MBS item

38241
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Coronary pressure wire use during angiography or intervention to measure fractional flow reserve or pressure ratios in intermediate stenoses (50-70%), when prior functional imaging is unavailable, inconclusive, or vessel-specific.

Category 3 · Therapeutic procedures[Group T8 · subgroup 6](/groups/T8)In hospital only (H)

Schedule fee$562.10

100% benefitGP, out of hospital—

85% benefitOut of hospital—

75% benefitIn hospital$421.60

The schedule fee for MBS item 38241 is $562.10. Medicare pays $421.60 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026.

Gap for what you charge
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Your fee$

In hospital (private)

Medicare pays$421.60

Fund pays (minimum)$140.50

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
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Use of a coronary pressure wire, if the service is: (a) performed during selective coronary angiography, percutaneous angioplasty or transluminal insertion of one or more stents; and (b) to measure fractional flow reserve, non-hyperaemic pressure ratios or coronary flow reserve in intermediate coronary artery or graft lesions (stenosis of 50 to 70%); and (c) to determine whether revascularisation is appropriate, if previous functional imaging: (i) has not been performed; or (ii) has been performed but the results are inconclusive or do not apply to the vessel being interrogated; and (d) performed on one or more coronary vascular territories (H) (Anaes.)

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=38241)

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)
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- [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)
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- [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=38241) before billing. This is a reference tool, not billing or financial advice.