MBS item

45070
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Single-stage surgical correction of developmental breast abnormality (implant insertion with/without mastopexy or reduction mammaplasty) on one breast when volume difference from other breast is ≥20% (normal) or ≥10% (tubular/abnormal folds), with do…

Category 3 · Therapeutic procedures[Group T8 · subgroup 13](/groups/T8)In hospital only (H)

Schedule fee$1,014.40

100% benefitGP, out of hospital—

85% benefitOut of hospital—

75% benefitIn hospital$760.80

The schedule fee for MBS item 45070 is $1,014.40. Medicare pays $760.80 (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$760.80

Fund pays (minimum)$253.60

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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Developmental breast abnormality, single stage correction of, involving surgery on one breast, if: (a) the correction involves either: (i) insertion of an implant with or without mastopexy; or(ii) reduction mammaplasty; and (b) there is a difference in breast volume with the other breast, as demonstrated by an appropriate volumetric measurement technique, of at least: (i) 20% in normally shaped breasts; or(ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds; and (c) photographic or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes Applicable only once per occasion on which the service is provided (H) (Anaes.) (Assist.)

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=45070)

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=45070) before billing. This is a reference tool, not billing or financial advice.