reposition a migrated or rotated breast prosthesis or tissue expander after reconstruction for cancer or developmental abnormality, reusing the existing implant. | $837.15 | $627.90 | — |
| 45548Surgical removal of a breast prosthesis performed as a standalone procedure under anaesthesia. | $331.25 | $248.45 | — |
| 45551Removal of breast prosthesis with excision of at least half the fibrous capsule, with mandatory histopathology of the specimen and documented volume in the pathology report. | $531.10 | $398.35 | — |
| 45553Removal and replacement of breast prosthesis for medical complications (rupture, migration, or capsular contracture) where removal alone would cause unacceptable deformity or original implant was for cancer/developmental abnormality, with documented… | $684.15 | $513.15 | — |
| 45554Removal and replacement of breast prosthesis for medical complications (rupture, migration, or capsular contracture) with capsule excision and pocket formation, requiring intra-operative photos, histopathology, and documented imaging evidence of clin… | $837.15 | $627.90 | — |
| 45556Correction of unilateral breast ptosis in breast cancer or developmental abnormality cases, with required photographic or imaging documentation of clinical need. | $916.85 | $687.65 | — |
| 45558Bilateral breast lift surgery for severe ptosis where at least two-thirds of breast tissue sits below the inframammary fold, supported by documented photographs; limited to once per lifetime unless combined with reconstruction. | $1,375.20 | $1,031.40 | — |
| 45560Hair transplantation for congenital, traumatic, or disease-related alopecia, excluding male pattern baldness, under anaesthesia. | $566.95 | $425.25 | $481.95 (85%) |
| 45561Surgical repair of blood vessels to a compromised flap during initial surgery or subsequent return to theatre to restore blood flow and salvage the tissue. | $2,124.10 | $1,593.10 | — |
| 45562Microvascular free tissue transfer to repair non-breast defects, including raising tissue on a vascular pedicle and direct repair of secondary skin defects if needed. | $1,315.85 | $986.90 | — |
| 45563Surgical transfer of neurovascular tissue to restore sensation in fingers, toes, or sole of foot, or for genital reconstruction, including pedicle dissection and any secondary defect repair, excluding simple V-Y or standard rotation flaps. | $1,315.85 | $986.90 | — |
| 45564Microvascular free tissue transfer for reconstruction of major head, neck or non-breast defects, including vessel anastomosis, tissue raising, recipient preparation, transfer and insetting, excluding certain related procedures. | $3,047.70 | $2,285.80 | — |
| 45565Microvascular free tissue transfer for major head and neck or non-breast defects, including vessel anastomoses, tissue raising, recipient preparation, transfer and insetting, excluding certain specified procedures. | $2,285.90 | $1,714.45 | — |
| 45566Insertion of a temporary tissue expander for reconstructive purposes (non-breast) with all follow-up expansion injections included, requiring subsequent removal. | $1,282.15 | $961.65 | — |
| 45567Microsurgical free tissue transfer to repair major head and neck or non-breast defects, including vessel anastomosis, tissue harvest on vascular pedicle, recipient vessel preparation, tissue transfer, and inset, performed by a single surgeon. | $3,515.20 | $2,636.40 | — |
| 45568Surgical removal of a tissue expander with complete excision of the surrounding fibrous capsule if needed, requiring anaesthesia and surgical assistance. | $531.10 | $398.35 | — |
| 45571Abdominal closure with umbilicus reconstruction and optional fat removal following autologous flap harvest, including muscle repair and mesh insertion if needed. | $1,238.75 | $929.10 | — |
| 45572Insertion of a prosthetic tissue expander during surgery under general anaesthetic or sedation, combined with another Group T8 procedure, excluding breast expansion. | $349.15 | $261.90 | — |
| 45575Free fascia graft procedure for facial nerve paralysis, including anaesthesia and surgical assistance. | $862.05 | $646.55 | — |
| 45578Surgical assistance for muscle transfer procedure to restore facial nerve function in paralysis patients, performed under anaesthesia. | $998.30 | $748.75 | — |
| 45581Surgical excision of tissue for facial nerve paralysis treatment under anaesthesia. | $331.25 | $248.45 | — |
| 45584Liposuction of one body area (limb or trunk) for post-traumatic pseudolipoma, requires documented photographic or imaging evidence of clinical need. | $756.10 | $567.10 | — |
| 45585Suction-assisted liposuction to one regional area for Barraquer-Simons syndrome, lymphoedema, macrodystrophia lipomatosa, or secondary buffalo hump, with documented photographic or imaging evidence of clinical need. | $756.10 | $567.10 | — |
| 45587Surgical correction of cheek asymmetry caused by trauma, congenital conditions, or medical conditions like facial nerve palsy, performed on one side of the face only. | $1,066.25 | $799.70 | — |
| 45588Bilateral cheek surgery to correct functional impairment from congenital conditions, disease, or trauma (with documented photographic/imaging evidence of clinical need). | $1,599.55 | $1,199.70 | — |
| 45589Autologous fat grafting for craniofacial asymmetry or burn scars with contracture/deformity/pain (up to 4 services per 3-month intervals, with documented imaging and diagnosis). | $756.10 | $567.10 | — |
| 45590Surgical reconstruction of the orbital cavity wall or floor using bone graft, cartilage graft, or implant, excluding cases managed with item 42530 or 45594 on the same side. | $578.40 | $433.80 | — |
| 45592Surgical reconstruction of orbital cavity wall or floor using bone graft, cartilage graft or implant, excluding cases covered by item 45594 on the same side. | $1,018.75 | $764.10 | — |
| 45594Surgical exploration of the orbital cavity wall or floor without grafts or implants, excluding cases linked to specific related procedures on the same side. | $477.45 | $358.10 | — |
| 45596Surgical removal of half of the upper jaw under general anaesthesia with surgical assistance. | $1,077.70 | $808.30 | — |
| 45597Surgical removal of both upper jawbones, performed under anaesthesia with surgical assistance. | $1,442.70 | $1,082.05 | — |
| 45599Surgical removal of the entire mandible (lower jaw), excluding cases already covered by item 45608, with anaesthesia and surgical assistance. | $1,121.00 | $840.75 | — |
| 45602Sub-total resection of mandible including lower border or maxilla, with anaesthesia and surgical assistance. | $837.15 | $627.90 | — |
| 45605Surgical removal of a section of lower or upper jaw bone for tumours or cysts, including anaesthesia and surgical assistance. | $703.25 | $527.45 | — |
| 45608Reconstruction of mandible, segmental mandible or maxilla using bone graft, excluding cases covered by item 45599. | $990.20 | $742.65 | — |
| 45609Reconstruction of mandible, maxilla or skull base using bony free flap with 3D planning, osteotomies, shaping, inset and fixation, performed with related ablative surgery. | $990.20 | $742.65 | — |
| 45611Surgical removal of the mandibular condyle under general anaesthesia with surgical assistance. | $567.05 | $425.30 | — |
| 45614Surgical reconstruction of an eyelid defect larger than one quarter of the lid length affecting all three layers, requiring flaps or grafts because direct closure isn't possible. | $998.30 | $748.75 | $893.80 (85%) |
| 45617Surgical reduction of upper eyelid for visual impairment, eyelid inflammation, orbital fat herniation, facial nerve palsy, post-traumatic scarring, or symmetry restoration, with documented photographic/imaging evidence. | $281.40 | $211.05 | $239.20 (85%) |
| 45620Surgical reduction of lower eyelid for herniated orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring, or to restore symmetry with the contralateral side, with documented photographic or imaging evidence of clinical need. | $390.25 | $292.70 | $331.75 (85%) |
| 45623Surgical correction of unilateral upper eyelid ptosis by suturing the tarsal plate to eyelid retractors or suspending to the brow muscle, excluding mechanical ptosis repairs. | $865.35 | $649.05 | $760.85 (85%) |
| 45624Surgical correction of upper eyelid ptosis using suture techniques (tarsal elevation or frontalis suspension) when prior ptosis surgery has been done on that eye. | $1,122.05 | $841.55 | $1,017.55 (85%) |
| 45625Revision of levator sutures within one week of primary ptosis repair by levator resection or advancement to correct eyelid height, performed in hospital under anaesthesia. | $224.55 | $168.45 | — |
| 45626Surgical correction of ectropion or entropion (eyelid turning outward or inward) in one eye, excluding trachoma-related cases, performed under anaesthesia. | $390.25 | $292.70 | $331.75 (85%) |
| 45627Surgical correction of eyelid turning (ectropion or entropion) caused by trachoma on one side, under anaesthesia. | $390.25 | $292.70 | $331.75 (85%) |
| 45629Surgical grafting to correct symblepharon (adhesion between eyelid and eyeball), requiring anaesthesia and surgical assistance. | $567.05 | $425.30 | — |
| 45632Partial rhinoplasty correcting lateral and/or alar cartilages for airway obstruction (NOSE score >45) or significant deformity, with documented photographic/NOSE Scale evidence. | $612.75 | $459.60 | — |
| 45635Partial rhinoplasty correcting the bony vault for airway obstruction (NOSE Scale >45) or significant deformity, with documented photographic or NOSE Scale evidence. | $703.25 | $527.45 | — |
| 45641Total rhinoplasty for airway obstruction (NOSE score >45) or significant acquired/congenital/developmental deformity, with documented photographic or NOSE Scale evidence in patient notes. | $1,275.90 | $956.95 | — |
| 45644Total rhinoplasty with autogenous graft from distant site for airway obstruction (NOSE Scale >45) or significant deformity, with documented photographic/NOSE Scale evidence in patient notes. | $1,531.35 | $1,148.55 | — |
| 45645Surgical repair of choanal atresia (blocked nasal passage) using puncture and dilatation technique under anaesthesia. | $267.60 | $200.70 | — |
| 45646Surgical correction of choanal atresia involving bone removal through an open operation, including anaesthesia and surgical assistance. | $1,077.70 | $808.30 | — |
| 45650Revision rhinoplasty for airway obstruction (NOSE Scale >45) or significant deformity, with documented photographic/NOSE Scale evidence of clinical need. | $176.85 | $132.65 | — |
| 45652Removal of moderate or severe rhinophyma (enlarged nose tissue) using CO2 or erbium laser under anaesthesia. | $426.55 | $319.95 | $362.60 (85%) |
| 45653Surgical removal of excess nasal tissue in rhinophyma under anaesthesia by shaving technique. | $426.55 | $319.95 | $362.60 (85%) |