MBS item

42785
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Laser treatment of the iris to create an opening, up to 3 treatments per eye within 2 years, performed under anaesthesia with assistant.

Category 3 · Therapeutic procedures[Group T8 · subgroup 9](/groups/T8)

Schedule fee$422.95

100% benefitGP, out of hospital—

85% benefitOut of hospital$359.55

75% benefitIn hospital$317.25

The schedule fee for MBS item 42785 is $422.95. Medicare pays $359.55 (85%) out of hospital, or $317.25 (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$359.55

Patient gap$63.40

Bulk billing means accepting $359.55 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=42785)

Item descriptor
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LASER IRIDOTOMY - each treatment episode to 1 eye, to a maximum of 3 treatments to that eye in a 2 year period (Anaes.) (Assist.)

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=42785)

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=42785) before billing. This is a reference tool, not billing or financial advice.