MBS item 35401 ===== Vertebroplasty for acute osteoporotic compression fractures (T11-L2) with severe pain (≥7/10) inadequately controlled by opiates and symptom duration ≤3 weeks, performed by trained specialist in radiology, neurosurgery, neurology or orthopaedics, wit… Category 3 · Therapeutic procedures[Group T8 · subgroup 3](/groups/T8)In hospital only (H) Schedule fee$817.25 100% benefitGP, out of hospital— 85% benefitOut of hospital— 75% benefitIn hospital$612.95 The schedule fee for MBS item 35401 is $817.25. Medicare pays $612.95 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026. Gap for what you charge ----------------------- Your fee$ In hospital (private) Medicare pays$612.95 Fund pays (minimum)$204.30 Patient gap$0.00 Assumes a privately admitted patient whose hospital cover includes this service. The fund must pay at least 25% of the schedule fee. Pick a fund rate below to see its no-gap or known-gap split. Item descriptor --------------- Vertebroplasty, for one or more fractures in one or more vertebrae, for the treatment of a painful osteoporotic thoracolumbar vertebral compression fracture of the thoracolumbar spinal segment (T11, T12, L1 or L2), if: (a) the service is performed by a specialist or consultant physician practicing in the specialist's or consultant physician's speciality of diagnostic radiology, neurosurgery, neurology or orthopaedic surgery; and (b) the specialist or consultant physician has undertaken appropriate training in the vertebroplasty procedure; and (c) pain is severe (numeric rated pain score greater than or equal to 7 out of 10); and (d) the symptoms are poorly controlled by opiate therapy; and (e) the severe pain duration is 3 weeks or less; and (f) there is MRI (or SPECT‑CT if MRI unavailable) evidence of acute vertebral fracture Applicable only once for the same fracture, but is applicable for a new fracture of the same vertebra or vertebrae (H) (Anaes.) [Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=35401) Health fund and DVA rates ------------------------- 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=35401) before billing. This is a reference tool, not billing or financial advice.