MBS item

42866
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Surgical repair of entropion or tarsal ectropion by tightening or shortening inferior retractors across the full eyelid width via open operation, excluding procedures using conjunctival approaches for fat reduction or orbital surgery.

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

Schedule fee$899.85

100% benefitGP, out of hospital—

85% benefitOut of hospital$795.35

75% benefitIn hospital$674.90

The schedule fee for MBS item 42866 is $899.85. Medicare pays $795.35 (85%) out of hospital, or $674.90 (75%) for a privately admitted patient in hospital. Fee effective 1 July 2026.

Gap for what you charge
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Your fee$

Out of hospitalIn hospital (private)

Medicare pays$795.35

Patient gap$104.50

Bulk billing means accepting $795.35 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=42866)

Item descriptor
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Entropion or tarsal ectropion, repair of, by tightening, shortening or repair of inferior retractors by open operation across the entire width of the eyelid, excluding when performed in conjunction with closure of the retractors using conjunctival approaches for fat pad reduction or orbital surgery (Anaes.) (Assist.)

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=42866)

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

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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=42866) before billing. This is a reference tool, not billing or financial advice.