MBS item

46068
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Double free flap transfer with vascularized bone component for major head, neck or other non-breast defects, including microvascular anastomoses, flap harvesting, and tissue inset.

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

Schedule fee$3,428.85

100% benefitGP, out of hospital—

85% benefitOut of hospital—

75% benefitIn hospital$2,571.65

The schedule fee for MBS item 46068 is $3,428.85. Medicare pays $2,571.65 (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$2,571.65

Fund pays (minimum)$857.20

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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Double free flap, including one free transfer of tissue with a vascularized bone component, for the repair of major defect of the head or neck or other non-breast defect, all necessary elements of the operation, including (but not limited to): (a) anastomoses of all required vessels using microvascular techniques; and(b) harvesting of flap (including osteotomies); and(c) raising of tissue on a vascular pedicle; and(d) preparation of recipient vessels; and(e) transfer of tissue, including fixation of bony element and inset of tissue at recipient site; and(f) direct repair of secondary cutaneous defect, if performed; other than the following: (g) bony reshaping for purposes of reconstruction of maxilla, mandible or skull base; (h) a service associated with a service to which item 30166, 30169, 30175, 30176, 30177, 30179, 45501, 45502, 45504, 45505 or 45562 appliesConjoint surgery, conjoint specialist surgeon (H) (Anaes.) (Assist.)

[Explanatory notes and rules on MBS Online ↗](https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=46068)

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=46068) before billing. This is a reference tool, not billing or financial advice.