MBS item

45617
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Surgical reduction of upper eyelid for visual impairment, eyelid inflammation, orbital fat herniation, facial nerve palsy, post-traumatic scarring, or symmetry restoration, with documented photographic/imaging evidence.

Category 3 · Therapeutic procedures[Group T8 · subgroup 13](/groups/T8)

Schedule fee$281.40

100% benefitGP, out of hospital—

85% benefitOut of hospital$239.20

75% benefitIn hospital$211.05

The schedule fee for MBS item 45617 is $281.40. Medicare pays $239.20 (85%) out of hospital, or $211.05 (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$239.20

Patient gap$42.20

Bulk billing means accepting $239.20 as full payment, with no gap and no extra charges. [Add incentives](/bulk-billing?item=45617)

Extended Medicare Safety Net cap: $225.12 (80% of the schedule fee). Once a patient reaches the EMSN threshold, the extra benefit for this item is 80% of their out-of-pocket cost, but no more than this cap. [How safety nets work](/guides/medicare-safety-nets)

Item descriptor
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Upper eyelid, reduction of, if: (a) the reduction is for any of the following: (i) history of a demonstrated visual impairment; (ii) intertriginous inflammation of the eyelid; (iii) herniation of orbital fat in exophthalmos; (iv) facial nerve palsy; (v) post‑traumatic scarring; (vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and (b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes (Anaes.)

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=45617)

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

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Guides
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- [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=45617) before billing. This is a reference tool, not billing or financial advice.