MBS item

11823
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Capsule endoscopy for small bowel surveillance in Peutz-Jeghers Syndrome patients, performed by trained specialists, once per 2 years, including capsule administration, imaging and interpretation.

Category 2 · Diagnostic procedures and investigations[Group D1 · subgroup 7](/groups/D1)

Schedule fee$1,471.40

100% benefitGP, out of hospital—

85% benefitOut of hospital$1,366.90

75% benefitIn hospital$1,103.55

The schedule fee for MBS item 11823 is $1,471.40. Medicare pays $1,366.90 (85%) out of hospital, or $1,103.55 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026.

Gap for what you charge
-----------------------

Your fee$

Out of hospitalIn hospital (private)

Medicare pays$1,366.90

Patient gap$104.50

Bulk billing means accepting $1,366.90 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=11823)

Item descriptor
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Capsule endoscopy to conduct small bowel surveillance of a patient diagnosed with Peutz-Jeghers Syndrome, using a capsule endoscopy device approved by the Therapeutic Goods Administration (including administration of the capsule, imaging, image reading and interpretation, and all attendances for providing the service on the day the capsule is administered) if: (a) the service is performed by a specialist or consultant physician with endoscopic training that is recognised by the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy; and (b) the item is performed only once in any 2 year period; and (c) the service is not associated with balloon enteroscopy.

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=11823)

Health fund and DVA rates
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Total fee each scheme recognises for this item in hospital.

StateNSWVICQLDSAWATASACTNT

Guides
------

- [How Medicare benefits work: schedule fees, 75%, 85% and 100%](/guides/how-medicare-benefits-work)
- [Medicare safety nets explained: original and extended (EMSN) thresholds for 2026](/guides/medicare-safety-nets)
- [In-hospital billing: the 75% benefit, the 25% fund benefit, and no-gap and known-gap schemes](/guides/in-hospital-billing-and-gap-cover)
- [Bulk billing incentives and BBPIP explained: 2026 amounts by MM area](/guides/bulk-billing-incentives)
- [The MBS multiple operation rule and surgical assistant fees](/guides/multiple-operation-rule)
- [Assignment of benefit for bulk billing: the changes from 1 July 2026](/guides/assignment-of-benefit-2026)
- [MBS telehealth rules: the eligible telehealth practitioner and phone items](/guides/mbs-telehealth-rules)
- [GP chronic condition management plans: items 965 and 967 explained](/guides/chronic-condition-management-plans)
- [Medicare billing compliance: claim time limits, records and the 80/20 rule](/guides/medicare-billing-compliance)

Data source: [Australian Government Medicare Benefits Schedule](https://www.mbsonline.gov.au/) · Record updated 1 September 2026. Health fund rates come from each fund's published schedule. Verify item descriptors, rules and fees on [MBS Online](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=11823) before billing. This is a reference tool, not billing or financial advice.