Health Insurance (General Medical Services Table) Regulations 2004

Statutory Rules 2004 No. 3081

I, PHILIP MICHAEL JEFFERY, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.

Dated 29 October 2004

P. M. JEFFERY

Governor-General

By His Excellency’s Command

TONY ABBOTT

Minister for Health and Ageing

Contents

 1 Name of Regulations 

 2 Commencement 

 3 Health Insurance (General Medical Services Table) Regulations 2003 — repeal             

 4 Definitions 

 5 General medical services table 

Schedule 1 Table of general medical services 

Part 1 Prescription of table 

 1 Prescription of table 

Part 2 Rules of interpretation 

 2 Application of table 

 3 General 

 4 Meaning of symbols (S) and (G)

 5 Meaning of symbol (H)

 6 Meaning of single course of treatment in certain circumstances             

 7 Meaning of professional attendance in certain items 

 8 Interpretation of items 104 to 131 and 300 to 388 

 9 Meaning of amount under rule 9 in certain items 

 10 Items 10809 and 10929 not to apply in certain circumstances             

 11 Personal attendance by medical practitioners generally 

 12 Personal attendance by certain medical practitioners 

 13 Certain services may be provided by persons other than medical practitioners             

 14 Conditions under which certain services to be provided 

 15 Application of items 1 to 10941 

 16 Application of items 51700 to 53706 

 17 Meaning of amount under rule 17 in certain items 

 18 Meaning of amount under rule 18 in certain items 

 19 Cleft lip and cleft palate services 

 20 Meaning of (AD) in Group C2 — Oral and maxillofacial surgical services and Group C3 — General and prosthodontic services             

 21 Orthodontic services 

 22 Oral surgery services 

 23 Meaning of report in Group D1 — Miscellaneous diagnostic procedures and investigations             

 24 Meaning of treatment cycle of a patient 

 25 Items provided as part of treatment cycle relating to assisted reproductive services not to apply             

 26 Items relating to assisted reproductive services not to apply in certain pregnancy-related circumstances             

 27 Meaning of embryology laboratory services in items 13200 and 13206             

 28 Meaning of delivery in certain items 

 29 Meaning of maxilla in certain items 

 30 Items 46300 to 46534 apply only in certain circumstances 

 31 Assistance at operations 

 32 Meaning of amount under rule 32 in items 51303 and 51803             

 33 Meaning of amount under rule 33 in item 51309 

 34 Meaning of amount under rule 34 in items 18219 and 18227             

 35 Histopathological proof of malignancy in certain cases for purposes of certain items relating to surgical procedures             

 36 Meaning of amount under rule 36 in items 16633 and 16636             

 37 Meaning of amount under rule 37 in item 51312 

 38 Meaning of amount under rule 38 in item 31340 

 39 Meaning of previous significant surgical complication in item 51318             

 40 Meaning of amount under rule 40 in item 30001 

 41 Consultant occupational physicians 

 42 Meaning of qualified sleep medicine practitioner

 43 Public health physicians 

 44 Application of items in Group A14 to certain patients only 

 45 Application of items in Group A15 to certain patients only 

 46 Meaning of health assessment

 47 Meaning of adult health check in item 710 

 48 Meaning of comprehensive medical assessment in item 712             

 49 Meaning of multidisciplinary care plan

 50 Meaning of multidisciplinary care plan team

 51 Meaning of multidisciplinary discharge care plan

 52 Meaning of review of a multidisciplinary care plan 

 53 Meaning of contribution to a plan 

 54 Meaning of multidisciplinary case conference

 55 Meaning of multidisciplinary discharge case conference

 56 Meaning of multidisciplinary case conference in a residential aged care facility

 57 Meaning of multidisciplinary case conference team

 58 Meaning of organise and co-ordinate in a multidisciplinary case conference and participation in a multidisciplinary case conference             

 59 Meaning of living in a community setting in item 900 

 60 Meaning of residential medication management review in item 903             

 61 Meaning of amount under rule 61 in certain items 

 62 Application of Subgroup 2 of Group A18 and Subgroup 2 of Group A19             

 63 Application of Subgroup 3 of Group A18 and Subgroup 3 of Group A19             

 64 Meaning of approved site in items 15338 and 37220 

 65 Group T10 applies only in connection with certain services 

 66 Services specified in Subgroups 21 to 25 of Group T10 

 67 Meaning of service time in Subgroups 21, 24, 25 and 26 of Group T10             

 68 Application of Subgroup 21 of Group T10 

 69 Application of Subgroups 22 and 23 of Group T10 

 70 Meaning of amount under rule 70 in items 25025, 25030 and 25050             

 71 Application of Subgroups 24 and 25 of Group T10 

 72 Meaning of complex paediatric case in item 25205 

 73 Meaning of amount under rule 73 in items 25200 and 25205             

 74 Restriction of telepsychiatry consultations to rural and remote areas             

 75 Meaning of recognised emergency department and problem focussed history in Group A21             

 76 Prolonged attendances by emergency physicians 

 77 Application of Subgroup 4 of Group A18 and Subgroup 4 of Group A19             

 78 Focussed psychological strategies 

 79 Meaning of qualified surgeon in items 31539 and 31545 

 80 Meaning of qualified radiologist in item 31542 

 81 Injection of botulinum toxin 

 82 Meaning of qualified medical acupuncturist in items 193, 195, 197 and 199             

 83 Application of items 10990 and 10991 

 84 Application of item 10993 

 85 Application of item 10996 

Part 3 Services and fees 

Part 4 Non-medicare services 

 


 

1 Name of Regulations

  These Regulations are the Health Insurance (General Medical Services Table) Regulations 2004.

2 Commencement

  These Regulations commence on 1 November 2004.

3 Health Insurance (General Medical Services Table) Regulations 2003 — repeal

  The following Statutory Rules are repealed:

  2003 Nos. 255, 318 and 359

  2004 Nos. 65, 77, 126, 183, 184, 237 and 267.

4 Definitions

  In these Regulations:

Act means the Health Insurance Act 1973.

this table means the table of general medical services set out in Schedule 1.

5 General medical services table

  The table of medical services (other than diagnostic imaging services and pathology services) set out in Schedule 1 is prescribed for subsection 4 (1) of the Act.


Schedule 1 Table of general medical services

(regulation 5)

Part 1 Prescription of table

1 Prescription of table

  For section 4 of the Act, these Regulations prescribe a table of general medical services that sets out:

 (a) in Part 2 — rules for interpretation of the table; and

 (b) in Part 3:

 (i) items of general medical services; and

 (ii) the amount of fees applicable for each item; and

 (c) in Part 4 — additional supporting information.

Part 2 Rules of interpretation

2 Application of table

  An item in Part 3 does not apply to a service provided in contravention of a law of the Commonwealth or of a State or Territory.

3 General

 (1) In this table, unless the contrary intention appears:

ACRRM means the Australian College of Rural and Remote Medicine.

approved day hospital facility means a day hospital facility within the meaning of the National Health Act 1953.

attendance of a minor nature or minor attendance, for an attendance on a patient by a consultant physician, means an attendance that:

 (a) is a second or subsequent attendance on the patient, in the course of a single course of treatment by the consultant physician, during which it is not necessary for the consultant physician to carry out a physical examination of the patient; and

 (b) does not result in a substantial alteration to the treatment of the patient.

closed reduction:

 (a) means treatment of a dislocation or fracture by
non-operative reduction; and

 (b) includes the use of percutaneous fixation, or external splintage by cast or splints.

comprehensive hyperbaric medicine facility means a separate hospital area that, on a 24-hour basis:

 (a) is equipped and staffed so that it is capable of providing to a patient:

 (i) hyperbaric oxygen therapy at a treatment pressure
of at least 2.8 atmospheric pressure absolute (180 kilopascal gauge pressure); and

 (ii) mechanical ventilation and invasive cardiovascular monitoring within a monoplace or multiplace chamber for the duration of the hyperbaric treatment; and

 (b) is under the direction of at least 1 practitioner who is rostered, and immediately available, to the facility during normal working hours and who:

 (i) is a specialist with training in diving and hyperbaric medicine; or

 (ii) holds a Diploma of Diving and Hyperbaric Medicine of the South Pacific Underwater Medicine Society; and

 (c) is staffed by:

 (i) at least 1 medical practitioner with training in diving and hyperbaric medicine who is present in the facility and immediately available at all times when patients are being treated at the facility; and

 (ii) at least 1 registered nurse with specific training in hyperbaric patient care to the published standards of the Hyperbaric Technicians and Nurses Association, who is present during hyperbaric oxygen therapy; and

 (d) has admission and discharge policies in operation.

general intensive care unit means a separate hospital area that:

 (a) is equipped and staffed so that it is capable of providing to a patient:

 (i) mechanical ventilation for a period of several days; and

 (ii) invasive cardiovascular monitoring; and

 (b) is supported by:

 (i) during normal working hours — at least 1 specialist, or consultant physician, in the specialty of intensive care, who is immediately available, and exclusively rostered, to that area; and

 (ii) at all times — at least 1 registered medical practitioner who is present in the hospital and immediately available to that area; and

 (iii) at least 18 hours each day — at least 1 registered nurse; and

 (c) has admission and discharge policies in operation.

general practitioner means:

 (a) a practitioner who is vocationally registered under section 3F of the Act; or

 (b) a practitioner who:

 (i) is a Fellow of the RACGP; and

 (ii) participates in the quality assurance and continuing medical education program of the RACGP; and

 (iii) meets the RACGP requirements for quality assurance and continuing education; or

 (c) a practitioner who is undertaking a placement in general practice that is approved by the RACGP:

 (i) as part of a training program for general practice leading to the award of Fellowship of the RACGP; or

 (ii) as part of another training program recognised by the RACGP as being of an equivalent standard; or

 (iii) as part of the Rural and Remote Area Placement Program administered by the Australian College of Rural and Remote Medicine; or

 (d) an eligible non-vocationally recognised medical practitioner; or

 (e) a practitioner who is undertaking a placement in general practice as part of the Pre-vocational General Practice Placements Program administered by the ACRRM, RACGP or GPET.

GPET means the body registered under the Corporations Act 2001 as General Practice Education and Training Limited (ACN 095 433 140).

institution means a place (other than a hospital or residential aged care facility) at which residential accommodation or day care is, or both residential accommodation and day care are, made available to:

 (a) disadvantaged children; or

 (b) juvenile offenders; or

 (c) aged persons; or

 (d) chronically ill psychiatric patients; or

 (e) homeless persons; or

 (f) unemployed persons; or

 (g) persons suffering from alcoholism; or

 (h) persons addicted to drugs; or

 (i) physically or intellectually disabled persons.

intensive care unit means a general intensive care unit or a neo-natal intensive care unit.

item means:

 (a) an item mentioned, by number, in column 1 of:

 (i) Part 3; or

 (ii) Part 3 of the diagnostic imaging services table; or

 (iii) Part 3 of the pathology services table; and

 (b) in a reference immediately followed by a number — the item so numbered.

Example

A reference (if any) by number to item 55028 is a reference to the item so numbered in the diagnostic imaging services table.

neo-natal intensive care unit means a separate hospital area that:

 (a) is equipped and staffed so that it is capable of providing to a patient who is a newly born child:

 (i) mechanical ventilation for a period of several days; and

 (ii) invasive cardiovascular monitoring; and

 (b) is supported by:

 (i) during normal working hours — at least 1 consultant physician in paediatric medicine who is immediately available, and exclusively rostered, to that area; and

 (ii) at all times — at least 1 registered medical practitioner who is present in the hospital and immediately available to that area; and

 (iii) at least 18 hours each day — at least 1 registered nurse; and

 (c) has admission and discharge policies in operation.

open reduction means treatment of a dislocation or fracture by either:

 (a) operative exposure, including the use of any internal or external fixation; or

 (b) non-operative (closed) reduction using intra-medullary fixation or external fixation.

RACGP means the Royal Australian College of General Practitioners.

referring practitioner, for the referral of a patient, means:

 (a) in the case of all referrals — a medical practitioner; and

 (b) for a referral made to a specialist who is an ophthalmologist — an optometrist; and

 (c) for a referral that arises out of a dental service provided by a dental practitioner and that is made to a specialist (but not a consultant physician) — a dental practitioner; and

 (d) for a referral that arises out of a dental service provided by a dental practitioner who is approved by the Minister for the purposes of paragraph (b) of the definition of professional service in subsection 3 (1) of the Act and that is made to a consultant physician — a dental practitioner.

residential aged care facility means a facility where residential care (within the meaning given by section 41-3 of the Aged Care Act 1997) is provided.

Rural, Remote and Metropolitan Areas Classification means the document so titled, as in force on 1 January 2001, setting out certain categories of areas in Australia that have been determined by the Department by reference to population size and remoteness of locality on the basis of 1991 census data published by the Australian Bureau of Statistics in 1994.

 (2) A reference to a Group in the table includes every item in the Group, and a reference to a Subgroup in the table includes every item in the Subgroup.

 (3) A reference in the table to an eligible non-vocationally recognised medical practitioner is a reference to:

 (a) a medical practitioner (including an overseas trained practitioner or a temporary resident medical practitioner) who:

 (i) is registered as a medical practitioner under the Rural Other Medical Practitioners’ Program; and

 (ii) is providing general medical services in accordance with that Program; or

 (b) a medical practitioner who:

 (i) is registered as a medical practitioner under the Outer Metropolitan (Other Medical Practitioners) Relocation Incentive Program; and

 (ii) is providing general medical services in accordance with that Program; and

 (iii) is not vocationally registered under section 3F of the Act, but is required under that Program to undertake additional training or other activities:

 (A) that could enable vocational registration within 4 years or, on written application, 5 years, after commencing the training or other activities; and

 (B) of which the Commission has written notice; or

 (c) a medical practitioner who:

 (i) is registered as a medical practitioner under the MedicarePlus for Other Medical Practitioners Program; and

 (ii) is providing general medical services in accordance with that Program; and

 (iii) is not vocationally registered under section 3F of the Act; or

 (d) a medical practitioner who:

 (i) is registered as a medical practitioner under the Medical Deputising Service — After Hours Other Medical Practitioners Program; and

 (ii) is providing general medical services in accordance with that Program; and

 (iii) is not vocationally registered under section 3F of the Act.

 (4) For subrule (3):

 (a) the Rural Other Medical Practitioners’ Program is a program administered by the Commission that, in relation to medical services provided in accordance with the Program, provides a particular level of medicare benefits; and

 (b) the Outer Metropolitan (Other Medical Practitioners) Relocation Incentive Program is a program administered by the Department that, in relation to medical services provided in accordance with the Program, provides a particular level of medicare benefits; and

 (c) the MedicarePlus for Other Medical Practitioners Program is a program administered by the Commission that, in relation to medical services provided in accordance with the Program, provides a particular level of medicare benefits; and

 (d) the Medical Deputising Service — After Hours Other Medical Practitioners Program is a program administered by the Commission that, in relation to medical services provided in accordance with the Program, provides a particular level of medicare benefits.

4 Meaning of symbols (S) and (G)

 (1) An item including the symbol (S) applies only to a service performed by a specialist (and not to a service performed by a consultant physician) in the practice of his or her specialty, being:

 (a) a service that:

 (i) is provided to a patient who has been referred to the specialist; and

 (ii) is the first service performed by the specialist in accordance with the referral; or

 (b) a service that:

 (i) is provided to a patient who has been referred to the specialist; and

 (ii) is part of a single course of treatment given for the condition identified in the referral or, if no condition was identified in the referral, part of a single course of treatment for the condition identified by the specialist; and

 (iii) is provided within the period of validity of the referral that is applicable under regulation 31 of the Health Insurance Regulations 1975; or

 (c) a service that:

 (i) is provided to a patient who has declared that a written referral completed by a named referring practitioner has been lost, stolen or destroyed before the service was provided; and

 (ii) is the first service performed by the specialist in accordance with the referral; or

 (d) a service that:

 (i) is provided to a patient who has not been referred to the specialist; and

 (ii) is a service that, in an emergency within the meaning of subregulation 30 (5) of the Health Insurance Regulations 1975, the specialist decides is necessary in the patient’s interests to be provided as soon as practicable without a referral.

 (2) An item including the symbol (G) applies only to a service provided otherwise than by a specialist in accordance with subrule (1).

5 Meaning of symbol (H)

  An item including the symbol (H) applies only to a service performed or provided in a hospital or approved day hospital facility.

6 Meaning of single course of treatment in certain circumstances

 (1) In subrules 3 (1), 4 (1) and 8 (1) and items 104, 105, 106, 107, 108, 110, 116, 119, 122, 128, 131, 385, 386, 387 and 388, single course of treatment, in relation to a patient, includes:

 (a) the initial attendance on the patient by a specialist or consultant physician; and

 (b) the continuing management or treatment up to and including the stage when the patient is referred back to the care of the referring practitioner; and

 (c) any subsequent review of the patient’s condition by the specialist or consultant physician that may be necessary, whether the review is initiated by the referring practitioner or by the specialist or consultant physician.

 (2) For subrule (1), single course of treatment does not include treatment of an unrelated illness that requires referral of the patient to the specialist’s or consultant physician’s care.

 (3) For subrule (1), an attendance (the later attendance) on the patient by the specialist or consultant physician, after the end of the period of validity of the last referral to have application under regulation 31 of the Health Insurance Regulations 1975, initiates a new course of treatment if:

 (a) the referring practitioner considers the later attendance necessary for the patient’s condition to be reviewed; and

 (b) the patient was most recently attended by the specialist or consultant physician more than 9 months before the later attendance.

7 Meaning of professional attendance in certain items

 (1) In items 1 to 338, 348 to 388, 410 to 417, 501 to 536, 601, 602, 697, 698, 2501 to 2727 and 10900 to 10929, professional attendance includes (but is not limited to) the provision, in relation to a patient, of any of the following services:

 (a) the evaluation of the patient’s condition or conditions including, if applicable, evaluation using a health screening service mentioned in subsection 19 (5) of the Act;

 (b) the formulation of a plan for the management and, if applicable, for the treatment of the patient’s condition or conditions;

 (c) the provision of advice to the patient about the patient’s condition or conditions and, if applicable, about treatment;

 (d) if authorised by the patient, the provision of advice to another person, or other persons, about the patient’s condition or conditions and, if applicable, about treatment;

 (e) the recording of the clinical details of the service or services provided to the patient.

 (2) If:

 (a) in connection with a professional attendance mentioned in any of items 3 to 96, vaccine is supplied to a patient; and

 (b) the cost of the vaccine is not subsidised by the Commonwealth or a State;

the professional attendance is taken not to include that supply.

8 Interpretation of items 104 to 131 and 300 to 388

 (1) In items 104 to 131 and 300 to 388, a reference to an attendance on a patient by a specialist, or consultant physician, in the practice of his or her specialty following referral of the patient to him or her:

 (a) includes such an attendance on a patient who:

 (i) has declared that a written referral of the patient was completed by a medical practitioner; or

 (ii) in an emergency (within the meaning of subregulation 30 (5) of the Health Insurance Regulations 1975) has not been referred to the specialist, or consultant physician, if the specialist or consultant physician decides that it is necessary in the patient’s interests to provide the service mentioned in the item as soon as practicable without a referral; but

 (b) does not include such an attendance if:

 (i) the attendance forms part of a single course of treatment in which the first service was provided more than 12 months (or such other period, if any, set by the referring practitioner in, or in connection with, the referral) before the attendance; and

 (ii) a later referral has not been made.

 (2) For this rule, referral means referral by a referring practitioner.

9 Meaning of amount under rule 9 in certain items

 (1) In items 4, 13, 19 and 20, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 3; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (2) In items 24, 25, 33 and 35, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 23; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (3) In items 37, 38, 40 and 43, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 36; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (4) In items 47, 48, 50 and 51, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 44; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (5) In items 58, 81, 87 and 92, amount under rule 9 means an amount equal to the sum of:

 (a) $8.50; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $15.50 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — 70 cents.

 (6) In items 59, 83, 89, 93, 2610, 2631 and 2673, amount under rule 9 means an amount equal to the sum of:

 (a) $16.00; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $17.50 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — 70 cents.

 (7) In items 60, 84, 90, 95, 2613, 2633, 2675 and 2707, amount under rule 9 means an amount equal to the sum of:

 (a) $35.50; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $15.50 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — 70 cents.

 (8) In items 65, 86, 91, 96, 2616, 2635, 2677 and 2708, amount under rule 9 means an amount equal to the sum of:

 (a) $57.50; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $15.50 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — 70 cents.

 (9) In item 195, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 193; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (10) In item 414, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 410; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (11) In item 415, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 411; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (12) In item 416, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 412; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (13) In item 417, amount under rule 9 means an amount equal to the sum of:

 (a) the fee for item 413; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

10 Items 10809 and 10929 not to apply in certain circumstances

  Items 10809 and 10929 do not apply if the patient’s requirement for contact lenses is only for any of the following reasons:

 (a) because the patient does not want to wear spectacles for reasons of appearance;

 (b) because the patient wants contact lenses for work or sporting purposes;

 (c) because the patient has difficulty in using, or cannot use, spectacles for psychological reasons.

11 Personal attendance by medical practitioners generally

 (1) The items mentioned in subrule (2) apply only to a service provided in the course of a personal attendance by a single medical practitioner on a single patient on a single occasion.

 (2) The items are items 1 to 164, 173 to 338, 348 to 10816, 11012, 11015, 11018, 11021, 11212, 11304, 11500, 11600, 11627, 11701, 11712, 11724, 11921, 12000, 12003, 12201, 13030, 13100, 13103, 13106, 13109, 13110, 13112, 13209, 13290, 13292, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13400, 13500, 13503, 13506, 13700, 13815, 13818, 13830, 13839, 13842, 13845, 13848, 13851, 13854, 13857, 13870, 13873, 13876, 13879, 13882, 13885, 13888, 14100, 14106, 14109, 14112, 14115, 14118, 14124, 14200, 14203, 14206, 14209, 14212, 14215, 14224, 15600, 16003 to 16512 and 16515 to 51318.

 (3) Items 170, 171, 172, 342, 344 and 346 apply only to a service provided in the course of a personal attendance by a single medical practitioner.

 (4) For this rule, an attendance by a medical practitioner on a patient by way of a telepsychiatry consultation, to which any of items 353 to 358 applies, is taken to be a personal attendance by the medical practitioner on the patient.

12 Personal attendance by certain medical practitioners

 (1) The items mentioned in subrule (3) apply only to a service provided in the course of a personal attendance by:

 (a) a medical practitioner (other than a medical practitioner employed by the proprietor of a hospital that is not a private hospital); or

 (b) a medical practitioner who:

 (i) is employed by the proprietor of a hospital that is not a private hospital; and

 (ii) provides the service otherwise than in the course of employment by that proprietor.

 (2) Paragraph (1) (b) applies whether or not another person provides essential assistance to the medical practitioner in accordance with accepted medical practice.

 (3) The items are items 1 to 10816, 11012, 11015, 11018, 11021, 11212, 11304, 11500, 11600, 11627, 11701, 11712, 11722, 11724, 11820, 11921, 12000, 12003, 12201, 13030, 13100, 13103, 13106, 13109, 13110, 13112, 13209, 13290, 13292, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13400, 13500, 13503, 13506, 13700, 13815, 13818, 13830, 13839, 13842, 13845, 13848, 13851, 13854, 13857, 13870, 13873, 13876, 13879, 13882, 13885, 13888, 14100, 14106, 14109, 14112, 14115, 14118, 14124, 14200, 14203, 14206, 14209, 14212, 14215, 14224, 15600, 16003 to 16512 and 16515 to 51318.

 (4) For this rule, an attendance by a medical practitioner on a patient by way of a telepsychiatry consultation, to which any of items 353 to 358 applies, is taken to be a personal attendance by the medical practitioner on the patient.

13 Certain services may be provided by persons other than medical practitioners

 (1) The items mentioned in subrule (2) apply whether the medical service is given by:

 (a) a medical practitioner; or

 (b) a person, other than a medical practitioner, who:

 (i) is employed by a medical practitioner; or

 (ii) in accordance with accepted medical practice, acts under the supervision of a medical practitioner.

 (2) The items are items 11000, 11003, 11004, 11005, 11006, 11009, 11024, 11027, 11200, 11203, 11204, 11205, 11210, 11211, 11215, 11218, 11221, 11222, 11224, 11225, 11235, 11237, 11240, 11241, 11242, 11243, 11300, 11303, 11306, 11309, 11312, 11315, 11318, 11321, 11324, 11327, 11330, 11332, 11333, 11336, 11339, 11503, 11506, 11509, 11512, 11602, 11604, 11605, 11610, 11611, 11612, 11614, 11615, 11700, 11702, 11708, 11709, 11710, 11711, 11713, 11715, 11718, 11721, 11800, 11810, 11830, 11833, 11900, 11903, 11906, 11909, 11912, 11915, 11919, 12012, 12015, 12018, 12021, 12200, 12203, 12207, 12210, 12213, 12215, 12217, 12500 to 12533, 13020, 13025, 13200, 13203, 13206, 13212, 13215, 13218, 13221, 13703, 13706, 13709, 13750, 13755, 13757, 13760, 13915 to 13948, 14050, 14053, 14218, 14221, 15000 to 15336, 15339 to 15357, 15500 to 15539 and 16514.

14 Conditions under which certain services to be provided

  Items 11309, 11312, 11315, 11318 and 11321 apply only to a service provided:

 (a) in conditions that allow the establishment of determinate thresholds; and

 (b) in a sound-attenuated environment with background noise conditions that comply with Australian Standard
AS1269-1983 of the Standards Association of Australia, as in force on 1 August 1987; and

 (c) using calibrated equipment that complies with Australian Standard AS2586-1983 of the Standards Association of Australia, as in force on 1 August 1987.

15 Application of items 1 to 10941

  An item in the range 1 to 10941 does not apply to the service described in that item if the service is provided at the same time as, or in connection with, any of the services specified in Part 4 of this table.

16 Application of items 51700 to 53706

  Items 51700 to 53706 apply only to a service provided in the course of dental practice by a dental practitioner approved by the Minister before 1 November 2004 for the purposes of the definition of professional service in subsection 3 (1) of the Act.

17 Meaning of amount under rule 17 in certain items

 (1) In item 15003, amount under rule 17 means an amount equal to the sum of:

 (a) the fee for item 15000; and

 (b) $14.50 for each field separately treated in excess of 1.

 (2) In item 15009, amount under rule 17 means an amount equal to the sum of:

 (a) the fee for item 15006; and

 (b) $15.75 for each field separately treated in excess of 1.

 (3) In item 15103, amount under rule 17 means an amount equal to the sum of:

 (a) the fee for item 15100; and

 (b) $16.00 for each field separately treated in excess of 1.

 (4) In item 15109, amount under rule 17 means an amount equal to the sum of:

 (a) the fee for item 15106; and

 (b) $19.25 for each field separately treated in excess of 1.

 (5) In item 15115, amount under rule 17 means an amount equal to the sum of:

 (a) the fee for item 15112; and

 (b) $40.15 for each field separately treated in excess of 1.

 (6) In item 15214, amount under rule 17 means an amount equal to the sum of:

 (a) the fee for item 15211; and

 (b) $27.05 for each field separately treated in excess of 1.

 (7) In items 15230, 15233, 15236, 15239, 15242, 15260, 15263, 15266, 15269 and 15272, amount under rule 17 means an amount equal to the sum of:

 (a) $50.65; and

 (b) $32.15 for each field separately treated in excess of 1.

18 Meaning of amount under rule 18 in certain items

  In item 44376 (reamputation), amount under rule 18 means an amount equal to 75% of the fee specified for the item relating to an original amputation (any of items 44325 to 44373) of the body part for which the reamputation is performed.

19 Cleft lip and cleft palate services

  An item in Group C1, C2 or C3 applies only to a service provided to a prescribed dental patient.

Note   For the meaning of prescribed dental patient, see section 3BA of the Act.

20 Meaning of (AD) in Group C2 — Oral and maxillofacial surgical services and Group C3 — General and prosthodontic services

  An item in the range 75200 to 75206 and 75800 to 75854 that includes the symbol (AD) applies only to a service provided by a dental practitioner.

21 Orthodontic services

 (1) An item in the range 75001 to 75006 or 75024 to 75051 that includes the symbol (AO) applies only to a service provided by an accredited orthodontist.

 (2) An item in the range 75009 to 75023 that includes the symbol (AO) and the symbol (AOS) applies only to a service provided by:

 (a) an accredited orthodontist; or

 (b) a dental practitioner who is:

 (i) registered or licensed as an oral and maxillofacial surgeon under a law of the State or Territory in which the service is rendered that provides for the registration or licensing of oral and maxillofacial surgeons; and

 (ii) a dental practitioner approved by the Minister for the purposes of the definition of professional service in subsection 3 (1) of the Act.

 (3) In this rule:

accredited orthodontist means:

 (a) a dental practitioner who is:

 (i) registered or licensed as an orthodontist under the relevant law; and

 (ii) accredited by the Minister for the purposes of this rule; or

 (b) a dental practitioner:

 (i) who is not registered or licensed under the relevant law as an orthodontist or who practises in a State or Territory in which there is no provision for the registration or licensing of orthodontists; and

 (ii) whose qualifications or experience demonstrate to the Committee his or her competence in the field of orthodontics that is applicable to the giving of the services specified in items 75001 to 75051; and

 (iii) who is accredited by the Minister for the purposes of this rule.

Committee means the Medical Benefits (Dental Practitioners) Advisory Committee established under section 136 of the National Health Act 1953.

relevant law, in relation to a service provided to a patient, means a law of the State or Territory in which the service is provided that provides for the registration or licensing of orthodontists.

22 Oral surgery services

  An item in the range 75150 to 75621 that includes the symbol (AOS) applies only to a service provided by a dental practitioner who is:

 (a) registered as an oral and maxillofacial surgeon under a law of the State or Territory in which the service is rendered that provides for the registration or licensing of oral and maxillofacial surgeons; and

 (b) a dental practitioner approved by the Minister for the purposes of the definition of professional service in subsection 3 (1) of the Act.

23 Meaning of report in Group D1 — Miscellaneous diagnostic procedures and investigations

  In items 11000 to 12217, report means a report prepared by a medical practitioner.

24 Meaning of treatment cycle of a patient

  In rule 25 and items 13200 to 13221, treatment cycle, of a patient, means a series of treatments of the patient that:

 (a) begins:

 (i) if treatment with superovulatory drugs is given — on the day on which that treatment begins; or

 (ii) if treatment with superovulatory drugs is not given — on the first day of a menstrual cycle of the patient; and

 (b) ends not more than 30 days after that day.

25 Items provided as part of treatment cycle relating to assisted reproductive services not to apply

 (1) Subrule (2) applies to a service mentioned in:

 (a) an item in Subgroup 3 of Group T1 (assisted reproductive services); and

 (b) any other item (the associated item) associated with an item in Subgroup 3 of Group T1.

 (2) A service provided as part of a treatment cycle to which an item in paragraph (1) (a) applies, is not a medical service for the purposes of the associated item.

26 Items relating to assisted reproductive services not to apply in certain pregnancy-related circumstances

  Items 13200 to 13221 do not apply to a service provided in relation to a patient’s pregnancy, or intended pregnancy, that is, at the time of the service, the subject of an agreement, or arrangement, under which the patient makes provision for transfer to another person of the guardianship of, or custodial rights to, a child born as a result of the pregnancy.

27 Meaning of embryology laboratory services in items 13200 and 13206

  In items 13200 and 13206, embryology laboratory services does not include semen preparation but includes:

 (a) egg recovery from aspirated follicular fluid; and

 (b) insemination; and

 (c) monitoring of fertilisation and embryo development; and

 (d) preparation of gametes or embryos for transfer or freezing.

28 Meaning of delivery in certain items

  In items 16515, 16519 and 16522, delivery includes:

 (a) induction of labour by surgical or intravenous infusion methods; and

 (b) forceps or vacuum extraction; and

 (c) breech delivery; and

 (d) management of multiple deliveries; and

 (e) episiotomy; and

 (f) repair of tears; and

 (g) evacuation of the products of conception by manual removal.

29 Meaning of maxilla in certain items

  In items 45720 to 45752 and 52342 to 52375, maxilla includes the zygoma.

30 Items 46300 to 46534 apply only in certain circumstances

  Items 46300 to 46534 apply only to a service provided in the course of an operation on a hand or hands.

31 Assistance at operations

 (1) Items 51300 to 51318 apply only to assistance rendered by a medical practitioner other than:

 (a) the practitioner performing the operation; or

 (b) the anaesthetist administering the anaesthetic in connection with the operation, if any; or

 (c) the assistant anaesthetist, if any.

 (2) Items 51800 and 51803 apply only to assistance rendered by an approved dental practitioner other than:

 (a) the practitioner performing the operation; or

 (b) the anaesthetist administering the anaesthetic in connection with the operation, if any; or

 (c) the assistant anaesthetist, if any.

32 Meaning of amount under rule 32 in items 51303 and 51803

  In items 51303 and 51803, amount under rule 32, in relation to assistance at an operation or series of operations, means an amount equal to 20% of the sum of the fees payable under the Act for the services provided at that operation, or series of operations, by the practitioner to whom the assistance was given.

33 Meaning of amount under rule 33 in item 51309

 (1) In item 51309, amount under rule 33, in relation to assistance at a series or combination of operations, means an amount equal to 20% of the sum of the fees payable under the Act for the services provided at those operations by the practitioner to whom the assistance was given.

 (2) For subrule (1), the fee for the caesarean section component of the operations is the fee applicable to item 16520.

34 Meaning of amount under rule 34 in items 18219 and 18227

 (1) In item 18219, amount under rule 34 means an amount equal to the sum of:

 (a) the fee for item 18216; and

 (b) $16.20 for each additional period of 15 minutes, and part of a period of 15 minutes, of continuous attendance beyond the first hour of attendance.

 (2) In item 18227, amount under rule 34 means an amount equal to the sum of:

 (a) the fee for item 18226; and

 (b) $23.65 for each additional period of 15 minutes, and part of a period of 15 minutes, of continuous attendance beyond the first hour of attendance.

35 Histopathological proof of malignancy in certain cases for purposes of certain items relating to surgical procedures

  For items 30196 to 30205, the requirement for histopathological proof of malignancy is satisfied in a case where multiple lesions are to be removed from a single anatomical region if a single lesion from that region is histologically tested and proven positive for malignancy.

36 Meaning of amount under rule 36 in items 16633 and 16636

 (1) In item 16633, amount under rule 36 means, for a second or subsequent foetus, the amount that is equal to 50% of the amount of the fee specified in items 16606, 16609, 16612, 16615 and 16627 for services provided in relation to the multiple pregnancy.

 (2) In item 16636, amount under rule 36 means, for a second or subsequent foetus, the amount that is equal to 50% of the amount of the fee specified in items 16600, 16603, 16618, 16621 and 16624 for services provided in relation to the multiple pregnancy.

37 Meaning of amount under rule 37 in item 51312

  In item 51312, amount under rule 37, in relation to assistance at a procedure, means an amount equal to 20% of the sum of the fees payable under the Act for the services provided at that procedure by the practitioner to whom the assistance was given.

38 Meaning of amount under rule 38 in item 31340

  In item 31340, amount under rule 38, in relation to the excision of muscle, bone or cartilage in association with the excision of a malignant tumour of skin under another item, means an amount equal to 75% of the fee payable under that other item.

39 Meaning of previous significant surgical complication in item 51318

  In item 51318, previous significant surgical complication means:

 (a) vitreous loss; or

 (b) rupture of posterior capsule; or

 (c) loss of nuclear material into the vitreous; or

 (d) intraocular haemorrhage; or

 (e) intraocular infection (endophthalmitis); or

 (f) cystoid macular oedema; or

 (g) corneal decompensation; or

 (h) retinal detachment.

40 Meaning of amount under rule 40 in item 30001

  In item 30001, amount under rule 40 means 50% of the specified fee that would normally apply for a surgical procedure if the surgical procedure had not been discontinued before completion.

41 Consultant occupational physicians

  A fee specified for an attendance by a consultant occupational physician only applies if the attendance relates to 1 or more of the following matters:

 (a) evaluation and assessment of a patient’s rehabilitation requirements where, in the consultant’s opinion, the patient has an accepted medical condition that:

 (i) may be affected by the patient’s working environment; or

 (ii) affects the patient’s capacity to be employed;

 (b) management of an accepted medical condition that, in the consultant’s opinion, may affect a patient’s capacity for continued employment, or return to employment, following a non-compensable accident, injury or ill-health;

 (c) evaluation and forming an opinion, including management as the case requires, of a patient’s medical condition where causation may be related to acute or chronic exposure to scientifically acknowledged environmental hazards or toxins.

42 Meaning of qualified sleep medicine practitioner

 (1) For items 12203 to 12217, qualified sleep medicine practitioner means a qualified adult sleep medicine practitioner or a qualified paediatric sleep medicine practitioner.

 (2) A person is a qualified adult sleep medicine practitioner or a qualified paediatric sleep medicine practitioner if:

 (a) the person has been assessed by the Credentialling Subcommittee or the Appeal Committee as having had, before 1 March 1999, sufficient training and experience in the relevant field of sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies; or

 (b) the person has been assessed by the Credentialling Subcommittee or the Appeal Committee as having had, before 1 March 1999, substantial training or experience in adult sleep medicine, but requiring further specified training or experience in the relevant field of sleep medicine to be competent in independent clinical assessment and management of patients with respiratory sleep disorders and in reporting sleep studies, and either:

 (i) the period of 2 years immediately following that assessment has not expired; or

 (ii) the person has been assessed by the Credentialling Subcommittee as having satisfactorily finished the further training or gained the further experience specified for that person; or

 (c) the person has attained Level I or Level II of the relevant Advanced Training Program of the Thoracic Society of Australia and New Zealand and the Australasian Sleep Association, after having completed at least 12 months core training, including clinical practice in the relevant field of sleep medicine and in reporting sleep studies; or

 (d) the Advisory Committee has recognised the person, in writing, as having training equivalent to the training mentioned in paragraph (c).

 (3) In this rule:

Advisory Committee means the Specialist Advisory Committee in Thoracic and Sleep Medicine of the Royal Australasian College of Physicians.

Appeal Committee means the Appeal Committee of the Royal Australasian College of Physicians.

Credentialling Subcommittee means the Credentialling Subcommittee of the Advisory Committee.

relevant Advanced Training Program means:

 (a) in relation to an assessment for qualification as a qualified adult sleep medicine practitioner — the Advanced Training Program in Adult Sleep Medicine; and

 (b) in relation to an assessment for qualification as a qualified paediatric sleep medicine practitioner — the Advanced Training Program in Paediatric Sleep Medicine.

relevant field of sleep medicine means:

 (a) in relation to an assessment for qualification as a qualified adult sleep medicine practitioner — adult sleep medicine; and

 (b) in relation to an assessment for qualification as a qualified paediatric sleep medicine practitioner — paediatric sleep medicine.

43 Public health physicians

  Items 410 to 417 apply to an attendance on a patient by a public health physician only if the attendance relates to 1 or more of the following matters:

 (a) management of a patient’s vaccination requirements for immunisation programs;

 (b) prevention or management of sexually transmitted disease;

 (c) prevention or management of disease caused by scientifically accepted environmental hazards or toxins;

 (d) prevention or management of infection arising from an outbreak of an infectious disease;

 (e) prevention or management of an exotic disease.

Note   An exotic disease is medically accepted as a disease that is of foreign origin.

44 Application of items in Group A14 to certain patients only

 (1) Items 700, 702, 704 and 706 apply only to a service in relation to a patient who:

 (a) is either:

 (i) at least 75 years old; or

 (ii) at least 55 years old and of Aboriginal or Torres Strait Islander descent; and

 (b) is not an in-patient of a hospital or approved day hospital facility, or a care recipient in a residential aged care facility.

 (2) Item 710 applies only to a service in relation to a patient who is:

 (a) of Aboriginal or Torres Strait Islander descent; and

 (b) at least 15 years old and less than 55 years old; and

 (c) not an in-patient of a hospital or approved day hospital facility, or a care recipient in a residential aged care facility.

 (3) For this rule, a person is of Aboriginal or Torres Strait Islander descent if the person identifies himself or herself as being of that descent.

45 Application of items in Group A15 to certain patients only

 (1) Items 720, 724, 726, 740, 742, 744, 759, 762 and 765 apply only to a service in relation to a patient who:

 (a) suffers from at least 1 medical condition that:

 (i) has been (or is likely to be) present for at least 6 months; or

 (ii) is terminal; and

 (b) is not an in-patient of a hospital or approved day hospital facility, or a care recipient in a residential aged care facility.

 (2) Items 722, 728, 746, 749, 757, 768, 771 and 773 apply only to a service in relation to a patient who:

 (a) suffers from at least 1 medical condition that:

 (i) has been (or is likely to be) present for at least 6 months; or

 (ii) is terminal; and

 (b) is an in-patient of a hospital or approved day hospital facility; and

 (c) is not a care recipient in a residential aged care facility.

 (3) Items 730, 734, 736, 738, 775, 778 and 779 apply only to a service in relation to a patient who:

 (a) suffers from at least 1 medical condition that:

 (i) has been (or is likely to be) present for at least 6 months; or

 (ii) is terminal; and

 (b) is a care recipient in a residential aged care facility; and

 (c) is not an in-patient of a hospital or approved day hospital facility.

46 Meaning of health assessment

 (1) For items 700, 702, 704 and 706, health assessment means the assessment of:

 (a) a patient’s health and physical, psychological and social function; and

 (b) whether preventative health care and education should be offered to the patient, to improve the patient’s health and physical, psychological or social function.

 (2) A health assessment involves all of the following:

 (a) a personal attendance by the medical practitioner;

 (b) measurement of the patient’s blood pressure, pulse rate and rhythm;

 (c) an assessment of the patient’s medication;

 (d) an assessment of the patient’s continence;

 (e) an assessment of the patient’s immunisation status for influenza, tetanus and pneumococcus;

 (f) an assessment of the patient’s physical functions, including the patient’s activities of daily living and whether or not the patient has had a fall in the last 3 months;

 (g) an assessment of the patient’s psychological function, including the patient’s cognition and mood;

 (h) an assessment of the patient’s social function, including:

 (i) the availability and adequacy of paid, and unpaid, help; and

 (ii) whether the patient is responsible for caring for another person.

 (3) A health assessment also includes:

 (a) keeping a record of the health assessment; and

 (b) offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and

 (c) offering the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.

47 Meaning of adult health check in item 710

 (1) For item 710, an adult health check means the assessment of:

 (a) a patient’s health and physical, psychological and social function; and

 (b) whether preventative health care, education and other assistance should be offered to that patient, to improve the patient’s health and physical, psychological or social function.

 (2) An adult health check of a patient involves all of the following:

 (a) a personal attendance by a medical practitioner;

 (b) taking the patient’s medical history, including the following:

 (i) current health problems and risk factors;

 (ii) relevant family medical history;

 (iii) medication usage (including medication obtained without prescription or from other doctors);

 (iv) immunisation status, by reference to the appropriate current age and sex immunisation schedule;

 (v) sexual and reproductive health;

 (vi) physical activity, nutrition and alcohol, tobacco or other substance use;

 (vii) hearing loss;

 (viii) mood (including incidence of depression and risk of self-harm);

 (ix) family relationships and whether the patient is a carer, or is cared for by another person;

 (c) examination of the patient, including the following:

 (i) measurement of the patient’s blood pressure, pulse rate and rhythm;

 (ii) measurement of height and weight to calculate body mass index and, if indicated, measurement of waist circumference for central obesity;

 (iii) oral examination (including gums and dentition);

 (iv) ear and hearing examination (including otoscopy and, if indicated, a whisper test);

 (v) urinalysis (by dipstick) for proteinurea;

 (d) undertaking or arranging any required investigation, considering the need for the following tests, in particular, (in accordance with national or regional guidelines or specific regional needs):

 (i) fasting blood sugar and lipids (by laboratory based test on venous sample) or, if necessary, random blood glucose levels;

 (ii) pap smear;

 (iii) examination for sexually transmitted infection (by urine or endocervical swab for chlamydia and gonorrhoea, especially for those aged from 15 to 35 years);

 (iv) mammography, where eligible (by scheduling appointments with visiting services or facilitating direct referral);

 (e) assessing the patient using the information gained in the adult health check;

 (f) making or arranging any necessary interventions and referrals, and documenting a simple strategy for the good health of the patient.

 (3) An adult health check also includes:

 (a) keeping a record of the adult health check; and

 (b) offering the patient a written report about the health check, with recommendations about matters covered by the health check (including a simple strategy for the good health of the patient).

48 Meaning of comprehensive medical assessment in item 712

 (1) For item 712, a comprehensive medical assessment of a resident of a residential aged care facility is a full systems review of the resident, including an assessment of the resident’s health and physical and psychological function.

 (2) A comprehensive medical assessment involves all of the following:

 (a) a personal attendance by a medical practitioner;

 (b) taking a detailed relevant medical history;

 (c) conducting a comprehensive medical examination of the resident;

 (d) developing a list of diagnoses and medical problems based on the medical history and examination;

 (e) providing, for the resident’s records, a written summary of the outcomes of the assessment to inform the provision of care for the resident and to assist in the provision of medication management review services for the resident.

 (3) A comprehensive medical assessment also includes:

 (a) making a written summary of the comprehensive medical assessment; and

 (b) providing a copy of the summary to the residential aged care facility; and

 (c) offering the resident a copy of the summary or relevant parts of the summary.

49 Meaning of multidisciplinary care plan

 (1) For items 720, 722, 724, 726, 728 and 730 preparation of a multidisciplinary care plan means the preparation of a written plan describing all of the following matters:

 (a) an assessment of the patient’s health care needs;

 (b) an assessment of the kinds of treatment, health services and health care that the patient is likely to need;

 (c) an assessment of any other kinds of services and care that the patient is likely to need;

 (d) arrangements for giving the treatment, services and care referred to in paragraphs (b) and (c);

 (e) management goals with which the patient agrees;

 (f) arrangements to review the plan by a day specified in the plan.

Example

For paragraph (c), other kinds of services and care may include home and community care service providers.

 (2) Preparation of a plan also includes:

 (a) discussing the preparation of the plan with the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and

 (b) telling the patient which persons will be included in the multidisciplinary care plan team; and

 (c) recording the plan and the patient’s agreement to the preparation of the plan; and

 (d) giving copies of relevant parts of the plan to persons who, under the plan, will give the patient the treatment, service and care mentioned in the plan; and

 (e) offering a copy of the plan (and evidence of the contribution made to the plan by members of the team) to the patient and the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees).

50 Meaning of multidisciplinary care plan team

 (1) A multidisciplinary care plan team:

 (a) includes a medical practitioner; and

 (b) includes at least 2 other members, each of whom provides a different kind of care or service to the patient and is not a family carer of the patient, and 1 of whom may be another medical practitioner; and

 (c) may additionally include a family carer of the patient.

Example

Examples of persons who, for paragraph (b), may be included in a team are:

(a) allied health professionals such as:

 Aboriginal health care workers

 asthma educators

 audiologists

 dental therapists

 dentists

 diabetes educators

 dieticians

 mental health workers

 occupational therapists

 optometrists

 orthoptists

 orthotists or prosthetists

 pharmacists

 physiotherapists

 podiatrists

 psychologists

 registered nurses

 social workers

 speech pathologists; and

(b) home and community service providers, or care organisers, such as:

 education providers

 ‘meals on wheels’ providers

 personal care workers

 probation officers.

 (2) In subrule (1):

family carer includes a person who:

 (a) is a relative or friend of the patient; and

 (b) is providing care to the patient other than as a paid service.

51 Meaning of multidisciplinary discharge care plan

  For items 722 and 728, a multidisciplinary discharge care plan is a multidisciplinary care plan that is prepared for a patient before the patient is discharged from a hospital.

52 Meaning of review of a multidisciplinary care plan

 (1) For item 724, review of a multidisciplinary care plan means a process by which the medical practitioner:

 (a) reviews the matters mentioned in subrule 49 (1); and

 (b) considers whether the arrangements for treatment, service and care have been carried out; and

 (c) considers, in consultation with other members of the multidisciplinary care plan team, whether different arrangements need to be made to achieve the management goals mentioned in the plan; and

 (d) if different arrangements need to be made, prepares a revised multidisciplinary care plan stating those arrangements.

 (2) The review of a plan also includes:

 (a) discussing the review of the plan with the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees); and

 (b) recording the patient’s agreement to reviewing the plan; and

 (c) offering a copy of relevant parts of the revised multidisciplinary care plan (if any) to the patient and the patient’s carer (if any, and if the practitioner considers it appropriate and the patient agrees), and giving copies to persons who, under the revised plan, will give the patient the treatment, service and care mentioned in the plan.

53 Meaning of contribution to a plan

 (1) For items 726, 728 and 730, a contribution to a multidisciplinary community care plan, a multidisciplinary discharge care plan or a multidisciplinary care plan in a residential aged care facility must be at the request of the person (or residential aged care facility) who prepares the plan, and may include:

 (a) preparation of a part of the plan that relates to the treatment, service or care that the medical practitioner will give to the patient; and

 (b) giving advice to the person who prepares the plan.

 (2) Contribution to a plan does not necessarily include preparation of the plan or part of the plan.

54 Meaning of multidisciplinary case conference

  For the items mentioned in Subgroup 2 of Group A15, a multidisciplinary case conference is a process by which a multidisciplinary case conference team (see rule 57) carries out all of the following activities:

 (a) discussing a patient’s history;

 (b) identifying the patient’s multidisciplinary care needs;

 (c) identifying outcomes to be achieved by members of the case conference team giving care and service to the patient;

 (d) identifying tasks that need to be undertaken to achieve these outcomes, and allocating those tasks to members of the case conference team;

 (e) assessing whether previously identified outcomes (if any) have been achieved.

55 Meaning of multidisciplinary discharge case conference

  For items 746, 749, 757, 768, 771 and 773, a multidisciplinary discharge case conference is a multidisciplinary case conference carried out in relation to a patient before the patient is discharged from a hospital or approved day hospital facility.

56 Meaning of multidisciplinary case conference in a residential aged care facility

  For items 734, 736, 738, 775, 778 and 779, a multidisciplinary case conference in a residential aged care facility is a multidisciplinary case conference carried out in relation to a care recipient in a residential aged care facility.

57 Meaning of multidisciplinary case conference team

 (1) For this table, a multidisciplinary case conference team:

 (a) includes a medical practitioner; and

 (b) includes at least 2 other members, each of whom provides a different kind of care or service to the patient and is not a family carer of the patient, and 1 of whom may be another medical practitioner; and

 (c) may additionally include a family carer of the patient.

Example

Examples of persons who, for paragraph (b), may be included in a team are:

(a) allied health professionals such as:

 Aboriginal health care workers

 asthma educators

 audiologists

 dental therapists

 dentists

 diabetes educators

 dieticians

 mental health workers

 occupational therapists

 optometrists

 orthoptists

 orthotists or prosthetists

 pharmacists

 physiotherapists

 podiatrists

 psychologists

 registered nurses

 social workers

 speech pathologists; and

(b) home and community service providers, or care organisers, such as:

 education providers

 ‘meals on wheels’ providers

 personal care workers

 probation officers.

 (2) In subrule (1):

family carer includes a person who:

 (a) is a relative or friend of the patient; and

 (b) is providing care to the patient other than as a paid service.

58 Meaning of organise and co-ordinate in a multidisciplinary case conference and participation in a multidisciplinary case conference

 (1) For items 734, 736, 738, 740, 742, 744, 746, 749 and 757, organise and co-ordinate a multidisciplinary case conference means undertaking all of the following activities in relation to a case conference:

 (a) explaining to the patient the nature of a multidisciplinary case conference, and asking the patient whether the patient agrees to the conference taking place;

 (b) recording the patient’s agreement to the conference;

 (c) recording the day on which the conference was held, and the times at which the conference started and ended;

 (d) recording the names of the participants;

 (e) recording the matters mentioned in rule 54, and putting a copy of that record in the patient’s medical records;

 (f) offering the patient and the patient’s carer (if any and if the practitioner considers appropriate and the patient agrees), and giving each other member of the team, a summary of the conference;

 (g) discussing the outcomes of the conference with the patient and the patient’s carer (if any and if the practitioner considers appropriate and the patient agrees).

 (2) For items 759, 762, 765, 768, 771, 773, 775, 778 and 779 participation in a multidisciplinary case conference must be at the request of the person who organises and co-ordinates the conference, and involves undertaking all of the following activities in relation to a case conference:

 (a) explaining to the patient the nature of a multidisciplinary case conference, and asking the patient whether the patient agrees to the practitioner’s participation in the conference;

 (b) recording the patient’s agreement to the practitioner’s participation;

 (c) recording the day on which the conference was held, and the times at which the conference started and ended;

 (d) recording the names of the participants;

 (e) recording the matters mentioned in rule 54, and putting a copy of that record in the patient’s medical records.

 (3) Participation in a multidisciplinary case conference does not include organising and co-ordinating a multidisciplinary case conference.

59 Meaning of living in a community setting in item 900

  For item 900, a patient is living in a community setting if the patient:

 (a) is not an in-patient of a hospital or approved day hospital facility; and

 (b) is not a care recipient in a residential aged care facility.

60 Meaning of residential medication management review in item 903

 (1) For item 903, a residential medication management review is a collaborative service provided by a medical practitioner and a pharmacist to review the medication management needs of a permanent resident of a residential aged care facility.

 (2) A medical practitioner’s involvement in a residential medication management review includes all of the following:

 (a) discussing the proposed review with the resident and seeking the resident’s consent to the review;

 (b) initiating the review and collaborating with the reviewing pharmacist about the pharmacist’s involvement in the review;

 (c) providing input from the resident’s most recent comprehensive medical assessment or, if such an assessment has not been undertaken, providing relevant clinical information for the review and for the resident’s records;

 (d) subject to subrule (4), participating in a post-review discussion (either face-to-face or by telephone) with the pharmacist to discuss the outcomes of the review including:

 (i) the findings of the review; and

 (ii) medication management strategies; and

 (iii) means to ensure that the strategies are implemented and reviewed, including any issues for implementation and follow-up;

 (e) developing or revising the resident’s medication management plan after discussion with the reviewing pharmacist, and finalising the plan after discussion with the resident.

 (3) A medical practitioner’s involvement in a residential medication management review also includes:

 (a) offering a copy of the medication management plan to the resident (or the resident’s carer or representative if appropriate); and

 (b) providing copies of the plan for the resident’s records and for the nursing staff of the residential aged care facility; and

 (c) discussing the plan with nursing staff if necessary.

 (4) A post-review discussion is not required if:

 (a) there are no recommended changes to the resident’s medication management arising out of the review; or

 (b) any changes are minor in nature and do not require immediate discussion; or

 (c) the pharmacist and medical practitioner agree that issues arising out of the review should be considered in an enhanced primary care case conference.

61 Meaning of amount under rule 61 in certain items

 (1) In item 2503, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2501; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (2) In item 2506, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2504; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (3) In item 2509, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2507; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (4) In item 2518, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2517; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (5) In item 2522, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2521; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (6) In item 2526, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2525; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (7) In item 2547, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2546; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (8) In item 2553, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2552; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (9) In item 2559, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2558; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (10) In item 2575, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2574; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (11) In item 2578, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2577; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (12) In item 2723, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2721; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

 (13) In item 2727, amount under rule 61 means an amount equal to the sum of:

 (a) the fee for item 2725; and

 (b) either:

 (i) if not more than 6 patients are attended at a single attendance — $21.55 divided by the number of patients attended; or

 (ii) if more than 6 patients are attended at a single attendance — $1.55.

62 Application of Subgroup 2 of Group A18 and Subgroup 2 of Group A19

 (1) An item in Subgroup 2 of Group A18 or Subgroup 2 of Group A19 does not apply to a service that is provided to a patient who has already been provided, in the previous 12 months, with another service to which an item in either of those Subgroups applies.

 (2) For an item in Subgroup 2 of Group A18 or Subgroup 2 of Group A19, a professional attendance completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus if the attendance completes a series of attendances that involve, over 12 months (the current cycle), the following:

 (a) at least 1 assessment of the patient’s diabetes control, by measuring the patient’s HbA1c;

 (b) if the patient has not had a comprehensive eye examination in the 12 months immediately before the current cycle — at least 1 comprehensive eye examination;

 (c) measurement of the patient’s weight and height, and calculation of the patient’s BMI;

 (d) further measurement of the patient’s weight at least once every 6 months;

 (e) measurement of the patient’s blood pressure at least once every 6 months;

 (f) examination of the patient’s feet at least once every 6 months;

 (g) at least 1 measurement of the patient’s total cholesterol, triglycerides and HDL cholesterol;

 (h) at least 1 test of the patient’s microalbuminuria;

 (i) provision to the patient of self-management education regarding diabetes;

 (j) a review of the patient’s diet, and provision to the patient of information about appropriate dietary choices;

 (k) a review of the patient’s level of physical activity, and provision to the patient of information about the appropriate level of physical activity;

 (l) checking the patient’s tobacco smoking activity, and, if relevant, encouraging the patient to stop smoking;

 (m) a review of the patient’s medication.

63 Application of Subgroup 3 of Group A18 and Subgroup 3 of Group A19

 (1) An item in Subgroup 3 of Group A18 or Subgroup 3 of Group A19 does not apply to a service that:

 (a) is provided to a patient who has already been provided, in the previous 12 months, with another service to which an item in either of those Subgroups applies; and

 (b) is not clinically indicated.

 (2) For an item in Subgroup 3 of Group A18 or Subgroup 3 of Group A19, a professional attendance completes the minimum requirements of the Asthma 3+ Visit Plan if the attendance completes a series of attendances that involve:

 (a) documented diagnosis and documented assessment of severity; and

 (b) at least 3 asthma-related consultations (at least 2 of which are consultations that have been planned at any of the earlier asthma-related consultations), over a period of not less than 4 weeks and not more than 4 months, that involve the following, for a patient with moderate to severe asthma:

 (i) a review of the patient’s use of asthma-related medication;

 (ii) either:

 (A) provision to the patient of a written asthma action plan; or

 (B) if the patient is unable to use a written asthma action plan — discussion with the patient about an alternative method of providing an asthma action plan, and documentation of the discussion in the patient’s medical records;

 (iii) provision to the patient of self-management education regarding asthma;

 (iv) a review of the patient’s asthma action plan.

64 Meaning of approved site in items 15338 and 37220

  For items 15338 and 37220, approved site, in relation to radiation oncology, means a site at which radiation oncology may be performed lawfully under the law of the State or Territory in which the site is located.

65 Group T10 applies only in connection with certain services

 (1) Each of items 20100 to 21990 (other than item 21965), 22060, 23010 to 24136, 25200 and 25205 applies to a service only if the service is provided in connection with a service that:

 (a) is a professional service within the meaning of subsection 3 (1) of the Act; and

 (b) is specified in an item that includes, in its description, ‘(Anaes.)’.

 (2) Each of items 22900 and 22905 applies to a service only if the service is provided in connection with a dental service (other than a dental service that is a prescribed medical service under paragraph (b) of the definition of professional service in subsection 3 (1) of the Act).

66 Services specified in Subgroups 21 to 25 of Group T10

  In Subgroups 21 to 25 of Group T10:

 (a) a reference to anaesthesia is a reference to administration of anaesthesia performed in association with a service to which any of items 20100 to 21997, 22900 and 22905 applies; and

 (b) a reference to perfusion is a reference to perfusion to which item 22060 applies; and

 (c) a reference to assistance is a reference to assistance:

 (i) in the administration of anaesthesia; and

 (ii) to which item 25200 or 25205 applies.

67 Meaning of service time in Subgroups 21, 24, 25 and 26 of Group T10

  In Subgroups 21, 24, 25 and 26 of Group T10:

service time means:

 (a) in relation to administration of anaesthesia on a patient by an anaesthetist — the period that:

 (i) begins when the anaesthetist commences exclusive and continuous care of the patient for anaesthesia; and

 (ii) ends when the anaesthetist places the patient safely under the supervision of other personnel; and

 (b) in relation to perfusion performed on a patient under anaesthesia — the period that:

 (i) begins when the anaesthetic commences; and

 (ii) ends with the closure of the chest of the patient; and

 (c) in relation to assistance given by an assistant anaesthetist in the administration of anaesthesia performed on a patient — the period when the assistant anaesthetist is actively attending on the patient.

68 Application of Subgroup 21 of Group T10

 (1) An item in the range 23010 to 24136 applies to perfusion in addition to any other item that applies to the perfusion.

 (2) An item in the range 23010 to 24136 applies to assistance only as a component of item 25200 or 25205 and for the purpose of calculating the amount of fee for that item.

69 Application of Subgroups 22 and 23 of Group T10

 (1) An item in the range 25000 to 25020 applies to anaesthesia in addition to any other item that applies to the anaesthesia.

 (2) An item in the range 25000 to 25020 applies to perfusion in addition to any other item that applies to the perfusion.

 (3) An item in the range 25000 to 25020 applies to assistance only as a component of item 25200 or 25205 and for the purpose of calculating the amount of fee for that item.

70 Meaning of amount under rule 70 in items 25025, 25030 and 25050

 (1) For item 25025, amount under rule 70 means the amount that is equal to 50% of the sum of:

 (a) the fee specified in any of items 20100 to 21997 and 22900 for the initiation of management of anaesthesia in association with which the anaesthesia is performed; and

 (b) the fee specified in the item in the range 23010 to 24136 that applies to the anaesthesia; and

 (c) if any of items 25000 to 25015 applies to the anaesthesia — the fee specified in that item; and

 (d) if a service specified in an item in the range 22001 to 22050 is performed in association with the anaesthesia — the fee specified in that item.

 (2) For item 25030, amount under rule 70 means the amount that is equal to 50% of the sum of:

 (a) the fee specified in the item in the range 23010 to 24136 that applies to the assistance; and

 (b) if any of items 25000 to 25015 or 25200 to 25205 applies to the assistance — the fee specified in that item; and

 (c) if a service specified in an item in the range 22001 to 22050 is performed in association with the assistance — the fee specified in that item.

 (3) For item 25050, amount under rule 70 means the amount that is equal to 50% of the sum of:

 (a) $337.00; and

 (b) the fee specified in the item in the range 23010 to 24136 that applies to the perfusion; and

 (c) if any of items 25000 to 25015 applies to the perfusion — the fee specified in that item; and

 (d) if a service specified in an item in the range 22001 to 22050 or 22065 to 22075 is performed in association with the perfusion — the fee specified in that item.

71 Application of Subgroups 24 and 25 of Group T10

  An item in the range 25025 to 25050 applies to the anaesthesia, assistance or perfusion in addition to any other item that applies to the service.

72 Meaning of complex paediatric case in item 25205

  For item 25205, a complex paediatric case involves 1 or more of the following services:

 (a) invasive monitoring, either intravascular or transoesophageal;

 (b) organ transplantation;

 (c) craniofacial surgery;

 (d) major tumour resection;

 (e) separation of conjoint twins.

73 Meaning of amount under rule 73 in items 25200 and 25205

  For each of items 25200 and 25205, amount under rule 73, means the sum of:

 (a) $84.25; and

 (b) the fee specified in the item in the range 23010 to 24136 that applies to the assistance; and

 (c) if any of items 25000 to 25020 applies to the assistance — the fee specified in that item.

74 Restriction of telepsychiatry consultations to rural and remote areas

  Each of items 353 to 358 applies only to a consultation that is provided:

 (a) by a consultant physician located in a Statistical Local Area that is a M1, M2 or R1 area within the meaning of the Rural, Remote and Metropolitan Areas Classification; and

 (b) to a patient located in a different Statistical Local Area that is a R1, R2, R3, Rem1 or Rem2 area within the meaning of the Rural, Remote and Metropolitan Areas Classification.

75 Meaning of recognised emergency department and problem focussed history in Group A21

 (1) In Group A21, recognised emergency department, of a private hospital, means a department of the hospital that is licensed, under a law of the State or Territory in which the hospital is located, to operate as an emergency department.

 (2) In items 501, 503 and 507, problem focussed history means a history focussing on the medical condition of the patient that necessitates the patient presenting for emergency attention.

76 Prolonged attendances by emergency physicians

  In items 519 to 536, an attendance for emergency evaluation of a critically ill patient with an immediately life threatening problem means an attendance that requires:

 (a) immediate and rapid assessment; and

 (b) initiation of resuscitation and electronic monitoring of vital signs; and

 (c) taking a comprehensive history and evaluation while undertaking resuscitative measures; and

 (d) ordering and evaluation of appropriate investigations; and

 (e) transitional evaluation and monitoring; and

 (f) formulation and documentation of a diagnosis and management plan in relation to 1 or more problems; and

 (g) initiation of appropriate treatment interventions; and

 (h) liaison with relevant health care professionals and discussion with, as appropriate, the patient or the patient’s relatives or agent.

77 Application of Subgroup 4 of Group A18 and Subgroup 4 of Group A19

 (1) An item in Subgroup 4 of Group A18 or Subgroup 4 of Group A19 applies only to a service that is provided by a medical practitioner:

 (a) whose name is entered in the register maintained by the Commission under regulation 3T of the Health Insurance Commission Regulations 1975; and

 (b) who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration, for providing services to which those Subgroups apply.

 (2) An item in Subgroup 4 of Group A18 or Subgroup 4 of Group A19 does not apply to a service that:

 (a) is provided to a patient who has already been provided, in the previous 12 months, with another service to which an item in either of those Subgroups applies; and

 (b) is not clinically indicated.

 (3) A reference in an item in Subgroup 4 of Group A18 or Subgroup 4 of Group A19 to the minimum requirements of the 3 Step Mental Health Process is a reference to the following procedures in relation to the patient concerned:

 (a) at least 3 consultations related to a mental health disorder:

 (i) at least 2 of which are consultations that have been planned at a previous consultation; and

 (ii) each of which is of at least 20 minutes duration;

 (b) assessment of the mental health disorder, including administration of an outcome measurement tool (except if considered clinically inappropriate);

 (c) formulation or diagnosis or both formulation and diagnosis of the mental health disorder;

 (d) supplying the patient or, if the patient agrees, the patient’s carer with:

 (i) a written mental health plan; and

 (ii) suitable education about the mental health disorder;

 (e) at least 4 weeks, but no later than 6 months, after the consultation at which the written mental health plan was prepared:

 (i) a review of the patient’s progress against the goals recorded in that plan; and

 (ii) if necessary, adjustment of that plan; and

 (iii) administration of the outcome measurement tool used in the assessment mentioned in paragraph (b) (except if considered clinically inappropriate).

 (4) In this rule:

mental health disorder means a significant impairment of any or all of an individual’s cognitive, affective and relational abilities that:

 (a) may require medical intervention; and

 (b) may be a recognised, medically diagnosable illness or disorder; and

 (c) is not dementia, delirium, tobacco use disorder or mental retardation.

Note   In relation to this definition, practitioners should be aware of the Diagnostic and Management Guidelines for Mental Health Disorders in Primary Care (ICD-10, Chapter 5, Primary Care Version), developed by the World Health Organisation and published in 1996.

outcome measurement tool means a tool used to monitor changes in a patient’s health that occur in response to treatment received by the patient.

written mental health plan means a written plan that:

 (a) is prepared in consultation with a patient or, if the patient agrees, a patient’s carer; and

 (b) describes arrangements for:

 (i) treatment of the mental health disorder or disorders; and

 (ii) crisis intervention; and

 (iii) relapse prevention.

78 Focussed psychological strategies

 (1) An item in Group A20 applies only to a service that:

 (a) is clinically indicated under the 3 Step Mental Health Process; and

 (b) is provided by a medical practitioner:

 (i) whose name is entered in the register maintained by the Commission under regulation 3T of the Health Insurance Commission Regulations 1975; and

 (ii) who is identified in the register as a practitioner who can provide services to which Group A20 applies; and

 (iii) who meets any training and skills requirements, as determined by the General Practice Mental Health Standards Collaboration, for providing services to which Group A20 applies; and

 (c) is provided in a general practice that participates in the Practice Incentives Program or is an accredited general practice that is not participating in the Program.

 (2) An item in Group A20 does not apply to:

 (a) a service that:

 (i) is provided to a patient who has already been provided, in the previous 12 months, with 6 other services to which any of the items in that Group applies; and

 (ii) is provided before the medical practitioner managing the 3 Step Mental Health Process has conducted a review and has noted in the patient’s records a recommendation that the patient have more than 6 sessions of psychological strategies in 12 months; or

 (b) a service that is provided to a patient who has already been provided, in the previous 12 months, with 12 other services to which any of items in that Group applies.

 (3) In Group A20, a reference to focussed psychological strategies is a reference to any of the following mental health care management strategies, being a strategy that has been derived from evidence-based psychological therapies:

 (a) psycho-education;

 (b) cognitive-behavioural therapy that involves cognitive or behavioural interventions;

 (c) relaxation strategies;

 (d) skills training;

 (e) interpersonal therapy.

 (4) In this rule:

general practice means a business, consisting of 1 or more medical practitioners, that provides a general practice of medical services.

79 Meaning of qualified surgeon in items 31539 and 31545

  For items 31539 and 31545, a medical practitioner is a qualified surgeon if:

 (a) he or she is a specialist in the practice of his or her specialty of surgery; and

 (b) the Commission has received a written notice from the Royal Australasian College of Surgeons stating that the person meets the skills requirements for providing services to which the items apply.

80 Meaning of qualified radiologist in item 31542

  For item 31542, a medical practitioner is a qualified radiologist if:

 (a) he or she is a specialist in the practice of his or her specialty of radiology; and

 (b) the Commission has received a written notice from the Royal Australian and New Zealand College of Radiologists stating that the person meets the skills requirements for providing services to which the item applies.

81 Injection of botulinum toxin

  Each of items 18350 to 18370 applies only to a service provided by a medical practitioner who is registered by the Commission to participate in the arrangements made, under paragraph 100 (1) (b) of the National Health Act 1953, for the purpose of providing an adequate pharmaceutical service for persons requiring treatment with botulinum toxin.

82 Meaning of qualified medical acupuncturist in items 193, 195, 197 and 199

  For items 193, 195, 197 and 199, a person is a qualified medical acupuncturist if:

 (a) the person is a general practitioner; and

 (b) the Commission has received a written notice from the Royal Australian College of General Practitioners stating that the person meets the skills requirements for providing services to which the items apply.

83 Application of items 10990 and 10991

 (1) If the medical service described in item 10991 is provided to a person, either that item or 10990, but not both those items, applies to the service.

 (2) If item 10990 or 10991 applies to a medical service, the fee specified in that item applies in addition to the fee specified in any other item in this table that applies to the service.

 (3) For items 10990 and 10991:

bulk-billed, in relation to a medical service, means:

 (a) a medicare benefit is payable to a person in respect of the service; and

 (b) under an agreement entered into under section 20A of the Act:

 (i) the person assigns to the medical practitioner by whom, or on whose behalf, the service is provided, his or her right to the payment of the medicare benefit; and

 (ii) the medical practitioner accepts the assignment in full payment of his or her fee for the service provided.

Commonwealth concession card holder means a person who is a concessional beneficiary within the meaning given by subsection 84 (1) of the National Health Act 1953.

unreferred service means a medical service provided to a person by, or on behalf of, a medical practitioner, being a service that has not been referred to that practitioner by another medical practitioner or person with referring rights.

 (4) For item 10991:

ASGC means the document titled Australian Standard Geographical Classification (ASGC) 2002, published by the Australian Bureau of Statistics, as in force on 1 July 2002.

practice location, in relation to the provision of a medical service, means the place of practice in respect of which the medical practitioner by whom, or on whose behalf, the service is provided, has been allocated a provider number by the Commission.

regional, rural or remote area means an area classified as RRMAs 3-7 under the Rural, Remote and Metropolitan Areas Classification.

Rural, Remote and Metropolitan Areas Classification has the meaning given by subrule 3 (1) of Part 2 of Schedule 1 to this table.

SLA means a Statistical Local Area specified in the ASGC.

SSD means a Statistical Subdivision specified in the ASGC.

84 Application of item 10993

 (1) For item 10993:

enrolled nurse means a person who:

 (a) holds a current practising certificate as a nurse issued by a State or Territory regulatory authority; and

 (b) is licensed to provide nursing care under the supervision of a registered nurse.

general practice means a business, consisting of 1 or more medical practitioners, that provides a general practice of medical services.

immunisation means the administration of a registered vaccine to a person for any purpose other than as part of a mass immunisation of persons.

practice nurse means a registered nurse or an enrolled nurse who is employed by, or whose services are otherwise retained by, a general practice.

registered vaccine means a vaccine that is included in the part of the Australian Register of Therapeutic Goods for registered goods, being the Register maintained under section 9A of the Therapeutic Goods Act 1989.

 (2) Item 10993 applies to an immunisation provided to a person by a practice nurse only if:

 (a) the practice nurse is appropriately qualified and trained to provide immunisations to persons; and

 (b) the medical practitioner under whose supervision the immunisation is provided retains responsibility for the health, safety and clinical outcomes of the person.

85 Application of item 10996

 (1) For item 10996:

enrolled nurse has the meaning given by subrule 84 (1).

general practice has the meaning given by subrule 84 (1).

practice nurse has the meaning given by subrule 84 (1).

 (2) Item 10996 applies to the treatment of a person’s wound (other than normal aftercare) provided by a practice nurse only if:

 (a) the practice nurse is appropriately qualified and trained to treat wounds; and

 (b) the medical practitioner under whose supervision the treatment is provided has conducted an initial assessment of the person; and

 (c) the practice nurse has been instructed by the medical practitioner in relation to the treatment of the wound; and

 (d) the medical practitioner retains responsibility for the health, safety and clinical outcomes of the person.

Part 3 Services and fees

 

Item

Service

Fee ($)

Attendances

Group A1 — General practitioner attendances to which no other item applies

1

Professional attendance being an attendance at other than consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

98.05

2

Professional attendance being an attendance at consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

98.05

3

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management — each attendance

14.10

4

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

13

Professional attendance at an institution (not being a service to which any other item applies) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

19

Professional attendance at a hospital (not being a service to which any other item applies) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

20

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in a residential aged care facility (not being accommodation in a self-contained unit) by a general practitioner for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

23

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 36 or 44 applies — each attendance

30.85

24

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 37 or 47 applies — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

25

Professional attendance at an institution (not being a service to which any other item applies) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 38 or 48 applies — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

33

Professional attendance at a hospital (not being a service to which any other item applies) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 40 or 50 applies — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

35

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) by a general practitioner involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or a professional attendance of less than 20 minutes duration involving components of a service to which item 43 or 51 applies — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

36

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 44 applies — each attendance

58.55

37

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general practitioner taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, or a professional attendance of less than 40 minutes duration involving components of a service to which item 47 applies — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

38

Professional attendance at an institution (not being a service to which any other item applies) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 48 applies — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

40

Professional attendance at a hospital (not being a service to which any other item applies) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 50 applies — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

43

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) by a general practitioner involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or a professional attendance of less than 40 minutes duration involving components of a service to which item 51 applies — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

44

Professional attendance at consulting rooms (not being a service to which any other item applies) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — each attendance

86.20

47

Professional attendance, other than a service to which any other item applies, and not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility by a general practitioner taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

48

Professional attendance at an institution (not being a service to which any other item applies) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

50

Professional attendance at a hospital (not being a service to which any other item applies) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

51

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) by a general practitioner involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or a professional attendance of at least 40 minutes duration for implementation of a management plan — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

Group A2 — Other non-referred attendances to which no other item applies

52

Professional attendance at consulting rooms of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

11.00

53

Professional attendance at consulting rooms of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

21.00

54

Professional attendance at consulting rooms of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

38.00

57

Professional attendance at consulting rooms of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — each attendance

61.00

58

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

59

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

60

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

65

Professional attendance (not being an attendance at consulting rooms, an institution, a hospital or a residential aged care facility) of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients on 1 occasion — each patient

Amount under rule 9

81

Professional attendance at an institution of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

83

Professional attendance at an institution of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

84

Professional attendance at an institution of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

86

Professional attendance at an institution of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 institution on 1 occasion — each patient

Amount under rule 9

87

Professional attendance at a hospital of not more than 5 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

89

Professional attendance at a hospital of more than 5 minutes duration but not more than 25 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

90

Professional attendance at a hospital of more than 25 minutes duration but not more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

91

Professional attendance at a hospital of more than 45 minutes duration (not being a service to which any other item applies) by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 hospital on 1 occasion — each patient

Amount under rule 9

92

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of not more than 5 minutes duration by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

93

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of more than 5 minutes duration but not more than 25 minutes duration by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

95

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of more than 25 minutes duration but not more than 45 minutes by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

96

Professional attendance (not being a service to which any other item applies) at a residential aged care facility (other than a professional attendance at a self-contained unit) or professional attendance at consulting rooms situated within such a complex where the patient is accommodated in the residential aged care facility (not being accommodation in a self-contained unit) of more than 45 minutes duration by a medical practitioner (not being a general practitioner) — an attendance on 1 or more patients at 1 residential aged care facility on 1 occasion — each patient

Amount under rule 9

97

Professional attendance being an attendance at other than consulting rooms, by a medical practitioner (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

84.05

98

Professional attendance being an attendance at consulting rooms, by a medical practitioner (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance, other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

84.05

Group A3 — Specialist attendances to which no other item applies

104

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms or hospital, not being a service to which item 106 applies

72.60

105

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms or hospital

36.40

106

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) at which refraction is performed by a specialist ophthalmologist, and the attendance results in the issuing of a prescription for spectacles or contact lenses, including any consultation on the same occasion and any other attendance on the same day (not being a service to which any of items 10801 to 10816 applies) where that attendance is at consulting rooms or hospital

60.25

107

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at a place other than consulting rooms or hospital

106.45

108

Professional attendance by a specialist in the practice of his or her specialty following referral of the patient to him or her — each attendance subsequent to the first in a single course of treatment where that attendance is at a place other than consulting rooms or hospital

67.35

Group A4 — Consultant physician attendances to which no other item applies

110

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

128.05

116

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each attendance (not being a service to which item 119 applies) subsequent to the first in a single course of treatment

64.10

119

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each minor attendance subsequent to the first in a single course of treatment

36.40

122

Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

155.40

128

Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each attendance (other than a service to which item 131 applies) subsequent to the first in a single course of treatment

93.95

131

Professional attendance at a place other than consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each minor attendance subsequent to the first in a single course of treatment

67.65

Group A5 — Prolonged attendances to which no other item applies

160

Professional attendance for a period of not less than 1 hour but less than 2 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

184.25

161

Professional attendance for a period of not less than 2 hours but less than 3 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

307.05

162

Professional attendance for a period of not less than 3 hours but less than 4 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

429.80

163

Professional attendance for a period of not less than 4 hours but less than 5 hours (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

552.75

164

Professional attendance for a period of 5 hours or more (not being a service to which any other item applies) on a patient in imminent danger of death requiring continuous attendance on the patient to the exclusion of all other patients

614.20

Group A6 — Group therapy

170

Professional attendance for the purpose of group therapy of not less than 1 hour’s duration given under the direct continuous supervision of a medical practitioner, other than a consultant physician in the practice of his or her specialty of psychiatry, involving members of a family and persons with close personal relationships with that family — each group of 2 patients

97.80

171

Professional attendance for the purpose of group therapy of not less than 1 hour’s duration given under the direct continuous supervision of a medical practitioner, other than a consultant physician in the practice of his or her specialty of psychiatry, involving members of a family and persons with close personal relationships with that family — each group of 3 patients

103.05

172

Professional attendance for the purpose of group therapy of not less than 1 hour’s duration given under the direct continuous supervision of a medical practitioner, other than a consultant physician in the practice of his or her specialty of psychiatry, involving members of a family and persons with close personal relationships with that family — each group of 4 or more patients

125.40

Group A7 — Acupuncture

173

Professional attendance at which acupuncture is performed by a medical practitioner by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

21.65

193

Professional attendance by a qualified medical acupuncturist at a place other than a hospital:

 (a) involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems; or

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 197 or 199 applies;

at which acupuncture is performed by the qualified medical acupuncturist by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

30.85

195

Professional attendance by a qualified medical acupuncturist on 1 or more patients at a hospital on 1 occasion:

 (a) involving taking a selective history, examination of each patient with implementation of a management plan in relation to 1 or more problems; or

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 197 or 199 applies;

at which acupuncture is performed by the qualified medical acupuncturist by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

Amount under rule 9

197

Professional attendance by a qualified medical acupuncturist at a place other than a hospital:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) being attendance of at least 20 minutes, but less than 40 minutes, duration involving components of a service to which item 199 applies;

at which acupuncture is performed by the qualified medical acupuncturist by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

58.55

199

Professional attendance by a qualified medical acupuncturist at a place other than a hospital:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

86.20

 

 (b) being attendance of at least 40 minutes duration for implementation of a management plan;

at which acupuncture is performed by the qualified medical acupuncturist by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed

 

Group A8 — Consultant psychiatrist attendances to which no other item applies

300

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration at consulting rooms (not being an attendance to which item 353 or 364 applies), if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

36.75

302

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes, but not more than 30 minutes, duration at consulting rooms (not being an attendance to which item 355 or 366 applies), if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

73.40

304

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes, but not more than 45 minutes, duration at consulting rooms (not being an attendance to which item 356 or 367 applies), if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

107.55

306

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes, but not more than 75 minutes, duration at consulting rooms (not being an attendance to which item 357 or 369 applies), if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

148.50

308

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration at consulting rooms (not being an attendance to which item 358 or 370 applies), if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

180.85

310

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration at consulting rooms, if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies exceed 50 attendances in a calendar year for the patient

18.40

312

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes, but not more than 30 minutes, duration at consulting rooms, if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies exceed 50 attendances in a calendar year for the patient

36.75

314

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes, but not more than 45 minutes, duration at consulting rooms, if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies exceed 50 attendances in a calendar year for the patient

53.80

316

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes, but not more than 75 minutes, duration at consulting rooms, if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies exceed 50 attendances in a calendar year for the patient

74.35

318

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration at consulting rooms, if that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies exceed 50 attendances in a calendar year for the patient

90.50

319

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes duration at consulting rooms, if the patient has:

 (a) been diagnosed as suffering severe personality disorder, anorexia nervosa, bulimia nervosa, dysthymic disorder, substance-related disorder, somatoform disorder or a pervasive development disorder; and

 (b) for persons 18 years and over, been rated with a level of functional impairment within the range 1 to 50 according to the Global Assessment of Functioning Scale — if that attendance and any other attendance to which any of items 300 to 319 and 353 to 370 applies have not exceeded 160 attendances in a calendar year for the patient

148.50

320

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration at hospital

36.75

322

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes, but not more than 30 minutes, duration at hospital

73.40

324

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes, but not more than 45 minutes, duration at hospital

107.55

326

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes, but not more than 75 minutes, duration at hospital

148.50

328

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration at hospital

180.85

330

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of not more than 15 minutes duration where that attendance is at a place other than consulting rooms or hospital

67.45

332

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 15 minutes, but not more than 30 minutes, duration where that attendance is at a place other than consulting rooms or hospital

105.85

334

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 30 minutes, but not more than 45 minutes, duration where that attendance is at a place other than consulting rooms or hospital

146.75

336

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 45 minutes, but not more than 75 minutes, duration where that attendance is at a place other than consulting rooms or hospital

177.60

338

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — an attendance of more than 75 minutes duration where that attendance is at a place other than consulting rooms or hospital

211.70

342

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his or her specialty of psychiatry, involving a group of 2 to 9 unrelated patients or a family group of more than 3 patients, each of whom is referred to the consultant physician by a medical practitioner — each patient

41.85

344

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his or her specialty of psychiatry, involving a family group of 3 patients, each of whom is referred to the consultant physician by a medical practitioner — each patient

55.60

346

Group psychotherapy (including any associated consultations with a patient taking place on the same occasion and relating to the condition for which group therapy is conducted) of not less than 1 hour’s duration given under the continuous direct supervision of a consultant physician in the practice of his or her specialty of psychiatry, involving a family group of 2 patients, each of whom is referred to the consultant physician by a medical practitioner — each patient

82.15

348

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry, following referral of the patient to him or her by a medical practitioner, involving an interview of a person other than the patient of not less than 20 minutes, but less than 45 minutes, duration, in the course of initial diagnostic evaluation of a patient

44.40

350

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry, following referral of the patient to him or her by a medical practitioner, involving an interview of a person other than the patient of not less than 45 minutes duration, in the course of initial diagnostic evaluation of a patient

99.85

352

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry, following referral of the patient to him or her by a medical practitioner, involving an interview of a person other than the patient of not less than 20 minutes duration, in the course of continuing management of a patient — if that attendance and any other attendance to which this item applies have not exceeded 4 in a calendar year for the patient

44.40

353

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a telepsychiatry consultation of not more than 15 minutes duration, if:

 (a) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 4 since:

 (i) the patient first started telepsychiatry consultation; or

 (ii) if the patient has had a face-to-face consultation to which any of items 364 to 370 applies — the patient’s last face-to-face consultation; and

 (b) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 12 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

42.25

355

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a telepsychiatry consultation of more than 15 minutes, but not more than 30 minutes, duration, if:

 (a) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 4 since:

 (i) the patient first started telepsychiatry consultation; or

84.40

 

 (ii) if the patient has had a face-to-face consultation to which any of items 364 to 370 applies — the patient’s last face-to-face consultation; and

 (b) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 12 attendances in a calendar year for the patient; and

 

 

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

 

356

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a telepsychiatry consultation of more than 30 minutes, but not more than 45 minutes, duration, if:

 (a) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 4 since:

 (i) the patient first started telepsychiatry consultation; or

 (ii) if the patient has had a face-to-face consultation to which any of items 364 to 370 applies — the patient’s last face-to-face consultation; and

 (b) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 12 attendances in a calendar year for the patient; and

123.75

 

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

 

357

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a telepsychiatry consultation of more than 45 minutes, but not more than 75 minutes, duration, if:

 (a) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 4 since:

 (i) the patient first started telepsychiatry consultation; or

 (ii) if the patient has had a face-to-face consultation to which any of items 364 to 370 applies — the patient’s last face-to-face consultation; and

170.80

 

 (b) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 12 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

 

358

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a telepsychiatry consultation of more than 75 minutes duration, if:

 (a) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 4 since:

 (i) the patient first started telepsychiatry consultation; or

 (ii) if the patient has had a face-to-face consultation to which any of items 364 to 370 applies — the patient’s last face-to-face consultation; and

208.05

 

 (b) that attendance and any other attendance to which any of items 353 to 358 applies have not exceeded 12 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

 

364

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a face-to-face consultation of not more than 15 minutes duration, if:

 (a) the patient has had 4 telepsychiatry consultations to which any of items 353 to 358 applies:

 (i) before that attendance; or

36.75

 

 (ii) if the patient has previously had a face-to-face consultation to which any of items 364 to 370 applies — since the patient’s last face-to-face consultation; and

 (b) that attendance and any other attendance to which any of items 364 to 370 applies have not exceeded 3 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

 

366

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a face-to-face consultation of more than 15 minutes, but not more than 30 minutes, duration, if:

 (a) the patient has had 4 telepsychiatry consultations to which any of items 353 to 358 applies:

 (i) before that attendance; or

 (ii) if the patient has previously had a face-to-face consultation to which any of items 364 to 370 applies — since the patient’s last face-to-face consultation; and

73.40

 

 (b) that attendance and any other attendance to which any of items 364 to 370 applies have not exceeded 3 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

 

367

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a face-to-face consultation of more than 30 minutes, but not more than 45 minutes, duration, if:

 (a) the patient has had 4 telepsychiatry consultations to which any of items 353 to 358 applies:

 (i) before that attendance; or

 (ii) if the patient has previously had a face-to-face consultation to which any of items 364 to 370 applies — since the patient’s last face-to-face consultation; and

 (b) that attendance and any other attendance to which any of items 364 to 370 applies have not exceeded 3 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

107.55

369

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a face-to-face consultation of more than 45 minutes, but not more than 75 minutes, duration, if:

 (a) the patient has had 4 telepsychiatry consultations to which any of items 353 to 358 applies:

 (i) before that attendance; or

 (ii) if the patient has previously had a face-to-face consultation to which any of items 364 to 370 applies — since the patient’s last face-to-face consultation; and

148.50

 

 (b) that attendance and any other attendance to which any of items 364 to 370 applies have not exceeded 3 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

 

370

Professional attendance by a consultant physician in the practice of his or her specialty of psychiatry following referral of the patient to him or her by a medical practitioner — a face-to-face consultation of more than 75 minutes duration, if:

 (a) the patient has had 4 telepsychiatry consultations to which any of items 353 to 358 applies:

 (i) before that attendance; or

 (ii) if the patient has previously had a face-to-face consultation to which any of items 364 to 370 applies — since the patient’s last face-to-face consultation; and

 (b) that attendance and any other attendance to which any of items 364 to 370 applies have not exceeded 3 attendances in a calendar year for the patient; and

 (c) that attendance and any other attendance to which any of items 300 to 308 and 353 to 370 applies have not exceeded 50 attendances in a calendar year for the patient

180.85

Group A12 — Consultant occupational physician attendances to which no other item applies

385

Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

72.60

386

Professional attendance at consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — each attendance subsequent to the first in a single course of treatment

36.40

387

Professional attendance at a place other than consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — initial attendance in a single course of treatment

106.45

388

Professional attendance at a place other than consulting rooms or hospital by a consultant occupational physician in the practice of his or her specialty of occupational medicine following referral of the patient to him or her by a medical practitioner — each attendance subsequent to the first in a single course of treatment

67.35

Group A13 — Public health physician attendances to which no other item applies

410

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management

14.10

411

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a selective patient history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or an attendance of less than 20 minutes duration involving components of a service to which item 412 applies

30.85

412

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a detailed patient history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or an attendance of less than 40 minutes duration involving components of a service to which item 413 applies

58.55

413

Professional attendance at consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking an exhaustive patient history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or an attendance of at least 40 minutes duration for implementation of a management plan

86.20

414

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management

Amount under rule 9

415

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a selective patient history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or an attendance of less than 20 minutes duration involving components of a service to which item 416 applies

Amount under rule 9

416

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking a detailed patient history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or an attendance of less than 40 minutes duration involving components of a service to which item 417 applies

Amount under rule 9

417

Professional attendance at other than consulting rooms by a public health physician in the practice of his or her specialty of public health medicine — attendance involving taking an exhaustive patient history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or an attendance of at least 40 minutes duration for implementation of a management plan

Amount under rule 9

Group A16 — Attendance by a medical practitioner who is a sports physician in the practice of sports medicine and to which no other item applies

Subgroup 1 — Surgery consultations

444

Professional attendance at consulting rooms for an obvious problem characterised by the straightforward nature of the task that requires a short patient history and, if required, limited examination and management

14.10

445

Professional attendance at consulting rooms involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems, or an attendance of less than 20 minutes duration involving components of a service to which item 446 applies

30.85

446

Professional attendance at consulting rooms involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes, or an attendance of less than 40 minutes duration involving components of a service to which item 447 applies

58.55

447

Professional attendance at consulting rooms involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes, or an attendance of at least 40 minutes duration for implementation of a management plan

86.20

Subgroup 2 — Emergency attendances — after hours

448

Professional attendance at consulting rooms where the attendance is initiated by or on behalf of the patient in the same unbroken after hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the practitioner to return to, and specially open, consulting rooms for the attendance — each attendance other than an attendance between 11 pm and 7 am, on a public holiday, on a Sunday, before 8 am or after 1 pm on a Saturday, or at any time other than between 8 am and 8 pm on a day not being a Saturday, Sunday or public holiday

98.05

449

Professional attendance at consulting rooms where the attendance is initiated by or on behalf of the patient in the same unbroken after hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the practitioner to return to, and specially open, consulting rooms for the attendance — each attendance on any day of the week between 11 pm and 7 am

117.25

Group A21 — Emergency physician attendances to which no other item applies

501

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for the unscheduled evaluation and management of a patient, involving straightforward medical decision making that requires:

 (a) taking a problem focussed history; and

 (b) limited examination; and

 (c) diagnosis; and

 (d) initiation of appropriate treatment interventions

14.10

503

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for the unscheduled evaluation and management of a patient, involving medical decision making of low complexity that requires:

 (a) taking an expanded problem focussed history; and

 (b) expanded examination of 1 or more systems; and

 (c) formulation and documentation of a diagnosis and management plan in relation to 1 or more problems; and

 (d) initiation of appropriate treatment interventions

30.85

507

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for the unscheduled evaluation and management of a patient, involving medical decision making of moderate complexity that requires:

 (a) taking an expanded problem focussed history; and

 (b) expanded examination of 1 or more systems; and

 (c) ordering and evaluation of appropriate investigations; and

 (d) formulation and documentation of a diagnosis and management plan in relation to 1 or more problems; and

 (e) initiation of appropriate treatment interventions

58.55

511

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for the unscheduled evaluation and management of a patient, involving medical decision making of moderate complexity that requires:

 (a) taking a detailed history; and

 (b) detailed examination of 1 or more systems; and

 (c) ordering and evaluation of appropriate investigations; and

86.20

 

 (d) formulation and documentation of a diagnosis and management plan in relation to 1 or more problems; and

 (e) initiation of appropriate treatment interventions; and

 (f) liaison with relevant health care professionals and discussion with, as appropriate, the patient or the patient’s relatives or agent

 

515

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for the unscheduled evaluation and management of a patient, involving medical decision making of high complexity that requires:

 (a) taking a comprehensive history; and

 (b) comprehensive examination of 1 or more systems; and

 (c) ordering and evaluation of appropriate investigations; and

 (d) formulation and documentation of a diagnosis and management plan in relation to 1 or more problems; and

 (e) initiation of appropriate treatment interventions; and

 (f) liaison with relevant health care professionals and discussion with, as appropriate, the patient or the patient’s relatives or agent

137.95

519

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for a total period (whether or not continuous) of at least 30 minutes but less than 1 hour (prior to patient’s admission to an in-patient hospital bed) for emergency evaluation of a critically ill patient with an immediately life threatening problem

92.10

520

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for a total period (whether or not continuous) of at least 1 hour but less than 2 hours (prior to patient’s admission to an in-patient hospital bed) for emergency evaluation of a critically ill patient with an immediately life threatening problem

184.25

530

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for a total period (whether or not continuous) of at least 2 hours but less than 3 hours (prior to patient’s admission to an in-patient hospital bed) for emergency evaluation of a critically ill patient with an immediately life threatening problem

307.05

532

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for a total period (whether or not continuous) of at least 3 hours but less than 4 hours (prior to patient’s admission to an in-patient hospital bed) for emergency evaluation of a critically ill patient with an immediately life threatening problem

429.80

534

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for a total period (whether or not continuous) of at least 4 hours but less than 5 hours (prior to patient’s admission to an in-patient hospital bed) for emergency evaluation of a critically ill patient with an immediately life threatening problem

552.75

536

Professional attendance at a recognised emergency department of a private hospital by a specialist in the practice of his or her specialty of emergency medicine — attendance for a total period (whether or not continuous) of at least 5 hours (prior to patient’s admission to an
in-patient hospital bed) for emergency evaluation of a critically ill patient with an immediately life threatening problem

614.20

Group A11 — Unsociable hours

601

Professional attendance, being an attendance at other than consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

117.25

602

Professional attendance, being an attendance at consulting rooms, by a general practitioner on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

117.25

697

Professional attendance, being an attendance at other than consulting rooms, by a medical practitioner, (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment

101.50

698

Professional attendance, being an attendance at consulting rooms, by a medical practitioner (not being a general practitioner) on not more than 1 patient on the 1 occasion — each attendance on any day of the week between 11 pm and 7 am, where the attendance is initiated by or on behalf of the patient in the same unbroken after-hours period and where the patient’s medical condition requires immediate treatment and where it is necessary for the doctor to return to, and specially open, consulting rooms for the attendance

101.50

Group A14 — Health assessments

700

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) at consulting rooms for a health assessment of a patient who is at least 75 years old — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 702, 704 or 706

160.80

702

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) not being an attendance at consulting rooms, a hospital or a residential aged care facility, for a health assessment of a patient who is at least 75 years old — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 700, 704 or 706

227.45

704

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) at consulting rooms for a health assessment of a patient who is at least 55 years old and of Aboriginal or Torres Strait Islander descent — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 700, 702 or 706

160.80

706

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) not being an attendance at consulting rooms, a hospital or a residential aged care facility, for a health assessment of a patient who is at least 55 years old and of Aboriginal or Torres Strait Islander descent — not being a health assessment of a patient in respect of whom, in the preceding 12 months, a payment has been made under this item or item 700, 702 or 704

227.45

710

Attendance by a medical practitioner (other than a specialist or consultant physician) at consulting rooms or another place (other than a hospital or residential aged care facility) for an adult health check of a patient who is of Aboriginal or Torres Strait Islander descent and at least 15 years old and less than 55 years old — not being an adult health check of a patient in respect of whom, in the preceding 18 months, a payment has been made under this item

191.65

712

Attendance by a medical practitioner (including a general practitioner but not including a specialist or consultant physician) at a residential aged care facility or at consulting rooms for a comprehensive medical assessment (CMA) of a permanent resident of a residential aged care facility — not being a CMA of a resident in respect of whom, in the preceding 12 months, a payment has been made under this item

180.20

Group A15 — Multidisciplinary care plans and multidisciplinary case conferences

Subgroup 1 — Multidisciplinary care plans

720

Preparation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), in consultation with a multidisciplinary care plan team, of a multidisciplinary community care plan for a patient (not being a service associated with a service to which items 734 to 779 apply) — payable not more than once in any 6 month period

206.75

722

Preparation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), in consultation with a multidisciplinary care plan team, of a multidisciplinary discharge care plan for a patient (not being a service associated with a service to which items 734 to 779 apply) — payable not more than once for each hospital admission

206.75

724

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), to review a multidisciplinary community care plan or a discharge care plan prepared by that medical practitioner for a patient and claimed for under item 720 or 722 (not being a payment for a service to which items 734 to 779 apply) — payable not more than once in any 3 month period, and not being an attendance in relation to a patient:

 (a) for whom, in the preceding 3 months, a payment has been made under item 720; or

 (b) for whom, in the preceding month, a payment has been made under item 722

103.40

726

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary community care plan or to a review of a multidisciplinary community care plan prepared by another provider (not being a payment for a service to which items 734 to 779 apply) — not being an attendance in relation to a patient for whom, in the preceding 6 months, a payment has been made under item 720

41.65

728

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to contribute to a multidisciplinary discharge care plan or to a review of a multidisciplinary discharge care plan prepared by another provider (not being a service associated with a service to which items 722 and 734 to 779 apply)

41.65

730

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary care plan team, to make a contribution to a multidisciplinary care plan in a residential aged care facility or to a review of a multidisciplinary care plan in a residential aged care facility prepared by the residential aged care facility (not being a payment in respect of a service to which items 734 to 779 apply)

41.65

Subgroup 2 — Case conferences

734

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary case conference in a residential aged care facility, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which item 730 applies)

80.45

736

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary case conference in a residential aged care facility, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which item 730 applies)

120.65

738

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary case conference in a residential aged care facility, where the conference time is at least 45 minutes (not being a service associated with a service to which item 730 applies)

160.80

740

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a community case conference, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply)

80.45

742

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a community case conference, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

120.65

744

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a community case conference, where the conference time is at least 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

160.80

746

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary discharge case conference, where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

80.45

749

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary discharge case conference, where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

120.65

757

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to organise and co-ordinate a multidisciplinary discharge case conference, where the conference time is at least 45 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

160.80

759

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and co-ordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply)

57.40

762

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and co-ordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

91.90

765

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a community case conference (other than to organise and co-ordinate the conference), where the conference time is at least 45 minutes (not being a service associated with a service to which items 720 to 730 apply)

126.30

768

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary discharge case conference (other than to organise and
co-ordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

57.40

771

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary discharge case conference (other than to organise and
co-ordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

91.90

773

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary discharge case conference (other than to organise and
co-ordinate the conference), where the conference time is at least 45 minutes, (not being a service associated with a service to which items 720 to 730 apply) — payable not more than once for each hospital admission

126.30

775

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary case conference in a residential aged care facility, (other than to organise and co-ordinate the conference), where the conference time is at least 15 minutes, but less than 30 minutes (not being a service associated with a service to which item 730 applies)

57.40

778

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary case conference in a residential aged care facility, (other than to organise and co-ordinate the conference), where the conference time is at least 30 minutes, but less than 45 minutes (not being a service associated with a service to which item 730 applies)

91.90

779

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician), as a member of a multidisciplinary case conference team, to participate in a multidisciplinary case conference in a residential aged care facility, (other than to organise and co-ordinate the conference), where the conference time is at least 45 minutes, (not being a service associated with a service to which item 730 applies)

126.30

820

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and co-ordinate a community case conference of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

118.00

822

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and co-ordinate a community case conference of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

177.05

823

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and co-ordinate a community case conference of at least 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

236.00

825

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a community case conference (other than to organise and to co-ordinate the conference) of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

84.80

826

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a community case conference (other than to organise and to co-ordinate the conference) of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

135.20

828

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a community case conference (other than to organise and to co-ordinate the conference) of at least 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

185.60

830

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and co-ordinate a discharge case conference of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

118.00

832

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and co-ordinate a discharge case conference of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

177.05

834

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to organise and co-ordinate a discharge case conference of at least 45 minutes, with a multidisciplinary team of at least 3 other formal care providers of different disciplines

236.00

835

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a discharge case conference (other than to organise and to co-ordinate the conference) of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

84.80

837

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a discharge case conference (other than to organise and to co-ordinate the conference) of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

135.20

838

Attendance by a consultant physician in the practice of his or her specialty, as a member of a case conference team, to participate in a discharge case conference (other than to organise and to co-ordinate the conference) of at least 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

185.60

855

Attendance by a consultant physician in the practice of his or her specialty of psychiatry, as a member of a case conference team, to organise and co-ordinate a community case conference of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

118.00

857

Attendance by a consultant physician in the practice of his or her specialty of psychiatry, as a member of a case conference team, to organise and co-ordinate a community case conference of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

177.05

858

Attendance by a consultant physician in the practice of his or her specialty of psychiatry, as a member of a case conference team, to organise and co-ordinate a community case conference of at least 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

236.00

861

Attendance by a consultant physician in the practice of his or her specialty of psychiatry, as a member of a case conference team, to organise and co-ordinate a discharge case conference of at least 15 minutes but less than 30 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

118.00

864

Attendance by a consultant physician in the practice of his or her specialty of psychiatry, as a member of a case conference team, to organise and co-ordinate a discharge case conference of at least 30 minutes but less than 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

177.05

866

Attendance by a consultant physician in the practice of his or her specialty of psychiatry, as a member of a case conference team, to organise and co-ordinate a discharge case conference of at least 45 minutes, with a multidisciplinary team of at least 2 other formal care providers of different disciplines

236.00

Group A17 — Domiciliary medication management review

900

Participation by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) in a Domiciliary Medication Management Review (DMMR) for patients living in a community setting, where the medical practitioner:

 (a) assesses a patient’s medication management needs and, following that assessment, refers the patient to a community pharmacy for a DMMR and, with the patient’s consent, provides relevant clinical information required for the review; and

 (b) discusses with the reviewing pharmacist the results of that review including suggested medication management strategies; and

128.75

 

 (c) develops a written medication management plan following discussion with the patient.

For any particular patient — applicable not more than once in each 12 month period, except where there has been a significant change in the patient’s condition or medication regimen requiring a new DMMR

 

903

Participation by a medical practitioner (including a general practitioner but not including a specialist or consultant physician) in a residential medication management review (RMMR) for a patient who is a permanent resident of a residential aged care facility — not being an RMMR for a resident in respect of whom, in the preceding 12 months, a payment has been made under this item, unless there has been a significant change in the resident’s medical condition or medication management plan requiring a new RMMR

88.20

Group A18 — General practitioner attendances associated with Practice Incentives Program (PIP) payments

Subgroup 1 — Taking of a cervical smear from an unscreened or significantly underscreened woman

2501

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 2504 or 2507 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

30.85

2503

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

Amount under rule 61

 

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 2506 or 2509 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

 

2504

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) being attendance of less than 40 minutes duration involving components of a service to which item 2507 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

58.55

2506

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) being attendance of less than 40 minutes duration involving components of a service to which item 2509 applies;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

Amount under rule 61

2507

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) being attendance of at least 40 minutes duration for implementation of a management plan;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

86.20

2509

Professional attendance at a place other than consulting rooms by a general practitioner involving:

 (a) taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) being attendance of at least 40 minutes duration for implementation of a management plan;

at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive), who has not had a cervical smear in the last 4 years

Amount under rule 61

Subgroup 2 — Completion of an annual cycle of care for patients with established diabetes mellitus

2517

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 2521 or 2525 applies;

that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

30.85

2518

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 2522 or 2526 applies;

that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 61

2521

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) being attendance of less than 40 minutes duration involving components of a service to which item 2525 applies;

that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

58.55

2522

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) being attendance of less than 40 minutes duration involving components of a service to which item 2526 applies;

that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 61

2525

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) being attendance of at least 40 minutes duration for implementation of a management plan;

that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

86.20

2526

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) being attendance of at least 40 minutes duration for implementation of a management plan;

that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 61

Subgroup 3 — Completion of the Asthma 3+ Visit Plan

2546

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 2552 or 2558 applies;

that completes the minimum requirements of the Asthma 3+ Visit Plan

30.85

2547

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking a selective history, examination of the patient with the implementation of a management plan in relation to 1 or more problems; or

 (b) being attendance of less than 20 minutes duration involving components of a service to which item 2553 or 2559 applies;

that completes the minimum requirements of the Asthma 3+ Visit Plan

Amount under rule 61

2552

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) being attendance of less than 40 minutes duration involving components of a service to which item 2558 applies;

that completes the minimum requirements of the Asthma 3+ Visit Plan

58.55

2553

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) being attendance of less than 40 minutes duration involving components of a service to which item 2559 applies;

that completes the minimum requirements of the Asthma 3+ Visit Plan

Amount under rule 61

2558

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) being attendance of at least 40 minutes duration for implementation of a management plan;

that completes the minimum requirements of the Asthma 3+ Visit Plan

86.20

2559

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) being attendance of at least 40 minutes duration for implementation of a management plan;

that completes the minimum requirements of the Asthma 3+ Visit Plan

Amount under rule 61

Subgroup 4 — Completion of the 3 Step Mental Health Process

2574

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) involving components of a service to which item 2577 applies, being attendance of less than 40 minutes duration;

that completes the minimum requirements of the 3 Step Mental Health Process

58.55

2575

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or

 (b) involving components of a service to which item 2578 applies, being attendance of less than 40 minutes duration;

that completes the minimum requirements of the 3 Step Mental Health Process

Amount under rule 61

2577

Professional attendance at consulting rooms by a general practitioner:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) for implementation of a management plan, being attendance of at least 40 minutes duration;

that completes the minimum requirements of the 3 Step Mental Health Process

86.20

2578

Professional attendance at a place other than consulting rooms by a general practitioner:

 (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or

 (b) for implementation of a management plan, being attendance of at least 40 minutes duration;

that completes the minimum requirements of the 3 Step Mental Health Process

Amount under rule 61

Group A19 — Other non-referred attendances associated with Practice Incentives Program (PIP) payments to which no other item applies

Subgroup 1 — Taking of a cervical smear from an unscreened or significantly underscreened woman

2600

Professional attendance at consulting rooms of more than 5 minutes, but not more than 25 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

21.00

2603

Professional attendance at consulting rooms of more than 25 minutes, but not more than 45 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

38.00

2606

Professional attendance at consulting rooms of more than 45 minutes duration by a medical practitioner who practises in general practice (other than a general practitioner), at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

61.00

2610

Professional attendance at a place other than consulting rooms of more than 5 minutes, but not more than 25 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

Amount under rule 9

2613

Professional attendance at a place other than consulting rooms of more than 25 minutes, but not more than 45 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

Amount under rule 9

2616

Professional attendance at a place other than consulting rooms of more than 45 minutes duration by a medical practitioner who practises in general practice (other than a general practitioner), at which a cervical smear is taken from a woman between the ages of 20 and 69 (inclusive) who has not had a cervical smear in the last 4 years

Amount under rule 9

Subgroup 2 — Completion of an annual cycle of care for patients with established diabetes mellitus

2620

Professional attendance at consulting rooms of more than 5 minutes, but not more than 25 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

21.00

2622

Professional attendance at consulting rooms of more than 25 minutes, but not more than 45 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the requirements for an annual cycle of care of a patient with established diabetes mellitus

38.00

2624

Professional attendance at consulting rooms of more than 45 minutes duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

61.00

2631

Professional attendance at a place other than consulting rooms of more than 5 minutes, but not more than 25 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 9

2633

Professional attendance at a place other than consulting rooms of more than 25 minutes, but not more than 45 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 9

2635

Professional attendance at a place other than consulting rooms of more than 45 minutes duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements for an annual cycle of care of a patient with established diabetes mellitus

Amount under rule 9

Subgroup 3 — Completion of the Asthma 3+ Visit Plan

2664

Professional attendance at consulting rooms of more than 5 minutes, but not more than 25 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements of the Asthma 3+ Visit Plan

21.00

2666

Professional attendance at consulting rooms of more than 25 minutes, but not more than 45 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements of the Asthma 3+ Visit Plan

38.00

2668

Professional attendance at consulting rooms of more than 45 minutes duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements of the Asthma 3+ Visit Plan

61.00

2673

Professional attendance at a place other than consulting rooms of more than 5 minutes, but not more than 25 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements of the Asthma 3+ Visit Plan

Amount under rule 9

2675

Professional attendance at a place other than consulting rooms of more than 25 minutes, but not more than 45 minutes, duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements of the Asthma 3+ Visit Plan

Amount under rule 9

2677

Professional attendance at a place other than consulting rooms of more than 45 minutes duration by a medical practitioner who practises in general practice (other than a general practitioner), that completes the minimum requirements of the Asthma 3+ Visit Plan

Amount under rule 9

Subgroup 4 — Completion of the 3 Step Mental Health Process

2704

Professional attendance at consulting rooms by a medical practitioner who practises in general practice (other than a general practitioner, a specialist or a consultant physician), that completes the minimum requirements of the 3 Step Mental Health Process, being attendance of more than 25 minutes, but not more than 45 minutes, duration

38.00

2705

Professional attendance at consulting rooms by a medical practitioner who practises in general practice (other than a general practitioner, a specialist or a consultant physician), that completes the minimum requirements of the 3 Step Mental Health Process, being attendance of more than 45 minutes duration

61.00

2707

Professional attendance at a place other than consulting rooms by a medical practitioner who practises in general practice (other than a general practitioner, a specialist or a consultant physician), that completes the minimum requirements of the 3 Step Mental Health Process, being attendance of more than 25 minutes, but not more than 45 minutes, duration

Amount under rule 9

2708

Professional attendance at a place other than consulting rooms by a medical practitioner who practises in general practice (other than a general practitioner, a specialist or a consultant physician), that completes the minimum requirements of the 3 Step Mental Health Process, being attendance of more than 45 minutes duration

Amount under rule 9

Group A20 — Focussed psychological strategies

2721

Professional attendance at consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies, being attendance of at least 30 minutes, but less than 40 minutes, duration

73.75

2723

Professional attendance at a place other than consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies, being attendance of at least 30 minutes, but less than 40 minutes, duration

Amount under rule 61

2725

Professional attendance at consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies, being attendance of at least 40 minutes duration

105.60

2727

Professional attendance at a place other than consulting rooms by a medical practitioner who practises in general practice (other than a specialist or a consultant physician), for providing focussed psychological strategies, being attendance of at least 40 minutes duration

Amount under rule 61

Group A9 — Contact lenses

10801

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with myopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

103.25

10802

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

103.25

10803

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with astigmatism of 3.0 dioptres or greater in 1 eye

103.25

10804

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, if the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12) and if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens

103.25

10805

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with anisometropia of 3.0 dioptres or greater (difference between spherical equivalents)

103.25

10806

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes, being patients for whom a contact lens is prescribed as part of a telescopic system

103.25

10807

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation or distortion, significant ocular deformity or corneal opacity — whether congenital, traumatic or surgical in origin

103.25

10808

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients who, by reason of physical deformity, are unable to wear spectacles

103.25

10809

Attendance for the investigation and evaluation of a patient for the fitting of contact lenses, with keratometry and testing with trial lenses and the issue of a prescription — 1 service in any period of 36 months — patients who have a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10806, 10807 or 10808 applies) requiring the use of a contact lens for correction, where the condition is specified on the patient’s account

103.25

10816

Attendance for the refitting of contact lenses with keratometry and testing with trial lenses and the issue of a prescription, where the patient requires a change in contact lens material or basic lens parameters, other than simple power change, because of a structural or functional change in the eye or an allergic response within 36 months of the fitting of a contact lens to which items 10801 to 10809 apply

103.25

Group A10 — Optometric services

10900

Professional attendance of more than 15 minutes duration, being the first in a course of attention — not payable within 24 months of an attendance to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10915 applies

60.25

10905

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has been referred by another optometrist who is not associated with the optometrist to whom the patient is referred

60.25

10907

Professional attendance of more than 15 minutes duration being the first in a course of attention where the patient has attended another optometrist within the previous 24 months for an attendance to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10915 applies. The appropriate fee for the purpose of paragraph 23A (2) (c) of the Health Insurance Act 1973 is $59.00

30.15

10912

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has suffered a significant change of visual function requiring comprehensive reassessment within 24 months of an initial consultation to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10915 at the same practice applies

60.25

10913

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has new signs or symptoms, unrelated to the earlier course of attention, requiring comprehensive reassessment within 24 months of an initial consultation to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10915 at the same practice applies

60.25

10914

Professional attendance of more than 15 minutes duration, being the first in a course of attention, where the patient has a progressive disorder (excluding presbyopia) requiring comprehensive reassessment within 24 months of an initial consultation to which item 10900, 10905, 10907, 10912, 10913, 10914 or 10915 applies

60.25

10915

Professional attendance of more than 15 minutes duration, being the first in a course of attention involving the examination of the eyes, with the instillation of a mydriatic, of a patient with diabetes mellitus, requiring comprehensive reassessment

60.25

10916

Professional attendance, being the first in a course of attention, of not more than 15 minutes duration (not being a service associated with a service to which item 10940 or 10941 applies)

30.15

10918

Professional attendance being the second or subsequent in a course of attention not related to the prescription and fitting of contact lenses (not being a service associated with a service to which item 10940 or 10941 applies)

30.15

10921

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients with myopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

149.45

10922

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients with manifest hyperopia of 5.0 dioptres or greater (spherical equivalent) in 1 eye

149.45

10923

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients with astigmatism of 3.0 dioptres or greater in 1 eye

149.45

10924

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients with irregular astigmatism in either eye, being a condition the existence of which has been confirmed by keratometric observation, if the maximum visual acuity obtainable with spectacle correction is worse than 0.3 logMAR (6/12) and if that corrected acuity would be improved by an additional 0.1 logMAR by the use of a contact lens

188.65

10925

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients with anisometropia of 3.0 dioptres or greater (difference between spherical equivalents)

149.45

10926

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients with corrected visual acuity of 0.7 logMAR (6/30) or worse in both eyes, being patients for whom a contact lens is prescribed as part of a telescopic system

149.45

10927

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia caused by pathological mydriasis, aniridia, coloboma of the iris, pupillary malformation or distortion, significant ocular deformity or corneal opacity — whether congenital, traumatic or surgical in origin

188.65

10928

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients who, by reason of physical deformity, are unable to wear spectacles

149.45

10929

All professional attendances after the first, being those attendances regarded as a single service, in a single course of attention involving the prescription and fitting of contact lenses, being a course of attention in respect of which the first attendance is a service to which item 10900, 10905, 10907, 10912, 10913, 10914, 10915 or 10916 applies — payable only once in a period of 36 months — patients who have a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition to which item 10926, 10927 or 10928 applies) requiring the use of a contact lens for correction, where the condition is specified on the patient’s account

188.65

10930

All professional attendances regarded as a single service in a single course of attention involving the prescription and fitting of contact lenses where the patient meets the requirements of an item in the series 10921 to 10929 and requires a change in contact lens material or basic lens parameters, other than a simple power change, because of a structural or functional change in the eye or an allergic response within 36 months of the fitting of a contact lens covered by items 10921 to 10929

149.45

10940

Full quantitative computerised perimetry (automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry, performed by an optometrist, where indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain with assessment and report, bilateral — to a maximum of 2 examinations (including examinations to which item 10941 applies) in any 12 month period, not being a service associated with a service to which item 10916 or 10918 applies

57.50

10941

Full quantitative computerised perimetry (automated absolute static threshold) not being a service involving multifocal multichannel objective perimetry, performed by an optometrist, where indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain with assessment and report, unilateral — to a maximum of 2 examinations (including examinations to which item 10940 applies) in any 12 month period, not being a service associated with a service to which item 10916 or 10918 applies

34.65

Miscellaneous services

Group 1 — Management of bulk-billed services

10990

A medical service to which an item in this table (other than this item or item 10991) applies if:

 (a) the service is an unreferred service; and

 (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and

 (c) the person is not an admitted patient of a hospital or approved day hospital facility; and

5.95

 

 (d) the service is bulk-billed in respect of the fees for:

 (i) this item; and

 (ii) the other item in this table applying to the service

 

10991

A medical service to which an item in this table (other than this item or item 10990) applies if:

 (a) the service is an unreferred service; and

 (b) the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and

 (c) the person is not an admitted patient of a hospital or approved day hospital facility; and

9.00

 

 (d) the service is bulk-billed in respect of the fees for:

 (i) this item; and

 (ii) the other item in this table applying to the service; and

 

 

 (e) the service is provided at, or from, a practice location in:

 (i) a regional, rural or remote area; or

 (ii) Tasmania; or

 (iii) a geographical area included in any of the following SSD spatial units:

 (A) Beaudesert Shire Part A

 (B) Belconnen

 (C) Darwin City

 (D) Eastern Outer Melbourne

 (E) East Metropolitan

 (F) Frankston City

 (G) Gosford-Wyong

 (H) Greater Geelong City Part A

 (I) Gungahlin-Hall

 (J) Ipswich City (Part in BSD)

 (K) Litchfield Shire

 (L) Melton-Wyndham

 (M) Mornington Peninsula Shire

 (N) Newcastle

 (O) North Canberra

 (P) Palmerston-East Arm

 (Q) Pine Rivers Shire

 (R) Queanbeyan

 (S) South Canberra

 (T) South Eastern Outer Melbourne

 (U) Southern Adelaide

 (V) South West Metropolitan

 (W) Thuringowa City Part A

 (X) Townsville City Part A

 (Y) Tuggeranong

 (Z) Weston Creek-Stromlo

 (ZA) Woden Valley

 (ZB) Yarra Ranges Shire Part A; or

 (iv) the geographical area included in the SLA spatial unit of Palm Island (AC)

 

Group 2 — Services provided by a practice nurse on behalf of a medical practitioner

10993

Immunisation provided to a person by a practice nurse if:

 (a) the immunisation is provided on behalf of, and under the supervision of, a medical practitioner; and

 (b) the immunisation is provided:

 (i) in the consulting rooms of a general practice; or

 (ii) in a residential aged care facility; or

 (iii) during a home visit to the person; or

 (iv) in an institution

10.20

10996

Treatment of a person’s wound (other than normal aftercare) provided by a practice nurse if:

 (a) the treatment is provided on behalf of, and under the supervision of, a medical practitioner; and

 (b) the person is not an admitted patient of a hospital or approved day hospital facility

10.20

Diagnostic procedures and investigations

Group D1 — Miscellaneous diagnostic procedures and investigations

Subgroup 1 — Neurology

11000

Electroencephalography, not being a service:

 (a) associated with a service to which item 11003, 11006 or 11009 applies; or

 (b) involving quantitative topographic mapping using neurometrics or similar devices (Anaes.)

104.45

11003

Electroencephalography, prolonged recording of at least 3 hours duration, not being a service:

 (a) associated with a service to which item 11000, 11004, 11005, 11006 or 11009 applies; or

 (b) involving quantitative topographic mapping using neurometrics or similar devices

276.40

11004

Electroencephalography, ambulatory or video, prolonged recording of at least 3 hours duration up to 24 hours duration, recording on the first day, not being a service:

 (a) associated with a service to which item 11000, 11003, 11005, 11006 or 11009 applies; or

 (b) involving quantitative topographic mapping using neurometrics or similar devices

276.40

11005

Electroencephalography, ambulatory or video, prolonged recording of at least 3 hours duration up to 24 hours duration, recording on each day subsequent to the first day, not being a service:

 (a) associated with a service to which item 11000, 11003, 11004, 11006 or 11009 applies; or

 (b) involving quantitative topographic mapping using neurometrics or similar devices

276.40

11006

Electroencephalography, temporosphenoidal, not being a service involving quantitative topographic mapping using neurometrics or similar devices

141.70

11009

Electrocorticography

193.20

11012

Neuromuscular electrodiagnosis — conduction studies on 1 nerve or electromyography of 1 or more muscles using concentric needle electrodes or both these examinations (not being a service associated with a service to which item 11015 or 11018 applies)

94.95

11015

Neuromuscular electrodiagnosis — conduction studies on 2 or 3 nerves with or without electromyography (not being a service associated with a service to which item 11012 or 11018 applies)

127.20

11018

Neuromuscular electrodiagnosis — conduction studies on 4 or more nerves with or without electromyography or recordings from single fibres of nerves and muscles or both of these examinations (not being a service associated with a service to which item 11012 or 11015 applies)

190.05

11021

Neuromuscular electrodiagnosis — repetitive stimulation for study of neuromuscular conduction or electromyography with quantitative computerised analysis or both of these examinations

127.20

11024

Central nervous system evoked responses, investigation of, by computerised averaging techniques, not being a service involving quantitative topographic mapping of event-related potentials or involving multifocal multichannel objective perimetry — 1 or 2 studies

96.65

11027

Central nervous system evoked responses, investigation of, by computerised averaging techniques, not being a service involving quantitative topographic mapping of event-related potentials or involving multifocal multichannel objective perimetry — 3 or more studies

143.30

Subgroup 2 — Ophthalmology

11200

Provocative test or tests for glaucoma, including water drinking

34.60

11203

Tonography — in the investigation or management of glaucoma, of one or both eyes — using an electrical tonography machine producing a directly recorded tracing

58.50

11204

Electroretinography of 1 or both eyes by computerised averaging techniques, including 3 or more studies performed according to current professional guidelines or standards

91.85

11205

Electrooculography of 1 or both eyes performed according to current professional guidelines or standards

91.85

11210

Pattern electroretinography of 1 or both eyes by computerised averaging techniques, including 3 or more studies performed according to current professional guidelines or standards

91.85

11211

Dark adaptometry of 1 or both eyes with a quantitative estimation of threshold in log lumens at 45 minutes of dark adaptations

91.85

11212

Optic fundi, examination of following intravenous dye injection

59.50

11215

Retinal photography, multiple exposures, of 1 eye with intravenous dye injection

104.35

11218

Retinal photography, multiple exposures of both eyes with intravenous dye injection

128.90

11221

Full quantitative computerised perimetry (automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry, performed by or on behalf of a specialist in the practice of his or her specialty, where indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain with assessment and report, bilateral — to a maximum of 2 examinations (including examinations to which item 11224 applies) in any 12 month period

57.50

11222

Full quantitative computerised perimetry (automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry, performed by or on behalf of a specialist in the practice of his or her specialty, with assessment and report, bilateral, where it can be demonstrated that a further examination is indicated in the same 12 month period to which item 11221 applies due to presence of 1 of the following conditions:

 (a) established glaucoma (where surgery may be required within a 6 month period) where there has been definite progression of damage over a 12 month period;

57.50

 

 (b) established neurological disease which may be progressive and where a visual field is necessary for the management of the patient;

 (c) monitoring for ocular disease or disease of the visual pathways which may be caused by systemic drug toxicity, where there may also be other disease such as glaucoma or neurological disease;

each additional examination

 

11224

Full quantitative computerised perimetry (automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry, performed by or on behalf of a specialist in the practice of his or her specialty, where indicated by the presence of relevant ocular disease or suspected pathology of the visual pathways or brain with assessment and report, unilateral — to a maximum of 2 examinations (including examinations to which item 11221 applies) in any 12 month period

34.65

11225

Full quantitative computerised perimetry (automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry, performed by or on behalf of a specialist in the practice of his or her specialty, with assessment and report, unilateral, where it can be demonstrated that a further examination is indicated in the same 12 month period to which item 11224 applies due to presence of 1 of the following conditions:

 (a) established glaucoma (where surgery may be required within a 6 month period) where there has been definite progression of damage over a 12 month period;

 (b) established neurological disease which may be progressive and where a visual field is necessary for the management of the patient;

 (c) monitoring for ocular disease or disease of the visual pathways which may be caused by systemic drug toxicity, where there may also be other disease such as glaucoma or neurological disease;

each additional examination

34.65

11235

Examination of the eye by impression cytology of cornea for the investigation of ocular surface dysplasia, including the collection of cells, processing and all cytological examinations and preparation of report

104.10

11237

Ocular contents, simultaneous ultrasonic echography by both unidimensional and bidimensional techniques, for the diagnosis, monitoring or measurement of choroidal and ciliary body melanomas, retinoblastoma or suspicious naevi or simulating lesions, 1 eye, not being a service associated with a service to which an item in Group I1 of the diagnostic imaging services table applies

69.05

11240

Orbital contents, unidimensional ultrasonic echography or partial coherence interferometry of, for the measurement of 1 eye prior to lens surgery on that eye, not being a service associated with a service to which an item in Group I1 of the diagnostic imaging services table applies

69.05

11241

Orbital contents, unidimensional ultrasonic echography or partial coherence interferometry of, for bilateral eye measurement prior to lens surgery on both eyes, not being a service associated with a service to which an item in Group I1 of the diagnostic imaging services table applies

87.95

11242

Orbital contents, unidimensional ultrasonic echography or partial coherence interferometry of, for the measurement of an eye previously measured and on which lens surgery has been performed, and where further lens surgery is contemplated in that eye, not being a service associated with a service to which an item in Group I1 of the diagnostic imaging services table applies

68.00

11243

Orbital contents, unidimensional ultrasonic echography or partial coherence interferometry of, for the measurement of a second eye if:

 (a) surgery for the first eye has resulted in more than 1 dioptre of error; or

 (b) more than 3 years have elapsed since the surgery for the first eye;

not being a service associated with a service to which an item in Group I1 of the diagnostic imaging services table applies

68.00

Subgroup 3 — Otolaryngology

11300

Brain stem evoked response audiometry (Anaes.)

163.30

11303

Electrocochleography, extratympanic method, 1 or both ears

163.30

11304

Electrocochleography, transtympanic membrane insertion technique, 1 or both ears

268.90

11306

Non-determinate audiometry

18.65

11309

Audiogram, air conduction

22.30

11312

Audiogram, air and bone conduction or air conduction and speech discrimination

31.50

11315

Audiogram, air and bone conduction and speech

41.75

11318

Audiogram, air and bone conduction and speech, with other cochlear tests

51.50

11321

Glycerol induced cochlear function changes assessed by a minimum of 4 air conduction and speech discrimination tests (Klockoff’s test)

97.90

11324

Impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed by, or on behalf of, a specialist in the practice of his or her specialty, where the patient is referred by a medical practitioner — not being a service associated with a service to which item 11309, 11312, 11315 or 11318 applies

27.85

11327

Impedance audiogram involving tympanometry and measurement of static compliance and acoustic reflex performed by, or on behalf of, a specialist in the practice of his or her specialty, where the patient is referred by a medical practitioner — being a service associated with a service to which item 11309, 11312, 11315 or 11318 applies

16.75

11330

Impedance audiogram where the patient is not referred by a medical practitioner — 1 examination in any 4 week period

6.70

11332

Oto-acoustic emission audiometry for the detection of permanent congenital hearing impairment, performed by or on behalf of a specialist or consultant physician, on an infant or child who is at risk due to 1 or more of the following factors:

 (a) admission to a neonatal intensive care unit;

 (b) family history of hearing impairment;

 (c) intra-uterine or perinatal infection (either suspected or confirmed);

 (d) birthweight less than 1.5 kg;

 (e) craniofacial deformity;

 (f) birth asphyxia;

 (g) chromosomal abnormality, including Down’s Syndrome;

49.65

 

 (h) exchange transfusion;

where:

 (i) the patient is referred by another medical practitioner; and

 (j) middle ear pathology has been excluded by specialist opinion

 

11333

Caloric test of labyrinth or labyrinths

37.85

11336

Simultaneous bithermal caloric test of labyrinths

37.85

11339

Electronystagmography

37.85

Subgroup 4 — Respiratory

11500

Bronchospirometry, including gas analysis

141.70

11503

Measurement of the mechanical or gas exchange function of the respiratory system, or of respiratory muscle function, or of ventilatory control mechanisms, using measurements of various parameters including pressures, volumes, flow, gas concentrations in inspired or expired air, alveolar gas or blood, electrical activity of muscles (the tests being performed under the supervision of a specialist or consultant physician or in the respiratory laboratory of a hospital) — each occasion at which 1 or more such tests are performed

117.65

11506

Measurement of respiratory function involving a permanently recorded tracing performed before and after inhalation of bronchodilator — each occasion at which 1 or more such tests are performed

17.40

11509

Measurement of respiratory function involving a permanently recorded tracing and written report, performed before and after inhalation of bronchodilator, with continuous technician attendance in a laboratory equipped to perform complex respiratory function tests (the tests being performed under the supervision of a specialist or consultant physician or in the respiratory laboratory of a hospital) — each occasion at which 1 or more such tests are performed

30.25

11512

Continuous measurement of the relationship between flow and volume during expiration or inspiration involving a permanently recorded tracing and written report, performed before and after inhalation of bronchodilator, with continuous technician attendance in a laboratory equipped to perform complex lung function tests (the tests being performed under the supervision of a specialist or consultant physician or in the respiratory laboratory of a hospital) — each occasion at which 1 or more such tests are performed

52.40

Subgroup 5 — Vascular

11600

Blood pressure monitoring (central venous, pulmonary arterial, systemic arterial or cardiac intracavity), by indwelling catheter — each day of monitoring for each type of pressure up to a maximum of 4 pressures (not being a service to which item 13876 applies or a service associated with administration of anaesthesia)

58.75

11602

Investigation of venous reflux or obstruction in 1 or more limbs at rest by CW Doppler or pulsed Doppler involving examination at multiple sites along the limb(s) using intermittent limb compression and/or Valsalva manoeuvres to detect prograde and retrograde flow, not being a service associated with a service to which item 32500 or 32501 applies — hard copy trace and report, maximum of two examinations in a 12 month period

48.95

11604

Plethysmographic assessment of chronic venous disease, assessment of chronic venous disease in the lower and upper extremities, or in the lower or upper extremities (unilateral or bilateral) using venous occlusion plethysmography, strain gauge plethysmography or air plethysmography, not being a service associated with a service to which item 32500 or 32501 applies — examination, hard copy trace and report

64.25

11605

Infrared photoplethysmographic assessment of complex chronic lower limb venous disease, assessment of chronic venous disease in the lower extremities (unilateral or bilateral) using infrared photoplethysmography, examination during and following exercise with and without superficial venous occlusion, to assess venous function (reflux and/or obstruction) to determine surgical intervention or the conservative management of deep venous thrombotic disease, not being a service associated with a service to which item 32500 or 32501 applies — hard copy trace, calculation of 90% recovery time and report

64.25

11610

Measurement of ankle — brachial indices and arterial waveform analysis, measurement of posterior tibial and dorsalis pedis (or toe) and brachial arterial pressures bilaterally using Doppler or plethysmographic techniques, the calculation of ankle (or toe) brachial systolic pressure indices and assessment of arterial waveforms for the evaluation of lower extremity arterial disease — examination, hard copy trace and report

54.05

11611

Measurement of wrist — brachial indices and arterial waveform analysis, measurement of radial and ulnar (or finger) and brachial arterial pressures bilaterally using Doppler or plethysmographic techniques, the calculation of the wrist (or finger) brachial systolic pressure indices and assessment of arterial waveforms for the evaluation of upper extremity arterial disease — examination, hard copy trace and report

54.05

11612

Exercise study for the evaluation of lower extremity arterial disease, measurement of posterior tibial and dorsalis pedis (or toe) and brachial arterial pressures bilaterally using Doppler or plethysmographic techniques, the calculation of ankle (or toe) brachial systolic pressure indices for the evaluation of lower extremity arterial disease at rest and following exercise using a treadmill or bicycle ergometer or other such equipment where the exercise workload is quantifiably documented — examination and report

95.35

11614

Transcranial doppler, examination of the intracranial arterial circulation using CW Doppler or pulsed Doppler with hard copy recording of waveforms, examination and report, not being a service associated with a service to which item 55280 of the diagnostic imaging services table applies

64.25

11615

Measurement of digital temperature, 1 or more digits, (unilateral or bilateral) and report, with hard copy recording of temperature before and for 10 minutes or more after cold stress testing

64.35

11627

Pulmonary artery pressure monitoring during open heart surgery, in a person under 12 years of age

194.00

Subgroup 6 — Cardiovascular

11700

Twelve-lead electrocardiography, tracing and report

26.50

11701

Twelve-lead electrocardiography, report only where the tracing has been forwarded to another medical practitioner, not in association with a consultation on the same occasion

13.20

11702

Twelve-lead electrocardiography, tracing only

13.20

11708

Continuous ECG recording of ambulatory patient for 12 or more hours (including resting ECG and the recording of parameters), not in association with ambulatory blood pressure monitoring, involving microprocessor based analysis equipment, interpretation and report of recordings by a specialist physician or consultant physician, not being a service to which item 11709 applies

108.55

11709

Continuous ECG recording (Holter) of ambulatory patient for 12 or more hours (including resting ECG and the recording of parameters), not in association with ambulatory blood pressure monitoring, utilising a system capable of superimposition and full disclosure printout of at least 12 hours of recorded ECG data, microprocessor based scanning analysis, with interpretation and report by a specialist physician or consultant physician

142.10

11710

Ambulatory ECG monitoring, patient activated, single or multiple event recording, utilising a looping memory recording device which is connected continuously to the patient for 12 hours or more and is capable of recording for at least 20 seconds prior to each activation and for 15 seconds after each activation, including transmission, analysis, interpretation and report — payable once in any 4 week period

44.00

11711

Ambulatory ECG monitoring for 12 hours or more, patient activated, single or multiple event recording, utilising a memory recording device which is capable of recording for at least 30 seconds after each activation, including transmission, analysis, interpretation and report — payable once in any 4 week period

23.95

11712

Multi channel ECG monitoring and recording during exercise (motorised treadmill or cycle ergometer capable of quantifying external workload in watts) or pharmacological stress, involving the continuous attendance of a medical practitioner for not less than 20 minutes, with resting ECG, and with or without continuous blood pressure monitoring and the recording of other parameters, on premises equipped with mechanical respirator and defibrillator

129.05

11713

Signal averaged ECG recording involving not more than 300 beats, using at least 3 leads with data acquisition at not less than 1000Hz of at least 100 QRS complexes, including analysis, interpretation and report of recording by a specialist physician or consultant physician

59.15

11715

Blood dye — dilution indicator test

102.50

11718

Implanted pacemaker testing involving electrocardiography, measurement of rate, width and amplitude of stimulus, including reprogramming when required, not being a service associated with a service to which item 11700 or 11721 applies

29.45

11721

Implanted pacemaker testing of atrioventricular (AV) sequential, rate responsive, or antitachycardia pacemakers, including reprogramming when required, not being a service associated with a service to which item 11700 or 11718 applies

59.15

11722

Implanted ECG loop recording for the investigation of recurrent unexplained syncope if:

 (a) a diagnosis has not been achieved through all other available cardiac investigations; and

 (b) a neurogenic cause is not suspected; and

 (c) the patient to whom the service is provided does not have a structural heart defect associated with a high risk of sudden cardiac death;

including reprogramming when required, retrieval of stored data, analysis, interpretation and report, not being a service to which item 38285 applies

29.45

11724

Up-right tilt table testing for the investigation of syncope of suspected cardiothoracic origin, including blood pressure monitoring, continuous ECG monitoring and the recording of the parameters, and involving an established intravenous line and the continuous attendance of a specialist or consultant physician — on premises equipped with a mechanical respirator and defibrillator

143.30

Subgroup 7 — Gastroenterology and colorectal

11800

Oesophageal motility test, manometric

148.10

11810

Clinical assessment of gastro-oesophageal reflux disease involving 24-hour pH monitoring, including analysis, interpretation and report and including any associated consultation

148.10

11820

Capsule endoscopy to investigate an episode of obscure gastrointestinal bleeding, using a capsule endoscopy device approved by the Therapeutic Goods Administration (including administration of the capsule, imaging, image reading and interpretation, and all attendances for providing the service on the day the capsule is administered) if:

 (a) the service is performed by a specialist or consultant physician with endoscopic training that is recognised by The Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy; and

 (b) the patient to whom the service is provided:

 (i) is aged 18 years or over; and

 (ii) has recurrent or persistent bleeding; and

 (iii) is anaemic or has active bleeding; and

 (c) an upper gastrointestinal endoscopy and a colonoscopy have been performed on the patient and have not identified the cause of the bleeding; and

 (d) the service is performed within 6 months after the upper gastrointestinal endoscopy and colonoscopy

1 730.25

11830

Diagnosis of abnormalities of the pelvic floor involving anal manometry or measurement of anorectal sensation or measurement of the rectosphincteric reflex

158.45

11833

Diagnosis of abnormalities of the pelvic floor and sphincter muscles involving electromyography or measurement of pudendal and spinal nerve motor latency

211.90

Subgroup 8 — Genito-urinary physiological investigations

11900

Urine flow study including peak urine flow measurement, not being a service associated with a service to which item 11919 applies

23.40

11903

Cystometrography, not being a service associated with a service to which any of items 11012 to 11027, 11912, 11915, 11919, 11921 and 36800 or an item in Group I3 of the diagnostic imaging services table applies

94.30

11906

Urethral pressure profilometry, not being a service associated with a service to which any of items 11012 to 11027, 11909, 11919, 11921 and 36800 or an item in Group I3 of the diagnostic imaging services table applies

94.30

11909

Urethral pressure profilometry with simultaneous measurement of urethral sphincter electromyography, not being a service associated with a service to which item 11906, 11915, 11919, 36800 or an item in Group I3 of the diagnostic imaging services table applies

140.05

11912

Cystometrography with simultaneous measurement of rectal pressure, not being a service associated with a service to which any of items 11012 to 11027, 11903, 11915, 11919, 11921 and 36800 or an item in Group I3 of the diagnostic imaging services table applies (Anaes.)

140.05

11915

Cystometrography with simultaneous measurement of urethral sphincter electromyography, not being a service associated with a service to which any of items 11012 to 11027, 11903, 11909, 11912, 11919, 11921 and 36800 or an item in Group I3 of the diagnostic imaging services table applies (Anaes.)

140.05

11917

Cystometrography in conjunction with ultrasound of 1 or more components of the urinary tract, with measurement of any 1 or more of urine flow rate, urethral pressure profile, rectal pressure, urethral sphincter electromyography; including all imaging associated with cystometrography, not being a service associated with a service to which any of items 11012 to 11027, 11900 to 11915, 11919, 11921 and 36800 applies (Anaes.)

363.40

11919

Cystometrography in conjunction with contrast micturating cystourethrography, with measurement of any 1 or more of urine flow rate, urethral pressure profile, rectal pressure, urethral sphincter electromyography; including all imaging associated with cystometrography, not being a service associated with a service to which any of items 11012 to 11027, 11900 to 11917, 11921 and 36800 applies (Anaes.)

363.40

11921

Bladder washout test for localisation of urinary infection — not including bacterial counts for organisms in specimens

63.65

Subgroup 9 — Allergy testing

12000

Skin sensitivity testing for allergens, using 1 to 20 allergens, not being a service associated with a service to which item 12012, 12015, 12018 or 12021 applies

33.05

12003

Skin sensitivity testing for allergens, using more than 20 allergens, not being a service associated with a service to which item 12012, 12015, 12018 or 12021 applies

49.95

12012

Epicutaneous patch testing in the investigation of allergic dermatitis using less than the number of allergens included in a standard patch test battery

17.60

12015

Epicutaneous patch testing in the investigation of allergic dermatitis using all of the allergens in a standard patch test battery

53.00

12018

Epicutaneous patch testing in the investigation of allergic dermatitis using all of the allergens in a standard patch test battery and additional allergens to a total of up to and including 50 allergens

68.25

12021

Epicutaneous patch testing in the investigation of allergic dermatitis, performed by or on behalf of a specialist in the practice of his or her specialty, using more than 50 allergens

100.00

Subgroup 10 — Other diagnostic procedures and investigations

12200

Collection of specimen of sweat by iontophoresis

31.55

12201

Administration, by a specialist or consultant physician in the practice of his or her specialty, of thyrotropin alfa-rch (recombinant human thyroid-stimulating hormone), and arranging services to which both items 61426 and 66650 apply, for the detection of recurrent well-differentiated thyroid cancer in a patient if:

 (a) the patient has had a total thyroidectomy and one ablative dose of radioactive iodine; and

 (b) the patient is maintained on thyroid hormone therapy; and

 (c) the patient is at risk of recurrence; and

2 030.40

 

 (d) on at least one previous whole body scan or serum thyroglobulin test when withdrawn from thyroid hormone therapy, the patient did not have evidence of well-differentiated thyroid cancer; and

 (e) either:

 (i) withdrawal from thyroid hormone therapy resulted in severe psychiatric disturbances when hypothyroid; or

 (ii) withdrawal is medically contra-indicated because the patient has:

 (A) unstable coronary artery disease; or

 (B) hypopituitarism; or

 (C) a high risk of relapse or exacerbation of a previous severe psychiatric illness

— payable once only in a 12 month period

 

12203

Overnight investigation for sleep apnoea for a period of at least 8 hours duration, for a patient aged 18 years or more where:

 (a) continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG, EOG, submental EMG, anterior tibial EMG, respiratory movement, airflow, oxygen saturation and ECG are performed; and

 (b) a technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

 (c) the patient is referred by a medical practitioner; and

498.90

 

 (d) the necessity for the investigation is determined by a qualified adult sleep medicine practitioner prior to the investigation; and

 

 

 (e) polygraphic records are analysed (for assessment of sleep stage, arousals, respiratory events and assessment of clinically significant alterations in heart rate and limb movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

 (f) interpretation and report are provided by a qualified adult sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient.

For any particular patient — applicable only in relation to each of the first 3 occasions the investigation is performed in any 12 month period

 

12207

Overnight investigation for sleep apnoea for a period of at least 8 hours duration, for a patient aged 18 years or more where:

 (a) continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG, EOG, submental EMG, anterior tibial EMG, respiratory movement, airflow, oxygen saturation and ECG are performed; and

498.90

 

 (b) a technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

 (c) the patient is referred by a medical practitioner; and

 (d) the necessity for the investigation is determined by a qualified adult sleep medicine practitioner prior to the investigation; and

 

 

 (e) polygraphic records are analysed (for assessment of sleep stage, arousals, respiratory events and assessment of clinically significant alterations in heart rate and limb movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

 (f) interpretation and report are provided by a qualified adult sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient;

where it can be demonstrated that a further investigation is indicated in the same 12 month period to which item 12203 applies for the adjustment or testing, or both, of the effectiveness of a positive pressure ventilatory support device (other than nasal continuous positive airway pressure) in sleep, in a patient with severe cardio-respiratory failure, and where previous studies have demonstrated failure of continuous positive airway pressure or oxygen — each additional investigation

 

12210

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged 12 years or less, where:

 (a) continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

595.50

 

 (b) a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified paediatric sleep medicine practitioner; and

 (c) the patient is referred by a medical practitioner; and

 (d) the necessity for the investigation is determined by a qualified paediatric sleep medicine practitioner prior to the investigation; and

 

 

 (e) polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

 (f) interpretation and report are provided by a qualified paediatric sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient.

For each particular patient — applicable only in relation to each of the first 3 occasions the investigation is performed in any 12 month period

 

12213

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged between 12 and 18 years, where:

 (a) recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

 (b) a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

 (c) the patient is referred by a medical practitioner; and

536.45

 

 (d) the necessity for the investigation is determined by a qualified sleep medicine practitioner prior to the investigation; and

 

 

 (e) polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

 (f) interpretation and report are provided by a qualified sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient.

For each particular patient — applicable only in relation to each of the first 3 occasions the investigation is performed in any 12 month period

 

12215

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged 12 years or less, where:

 (a) continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

 (b) a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified paediatric sleep medicine practitioner; and

 (c) the patient is referred by a medical practitioner; and

 (d) the necessity for the investigation is determined by a qualified paediatric sleep medicine practitioner prior to the investigation; and

595.50

 

 (e) polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

 

 

 (f) interpretation and report are provided by a qualified paediatric sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient;

where it can be demonstrated that a further investigation is indicated in the same 12 month period to which item 12210 applies, for the adjustment, or testing of the effectiveness, or both, of Continuous Positive Airway Pressure (CPAP) or of the bilevel pressure support or ventilation (or both), or if supplemental oxygen is required because of recurring hypoxia — each additional investigation

 

12217

Overnight paediatric investigation for a period of at least 8 hours duration for a patient aged between 12 and 18 years, where:

 (a) continuous monitoring of oxygen saturation and breathing using a multi-channel polygraph, and recordings of EEG (with a minimum of 4 EEG leads or, in selected investigations, of 6 EEG leads), EOG, submental or diaphragm EMG (or both), respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen), airflow, measurement of carbon dioxide (either end-tidal or transcutaneous), oxygen saturation and ECG are performed; and

 (b) a technician or registered nurse with sleep technology training is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

 (c) the patient is referred by a medical practitioner; and

 (d) the necessity for the investigation is determined by a qualified sleep medicine practitioner prior to the investigation; and

536.45

 

 (e) polygraphic records are analysed (for assessment of sleep stage, and maturation of sleep indices, arousals, respiratory events and assessment of clinically significant alterations in heart rate and body movement) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; and

 

 

 (f) interpretation and report to be provided by a qualified sleep medicine practitioner based on reviewing the direct original recording of polygraphic data from the patient;

where it can be demonstrated that a further investigation is indicated in the same 12 month period to which item 12213 applies, for the adjustment, or testing of the effectiveness, or both, of Continuous Positive Airway Pressure (CPAP) or of the bilevel pressure support or ventilation (or both), or if there is recurring hypoxia and supplemental oxygen is required — each additional investigation

 

Group D2 — Nuclear medicine (non-imaging)

12500

Blood volume estimation

183.80

12503

Erythrocyte radioactive uptake survival time test or iron kinetic test

360.45

12506

Gastrointestinal blood loss estimation involving examination of stool specimens

257.35

12509

Gastrointestinal protein loss

183.80

12512

Radioactive B12 absorption test — 1 isotope

89.10

12515

Radioactive B12 absorption test — 2 isotopes

195.05

12518

Thyroid uptake (using probe)

89.10

12521

Perchlorate discharge study

107.45

12524

Renal function test (without imaging procedure)

134.30

12527

Renal function test (with imaging and at least 2 blood samples)

72.05

12530

Whole body count — not being a service associated with a service to which another item applies

107.45

12533

Carbon-labelled urea breath test using oral C-13 or C-14 urea, performed by a specialist or consultant physician, including the measurement of exhaled 13CO2 or 14CO2 , for either:

 (a) the confirmation of Helicobactor pylori colonisation, where:

 (i) suitable biopsy material for diagnosis cannot be obtained at endoscopy in patients with peptic ulcer disease, or where the diagnosis of peptic ulcer has been made on barium meal; or

 (ii) in patients with past history of duodenal ulcer, gastric ulcer or gastric neoplasia, where endoscopy is not indicated; or

71.75

 

 (b) the monitoring of the success of eradication of Helicobactor pylori in patients with peptic ulcer disease;

where any request for the test by another medical practitioner who collects the breath sample specifically identifies in writing 1 or more of the clinical indications for the test

 

Therapeutic procedures

Group T1 — Miscellaneous therapeutic procedures

Subgroup 1 — Hyperbaric oxygen therapy

13020

Hyperbaric oxygen therapy, for treatment of decompression illness, gas gangrene, air or gas embolism, diabetic wounds (including diabetic gangrene and diabetic foot ulcers) or necrotising soft tissue infections (including necrotising fasciitis or Fournier’s gangrene), or for the prevention and treatment of osteoradionecrosis, performed in a comprehensive hyperbaric medicine facility, under the supervision of a medical practitioner qualified in hyperbaric medicine, for a period in the hyperbaric chamber of between 1 hour 30 minutes and 3 hours (both inclusive), including any associated attendance

219.55

13025

Hyperbaric oxygen therapy, for treatment of decompression illness, air or gas embolism, performed in a comprehensive hyperbaric medicine facility, under the supervision of a medical practitioner qualified in hyperbaric medicine, for a period in the hyperbaric chamber greater than 3 hours, including any associated attendance — per hour (or part of an hour)

98.20

13030

Hyperbaric oxygen therapy performed in a comprehensive hyperbaric medicine facility where the medical practitioner is pressurised in the hyperbaric chamber for the purpose of providing continuous life saving emergency treatment, including any associated attendance — per hour (or part of an hour)

138.70

Subgroup 2 — Dialysis

13100

Supervision in hospital by a medical specialist of — haemodialysis, haemofiltration, haemoperfusion or peritoneal dialysis, including all professional attendances, where the total attendance time on the patient by the supervising medical specialist exceeds 45 minutes in 1 day

115.95

13103

Supervision in hospital by a medical specialist of — haemodialysis, haemofiltration, haemoperfusion or peritoneal dialysis, including all professional attendances, where the total attendance time on the patient by the supervising medical specialist does not exceed 45 minutes in 1 day

60.40

13106

Declotting of an arteriovenous shunt

103.00

13109

Indwelling peritoneal catheter (Tenckhoff or similar) for dialysis — insertion and fixation of (Anaes.)

193.20

13110

Tenckhoff peritoneal dialysis catheter, removal of (including catheter cuffs) (Anaes.)

193.85

13112

Peritoneal dialysis, establishment of, by abdominal puncture and insertion of temporary catheter (including associated consultation) (Anaes.)

115.95

Subgroup 3 — Assisted reproductive services

13200

Assisted reproductive services (such as in vitro fertilisation, gamete intra-fallopian transfer or similar procedures) involving the use of drugs to induce superovulation, and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination or transfer of frozen embryos or donated embryos or ova or a service to which item 13203, 13206 or 13218 applies — being services rendered during 1 treatment cycle, if the duration of the treatment cycle is at least 9 days

1 696.35

13203

Ovulation monitoring services, for superovulated treatment cycles of less than 9 days duration and artificial insemination — including quantitative estimation of hormones and ultrasound examinations, being services rendered during 1 treatment cycle but excluding a service to which item 13200, 13206, 13212, 13215 or 13218 applies

424.10

13206

Assisted reproductive services (such as in vitro fertilisation, gamete intra-fallopian transfer or similar procedures), using unstimulated ovulation or ovulation stimulated only by clomiphene citrate, and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services — but excluding artificial insemination, frozen embryo transfer or donated embryos or ova or treatment involving the use of drugs to induce superovulation — being services rendered during 1 treatment cycle but only if rendered in conjunction with a service to which item 13212 applies

726.95

13209

Planning and management of a referred patient by a specialist for the purpose of treatment by assisted reproductive technologies including in vitro fertilisation, gamete intra-fallopian transfer and similar procedures, or for artificial insemination — payable once only during 1 treatment cycle

72.60

13212

Oocyte retrieval by any means including laparoscopy or ultrasound-guided ova flushing, for the purposes of assisted reproductive technologies including in vitro fertilisation, gamete intra-fallopian transfer or similar procedures — only if rendered in conjunction with a service to which item 13200 or 13206 applies (Anaes.)

309.00

13215

Transfer of embryos or both ova and sperm to the female reproductive system, by any means but excluding artificial insemination or the transfer of frozen or donated embryos — only if rendered in conjunction with a service to which item 13200 or 13206 applies, being services rendered in 1 treatment cycle (Anaes.)

96.95

13218

Preparation and transfer of frozen or donated embryos or both ova and sperm, to the female reproductive system, by any means and including quantitative estimation of hormones and all treatment counselling but excluding artificial insemination services rendered in 1 treatment cycle and excluding a service to which item 13200, 13203, 13206, 13212 or 13215 applies (Anaes.)

726.95

13221

Preparation of semen for the purposes of assisted reproductive technologies or for artificial insemination

44.25

13290

Semen, collection of, from a patient with spinal injuries or medically induced impotence, for the purposes of analysis, storage or assisted reproduction, by a medical practitioner using a vibrator or electro-ejaculation device including catheterisation and drainage of bladder where required

173.35

13292

Semen, collection of, from a patient with spinal injuries or medically induced impotence, for the purposes of analysis, storage or assisted reproduction, by a medical practitioner using a vibrator or electro-ejaculation device including catheterisation and drainage of bladder where required, under general anaesthetic (H) (Anaes.)

346.75

Subgroup 4 — Paediatric and neonatal

13300

Umbilical or scalp vein catheterisation in a neonate with or without infusion or cannulation of a vein

48.35

13303

Umbilical artery catheterisation with or without infusion

71.60

13306

Blood transfusion with venesection and complete replacement of blood, including collection from donor

283.45

13309

Blood transfusion with venesection and complete replacement of blood, using blood already collected

241.65

13312

Blood for pathology test, collection of, by femoral or external jugular vein puncture in infants

24.10

13318

Central vein catheterisation (via jugular or subclavian vein) — by open exposure, in a person under 12 years of age (Anaes.)

193.00

13319

Central vein catheterisation in a neonate via peripheral vein (Anaes.)

193.00

Subgroup 5 — Cardiovascular

13400

Restoration of cardiac rhythm by electrical stimulation (cardioversion), other than in the course of cardiac surgery (Anaes.)

82.15

Subgroup 6 — Gastroenterology

13500

Gastric hypothermia by closed circuit circulation of refrigerant in the absence of gastrointestinal haemorrhage

153.00

13503

Gastric hypothermia by closed circuit circulation of refrigerant for upper gastrointestinal haemorrhage

306.05

13506

Gastro-oesophageal balloon intubation, Minnesota, Sengstaken-Blakemore or similar, for control of bleeding from gastric oesophageal varices

156.50

Subgroup 8 — Haematology

13700

Harvesting of homologous (including allogeneic) or autologous bone marrow for the purpose of transplantation (Anaes.)

282.80

13703

Administration of blood including collection from donor

101.35

13706

Administration of blood or bone marrow already collected

70.80

13709

Collection of blood for autologous transfusion or when homologous blood is required for immediate transfusion in emergency situation

41.10

13750

Therapeutic haemapheresis for the removal of plasma or cellular (or both) elements of blood, utilising continuous or intermittent flow techniques, including morphological tests for cell counts and viability studies, if performed; continuous monitoring of vital signs, fluid balance, blood volume and other parameters with continuous registered nurse attendance under the supervision of a consultant physician, not being a service associated with a service to which item 13755 applies — each day

115.95

13755

Donor haemapheresis for the collection of blood products for transfusion, utilising continuous or intermittent flow techniques, including morphological tests for cell counts and viability studies; continuous monitoring of vital signs, fluid balance, blood volume and other parameters; with continuous registered nurse attendance under the supervision of a consultant physician — not being a service associated with a service to which item 13750 applies — each day

115.95

13757

Therapeutic venesection for the management of haemochromatosis, polycythemia vera or porphyria cutanea tarda

61.90

13760

In vitro processing (and cryopreservation) of bone marrow or peripheral blood for autologous stem cell transplantation as an adjunct to high dose chemotherapy for:

 (a) chemosensitive intermediate or high grade
non-Hodgkin’s lymphoma at high risk of relapse following first line chemotherapy; or

 (b) Hodgkin’s disease which has relapsed following, or is refractory to, chemotherapy; or

 (c) acute myelogenous leukaemia in first remission, where suitable genotypically matched sibling donor is not available for allogenic bone marrow transplant; or

 (d) multiple myeloma in remission (complete or partial) following standard dose chemotherapy; or

 (e) small round cell sarcomas; or

 (f) primitive neuroectodermal tumour; or

 (g) germ cell tumours which have relapsed following, or are refractory to, chemotherapy; or

 (h) germ cell tumours which have had an incomplete response to first line therapy;

performed under the supervision of a consultant physician — each day

647.10

Subgroup 9 — Procedures associated with intensive care and cardiopulmonary support

13815

Central vein catheterisation (via jugular, subclavian or femoral vein) by percutaneous or open exposure not being a service to which item 13318 applies (Anaes.)

72.35

13818

Right heart balloon catheter, insertion of, including pulmonary wedge pressure and cardiac output measurement (Anaes.)

96.50

13830

Intracranial pressure, monitoring of, by intraventricular or subdural catheter, subarachnoid bolt or similar, by a specialist or consultant physician — each day

63.95

13839

Arterial puncture and collection of blood for diagnostic purposes

19.50

13842

Intra-arterial cannulation for the purpose of taking multiple arterial blood samples for blood gas analysis

58.75

13845

Counterpulsation by intra-aortic balloon-management on the first day, including percutaneous insertion, initial and subsequent consultations and monitoring of parameters (Anaes.)

459.00

13848

Counterpulsation by intra-aortic balloon-management on each day subsequent to the first, including associated consultations and monitoring of parameters

111.20

13851

Circulatory support device, management of, on first day

418.85

13854

Circulatory support device, management of, on each day subsequent to the first

97.40

13857

Mechanical ventilation, initiation of (other than initiation of ventilation in the context of an anaesthetic for surgery), outside of an intensive care unit, where subsequent management of ventilatory support is undertaken in an intensive care unit

124.20

Subgroup 10 — Management and procedures undertaken in an intensive care unit

13870

Management of a patient in an intensive care unit by a specialist or consultant physician — including initial and subsequent attendances, electrocardiographic monitoring, arterial sampling, bladder catheterisation and blood sampling — management on the first day

258.85

13873

Management of a patient in an intensive care unit by a specialist or consultant physician — including all attendances, electrocardiographic monitoring, arterial sampling, bladder catheterisation and blood sampling — management on each day subsequent to the first day

192.75

13876

Central venous pressure, pulmonary arterial pressure, systemic arterial pressure or cardiac intracavity pressure, continuous monitoring by indwelling catheter by a specialist or consultant physician in an intensive care unit — each day of monitoring for each type of pressure up to a maximum of 4 pressures

58.75

13879

Mechanical ventilation, initiation of, by a specialist or consultant physician, in an intensive care unit, including subsequent management of ventilatory support on the first day

187.85

13882

Ventilatory support in an intensive care unit, management of, by a specialist or consultant physician — not being a service to which item 13879 applies — each day

63.95

13885

Continuous arterio venous or veno venous haemofiltration, management by a specialist or consultant physician — on the first day in an intensive care unit

115.65

13888

Continuous arterio venous or veno venous haemofiltration, management by a specialist or consultant physician — on each day subsequent to the first day in an intensive care unit

60.25

Subgroup 11 — Chemotherapeutic procedures

13915

Cytotoxic chemotherapy, administration of, either by intravenous push technique (directly into a vein, or a butterfly needle, or the side-arm of an infusion) or by intravenous infusion of not more than 1 hour’s duration, not being a service associated with photodynamic therapy with verteporfin — for any particular patient, once only on the same day

55.20

13918

Cytotoxic chemotherapy, administration of, by intravenous infusion of more than 1 hour’s duration but not more than 6 hours duration — for any particular patient, once only on the same day

83.05

13921

Cytotoxic chemotherapy, administration of, by intravenous infusion of more than 6 hours duration — for the first day of treatment

94.00

13924

Cytotoxic chemotherapy, administration of, by intravenous infusion of more than 6 hours duration — on each day subsequent to the first in the same continuous treatment episode

55.40

13927

Cytotoxic chemotherapy, administration of, either by intra-arterial push technique (directly into an artery, a butterfly needle or the side-arm of an infusion) or by intra-arterial infusion of not more than 1 hour’s duration — for any particular patient, once only on the same day

71.60

13930

Cytotoxic chemotherapy, administration of, by
intra-arterial infusion of more than 1 hour’s duration but not more than 6 hours duration — for any particular patient, once only on the same day

99.95

13933

Cytotoxic chemotherapy, administration of, by
intra-arterial infusion of more than 6 hours duration — for the first day of treatment

110.90

13936

Cytotoxic chemotherapy, administration of, by
intra-arterial infusion of more than 6 hours duration — on each day subsequent to the first in the same continuous treatment episode

72.25

13939

Implanted pump or reservoir, loading of, with a cytotoxic agent or agents, not being a service associated with a service to which item 13915, 13918, 13921, 13924, 13927, 13930, 13933, 13936 or 13945 applies

83.05

13942

Ambulatory drug delivery device, loading of, with a cytotoxic agent or agents for the infusion of the agent or agents via the intravenous, intra-arterial or spinal routes, not being a service associated with a service to which item 13915, 13918, 13921, 13924, 13927, 13930, 13933, 13936 or 13945 applies

55.40

13945

Long-term implanted drug delivery device for cytotoxic chemotherapy, accessing of

44.55

13948

Cytotoxic agent, instillation of, into a body cavity

55.40

Subgroup 12 — Dermatology

14050

PUVA therapy or UVB therapy administered in whole body cabinet (not being a service associated with a service to which item 14053 applies) including associated consultations other than an initial consultation

44.75

14053

PUVA therapy or UVB therapy administered to localised body areas in a hand and foot cabinet (not being a service associated with a service to which item 14050 applies) including associated consultations other than an initial consultation

44.75

14100

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of vascular lesions of the head or neck where abnormality is visible from 3 metres, including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period (Anaes.)

129.40

14106

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas of infancy, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), where abnormality is visible from 3 metres, including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment up to 50 cm2 (Anaes.)

129.40

14109

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas of infancy, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment more than 50 cm2 and up to 100 cm2 (Anaes.)

158.90

14112

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas of infancy, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment more than 100 cm2 and up to 150 cm2 (Anaes.)

188.20

14115

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas of infancy, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — area of treatment more than 150 cm2 and up to 250 cm2 (Anaes.)

217.60

14118

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of port wine stains, haemangiomas of infancy, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 apply) in any 12 month period — area of treatment more than 250 cm2 (Anaes.)

276.45

14124

Laser photocoagulation using laser light within the wave length of 510-1064nm in the treatment of haemangiomas of infancy, including any associated consultation — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (Anaes.)

129.40

Subgroup 13 — Other therapeutic procedures

14200

Gastric lavage in the treatment of ingested poison

50.80

14203

Hormone or living tissue implantation, by direct implantation involving incision and suture (Anaes.)

43.40

14206

Hormone or living tissue implantation — by cannula

30.20

14209

Intra-arterial infusion or retrograde intravenous perfusion of a sympatholytic agent

75.30

14212

Intussusception, management of fluid or gas reduction for (Anaes.)

157.25

14215

Long-term implanted reservoir associated with the adjustable gastric band, accessing of to add or remove fluid

83.05

14218

Implanted pump or reservoir, loading of, with a therapeutic agent or agents, for infusion to the subarachnoid or epidural space

83.05

14221

Long-term implanted device for delivery of therapeutic agents, accessing of, not being a service associated with a service to which item 13945 applies

44.55

14224

Electroconvulsive therapy, with or without the use of stimulus dosing techniques, including any electroencephalographic monitoring and associated consultation (Anaes.)

59.70

Group T2 — Radiation oncology

Subgroup 1 — Superficial

15000

Radiotherapy, superficial (including treatment with
x-rays, radium rays or other radioactive substances), not being a service to which another item in this group applies — each attendance at which fractionated treatment is given — 1 field

36.15

15003

Radiotherapy, superficial (including treatment with
x-rays, radium rays or other radioactive substances), not being a service to which another item in this group applies — each attendance at which fractionated treatment is given — 2 or more fields up to a maximum of 5 additional fields

Amount under rule 17

15006

Radiotherapy, superficial-attendance at which a single dose technique is applied — 1 field

80.10

15009

Radiotherapy, superficial-attendance at which a single dose technique is applied — 2 or more fields up to a maximum of 5 additional fields

Amount under rule 17

15012

Radiotherapy, superficial — each attendance at which treatment is given to an eye

45.35

Subgroup 2 — Orthovoltage

15100

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 3 or more treatments per week — 1 field

40.50

15103

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 3 or more treatments per week — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 17

15106

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 2 treatments per week or less frequently — 1 field

47.80

15109

Radiotherapy, deep or orthovoltage — each attendance at which fractionated treatment is given at 2 treatments per week or less frequently — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 17

15112

Radiotherapy, deep or orthovoltage — attendance at which a single dose technique is applied — 1 field

102.00

15115

Radiotherapy, deep or orthovoltage — attendance at which a single dose technique is applied — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 17

Subgroup 3 — Megavoltage

15211

Radiation oncology treatment, using cobalt unit or caesium teletherapy unit — each attendance at which treatment is given — 1 field

46.40

15214

Radiation oncology treatment, using cobalt unit or caesium teletherapy unit — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields)

Amount under rule 17

15215

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (lung)

50.65

15218

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (prostate)

50.65

15221

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (breast)

50.65

15224

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site for diseases or conditions not covered by item 15215, 15218 or 15221

50.65

15227

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to secondary site

50.65

15230

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (lung)

Amount under rule 17

15233

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (prostate)

Amount under rule 17

15236

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (breast)

Amount under rule 17

15239

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site for diseases or conditions not covered by item 15230, 15233 or 15236

Amount under rule 17

15242

Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to secondary site

Amount under rule 17

15245

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (lung)

50.65

15248

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (prostate)

50.65

15251

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (breast)

50.65

15254

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site for diseases or conditions not covered by item 15245, 15248 or 15251

50.65

15257

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to secondary site

50.65

15260

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (lung)

Amount under rule 17

15263

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (prostate)

Amount under rule 17

15266

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (breast)

Amount under rule 17

15269

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site for diseases or conditions not covered by item 15260, 15263 or 15266

Amount under rule 17

15272

Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to secondary site

Amount under rule 17

Subgroup 4 — Brachytherapy

15303

Intrauterine treatment alone using radioactive sealed sources having a half-life greater than 115 days using manual afterloading techniques (Anaes.)

302.95

15304

Intrauterine treatment alone using radioactive sealed sources having a half-life greater than 115 days using automatic afterloading techniques (Anaes.)

302.95

15307

Intrauterine treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using manual afterloading techniques (Anaes.)

574.30

15308

Intrauterine treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using automatic afterloading techniques (Anaes.)

574.30

15311

Intravaginal treatment alone using radioactive sealed sources having a half-life greater than 115 days using manual afterloading techniques (Anaes.)

282.75

15312

Intravaginal treatment alone using radioactive sealed sources having a half-life greater than 115 days using automatic afterloading techniques (Anaes.)

280.70

15315

Intravaginal treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using manual afterloading techniques (Anaes.)

555.10

15316

Intravaginal treatment alone using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium or tantalum using automatic afterloading techniques (Anaes.)

555.10

15319

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life greater than 115 days using manual afterloading techniques (Anaes.)

344.50

15320

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life greater than 115 days using automatic afterloading techniques (Anaes.)

344.50

15323

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium, or tantalum using manual afterloading techniques (Anaes.)

612.60

15324

Combined intrauterine and intravaginal treatment using radioactive sealed sources having a half-life of less than 115 days including iodine, gold, iridium, or tantalum using automatic afterloading techniques (Anaes.)

612.60

15327

Implantation of a sealed radioactive source (having a
half-life of less than 115 days including iodine, gold, iridium or tantalum) to a region, under general anaesthesia, or epidural or spinal (intrathecal) nerve block, requiring surgical exposure and using manual afterloading techniques (Anaes.)

666.45

15328

Implantation of a sealed radioactive source (having a
half-life of less than 115 days including iodine, gold, iridium or tantalum) to a region, under general anaesthesia, or epidural or spinal (intrathecal) nerve block, requiring surgical exposure and using automatic afterloading techniques (Anaes.)

666.45

15331

Implantation of a sealed radioactive source (having a
half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site (including the tongue, mouth, salivary gland, axilla, subcutaneous sites), where the volume treated involves multiple planes but does not require surgical exposure and using manual afterloading techniques (Anaes.)

632.80

15332

Implantation of a sealed radioactive source (having a
half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site (including the tongue, mouth, salivary gland, axilla, subcutaneous sites), where the volume treated involves multiple planes but does not require surgical exposure and using automatic afterloading techniques (Anaes.)

632.80

15335

Implantation of a sealed radioactive source (having a
half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site where the volume treated involves only a single plane but does not require surgical exposure and using manual afterloading techniques (Anaes.)

574.30

15336

Implantation of a sealed radioactive source (having a
half-life of less than 115 days including iodine, gold, iridium or tantalum) to a site where the volume treated involves only a single plane but does not require surgical exposure and using automatic afterloading techniques (Anaes.)

574.30

15338

Prostate, radioactive seed implantation of, radiation oncology component, using transrectal ultrasound guidance, for localised prostatic malignancy at clinical stage T1, T2A or T2B, with a Gleason score of 6 or less and a prostate specific antigen (PSA) of 10ng/ml or less at the time of diagnosis, where the procedure is performed at an approved site in association with a urologist

793.80

15339

Removal of a sealed radioactive source under general anaesthesia, or under epidural or spinal nerve block (Anaes.)

64.65

15342

Construction and application of a radioactive mould using a sealed source having a half-life of greater than 115 days, to treat intracavity, intraoral or intranasal site

161.45

15345

Construction and application of a radioactive mould using a sealed source having a half-life of less than 115 days including iodine, gold, iridium or tantalum to treat intracavity, intraoral or intranasal sites

430.90

15348

Subsequent applications of radioactive mould referred to in item 15342 or 15345 — each attendance

49.55

15351

Construction and first application of a radioactive mould not exceeding 5 cm in diameter to an external surface

98.95

15354

Construction and first application of a radioactive mould more than 5 cm in diameter to an external surface

120.10

15357

Attendance upon a patient to apply a radioactive mould constructed for application to an external surface of the patient other than an attendance which is the first attendance to apply the mould — each attendance

33.90

15360

Catheter based intravascular brachytherapy for the treatment of in-stent restenoses of 1 coronary artery, administration of radioactive sealed sources having a half life of 115 days or less using automated intravascular brachytherapy systems approved by the Therapeutic Goods Administration. The procedure must be performed by a radiation oncologist in association with a cardiologist and be associated with a service to which item 35347, 35350, 35353 or 35356 applies

306.30

15363

Catheter based intravascular brachytherapy for the treatment of in-stent restenoses of 1 coronary artery, administration of radioactive sealed sources having a half life of greater than 115 days using automated intravascular brachytherapy systems approved by the Therapeutic Goods Administration. The procedure must be performed by a radiation oncologist in association with a cardiologist and be associated with a service to which item 35347, 35350, 35353 or 35356 applies

306.30

Subgroup 5 — Computerised planning

15500

Radiation field setting using a simulator or isocentric
x-ray or megavoltage machine or CT of a single area for treatment by a single field or parallel opposed fields (not being a service associated with a service to which item 15509 applies)

205.95

15503

Radiation field setting using a simulator or isocentric
x-ray or megavoltage machine or CT of a single area, where views in more than 1 plane are required for treatment by multiple fields, or of 2 areas (not being a service associated with a service to which item 15512 applies)

264.40

15506

Radiation field setting using a simulator or isocentric
x-ray or megavoltage machine or CT of 3 or more areas, or of total body or half body irradiation, or of mantle therapy or inverted Y fields, or of irregularly shaped fields using multiple blocks, or of off-axis fields or several joined fields (not being a service associated with a service to which item 15515 applies)

394.80

15509

Radiation field setting using a diagnostic x-ray unit of a single area for treatment by a single field or parallel opposed fields (not being a service associated with a service to which item 15500 applies)

178.50

15512

Radiation field setting using a diagnostic x-ray unit of a single area, where views in more than 1 plane are required for treatment by multiple fields, or of 2 areas (not being a service associated with a service to which item 15503 applies)

230.05

15513

Radiation source localisation using a simulator or x-ray machine or CT of a single area, where views in more than 1 plane are required, for brachytherapy treatment planning for Iodine 125 seed implantation of localised prostate cancer, being a service associated with a service to which item 15338 applies

260.20

15515

Radiation field setting using a diagnostic x-ray unit of 3 or more areas, or of total body or half body irradiation, or of mantle therapy or inverted Y fields, or of irregularly shaped fields using multiple blocks, or of off-axis fields or several joined fields (not being a service associated with a service to which item 15506 applies)

333.00

15518

Radiation Dosimetry by a CT interfacing planning computer for megavoltage or teletherapy radiotherapy by a single field or parallel opposed fields to 1 area with up to 2 shielding blocks

65.30

15521

Radiation Dosimetry by a CT interfacing planning computer for megavoltage or teletherapy radiotherapy to a single area by 3 or more fields, or by a single field or parallel opposed fields to 2 areas, or where wedges are used

288.40

15524

Radiation Dosimetry by a CT interfacing planning computer for megavoltage or teletherapy radiotherapy to 3 or more areas, or by mantle fields or inverted Y fields or tangential fields or irregularly shaped fields using multiple blocks, or off-axis fields, or several joined fields

540.75

15527

Radiation Dosimetry by a non-CT interfacing planning computer for megavoltage or teletherapy radiotherapy by a single field or parallel opposed fields to 1 area with up to 2 shielding blocks

66.95

15530

Radiation Dosimetry by a non-CT interfacing planning computer for megavoltage or teletherapy radiotherapy to a single area by 3 or more fields, or by a single field or parallel opposed fields to 2 areas, or where wedges are used

298.75

15533

Radiation Dosimetry by a non-CT interfacing planning computer for megavoltage or teletherapy radiotherapy to 3 or more areas, or by mantle fields or inverted Y fields, or tangential fields or irregularly shaped fields using multiple blocks, or off-axis fields, or several joined fields

566.50

15536

Brachytherapy planning, computerised Radiation Dosimetry

226.40

15539

Brachytherapy planning, computerised radiation dosimetry for Iodine 125 seed implantation of localised prostate cancer, being a service associated with a service to which item 15338 applies

532.25

15541

Catheter based intravascular brachytherapy planning, computerised radiation dosimetry. The procedure must be performed by a radiation oncologist in association with a cardiologist and be associated with a service to which item 35347, 35350, 35353 or 35356 applies

226.40

Subgroup 6 — Stereotactic radiosurgery

15600

Stereotactic radiosurgery, including all radiation oncology consultations, planning, simulation, dosimetry and treatment

1 444.40

Group T3 — Therapeutic nuclear medicine

16003

Intra-cavitary administration of a therapeutic dose of Yttrium 90 (not including preliminary paracentesis and not being a service associated with selective internal radiation therapy) (Anaes.)

552.00

16006

Administration of a therapeutic dose of Iodine 131 for thyroid cancer by single dose technique

424.15

16009

Administration of a therapeutic dose of Iodine 131 for thyrotoxicosis by single dose technique

289.45

16012

Intravenous administration of a therapeutic dose of Phosphorous 32

250.45

16015

Administration of Strontium 89 for painful bony metastases from carcinoma of the prostate where hormone therapy has failed and either:

 (a) the disease is poorly controlled by conventional radiotherapy; or

3 446.70

 

 (b) conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain

 

16018

Administration of 153 Sm-lexidronam for the relief of bone pain due to skeletal metastases (as indicated by a positive bone scan) from:

 (a) carcinoma of the prostate, where hormonal therapy has failed; or

2 072.35

 

 (b) carcinoma of the breast, where both hormonal therapy and chemotherapy have failed and:

 (i) the disease is poorly controlled by conventional radiotherapy; or

 (ii) conventional radiotherapy is inappropriate, due to the wide distribution of sites of bone pain

 

Group T4 — Obstetrics

16500

Antenatal attendance

30.85

16501

External cephalic version for breech presentation, after 36 weeks where no contraindication exists, in a unit with facilities for caesarean section, including pre and post version CTG, with or without tocolysis, not being a service to which items 55718 to 55728 and 55768 to 55774 apply — chargeable whether or not the version is successful and limited to a maximum of 2 ECV’s per pregnancy

119.25

16502

Polyhydramnios, unstable lie, multiple pregnancy, pregnancy complicated by diabetes or anaemia, threatened premature labour treated by bed rest only or oral medication, requiring admission to hospital — each attendance that is not a routine antenatal attendance, to a maximum of 1 visit per day

30.85

16504

Treatment of habitual miscarriage by injection of hormones — each injection up to a maximum of 12 injections, where the injection is not administered during a routine antenatal attendance

30.85

16505

Threatened abortion, threatened miscarriage or hyperemesis gravidarum, requiring admission to hospital, treatment of — each attendance that is not a routine antenatal attendance

30.85

16508

Pregnancy complicated by acute intercurrent infection, intra-uterine growth retardation, threatened premature labour with ruptured membranes or threatened premature labour treated by intravenous therapy, requiring admission to hospital — each attendance that is not a routine antenatal attendance, to a maximum of 1 visit per day

30.85

16509

Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of — each attendance that is not a routine antenatal attendance

30.85

16511

Cervix, purse string ligation of (Anaes.)

186.60

16512

Cervix, removal of purse string ligature of (Anaes.)

53.85

16514

Antenatal cardiotocography in the management of high risk pregnancy (not during the course of the confinement)

31.15

16515

Management of vaginal delivery as an independent procedure where the patient’s care has been transferred by another medical practitioner for management of the delivery and the attending medical practitioner has not provided antenatal care to the patient, including all attendances related to the delivery (Anaes.)

294.10

16518

Management of labour, incomplete, where the patient’s care has been transferred to another medical practitioner for completion of the delivery (Anaes.)

294.10

16519

Management of labour and delivery by any means (including Caesarean section) including post-partum care for 5 days (Anaes.)

452.90

16520

Caesarean section and post-operative care for 7 days where the patient’s care has been transferred by another medical practitioner for management of the confinement and the attending medical practitioner has not provided any of the antenatal care (Anaes.)

529.30

16522

Management of labour and delivery, or delivery alone, (including Caesarean section), where in the course of antenatal supervision or intrapartum management, 1 or more, of the following conditions is present, including postnatal care for 7 days:

 (a) multiple pregnancy;

1 063.45

 

 (b) recurrent antepartum haemorrhage from 20 weeks gestation;

 (c) grade 2, 3 or 4 placenta praevia;

 (d) baby with a birth weight less than or equal to 2 500 gm;

 (e) pre-existing diabetes mellitus dependent on medication, or gestational diabetes requiring at least daily blood glucose monitoring;

 (f) trial of vaginal delivery in a patient with uterine scar, or trial of vaginal breech delivery;

 (g) pre-existing hypertension requiring antihypertensive medication, or pregnancy induced hypertension of at least 140/90mmHg associated with at least 1+ proteinuria on urinalysis;

 

 

 (h) prolonged labour greater than 12 hours with partogram evidence of abnormal cervimetric progress;

 (i) fetal distress defined by significant cardiotocograph or scalp pH abnormalities requiring immediate delivery;

 (j) conditions that pose a significant risk of maternal death

(Anaes.)

 

16525

Management of second trimester labour, with or without induction, for intrauterine fetal death, gross fetal abnormality or life threatening maternal disease, not being a service to which item 35643 applies (Anaes.)

250.90

16564

Evacuation of retained products of conception (placenta, membranes or mole) as a complication of confinement, with or without curettage of the uterus, as an independent procedure (Anaes.)

184.95

16567

Management of postpartum haemorrhage by special measures such as packing of uterus, as an independent procedure (Anaes.)

270.55

16570

Acute inversion of the uterus, vaginal correction of, as an independent procedure (Anaes.)

353.00

16571

Cervix, repair of extensive laceration or lacerations (Anaes.)

270.55

16573

Third degree tear, involving anal sphincter muscles and rectal mucosa, repair of, as an independent procedure (Anaes.)

220.50

16600

Amniocentesis, diagnostic

53.85

16603

Chorionic villus sampling, by any route

103.45

16606

Fetal blood sampling, using interventional techniques from umbilical cord or fetus, including fetal neuromuscular blockade and amniocentesis (Anaes.)

206.35

16609

Fetal intravascular blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling (Anaes.)

420.85

16612

Fetal intraperitoneal blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling — not performed in conjunction with a service described in item 16609 (Anaes.)

331.10

16615

Fetal intraperitoneal blood transfusion, using blood already collected, including neuromuscular blockade, amniocentesis and fetal blood sampling — performed in conjunction with a service described in item 16609 (Anaes.)

176.30

16618

Amniocentesis, therapeutic, when indicated because of polyhydramnios with at least 500 ml being aspirated

176.30

16621

Amnioinfusion, for diagnostic or therapeutic purposes in the presence of severe oligohydramnios

176.30

16624

Fetal fluid filled cavity, drainage of

253.75

16627

Feto-amniotic shunt, insertion of, into fetal fluid filled cavity, including neuromuscular blockade and amniocentesis

516.70

16633

Procedure on multiple pregnancies relating to items 16606, 16609, 16612, 16615 and 16627

Amount under rule 36

16636

Procedure on multiple pregnancies relating to items 16600, 16603, 16618, 16621 and 16624

Amount under rule 36

Group T6 — Examination by an anaesthetist

17603

Examination of a patient in preparation for the administration of an anaesthetic relating to a clinically relevant service, being an examination carried out at a place other than an operating theatre or an anaesthetic induction room

36.40

Group T7 — Regional or field nerve blocks

18213

Intravenous regional anaesthesia of limb by retrograde perfusion

75.25

18216

Intrathecal or epidural infusion of a therapeutic substance, initial injection or commencement of, including up to 1 hour of continuous attendance by the medical practitioner (Anaes.)

161.10

18219

Intrathecal or epidural infusion of a therapeutic substance, initial injection or commencement of, where continuous attendance by the medical practitioner extends beyond the first hour (Anaes.)

Amount under rule 34

18222

Infusion of a therapeutic substance to maintain regional anaesthesia or analgesia, subsequent injection or revision of, where the period of continuous medical practitioner attendance is 15 minutes or less

31.90

18225

Infusion of a therapeutic substance to maintain regional anaesthesia or analgesia, subsequent injection or revision of, where the period of continuous medical practitioner attendance is more than 15 minutes

42.50

18226

Intrathecal or epidural infusion of a therapeutic substance, initial injection or commencement of, including up to 1 hour of continuous attendance by the medical practitioner — for a patient in labour, where the service is provided between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday

241.60

18227

Intrathecal or epidural infusion of a therapeutic substance, initial injection or commencement of, where continuous attendance by a medical practitioner extends beyond the first hour — for a patient in labour, where the service is provided between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday

Amount under rule 34

18228

Interpleural block, initial injection or commencement of infusion of a therapeutic substance

53.05

18230

Intrathecal or epidural injection of neurolytic substance (Anaes.)

202.30

18232

Intrathecal or epidural injection of substance other than anaesthetic, contrast or neurolytic solutions, not being a service to which another item in this group applies (Anaes.)

161.10

18233

Epidural injection of blood for blood patch (Anaes.)

161.10

18234

Trigeminal nerve, primary division of, injection of an anaesthetic agent (Anaes.)

105.95

18236

Trigeminal nerve, peripheral branch of, injection of an anaesthetic agent (Anaes.)

53.05

18238

Facial nerve, injection of an anaesthetic agent, not being a service associated with a service to which item 18240 applies

31.90

18240

Retrobulbar or peribulbar injection of an anaesthetic agent

79.40

18242

Greater occipital nerve, injection of an anaesthetic agent (Anaes.)

31.90

18244

Vagus nerve, injection of an anaesthetic agent

85.50

18246

Glossopharyngeal nerve, injection of an anaesthetic agent

85.50

18248

Phrenic nerve, injection of an anaesthetic agent

75.25

18250

Spinal accessory nerve, injection of an anaesthetic agent

53.05

18252

Cervical plexus, injection of an anaesthetic agent

85.50

18254

Brachial plexus, injection of an anaesthetic agent

85.50

18256

Suprascapular nerve, injection of an anaesthetic agent

53.05

18258

Intercostal nerve (single), injection of an anaesthetic agent

53.05

18260

Intercostal nerves (multiple), injection of an anaesthetic agent

75.25

18262

Ilio-inguinal, iliohypogastric or genitofemoral nerves, 1 or more of, injection of an anaesthetic agent (Anaes.)

53.05

18264

Pudendal nerve, injection of an anaesthetic agent

85.50

18266

Ulnar, radial or median nerve, main trunk of, 1 or more of, injection of an anaesthetic agent, not being associated with a brachial plexus block

53.05

18268

Obturator nerve, injection of an anaesthetic agent

75.25

18270

Femoral nerve, injection of an anaesthetic agent

75.25

18272

Saphenous, sural, popliteal or posterior tibial nerve, main trunk of, 1 or more of, injection of an anaesthetic agent

53.05

18274

Paravertebral, cervical, thoracic, lumbar, sacral or coccygeal nerves, injection of an anaesthetic agent, (single vertebral level)

75.25

18276

Paravertebral nerves, injection of an anaesthetic agent, (multiple levels)

105.95

18278

Sciatic nerve, injection of an anaesthetic agent

75.25

18280

Sphenopalatine ganglion, injection of an anaesthetic agent (Anaes.)

105.95

18282

Carotid sinus, injection of an anaesthetic agent, as an independent percutaneous procedure

85.50

18284

Stellate ganglion, injection of an anaesthetic agent (cervical sympathetic block) (Anaes.)

125.30

18286

Lumbar or thoracic nerves, injection of an anaesthetic agent (paravertebral sympathetic block) (Anaes.)

125.30

18288

Coeliac plexus or splanchnic nerves, injection of an anaesthetic agent (Anaes.)

125.30

18290

Cranial nerve other than trigeminal, destruction by a neurolytic agent, not being a service associated with the injection of botulinum toxin (Anaes.)

211.90

18292

Nerve branch, destruction by a neurolytic agent, not being a service to which any other item in this group applies or a service associated with the injection of botulinum toxin (Anaes.)

105.95

18294

Coeliac plexus or splanchnic nerves, destruction by a neurolytic agent (Anaes.)

149.30

18296

Lumbar sympathetic chain, destruction by a neurolytic agent (Anaes.)

127.70

18298

Cervical or thoracic sympathetic chain, destruction by a neurolytic agent (Anaes.)

149.30

18350

Botulinum toxin (Botox), injection of, for hemifacial spasm in a patient over 12 years of age, including all such injections on any 1 day

105.95

18352

Botulinum toxin (Botox or Dysport), injection of, for cervical dystonia (spasmodic torticollis), including all such injections on any 1 day

211.90

18354

Botulinum toxin (Botox or Dysport), injection of, for dynamic equinus foot deformity due to spasticity in an ambulant cerebral palsy patient between the ages of 2 and 17 (inclusive), including all such injections on any 1 day for all or any of the muscles subserving 1 functional activity and supplied by 1 motor nerve — applicable only to the first 2 treatments of each limb of the patient on any 1 day (Anaes.)

105.95

18356

Botulinum toxin (Botox or Dysport), injection of, for dynamic equinovarus foot deformity due to spasticity in an ambulant cerebral palsy patient between the ages of 2 and 17 (inclusive), including all such injections on any 1 day for all or any of the muscles subserving 1 functional activity and supplied by 1 motor nerve — applicable only to the first 2 treatments of each limb of the patient on any 1 day (Anaes.)

105.95

18358

Botulinum toxin (Botox or Dysport), injection of, for dynamic equinovalgus foot deformity due to spasticity in an ambulant cerebral palsy patient between the ages of 2 and 17 (inclusive), including all such injections on any 1 day for all or any of the muscles subserving 1 functional activity and supplied by 1 motor nerve — applicable only to the first 2 treatments of each limb of the patient on any 1 day (Anaes.)

105.95

18370

Botulinum toxin, injection of, for blepharospasm, including all such injections on any 1 day (Anaes.)

38.25

Group T10 — Anaesthesia performed in connection with certain services (Relative Value Guide)

Subgroup 1 — Head

20100

Initiation of management of anaesthesia for procedures on the skin, subcutaneous tissue, muscles, salivary glands or superficial vessels of the head, including biopsy, not being a service to which another item in this subgroup applies

84.25

20102

Initiation of management of anaesthesia for plastic repair of cleft lip

101.10

20104

Initiation of management of anaesthesia for electroconvulsive therapy

67.40

20120

Initiation of management of anaesthesia for procedures on external, middle or inner ear, including biopsy, not being a service to which another item in this subgroup applies

84.25

20124

Initiation of management of anaesthesia for otoscopy

67.40

20140

Initiation of management of anaesthesia for procedures on eye, not being a service to which another item in this subgroup applies

84.25

20142

Initiation of management of anaesthesia for lens surgery

101.10

20143

Initiation of management of anaesthesia for retinal surgery

101.10

20144

Initiation of administration of anaesthesia for corneal transplant

134.80

20145

Initiation of management of anaesthesia for vitrectomy

134.80

20146

Initiation of management of anaesthesia for biopsy of conjunctiva

84.25

20148

Initiation of management of anaesthesia for ophthalmoscopy

67.40

20160

Initiation of management of anaesthesia for procedures on nose or accessory sinuses, not being a service to which another item in this subgroup applies

84.25

20162

Initiation of management of anaesthesia for radical surgery on the nose and accessory sinuses

117.95

20164

Initiation of management of anaesthesia for biopsy of soft tissue of the nose and accessory sinuses

67.40

20170

Initiation of management of anaesthesia for intraoral procedures, including biopsy, not being a service to which another item in this subgroup applies

84.25

20172

Initiation of management of anaesthesia for repair of cleft palate

117.95

20174

Initiation of management of anaesthesia for excision of retropharyngeal tumour

151.65

20176

Initiation of management of anaesthesia for radical intraoral surgery

168.50

20190

Initiation of management of anaesthesia for procedures on facial bones, not being a service to which another item in this subgroup applies

84.25

20192

Initiation of management of anaesthesia for extensive surgery on facial bones (including prognathism and extensive facial bone reconstruction)

168.50

20210

Initiation of management of anaesthesia for intracranial procedures, not being a service to which another item in this subgroup applies

252.75

20212

Initiation of management of anaesthesia for subdural taps

84.25

20214

Initiation of management of anaesthesia for burr holes of the cranium

151.65

20216

Initiation of management of anaesthesia for intracranial vascular procedures, including those for aneurysms or arterio-venous abnormalities

337.00

20220

Initiation of management of anaesthesia for spinal fluid shunt procedures

168.50

20222

Initiation of management of anaesthesia for ablation of an intracranial nerve

101.10

20225

Initiation of management of anaesthesia for all cranial bone procedures

202.20

Subgroup 2 — Neck

20300

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the neck, not being a service to which another item in this subgroup applies

84.25

20305

Initiation of management of anaesthesia for incision and drainage of large haematoma, large abscess, cellulitis or similar lesion or epiglottitis, causing life threatening airway obstruction

252.75

20320

Initiation of management of anaesthesia for procedures on oesophagus, thyroid, larynx, trachea, lymphatic system, muscles, nerves or other deep tissues of the neck, not being a service to which another item in this subgroup applies

101.10

20321

Initiation of management of anaesthesia for laryngectomy, hemi laryngectomy, laryngopharyngectomy or pharyngectomy

168.50

20330

Initiation of management of anaesthesia for laser surgery to the airway (excluding nose and mouth)

134.80

20350

Initiation of management of anaesthesia for procedures on major vessels of neck, not being a service to which another item in this subgroup applies

168.50

20352

Initiation of management of anaesthesia for simple ligation of major vessels of neck

84.25

Subgroup 3 — Thorax

20400

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the anterior part of the chest, not being a service to which another item in this subgroup applies

50.55

20401

Initiation of management of anaesthesia for procedures on the breast, not being a service to which another item in this subgroup applies

67.40

20402

Initiation of management of anaesthesia for reconstructive procedures on breast

84.25

20403

Initiation of management of anaesthesia for removal of breast lump or for breast segmentectomy, where axillary node dissection is performed

84.25

20404

Initiation of management of anaesthesia for mastectomy

101.10

20405

Initiation of management of anaesthesia for reconstructive procedures on the breast using myocutaneous flaps

134.80

20406

Initiation of management of anaesthesia for radical or modified radical procedures on breast with internal mammary node dissection

219.05

20410

Initiation of management of anaesthesia for electrical conversion of arrhythmias

84.25

20420

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the posterior part of the chest, not being a service to which another item in this subgroup applies

84.25

20440

Initiation of management of anaesthesia for percutaneous bone marrow biopsy of the sternum

67.40

20450

Initiation of management of anaesthesia for procedures on clavicle, scapula or sternum, not being a service to which another item in this subgroup applies

84.25

20452

Initiation of management of anaesthesia for radical surgery on clavicle, scapula or sternum

101.10

20470

Initiation of management of anaesthesia for partial rib resection, not being a service to which another item in this subgroup applies

101.10

20472

Initiation of management of anaesthesia for thoracoplasty

168.50

20474

Initiation of management of anaesthesia for radical procedures on chest wall

219.05

Subgroup 4 — Intrathoracic

20500

Initiation of management of anaesthesia for open procedures on the oesophagus

252.75

20520

Initiation of management of anaesthesia for all closed chest procedures (including rigid oesophagoscopy or bronchoscopy), not being a service to which another item in this subgroup applies

101.10

20522

Initiation of management of anaesthesia for needle biopsy of pleura

67.40

20524

Initiation of management of anaesthesia for pneumocentesis

67.40

20526

Initiation of management of anaesthesia for thoracoscopy

168.50

20528

Initiation of management of anaesthesia for mediastinoscopy

134.80

20540

Initiation of management of anaesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, or mediastinum, not being a service to which another item in this subgroup applies

219.05

20542

Initiation of management of anaesthesia for pulmonary decortication

252.75

20546

Initiation of management of anaesthesia for pulmonary resection with thoracoplasty

252.75

20548

Initiation of management of anaesthesia for intrathoracic repair of trauma to trachea and bronchi

252.75

20560

Initiation of management of anaesthesia for open procedures on the heart, pericardium or great vessels of chest

337.00

Subgroup 5 — Spine and spinal cord

20600

Initiation of management of anaesthesia for procedures on cervical spine or spinal cord, or both, not being a service to which another item in this subgroup applies

168.50

20604

Initiation of management of anaesthesia for posterior cervical laminectomy with the patient in the sitting position

219.05

20620

Initiation of management of anaesthesia for procedures on thoracic spine or spinal cord, or both, not being a service to which another item in this subgroup applies

168.50

20622

Initiation of management of anaesthesia for thoracolumbar sympathectomy

219.05

20630

Initiation of management of anaesthesia for procedures in lumbar region, not being a service to which another item in this subgroup applies

134.80

20632

Initiation of management of anaesthesia for lumbar sympathectomy

117.95

20634

Initiation of management of anaesthesia for chemonucleolysis

168.50

20670

Initiation of management of anaesthesia for extensive spine or spinal cord procedures, or both

219.05

20680

Initiation of management of anaesthesia for manipulation of spine when performed in the operating theatre of a hospital or approved day hospital facility

50.55

20690

Initiation of management of anaesthesia for percutaneous spinal procedures, not being a service to which another item in this subgroup applies

84.25

Subgroup 6 — Upper abdomen

20700

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the upper anterior abdominal wall, not being a service to which another item in this subgroup applies

50.55

20702

Initiation of management of anaesthesia for percutaneous liver biopsy

67.40

20705

Initiation of management of anaesthesia for diagnostic laparoscopy procedures

101.10

20706

Initiation of management of anaesthesia for laparoscopic procedures in the upper abdomen, not being a service to which another item in this subgroup applies

117.95

20730

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the upper posterior abdominal wall, not being a service to which another item in this subgroup applies

84.25

20740

Initiation of management of anaesthesia for upper gastrointestinal endoscopic procedures

84.25

20745

Initiation of management of anaesthesia for upper gastrointestinal endoscopic procedures in association with acute gastrointestinal haemorrhage

101.10

20750

Initiation of management of anaesthesia for hernia repairs in upper abdomen, not being a service to which another item in this subgroup applies

67.40

20752

Initiation of management of anaesthesia for repair of incisional hernia or wound dehiscence, or both

101.10

20754

Initiation of management of anaesthesia for procedures on an omphalocele

117.95

20756

Initiation of management of anaesthesia for transabdominal repair of diaphragmatic hernia

151.65

20770

Initiation of management of anaesthesia for procedures on major upper abdominal blood vessels

252.75

20790

Initiation of management of anaesthesia for procedures within the peritoneal cavity in upper abdomen including cholecystectomy, gastrectomy, laparoscopic nephrectomy or bowel shunts

134.80

20791

Initiation of management of anaesthesia for gastric reduction or gastroplasty for the treatment of morbid obesity

168.50

20792

Initiation of management of anaesthesia for partial hepatectomy (excluding liver biopsy)

219.05

20793

Initiation of management of anaesthesia for extended or trisegmental hepatectomy

252.75

20794

Initiation of management of anaesthesia for pancreatectomy, partial or total

202.20

20798

Initiation of management of anaesthesia for neuro endocrine tumour removal in the upper abdomen

168.50

20799

Initiation of management of anaesthesia for percutaneous procedures on an intra-abdominal organ in the upper abdomen

101.10

Subgroup 7 — Lower abdomen

20800

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the lower anterior abdominal walls, not being a service to which another item in this subgroup applies

50.55

20802

Initiation of management of anaesthesia for lipectomy of the lower abdomen

84.25

20805

Initiation of management of anaesthesia for diagnostic laparoscopic procedures

101.10

20806

Initiation of management of anaesthesia for laparoscopic procedures in the lower abdomen

117.95

20810

Initiation of management of anaesthesia for lower intestinal endoscopic procedures

67.40

20815

Initiation of management of anaesthesia for extracorporeal shock wave lithotripsy to urinary tract

101.10

20820

Initiation of management of anaesthesia for procedures on the skin, its derivatives or subcutaneous tissue of the lower posterior abdominal wall

84.25

20830

Initiation of management of anaesthesia for hernia repairs in lower abdomen, not being a service to which another item in this subgroup applies

67.40

20832

Initiation of management of anaesthesia for repair of incisional herniae or wound dehiscence, or both, of the lower abdomen

101.10

20840

Initiation of management of anaesthesia for all procedures within the peritoneal cavity in lower abdomen, including appendicectomy, not being a service to which another item in this subgroup applies

101.10

20841

Initiation of management of anaesthesia for bowel resection, including laparoscopic bowel resection, not being a service to which another item in this subgroup applies

134.80

20842

Initiation of management of anaesthesia for amniocentesis

67.40

20844

Initiation of management of anaesthesia for abdominoperineal resection, including pull through procedures, ultra low anterior resection and formation of bowel reservoir

168.50

20845

Initiation of management of anaesthesia for radical prostatectomy

168.50

20846

Initiation of management of anaesthesia for radical hysterectomy

168.50

20848

Initiation of management of anaesthesia for pelvic exenteration

168.50

20850

Initiation of management of anaesthesia for caesarean section

202.20

20855

Initiation of management of anaesthesia for caesarean hysterectomy or hysterectomy within 24 hours of delivery

252.75

20860

Initiation of management of anaesthesia for extraperitoneal procedures in lower abdomen, including those on the urinary tract, not being a service to which another item in this subgroup applies

101.10

20862

Initiation of management of anaesthesia for renal procedures, including upper one-third of ureter

117.95

20864

Initiation of management of anaesthesia for total cystectomy

168.50

20866

Initiation of management of anaesthesia for adrenalectomy

168.50

20867

Initiation of management of anaesthesia for neuro endocrine tumour removal in the lower abdomen

168.50

20868

Initiation of management of anaesthesia for renal transplantation (donor or recipient)

168.50

20880

Initiation of management of anaesthesia for procedures on major lower abdominal vessels, not being a service to which another item in this subgroup applies

252.75

20882

Initiation of management of anaesthesia for inferior vena cava ligation

168.50

20884

Initiation of management of anaesthesia for percutaneous umbrella insertion

84.25

20886

Initiation of management of anaesthesia for percutaneous procedures on an intra-abdominal organ in the lower abdomen

101.10

Subgroup 8 — Perineum

20900

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the perineum (including biopsy of male genital system), not being a service to which another item in this subgroup applies

50.55

20902

Initiation of management of anaesthesia for anorectal procedures (including endoscopy or biopsy, or both)

67.40

20904

Initiation of management of anaesthesia for radical perineal procedures, including radical perineal prostatectomy or radical vulvectomy

117.95

20906

Initiation of management of anaesthesia for vulvectomy

67.40

20910

Initiation of management of anaesthesia for transurethral procedures (including urethrocyctoscopy), not being a service to which another item in this subgroup applies

67.40

20912

Initiation of management of anaesthesia for transurethral resection of bladder tumour or tumours

84.25

20914

Initiation of management of anaesthesia for transurethral resection of prostate

117.95

20916

Initiation of management of anaesthesia for bleeding post-transurethral resection

117.95

20920

Initiation of management of anaesthesia for procedures on male external genitalia, not being a service to which another item in this subgroup applies

50.55

20924

Initiation of management of anaesthesia for procedures on undescended testis, unilateral or bilateral

67.40

20926

Initiation of management of anaesthesia for radical orchidectomy, inguinal approach

67.40

20928

Initiation of management of anaesthesia for radical orchidectomy, abdominal approach

101.10

20930

Initiation of management of anaesthesia for orchiopexy, unilateral or bilateral

67.40

20932

Initiation of management of anaesthesia for complete amputation of penis

67.40

20934

Initiation of management of anaesthesia for complete amputation of penis with bilateral inguinal lymphadenectomy

101.10

20936

Initiation of management of anaesthesia for complete amputation of penis with bilateral inguinal and iliac lymphadenectomy

134.80

20938

Initiation of management of anaesthesia for insertion of penile prosthesis

67.40

20940

Initiation of management of anaesthesia for per vagina and vaginal procedures (including biopsy of labia, vagina, cervix or endometrium), not being a service to which another item in this subgroup applies

50.55

20942

Initiation of management of anaesthesia for colpotomy, colpectomy or colporrhaphy

67.40

20943

Initiation of management of anaesthesia for transvaginal assisted reproductive services

67.40

20944

Initiation of management of anaesthesia for vaginal hysterectomy

101.10

20946

Initiation of management of anaesthesia for vaginal delivery

134.80

20948

Initiation of management of anaesthesia for purse string ligation of cervix, or removal of purse string ligature, or removal of purse string ligature

67.40

20950

Initiation of management of anaesthesia for culdoscopy

84.25

20952

Initiation of management of anaesthesia for hysteroscopy

67.40

20954

Initiation of management of anaesthesia for correction of inverted uterus

168.50

20956

Initiation of management of anaesthesia for evacuation of retained products of conception, as a complication of confinement

67.40

20958

Initiation of management of anaesthesia for manual removal of retained placenta or for repair of vaginal or perineal tear following delivery

84.25

20960

Initiation of management of anaesthesia for vaginal procedures in the management of post partum haemorrhage, where the blood loss is greater than 500 mls

117.95

Subgroup 9 — Pelvis (except hip)

21100

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the anterior pelvic region (anterior to iliac crest), except external genitalia

50.55

21110

Initiation of management of anaesthesia for procedures on the skin, its derivatives or subcutaneous tissue of the pelvic region (posterior to iliac crest), except perineum

84.25

21112

Initiation of management of anaesthesia for percutaneous bone marrow biopsy of the anterior iliac crest

67.40

21114

Initiation of management of anaesthesia for percutaneous bone marrow biopsy of the posterior iliac crest

84.25

21116

Initiation of management of anaesthesia for percutaneous bone marrow harvesting from the pelvis

101.10

21120

Initiation of management of anaesthesia for procedures on the bony pelvis

101.10

21130

Initiation of management of anaesthesia for body cast application or revision, when performed in the operating theatre of a hospital or approved day hospital facility

50.55

21140

Initiation of management of anaesthesia for interpelviabdominal (hindquarter) amputation

252.75

21150

Initiation of management of anaesthesia for radical procedures for tumour of the pelvis, except hindquarter amputation

168.50

21160

Initiation of management of anaesthesia for closed procedures involving symphysis pubis or sacroiliac joint, when performed in the operating theatre of a hospital or approved day hospital facility

67.40

21170

Initiation of management of anaesthesia for open procedures involving symphysis pubis or sacroiliac joint

134.80

Subgroup 10 — Upper leg (except knee)

21195

Initiation of management of anaesthesia for procedures on the skins or subcutaneous tissue of the upper leg

50.55

21199

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of the upper leg

67.40

21200

Initiation of management of anaesthesia for closed procedures involving hip joint, when performed in the operating theatre of a hospital or approved day hospital facility

67.40

21202

Initiation of management of anaesthesia for arthroscopic procedures of the hip joint

67.40

21210

Initiation of management of anaesthesia for open procedures involving hip joint, not being a service to which another item in this subgroup applies

101.10

21212

Initiation of management of anaesthesia for hip disarticulation

168.50

21214

Initiation of management of anaesthesia for total hip replacement or revision

168.50

21220

Initiation of management of anaesthesia for closed procedures involving upper two-third of femur, when performed in the operating theatre of a hospital or approved day hospital facility

67.40

21230

Initiation of management of anaesthesia for open procedures involving upper two-third of femur, not being a service to which another item in this subgroup applies

101.10

21232

Initiation of management of anaesthesia for above knee amputation

84.25

21234

Initiation of management of anaesthesia for radical resection of the upper two-third of femur

134.80

21260

Initiation of management of anaesthesia for procedures involving veins of upper leg, including exploration

67.40

21270

Initiation of management of anaesthesia for procedures involving arteries of upper leg, including bypass graft, not being a service to which another item in this subgroup applies

134.80

21272

Initiation of management of anaesthesia for femoral artery ligation

67.40

21274

Initiation of management of anaesthesia for femoral artery embolectomy

101.10

21280

Initiation of management of anaesthesia for microsurgical reimplantation of upper leg

252.75

Subgroup 11 — Knee and popliteal area

21300

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the knee or popliteal area, or both

50.55

21321

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of knee or popliteal area, or both

67.40

21340

Initiation of management of anaesthesia for closed procedures on lower one-third of femur, when performed in the operating theatre of a hospital or approved day hospital facility

67.40

21360

Initiation of management of anaesthesia for open procedures on lower one-third of femur

84.25

21380

Initiation of management of anaesthesia for closed procedures on knee joint when performed in the operating theatre of a hospital or approved day hospital facility

50.55

21382

Initiation of management of anaesthesia for arthroscopic procedures of knee joint

67.40

21390

Initiation of management of anaesthesia for closed procedures on upper ends of tibia, fibula or patella, or any of them, when performed in the operating theatre of a hospital or approved day hospital facility

50.55

21392

Initiation of management of anaesthesia for open procedures on upper ends of tibia, fibula or patella, or any of them

67.40

21400

Initiation of management of anaesthesia for open procedures on knee joint, not being a service to which another item in this subgroup applies

67.40

21402

Initiation of management of anaesthesia for knee replacement

117.95

21403

Initiation of management of anaesthesia for bilateral knee replacement

168.50

21404

Initiation of management of anaesthesia for disarticulation of knee

84.25

21420

Initiation of management of anaesthesia for cast application, removal or repair, involving knee joint, undertaken in a hospital or approved day hospital facility

50.55

21430

Initiation of management of anaesthesia for procedures on veins of knee or popliteal area, not being a service to which another item in this subgroup applies

67.40

21432

Initiation of management of anaesthesia for repair of arteriovenous fistula of knee or popliteal area

84.25

21440

Initiation of management of anaesthesia for procedures on arteries of knee or popliteal area, not being a service to which another item in this subgroup applies

134.80

Subgroup 12 — Lower leg (below knee)

21460

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of lower leg, ankle or foot

50.55

21461

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons or fascia of lower leg, ankle or foot, not being a service to which another item in this subgroup applies

67.40

21462

Initiation of management of anaesthesia for all closed procedures on lower leg, ankle or foot

50.55

21464

Initiation of management of anaesthesia for arthroscopic procedure of ankle joint

67.40

21472

Initiation of management of anaesthesia for repair of achilles tendon

84.25

21474

Initiation of management of anaesthesia for gastrocnemius recession

84.25

21480

Initiation of management of anaesthesia for open procedures on bones of lower leg, ankle or foot, including amputation, not being a service to which another item in this subgroup applies

67.40

21482

Initiation of management of anaesthesia for radical resection of bone involving lower leg, ankle or foot

84.25

21484

Initiation of management of anaesthesia for osteotomy or osteoplasty of tibia or fibula

84.25

21486

Initiation of management of anaesthesia for total ankle replacement

117.95

21490

Initiation of management of anaesthesia for lower leg cast application, removal or repair, undertaken in a hospital or approved day hospital facility

50.55

21500

Initiation of management of anaesthesia for procedures on arteries of lower leg, including bypass graft, not being a service to which another item in this subgroup applies

134.80

21502

Initiation of management of anaesthesia for embolectomy of the lower leg

101.10

21520

Initiation of management of anaesthesia for procedures on veins of lower leg, not being a service to which another item in this subgroup applies

67.40

21522

Initiation of management of anaesthesia for venous thrombectomy of the lower leg

84.25

21530

Initiation of management of anaesthesia for microsurgical reimplantation of lower leg, ankle or foot

252.75

21532

Initiation of management of anaesthesia for microsurgical reimplantation of toe

134.80

Subgroup 13 — Shoulder and axilla

21600

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the shoulder or axilla

50.55

21610

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of shoulder or axilla, including axillary dissection

84.25

21620

Initiation of management of anaesthesia for closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint, when performed in the operating theatre of a hospital or approved day hospital facility

67.40

21622

Initiation of management of anaesthesia for arthroscopic procedures of shoulder joint

84.25

21630

Initiation of management of anaesthesia for open procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint, not being a service to which another item in this subgroup applies

84.25

21632

Initiation of management of anaesthesia for radical resection involving humeral head and neck, sternoclavicular joint, acromioclavicular joint or shoulder joint

101.10

21634

Initiation of management of anaesthesia for shoulder disarticulation

151.65

21636

Initiation of management of anaesthesia for interthoracoscapular (forequarter) amputation

252.75

21638

Initiation of management of anaesthesia for total shoulder replacement

168.50

21650

Initiation of management of anaesthesia for procedures on arteries of shoulder or axilla, not being a service to which another item in this subgroup applies

134.80

21652

Initiation of management of anaesthesia for procedures for axillary-brachial aneurysm

168.50

21654

Initiation of management of anaesthesia for bypass graft of arteries of shoulder or axilla

134.80

21656

Initiation of management of anaesthesia for
axillary-femoral bypass graft

168.50

21670

Initiation of management of anaesthesia for procedures on veins of shoulder or axilla

67.40

21680

Initiation of management of anaesthesia for shoulder cast application, removal or repair, not being a service to which another item in this subgroup applies, when undertaken in a hospital or approved day hospital facility 

50.55

21682

Initiation of management of anaesthesia for shoulder spica application, when undertaken in a hospital or approved day hospital facility

67.40

Subgroup 14 — Upper arm and elbow

21700

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the upper arm or elbow

50.55

21710

Initiation of management of anaesthesia for procedures on nerves, muscles, tendons, fascia or bursae of upper arm or elbow, not being a service to which another item in this subgroup applies

67.40

21712

Initiation of management of anaesthesia for open tenotomy of the upper arm or elbow

84.25

21714

Initiation of management of anaesthesia for tenoplasty of the upper arm or elbow

84.25

21716

Initiation of management of anaesthesia for tenodesis for rupture of long tendon of biceps

84.25

21730

Initiation of management of anaesthesia for closed procedures on the upper arm or elbow, when performed in the operating theatre of a hospital or approved day hospital facility

50.55

21732

Initiation of management of anaesthesia for arthroscopic procedures of elbow joint

67.40

21740

Initiation of management of anaesthesia for open procedures on the upper arm or elbow, not being a service to which another item in this subgroup applies

84.25

21756

Initiation of management of anaesthesia for radical procedures on the upper arm or elbow

101.10

21760

Initiation of management of anaesthesia for total elbow replacement

117.95

21770

Initiation of management of anaesthesia for procedures on arteries of upper arm, not being a service to which another item in this subgroup applies

134.80

21772

Initiation of management of anaesthesia for embolectomy of arteries of the upper arm

101.10

21780

Initiation of management of anaesthesia for procedures on veins of upper arm, not being a service to which another item in this subgroup applies

67.40

21790

Initiation of management of anaesthesia for microsurgical reimplantation of upper arm

252.75

Subgroup 15 — Forearm wrist and hand

21800

Initiation of management of anaesthesia for procedures on the skin or subcutaneous tissue of the forearm, wrist or hand

50.55

21810

Initiation of management of anaesthesia for procedures on the nerves, muscles, tendons, fascia, or bursae of the forearm, wrist or hand

67.40

21820

Initiation of management of anaesthesia for closed procedures on the radius, ulna, wrist, or hand bones, when performed in the operating theatre of a hospital or approved day hospital facility

50.55

21830

Initiation of management of anaesthesia for open procedures on the radius, ulna, wrist, or hand bones, not being a service to which another item in this subgroup applies

67.40

21832

Initiation of management of anaesthesia for total wrist replacement

117.95

21834

Initiation of management of anaesthesia for arthroscopic procedures of the wrist joint

67.40

21840

Initiation of management of anaesthesia for procedures on the arteries of forearm, wrist or hand, not being a service to which another item in this subgroup applies

134.80

21842

Initiation of management of anaesthesia for embolectomy of artery of forearm, wrist or hand

101.10

21850

Initiation of management of anaesthesia for procedures on the veins of forearm, wrist or hand, not being a service to which another item in this subgroup applies

67.40

21860

Initiation of management of anaesthesia for forearm, wrist, or hand cast application, removal or repair, when undertaken in a hospital or approved day hospital facility

50.55

21870

Initiation of management of anaesthesia for microsurgical reimplantation of forearm, wrist or hand

252.75

21872

Initiation of management of anaesthesia for microsurgical reimplantation of a finger

134.80

Subgroup 16 — Anaesthesia for burns

21878

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves not more than 3% of total body surface

50.55

21879

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves more than 3% but less than 10% of total body surface

84.25

21880

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 10% or more but less than 20% of total body surface

117.95

21881

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 20% or more but less than 30% of total body surface

151.65

21882

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 30% or more but less than 40% of total body surface

185.35

21883

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 40% or more but less than 50% of total body surface

219.05

21884

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 50% or more but less than 60% of total body surface

252.75

21885

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 60% or more but less than 70% of total body surface

286.45

21886

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 70% or more but less than 80% of total body surface

320.15

21887

Initiation of management of anaesthesia for excision or debridement of burns, with or without skin grafting, where the area of burn involves 80% or more of total body surface

353.85

Subgroup 17 — Anaesthesia for radiological or other diagnostic or therapeutic procedures

21900

Initiation of management of anaesthesia for injection procedure for hysterosalpingography

50.55

21906

Initiation of management of anaesthesia for injection procedure for myelography — lumbar or thoracic

84.25

21908

Initiation of management of anaesthesia for injection procedure for myelography — cervical

101.10

21910

Initiation of management of anaesthesia for injection procedure for myelography — posterior fossa

151.65

21912

Initiation of management of anaesthesia for injection procedure for discography — lumbar or thoracic

84.25

21914

Initiation of management of anaesthesia for injection procedure for discography — cervical

101.10

21915

Initiation of management of anaesthesia for peripheral arteriogram

84.25

21916

Initiation of management of anaesthesia for arteriograms — cerebral, carotid or vertebral

84.25

21918

Initiation of management of anaesthesia for retrograde arteriogram — brachial or femoral

84.25

21922

Initiation of management of anaesthesia for computerised axial tomography scanning, magnetic resonance scanning or digital subtraction angiography scanning

117.95

21925

Initiation of management of anaesthesia for retrograde cystography, retrograde urethrography or retrograde cystourethrography

67.40

21926

Initiation of management of anaesthesia for fluoroscopy

84.25

21927

Initiation of management of anaesthesia for barium enema or other opaque study of the small bowel

84.25

21930

Initiation of management of anaesthesia for bronchography

101.10

21935

Initiation of management of anaesthesia for phlebography

84.25

21936

Initiation of management of anaesthesia for heart — 2 dimensional real time transoesophageal examination

101.10

21939

Initiation of management of anaesthesia for peripheral venous cannulation

50.55

21941

Initiation of management of anaesthesia for cardiac catheterisation (including coronary arteriography, ventriculography, cardiac mapping or insertion of automatic defibrillator or transvenous pacemaker)

117.95

21942

Initiation of management of anaesthesia for cardiac electrophysiological procedures including radio frequency ablation

168.50

21943

Initiation of management of anaesthesia for central vein catheterisation or insertion of right heart balloon catheter (via jugular, subclavian or femoral vein) by percutaneous or open exposure

84.25

21945

Initiation of management of anaesthesia for lumbar puncture, cisternal puncture or epidural injection

84.25

21949

Initiation of management of anaesthesia for harvesting of bone marrow for the purpose of transplantation

84.25

21952

Initiation of management of anaesthesia for muscle biopsy for malignant hyperpyrexia

168.50

21955

Initiation of management of anaesthesia for electroencephalography

84.25

21959

Initiation of management of anaesthesia for brain stem evoked response audiometry

84.25

21962

Initiation of management of anaesthesia for electrocochleography by extratympanic method or transtympanic membrane insertion method

84.25

21965

Initiation of management of anaesthesia as a therapeutic procedure where it can be demonstrated that there is a clinical need for anaesthesia

84.25

21969

Initiation of management of anaesthesia during hyperbaric therapy, where the medical practitioner is not confined in the chamber (including the administration of oxygen)

134.80

21970

Initiation of management of anaesthesia during hyperbaric therapy, where the medical practitioner is confined in the chamber (including the administration of oxygen)

252.75

21973

Initiation of management of anaesthesia for brachytherapy using radioactive sealed sources

84.25

21976

Initiation of management of anaesthesia for therapeutic nuclear medicine

84.25

21980

Initiation of management of anaesthesia for radiotherapy

84.25

Subgroup 18 — Miscellaneous

21990

Initiation of management of anaesthesia, being a service to which another item in this subgroup or in Subgroups 1 to 17 or 20 would have applied if the procedure in connection with which the service is provided had not been discontinued

50.55

21992

Initiation of management of anaesthesia performed on a person under the age of 10 years in connection with a procedure covered by an item that does not include the word ‘(Anaes.)’

67.40

21997

Initiation of management of anaesthesia in connection with a procedure covered by an item that does not include the word ‘(Anaes.)’, not being a service to which item 21965 or 21992 applies, where it can be demonstrated that there is a clinical need for anaesthesia

67.40

Subgroup 19 — Therapeutic and diagnostic services performed in connection with administration of anaesthesia

22001

Collection of blood for autologous transfusion or when homologous blood is required for immediate transfusion in an emergency situation, when performed in association with the administration of anaesthesia

50.55

22002

Administration of blood or bone marrow already collected, when performed in association with the administration of anaesthesia

67.40

22007

Awake endotracheal intubation with flexible fibreoptic scope associated with difficult airway, when performed in association with the administration of anaesthesia

67.40

22008

Double lumen endobronchial tube or bronchial blocker, insertion of, when performed in association with the administration of anaesthesia

67.40

22012

Blood pressure monitoring (central venous, pulmonary arterial, systemic arterial or cardiac intracavity) by indwelling catheter — for each type of pressure up to a maximum of 4 pressures (not being a service to which item 13876 applies), when performed in association with the administration of anaesthesia

50.55

22014

Blood pressure monitoring (central venous, pulmonary arterial, systemic arterial or cardiac intracavity) by indwelling catheter — for each type of pressure up to a maximum of 4 pressures (not being a service to which item 13876 applies), when performed in association with the administration of anaesthesia relating to another discrete operation on the same day

50.55

22015

Right heart balloon catheter, insertion of, including pulmonary wedge pressure and cardiac output measurement, when performed in association with the administration of anaesthesia

101.10

22020

Central vein catheterisation (via jugular, subclavian or femoral vein) by percutaneous or open exposure, not being a service to which item 13318 applies, when performed in association with the administration of anaesthesia

67.40

22025

Intraarterial cannulation when performed in association with the administration of anaesthesia

67.40

22030

Introduction of a narcotic, for the control of postoperative pain, into the epidural or intrathecal space in conjunction with an operation

33.70

22035

Introduction of a local anaesthetic, for control of postoperative pain, into the epidural or intrathecal space, in conjunction with an operation

33.70

22040

Introduction of a regional or field nerve block
peri-operatively performed in the induction room, theatre or recovery room, for the control of post operative pain, via the femoral or sciatic nerves, in conjunction with hip, knee, ankle or foot surgery

33.70

22045

Introduction of a regional or field nerve block
peri-operatively performed in the induction room, theatre or recovery room, for the control of post operative pain, via the femoral and sciatic nerves, in conjunction with hip, knee, ankle or foot surgery

50.55

22050

Introduction of a regional of field nerve block
peri-operatively performed in the induction room, theatre or recovery room, for the control of post operative pain, via the brachial plexus in conjunction with shoulder surgery

33.70

22055

Perfusion of limb or organ using heart-lung machine or equivalent, not being a service associated with a service to which an item in Subgroup 21 applies

202.20

22060

Whole body perfusion, cardiac bypass, using heart-lung machine or equivalent, not being a service associated with anaesthesia to which an item in Subgroup 21 applies

337.00

22065

Induced controlled hypothermia — total body, not being a service associated with a service to which an item in Subgroup 21 applies

84.25

22070

Cardioplegia, blood or crystalloid, administration by any route, not being a service associated with a service to which an item in Subgroup 21 applies

168.50

22075

Deep hypothermic circulatory arrest, with core temperature less than 22°c, including management of retrograde cerebral perfusion (if performed), not being a service associated with a service to which an item in Subgroup 21 applies

252.75

Subgroup 20 — Administration of anaesthesia in connection with a dental service

22900

Initiation of management by a medical practitioner of anaesthesia for extraction of tooth or teeth, with or without incision of soft tissue or removal of bone

84.25

22905

Initiation of management of anaesthesia for restorative dental work

84.25

Subgroup 21 — Anaesthesia, perfusion and assistance at anaesthesia (time component)

23010

Anaesthesia, perfusion or assistance, where the service time is not more than 15 minutes

16.50

23021

Anaesthesia, perfusion or assistance, where the service time is more than 15 minutes but not more than 20 minutes

33.70

23022

Anaesthesia, perfusion or assistance, where the service time is more than 20 minutes but not more than 25 minutes

33.70

23023

Anaesthesia, perfusion or assistance, where the service time is more than 25 minutes but not more than 30 minutes

33.70

23031

Anaesthesia, perfusion or assistance, where the service time is more than 30 minutes but not more than 35 minutes

50.55

23032

Anaesthesia, perfusion or assistance, where the service time is more than 35 minutes but not more than 40 minutes

50.55

23033

Anaesthesia, perfusion or assistance, where the service time is more than 40 minutes but not more than 45 minutes

50.55

23041

Anaesthesia, perfusion or assistance, where the service time is more than 45 minutes but not more than 50 minutes

67.40

23042

Anaesthesia, perfusion or assistance, where the service time is more than 50 minutes but not more than 55 minutes

67.40

23043

Anaesthesia, perfusion or assistance, where the service time is more than 55 minutes but not more than 1 hour

67.40

23051

Anaesthesia, perfusion or assistance, where the service time is more than 1:01 hours but not more than 1:05 hours

84.25

23052

Anaesthesia, perfusion or assistance, where the service time is more than 1:05 hours but not more than 1:10 hours

84.25

23053

Anaesthesia, perfusion or assistance, where the service time is more than 1:10 hours but not more than 1:15 hours

84.25

23061

Anaesthesia, perfusion or assistance, where the service time is more than 1:15 hours but not more than 1:20 hours

101.10

23062

Anaesthesia, perfusion or assistance, where the service time is more than 1:20 hours but not more than 1:25 hours

101.10

23063

Anaesthesia, perfusion or assistance, where the service time is more than 1:25 hours but not more than 1:30 hours

101.10

23071

Anaesthesia, perfusion or assistance, where the service time is more than 1:30 hours but not more than 1:35 hours

117.95

23072

Anaesthesia, perfusion or assistance, where the service time is more than 1:35 hours but not more than 1:40 hours

117.95

23073

Anaesthesia, perfusion or assistance, where the service time is more than 1:40 hours but not more than 1:45 hours

117.95

23081

Anaesthesia, perfusion or assistance, where the service time is more than 1:45 hours but not more than 1:50 hours

134.80

23082

Anaesthesia, perfusion or assistance, where the service time is more than 1:50 hours but not more than 1:55 hours

134.80

23083

Anaesthesia, perfusion or assistance, where the service time is more than 1:55 hours but not more than 2:00 hours

134.80

23090

Anaesthesia, perfusion or assistance, where the service time is more than 2:00 hours but not more than 2:15 hours

151.65

23100

Anaesthesia, perfusion or assistance, where the service time is more than 2:15 hours but not more than 2:30 hours

168.50

23110

Anaesthesia, perfusion or assistance, where the service time is more than 2:30 hours but not more than 2:45 hours

185.35

23120

Anaesthesia, perfusion or assistance, where the service time is more than 2:45 hours but not more than 3:00 hours

202.20

23130

Anaesthesia, perfusion or assistance, where the service time is more than 3:00 hours but not more than 3:15 hours

219.05

23140

Anaesthesia, perfusion or assistance, where the service time is more than 3:15 hours but not more than 3:30 hours

235.90

23150

Anaesthesia, perfusion or assistance, where the service time is more than 3:30 hours but not more than 3:45 hours

252.75

23160

Anaesthesia, perfusion or assistance, where the service time is more than 3:45 hours but not more than 4:00 hours

269.60

23170

Anaesthesia, perfusion or assistance, where the service time is more than 4:00 hours but not more than 4:10 hours

286.45

23180

Anaesthesia, perfusion or assistance, where the service time is more than 4:10 hours but not more than 4:20 hours

303.30

23190

Anaesthesia, perfusion or assistance, where the service time is more than 4:20 hours but not more than 4:30 hours

320.15

23200

Anaesthesia, perfusion or assistance, where the service time is more than 4:30 hours but not more than 4:40 hours

337.00

23210

Anaesthesia, perfusion or assistance, where the service time is more than 4:40 hours but not more than 4:50 hours

353.85

23220

Anaesthesia, perfusion or assistance, where the service time is more than 4:50 hours but not more than 5:00 hours

370.70

23230

Anaesthesia, perfusion or assistance, where the service time is more than 5:00 hours but not more than 5:10 hours

387.55

23240

Anaesthesia, perfusion or assistance, where the service time is more than 5:10 hours but not more than 5:20 hours

404.40

23250

Anaesthesia, perfusion or assistance, where the service time is more than 5:20 hours but not more than 5:30 hours

421.25

23260

Anaesthesia, perfusion or assistance, where the service time is more than 5:30 hours but not more than 5:40 hours

438.10

23270

Anaesthesia, perfusion or assistance, where the service time is more than 5:40 hours but not more than 5:50 hours

454.95

23280

Anaesthesia, perfusion or assistance, where the service time is more than 5:50 hours but not more than 6:00 hours

471.80

23290

Anaesthesia, perfusion or assistance, where the service time is more than 6:00 hours but not more than 6:10 hours

488.65

23300

Anaesthesia, perfusion or assistance, where the service time is more than 6:10 hours but not more than 6:20 hours

505.50

23310

Anaesthesia, perfusion or assistance, where the service time is more than 6:20 hours but not more than 6:30 hours

522.35

23320

Anaesthesia, perfusion or assistance, where the service time is more than 6:30 hours but not more than 6:40 hours

539.20

23330

Anaesthesia, perfusion or assistance, where the service time is more than 6:40 hours but not more than 6:50 hours

556.05

23340

Anaesthesia, perfusion or assistance, where the service time is more than 6:50 hours but not more than 7:00 hours

572.90

23350

Anaesthesia, perfusion or assistance, where the service time is more than 7:00 hours but not more than 7:10 hours

589.75

23360

Anaesthesia, perfusion or assistance, where the service time is more than 7:10 hours but not more than 7:20 hours

606.60

23370

Anaesthesia, perfusion or assistance, where the service time is more than 7:20 hours but not more than 7:30 hours

623.45

23380

Anaesthesia, perfusion or assistance, where the service time is more than 7:30 hours but not more than 7:40 hours

640.30

23390

Anaesthesia, perfusion or assistance, where the service time is more than 7:40 hours but not more than 7:50 hours

657.15

23400

Anaesthesia, perfusion or assistance, where the service time is more than 7:50 hours but not more than 8:00 hours

674.00

23410

Anaesthesia, perfusion or assistance, where the service time is more than 8:00 hours but not more than 8:10 hours

690.85

23420

Anaesthesia, perfusion or assistance, where the service time is more than 8:10 hours but not more than 8:20 hours

707.70

23430

Anaesthesia, perfusion or assistance, where the service time is more than 8:20 hours but not more than 8:30 hours

724.55

23440

Anaesthesia, perfusion or assistance, where the service time is more than 8:30 hours but not more than 8:40 hours

741.40

23450

Anaesthesia, perfusion or assistance, where the service time is more than 8:40 hours but not more than 8:50 hours

758.25

23460

Anaesthesia, perfusion or assistance, where the service time is more than 8:50 hours but not more than 9:00 hours

775.10

23470

Anaesthesia, perfusion or assistance, where the service time is more than 9:00 hours but not more than 9:10 hours

791.95

23480

Anaesthesia, perfusion or assistance, where the service time is more than 9:10 hours but not more than 9:20 hours

808.80

23490

Anaesthesia, perfusion or assistance, where the service time is more than 9:20 hours but not more than 9:30 hours

825.65

23500

Anaesthesia, perfusion or assistance, where the service time is more than 9:30 hours but not more than 9:40 hours

842.50

23510

Anaesthesia, perfusion or assistance, where the service time is more than 9:40 hours but not more than 9:50 hours

859.35

23520

Anaesthesia, perfusion or assistance, where the service time is more than 9:50 hours but not more than 10:00 hours

876.20

23530

Anaesthesia, perfusion or assistance, where the service time is more than 10:00 hours but not more than 10:10 hours

893.05

23540

Anaesthesia, perfusion or assistance, where the service time is more than 10:10 hours but not more than 10:20 hours

909.90

23550

Anaesthesia, perfusion or assistance, where the service time is more than 10:20 hours but not more than 10:30 hours

926.75

23560

Anaesthesia, perfusion or assistance, where the service time is more than 10:30 hours but not more than 10:40 hours

943.60

23570

Anaesthesia, perfusion or assistance, where the service time is more than 10:40 hours but not more than 10:50 hours

960.45

23580

Anaesthesia, perfusion or assistance, where the service time is more than 10:50 hours but not more than 11:00 hours

977.30

23590

Anaesthesia, perfusion or assistance, where the service time is more than 11:00 hours but not more than 11:10 hours

994.15

23600

Anaesthesia, perfusion or assistance, where the service time is more than 11:10 hours but not more than 11:20 hours

1 011.00

23610

Anaesthesia, perfusion or assistance, where the service time is more than 11:20 hours but not more than 11:30 hours

1 027.85

23620

Anaesthesia, perfusion or assistance, where the service time is more than 11:30 hours but not more than 11:40 hours

1 044.70

23630

Anaesthesia, perfusion or assistance, where the service time is more than 11:40 hours but not more than 11:50 hours

1 061.55

23640

Anaesthesia, perfusion or assistance, where the service time is more than 11:50 hours but not more than 12:00 hours

1 078.40

23650

Anaesthesia, perfusion or assistance, where the service time is more than 12:00 hours but not more than 12:10 hours

1 095.25

23660

Anaesthesia, perfusion or assistance, where the service time is more than 12:10 hours but not more than 12:20 hours

1 112.10

23670

Anaesthesia, perfusion or assistance, where the service time is more than 12:20 hours but not more than 12:30 hours

1 128.95

23680

Anaesthesia, perfusion or assistance, where the service time is more than 12:30 hours but not more than 12:40 hours

1 145.80

23690

Anaesthesia, perfusion or assistance, where the service time is more than 12:40 hours but not more than 12:50 hours

1 162.65

23700

Anaesthesia, perfusion or assistance, where the service time is more than 12:50 hours but not more than 13:00 hours

1 179.50

23710

Anaesthesia, perfusion or assistance, where the service time is more than 13:00 hours but not more than 13:10 hours

1 196.35

23720

Anaesthesia, perfusion or assistance, where the service time is more than 13:10 hours but not more than 13:20 hours

1 213.20

23730

Anaesthesia, perfusion or assistance, where the service time is more than 13:20 hours but not more than 13:30 hours

1 230.05

23740

Anaesthesia, perfusion or assistance, where the service time is more than 13:30 hours but not more than 13:40 hours

1 246.90

23750

Anaesthesia, perfusion or assistance, where the service time is more than 13:40 hours but not more than 13:50 hours

1 263.75

23760

Anaesthesia, perfusion or assistance, where the service time is more than 13:50 hours but not more than 14:00 hours

1 280.60

23770

Anaesthesia, perfusion or assistance, where the service time is more than 14:00 hours but not more than 14:10 hours

1 297.45

23780

Anaesthesia, perfusion or assistance, where the service time is more than 14:10 hours but not more than 14:20 hours

1 314.30

23790

Anaesthesia, perfusion or assistance, where the service time is more than 14:20 hours but not more than 14:30 hours

1 331.15

23800

Anaesthesia, perfusion or assistance, where the service time is more than 14:30 hours but not more than 14:40 hours

1 348.00

23810

Anaesthesia, perfusion or assistance, where the service time is more than 14:40 hours but not more than 14:50 hours

1 364.85

23820

Anaesthesia, perfusion or assistance, where the service time is more than 14:50 hours but not more than 15:00 hours

1 381.70

23830

Anaesthesia, perfusion or assistance, where the service time is more than 15:00 hours but not more than 15:10 hours

1 398.55

23840

Anaesthesia, perfusion or assistance, where the service time is more than 15:10 hours but not more than 15:20 hours

1 415.40

23850

Anaesthesia, perfusion or assistance, where the service time is more than 15:20 hours but not more than 15:30 hours

1 432.25

23860

Anaesthesia, perfusion or assistance, where the service time is more than 15:30 hours but not more than 15:40 hours

1 449.10

23870

Anaesthesia, perfusion or assistance, where the service time is more than15:40 hours but not more than 15:50 hours

1 465.95

23880

Anaesthesia, perfusion or assistance, where the service time is more than 15:50 hours but not more than 16:00 hours

1 482.80

23890

Anaesthesia, perfusion or assistance, where the service time is more than 16:00 hours but not more than 16:10 hours

1 499.65

23900

Anaesthesia, perfusion or assistance, where the service time is more than 16:10 hours but not more than 16:20 hours

1 516.50

23910

Anaesthesia, perfusion or assistance, where the service time is more than 16:20 hours but not more than 16:30 hours

1 533.35

23920

Anaesthesia, perfusion or assistance, where the service time is more than 16:30 hours but not more than 16:40 hours

1 550.20

23930

Anaesthesia, perfusion or assistance, where the service time is more than 16:40 hours but not more than 16:50 hours

1 567.05

23940

Anaesthesia, perfusion or assistance, where the service time is more than 16:50 hours but not more than 17:00 hours

1 583.90

23950

Anaesthesia, perfusion or assistance, where the service time is more than 17:00 hours but not more than 17:10 hours

1 600.75

23960

Anaesthesia, perfusion or assistance, where the service time is more than 17:10 hours but not more than 17:20 hours

1 617.60

23970

Anaesthesia, perfusion or assistance, where the service time is more than 17:20 hours but not more than 17:30 hours

1 634.45

23980

Anaesthesia, perfusion or assistance, where the service time is more than 17:30 hours but not more than 17:40 hours

1 651.30

23990

Anaesthesia, perfusion or assistance, where the service time is more than17:40 hours but not more than 17:50 hours

1 668.15

24100

Anaesthesia, perfusion or assistance, where the service time is more than 17:50 hours but not more than 18:00 hours

1 685.00

24101

Anaesthesia, perfusion or assistance, where the service time is more than 18:00 hours but not more than 18:10 hours

1 701.85

24102

Anaesthesia, perfusion or assistance, where the service time is more than 18:10 hours but not more than 18:20 hours

1 718.70

24103

Anaesthesia, perfusion or assistance, where the service time is more than 18:20 hours but not more than 18:30 hours

1 735.55

24104

Anaesthesia, perfusion or assistance, where the service time is more than 18:30 hours but not more than 18:40 hours

1 752.40

24105

Anaesthesia, perfusion or assistance, where the service time is more than 18:40 hours but not more than 18:50 hours

1 769.25

24106

Anaesthesia, perfusion or assistance, where the service time is more than 18:50 hours but not more than 19:00 hours

1 786.10

24107

Anaesthesia, perfusion or assistance, where the service time is more than 19:00 hours but not more than 19:10 hours

1 802.95

24108

Anaesthesia, perfusion or assistance, where the service time is more than 19:10 hours but not more than 19:20 hours

1 819.80

24109

Anaesthesia, perfusion or assistance, where the service time is more than 19:20 hours but not more than 19:30 hours

1 836.65

24110

Anaesthesia, perfusion or assistance, where the service time is more than 19:30 hours but not more than 19:40 hours

1 853.50

24111

Anaesthesia, perfusion or assistance, where the service time is more than 19:40 hours but not more than 19:50 hours

1 870.35

24112

Anaesthesia, perfusion or assistance, where the service time is more than 19:50 hours but not more than 20:00 hours

1 887.20

24113

Anaesthesia, perfusion or assistance, where the service time is more than 20:00 hours but not more than 20:10 hours

1 904.05

24114

Anaesthesia, perfusion or assistance, where the service time is more than 20:10 hours but not more than 20:20 hours

1 920.90

24115

Anaesthesia, perfusion or assistance, where the service time is more than 20:20 hours but not more than 20:30 hours

1 937.75

24116

Anaesthesia, perfusion or assistance, where the service time is more than 20:30 hours but not more than 20:40 hours

1 954.60

24117

Anaesthesia, perfusion or assistance, where the service time is more than 20:40 hours but not more than 20:50 hours

1 971.45

24118

Anaesthesia, perfusion or assistance, where the service time is more than 20:50 hours but not more than 21:00 hours

1 988.30

24119

Anaesthesia, perfusion or assistance, where the service time is more than 21:00 hours but not more than 21:10 hours

2 005.15

24120

Anaesthesia, perfusion or assistance, where the service time is more than 21:10 hours but not more than 21:20 hours

2 022.00

24121

Anaesthesia, perfusion or assistance, where the service time is more than 21:20 hours but not more than 21:30 hours

2 038.85

24122

Anaesthesia, perfusion or assistance, where the service time is more than 21:30 hours but not more than 21:40 hours

2 055.70

24123

Anaesthesia, perfusion or assistance, where the service time is more than 21:40 hours but not more than 21:50 hours

2 072.55

24124

Anaesthesia, perfusion or assistance, where the service time is more than 21:50 hours but not more than 22:00 hours

2 089.40

24125

Anaesthesia, perfusion or assistance, where the service time is more than 22:00 hours but not more than 22:10 hours

2 106.25

24126

Anaesthesia, perfusion or assistance, where the service time is more than 22:10 hours but not more than 22:20 hours

2 123.10

24127

Anaesthesia, perfusion or assistance, where the service time is more than 22:20 hours but not more than 22:30 hours

2 139.95

24128

Anaesthesia, perfusion or assistance, where the service time is more than 22:30 hours but not more than 22:40 hours

2 156.80

24129

Anaesthesia, perfusion or assistance, where the service time is more than 22:40 hours but not more than 22:50 hours

2 173.65

24130

Anaesthesia, perfusion or assistance, where the service time is more than 22:50 hours but not more than 23:00 hours

2 190.50

24131

Anaesthesia, perfusion or assistance, where the service time is more than 23:00 hours but not more than 23:10 hours

2 207.35

24132

Anaesthesia, perfusion or assistance, where the service time is more than 23:10 hours but not more than 23:20 hours

2 224.20

24133

Anaesthesia, perfusion or assistance, where the service time is more than 23:20 hours but not more than 23:30 hours

2 241.05

24134

Anaesthesia, perfusion or assistance, where the service time is more than 23:30 hours but not more than 23:40 hours

2 257.90

24135

Anaesthesia, perfusion or assistance, where the service time is more than 23:40 hours but not more than 23:50 hours

2 274.75

24136

Anaesthesia, perfusion or assistance, where the service time is more than 23:50 hours but not more than 24:00 hours

2 291.60

Subgroup 22 — Anaesthesia, perfusion and assistance at anaesthesia (modifying components — physical status)

25000

Anaesthesia, perfusion or assistance, where the patient has severe systemic disease (equivalent to ASA physical status indicator 3)

16.85

25005

Anaesthesia, perfusion or assistance, where the patient has severe systemic disease which is a constant threat to life (equivalent to ASA physical status indicator 4)

33.70

25010

Anaesthesia, perfusion or assistance, where the patient is not expected to survive for 24 hours, with or without the associated operation (equivalent to ASA physical status indicator 5)

50.55

Subgroup 23 — Anaesthesia, perfusion and assistance at anaesthesia (modifying components — other)

25015

Anaesthesia, perfusion or assistance, where the patient’s age is less than 12 months or is 70 years or more

16.85

25020

Anaesthesia, perfusion or assistance, where the patient requires immediate treatment without which there would be significant threat to life or body part — not being a service associated with a service to which item 25025, 25030 or 25050 applies

33.70

Subgroup 24 — Anaesthesia and assistance at anaesthesia (after hours emergency modifier)

25025

Anaesthesia, where the patient requires immediate treatment without which there would be significant threat to life or body part and where more than 50% of the service time occurs between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday

Amount under rule 70

25030

Assistance, where the patient requires immediate treatment without which there would be significant threat to life or body part and where more than 50% of the service time occurs between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday

Amount under rule 70

Subgroup 25 — Perfusion (after hours emergency modifier)

25050

Perfusion, where the patient requires immediate treatment without which there would be significant threat to life or body part and where more than 50% of the service time occurs between 8 pm to 8 am on any weekday, or on a Saturday, Sunday or public holiday

Amount under rule 70

Subgroup 26 — Assistance at anaesthesia

25200

Assistance in the administration of anaesthesia requiring continuous anaesthesia on a patient in imminent danger of death requiring continuous life saving emergency treatment, to the exclusion of attendance on all other patients

Amount under rule 73

25205

Assistance in the administration of elective anaesthesia, where:

 (a) the patient has complex airway problems; or

 (b) the patient is a neonate or a complex paediatric case; or

 (c) there is anticipated to be massive blood loss (greater than 50% of blood volume) during the procedure; or

 (d) the patient is critically ill, with multiple organ failure; or

 (e) the service time of the administration of anaesthesia exceeds 6 hours and the assistance is provided to the exclusion of attendance on all other patients

Amount under rule 73

Group T8 — Surgical operations

Subgroup 1 — General

30001

Operative procedure, not being a service to which any other item in this group applies, being a service to which an item in this group would have applied had the procedure not been discontinued on medical grounds

Amount under rule 40

30003

Localised burns, dressing of, (not involving grafting) — each attendance at which the procedure is performed, including any associated consultation

30.85

30006

Extensive burns, dressing of, without anaesthesia (not involving grafting) — each attendance at which the procedure is performed, including any associated consultation

39.45

30009

Localised burns, dressing of, under general anaesthesia (not involving grafting) (G) (H) (Anaes.)

51.50

30010

Localised burns, dressing of, under general anaesthesia (not involving grafting) (S) (H) (Anaes.)

62.70

30013

Extensive burns, dressing of, under general anaesthesia (not involving grafting) (G) (H) (Anaes.)

111.05

30014

Extensive burns, dressing of, under general anaesthesia (not involving grafting) (S) (H) (Anaes.)

131.85

30017

Burns, excision of, under general anaesthesia, involving not more than 10% of body surface, where grafting is not carried out during the same operation (Anaes.) (Assist.)

276.60

30020

Burns, excision of, under general anaesthesia, involving more than 10% of body surface, where grafting is not carried out during the same operation (H) (Anaes.) (Assist.)

538.75

30023

Wound of soft tissue, deep or extensively contaminated, debridement of, under general anaesthesia or regional or field block, including suturing of that wound when performed (Anaes.) (Assist.)

276.60

30026

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, not on face or neck, small (not more than 7 cm long), superficial, not being a service to which another item in Group T4 applies (Anaes.)

44.30

30029

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, not on face or neck, small (not more than 7 cm in length), involving deeper tissue, not being a service to which another item in Group T4 applies (Anaes.)

76.30

30032

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, on face or neck, small (not more than 7 cm long), superficial (Anaes.)

70.00

30035

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, on face or neck, small (not more than 7 cm long), involving deeper tissue (Anaes.)

99.70

30038

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, not on face or neck, large (more than 7 cm long), superficial, not being a service to which another item in Group T4 applies (Anaes.)

76.30

30041

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, not on face or neck, large (more than 7 cm long), involving deeper tissue, not being a service to which another item in Group T4 applies (G) (Anaes.)

122.20

30042

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, other than on face or neck, large (more than 7 cm long), involving deeper tissue, not being a service to which another item in Group T4 applies (S) (Anaes.)

157.55

 

30045

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, on face or neck, large (more than 7 cm long), superficial (Anaes.)

99.70

30048

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, on face or neck, large (more than 7 cm long), involving deeper tissue (G) (Anaes.)

127.05

30049

Skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, on face or neck, large (more than 7 cm long), involving deeper tissue (S) (Anaes.)

157.55

30052

Full thickness laceration of ear, eyelid, nose or lip, repair of, with accurate apposition of each layer of tissue (Anaes.) (Assist.)

215.50

30055

Wounds, dressing of, under general anaesthesia, with or without removal of sutures, not being a service associated with a service to which another item in this group applies (Anaes.)

62.70

30058

Post-operative haemorrhage, control of, under general anaesthesia, as an independent procedure (Anaes.)

122.20

30061

Superficial foreign body, removal of, (including from cornea or sclera) as an independent procedure (Anaes.)

19.90

30064

Subcutaneous foreign body, removal of, requiring incision and exploration, including closure of wound if performed, as an independent procedure (Anaes.)

93.25

30067

Foreign body in muscle, tendon or other deep tissue, removal of, as an independent procedure (G) (Anaes.) (Assist.)

189.75

30068

Foreign body in muscle, tendon or other deep tissue, removal of, as an independent procedure (S) (Anaes.) (Assist.)

234.80

30071

Diagnostic biopsy of skin or mucous membrane, as an independent procedure, where the biopsy specimen is sent for pathological examination (Anaes.)

44.30

30074

Diagnostic biopsy of lymph gland, muscle or other deep tissue or organ, as an independent procedure, where the biopsy specimen is sent for pathological examination (G) (Anaes.)

99.70

30075

Diagnostic biopsy of lymph gland, muscle or other deep tissue or organ, as an independent procedure, where the biopsy specimen is sent for pathological examination (S) (Anaes.)

127.05

30078

Diagnostic drill biopsy of lymph gland, deep tissue or organ, as an independent procedure, where the biopsy specimen is sent for pathological examination (Anaes.)

41.10

30081

Diagnostic biopsy of bone marrow by trephine using an open approach, where the biopsy specimen is sent for pathological examination (Anaes.)

93.25

30084

Diagnostic biopsy of bone marrow by trephine using a percutaneous approach with a Jamshidi needle or similar device, where the biopsy specimen is sent for pathological examination (Anaes.)

49.90

30087

Diagnostic biopsy of bone marrow by aspiration or punch biopsy of synovial membrane, where the biopsy specimen is sent for pathological examination (Anaes.)

25.00

30090

Diagnostic biopsy of pleura, percutaneous, where the biopsy specimen is sent for pathological examination — 1 or more biopsies on any 1 occasion (Anaes.)

109.05

30093

Diagnostic needle biopsy of vertebra, where the biopsy specimen is sent for pathological examination (Anaes.)

145.60

30094

Diagnostic percutaneous aspiration biopsy of deep organ using interventional techniques (but not including imaging) where the biopsy specimen is sent for pathological examination (Anaes.)

160.70

30096

Diagnostic scalene node biopsy, by open procedure, if the specimen excised is sent for pathological examination (Anaes.)

156.05

30099

Sinus, excision of, involving superficial tissue only (Anaes.)

76.30

30102

Sinus, excision of, involving muscle and deep tissue (G) (Anaes.)

127.05

30103

Sinus, excision of, involving muscle and deep tissue (S) (Anaes.)

156.05

30104

Pre-auricular sinus, excision of (Anaes.)

107.70

30106

Ganglion or small bursa, excision of, not being a service associated with a service to which another item in this group applies (G) (Anaes.)

131.85

30107

Ganglion or small bursa, excision of, not being a service associated with a service to which another item in this group applies (S) (Anaes.)

186.60

30110

Bursa (large), including olecranon, calcaneum or patella, excision of (G) (Anaes.) (Assist.)

241.25

30111

Bursa (large), including olecranon, calcaneum or patella, excision of (S) (Anaes.) (Assist.)

315.25

30114

Bursa, semimembranosus (Baker’s cyst), excision of (H) (Anaes.) (Assist.)

315.25

30165

Lipectomy — transverse wedge excision of abdominal apron, not being a service associated with a service to which item 45530, 45564 or 45565 applies, and not being a service performed within 12 months after the end of a pregnancy of the patient (Anaes.) (Assist.)

385.95

30168

Lipectomy — wedge excision of skin or fat, not being a service associated with a service to which item 45530, 45564 or 45565 applies, and not being a service to which item 30165 applies — 1 excision (Anaes.) (Assist.)

385.95

30171

Lipectomy — wedge excision of skin or fat, not being a service associated with a service to which item 45530, 45564 or 45565 applies, and not being a service to which item 30165 applies — 2 or more excisions (Anaes.) (Assist.)

587.00

30174

Lipectomy — subumbilical excision with undermining of skin edges and strengthening of musculo-aponeurotic wall, not being a service associated with a service to which item 45530, 45564 or 45565 applies (Anaes.) (Assist.)

587.00

30177

Lipectomy — radical abdominoplasty (Pitanguy type or similar) with excision of skin and subcutaneous tissue, repair of musculo-aponeurotic layer and transposition of umbilicus, not being a service associated with a service to which item 45530, 45564 or 45565 applies, and not being a service performed within 12 months after the end of a pregnancy of the patient (H) (Anaes.) (Assist.)

836.40

30178

Closure of abdomen with reconstruction of umbilicus, with or without lipectomy, being a service associated with items 45530, 45564 or 45565 (H) (Anaes.) (Assist.)

578.00

30180

Axillary hyperhidrosis, partial excision for (Anaes.)

115.80

30183

Axillary hyperhidrosis, total excision of sweat gland bearing area (Anaes.)

209.10

30185

Palmar or plantar warts (10 or more), definitive removal of, excluding ablative methods alone, not being a service to which item 30186 or 30187 applies

154.85

30186

Palmar or plantar warts (for each wart, up to a total of 9 warts), definitive removal of, excluding ablative methods alone, not being a service to which item 30185 or 30187 applies (Anaes.)

Note   Section 15 of the Health Insurance Act 1973 provides for the reduction of the fees payable for 2 or more removals performed on the same patient on the same occasion.

40.30

30187

Palmar or plantar warts, removal of, by carbon dioxide laser or erbium laser, requiring admission to a hospital or approved day hospital facility, or when performed by a specialist in the practice of his or her specialty (5 or more warts) (Anaes.)

218.05

30189

Warts or molluscum contagiosum (1 or more), removal of, by any method (other than by chemical means), where undertaken in the operating theatre of a hospital or approved day hospital facility, not being a service associated with a service to which another item in this group applies (Anaes.)

124.95

30190

Angiofibromas, trichoepitheliomas or other severely disfiguring tumours of the face or neck, suitable for laser excision as confirmed by specialist opinion — removal of, by serial curettage or carbon dioxide laser or erbium laser excision-ablation, including any associated resurfacing (10 or more tumours) (Anaes.)

337.50

30192

Premalignant skin lesions (including solar keratoses), treatment of, by ablative technique (10 or more lesions) (Anaes.)

33.65

30195

Benign neoplasm of skin, other than viral verrucae (common warts), seborrheic keratoses or skin tags, treatment by electrosurgical destruction, simple curettage or shave excision, or laser photocoagulation, not being a service to which item 30196, 30197, 30202, 30203 or 30205 applies (1 or more lesions) (Anaes.)

53.85

30196

Malignant neoplasm of skin or mucous membrane proven by histopathology or confirmed by specialist opinion, removal of, by serial curettage or carbon dioxide laser or erbium laser excision-ablation, including any associated cryotherapy, or diathermy, not being a service to which item 30197 applies (Anaes.)

107.15

30197

Malignant neoplasm of skin or mucous membrane proven by histopathology or confirmed by specialist opinion, removal of, by serial curettage or carbon dioxide laser excision-ablation, including any associated cryotherapy or diathermy (10 or more lesions) (Anaes.)

373.40

30202

Malignant neoplasm of skin or mucous membrane proven by histopathology or confirmed by specialist opinion, removal of, by liquid nitrogen cryotherapy using repeat freeze-thaw cycles, not being a service to which item 30203 applies

41.00

30203

Malignant neoplasm of skin or mucous membrane proven by histopathology or confirmed by specialist opinion, removal of, by liquid nitrogen cryotherapy using repeat freeze-thaw cycles (10 or more lesions)

144.45

30205

Malignant neoplasm of skin proven by histopathology, removal of, by liquid nitrogen cryotherapy using repeat freeze-thaw cycles if the malignant neoplasm extends into cartilage (Anaes.)

107.15

30207

Skin lesions, multiple injections with hydrocortisone or similar preparations (Anaes.)

37.85

30210

Keloid and other skin lesions, extensive, multiple injections of hydrocortisone or similar preparations where undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

138.30

30213

Telangiectases or starburst vessels on the head or neck where lesions are visible from 4 metres, diathermy or sclerosant injection of, including associated consultation — limited to a maximum of 6 sessions (including any sessions to which items 14100 to 14118 and 30213 apply) in any 12 month period — for a session of at least 20 minutes duration (Anaes.)

93.15

30214

Telangiectases or starburst vessels on the head or neck where lesions are visible from 4 metres, diathermy or sclerosant injection of, including associated consultation-session of at least 20 minutes duration — where it can be demonstrated that a 7th or subsequent session (including any sessions to which items 14100 to 14118 and 30213 apply) is indicated in a 12 month period (H)

93.15

30216

Haematoma, aspiration of (Anaes.)

23.20

30219

Haematoma, furuncle, small abscess or similar lesion not requiring admission to a hospital or approved day hospital facility, incision with drainage of, excluding after-care

23.20

30223

Large haematoma, large abscess, carbuncle, cellulitis or similar lesion, incision with drainage of, excluding
after-care (H) (Anaes.)

138.30

30224

Percutaneous drainage of deep abscess using interventional techniques — but not including imaging (Anaes.)

201.60

30225

Abscess drainage tube, exchange of using interventional techniques — but not including imaging (Anaes.)

227.10

30226

Muscle, excision of (limited) or fasciotomy (Anaes.)

127.05

30229

Muscle, excision of (extensive) (Anaes.) (Assist.)

231.60

30232

Muscle, ruptured, repair of (limited), not associated with external wound (Anaes.)

189.75

30235

Muscle, ruptured, repair of (extensive), not associated with external wound (Anaes.) (Assist.)

250.90

30238

Fascia, deep, repair of, for herniated muscle (Anaes.)

127.05

30241

Bone tumour, innocent, excision of, not being a service to which another item in this group applies (Anaes.) (Assist.)

302.35

30244

Styloid process of temporal bone, removal of (H) (Anaes.) (Assist.)

302.35

30246

Parotid duct, repair of, using micro-surgical techniques (H) (Anaes.) (Assist.)

585.30

30247

Parotid gland, total extirpation of (H) (Anaes.) (Assist.)

627.30

30250

Parotid gland, total extirpation of with preservation of facial nerve (H) (Anaes.) (Assist.)

1 061.50

30251

Recurrent parotid tumour, excision of, with preservation of facial nerve (Anaes.) (Assist.)

1 630.55

30253

Parotid gland, superficial lobectomy of, with exposure of facial nerve (H) (Anaes.) (Assist.)

707.75

30255

Submandibular ducts, relocation of, for surgical control of drooling (H) (Anaes.) (Assist.)

942.40

30256

Submandibular gland, extirpation of (H) (Anaes.) (Assist.)

377.95

30259

Sublingual gland, extirpation of (Anaes.)

167.25

30262

Salivary gland, dilatation or diathermy of duct (Anaes.)

49.90

30265

Salivary gland, removal of calculus from duct or meatotomy or marsupialisation, 1 or more such procedures (G) (Anaes.)

99.70

30266

Salivary gland, removal of calculus from duct or meatotomy or marsupialisation, 1 or more such procedures (S) (Anaes.)

127.05

30269

Salivary gland, repair of cutaneous fistula of (Anaes.)

127.05

30272

Tongue, partial excision of (Anaes.) (Assist.)

250.90

30275

Radical excision of intra-oral tumour involving resection of mandible and lymph glands of neck (commando-type operation) (H) (Anaes.) (Assist.)

1 495.75

30278

Tongue tie, repair of, not being a service to which another item in this group applies (Anaes.)

39.45

30281

Tongue tie, mandibular frenulum or maxillary frenulum, repair of, in a person aged 2 years and over, under general anaesthesia (Anaes.)

101.35

30282

Ranula or mucous cyst of mouth, removal of (G) (Anaes.)

131.85

30283

Ranula or mucous cyst of mouth, removal of (S) (Anaes.)

173.70

30286

Branchial cyst, removal of (Anaes.) (Assist.)

337.60

30289

Branchial fistula, removal of (H) (Anaes.) (Assist.)

426.20

30293

Cervical oesophagostomy, or closure of cervical oesophagostomy with or without plastic repair (Anaes.) (Assist.)

377.95

30294

Cervical oesophagectomy with tracheostomy and oesophagostomy, with or without plastic reconstruction, or laryngopharyngectomy with tracheostomy and plastic reconstruction (H) (Anaes.) (Assist.)

1 495.75

30296

Thyroidectomy, total (H) (Anaes.) (Assist.)

868.65

30297

Thyroidectomy following previous thyroid surgery (H) (Anaes.) (Assist.)

868.65

30306

Total hemithyroidectomy (H) (Anaes.) (Assist.)

677.65

30308

Bilateral sub-total thyroidectomy (H) (Anaes.) (Assist.)

677.65

30309

Thyroidectomy, sub-total for thyrotoxicosis (H) (Anaes.) (Assist.)

868.65

30310

Thyroid, unilateral sub-total thyroidectomy or equivalent partial thyroidectomy (H) (Anaes.) (Assist.)

388.10

30313

Thyroglossal cyst, removal of (Anaes.) (Assist.)

231.60

30314

Thyroglossal cyst or fistula or both, radical removal of, including thyroglossal duct and portion of hyoid bone (H) (Anaes.) (Assist.)

388.10

30315

Parathyroid operation for hyperparathyroidism (H) (Anaes.) (Assist.)

967.20

30317

Cervical re-exploration for recurrent or persistent hyperparathyroidism (H) (Anaes.) (Assist.)

1 158.15

30318

Mediastinum, exploration of, via the cervical route, for hyperparathyroidism (including thymectomy) (H) (Anaes.) (Assist.)

770.10

30320

Mediastinum, exploration of, via mediastinotomy, for hyperparathyroidism (including thymectomy) (H) (Anaes.) (Assist.)

1 158.15

30321

Retroperitoneal neuroendocrine tumour, removal of (H) (Anaes.) (Assist.)

770.10

30323

Retroperitoneal neuroendocrine tumour, removal of, requiring complex and extensive dissection (H) (Anaes.) (Assist.)

1 158.15

30324

Adrenal gland tumour, excision of (H) (Anaes.) (Assist.)

1 158.15

30329

Lymph glands of groin, limited excision of (Anaes.)

209.50

30330

Lymph glands of groin, radical excision of (H) (Anaes.) (Assist.)

609.85

30332

Lymph nodes of axilla, limited excision of (sampling) (H) (Anaes.) (Assist.)

294.25

30335

Lymph nodes of axilla, complete excision of, to level I (H) (Anaes.) (Assist.)

735.55

30336

Lymph nodes of axilla, complete excision of, to
level II or III (H) (Anaes.) (Assist.)

882.70

30373

Laparotomy (exploratory), including associated biopsies, where no other intra-abdominal procedure is performed (H) (Anaes.) (Assist.)

410.05

30375

Laparotomy involving caecostomy, enterostomy, colostomy, enterotomy, colotomy, cholecystostomy, gastrostomy, gastrotomy, reduction of intussusception, removal of Meckel’s diverticulum, suture of perforated peptic ulcer, simple repair of ruptured viscus, reduction of volvulus, pyloroplasty (adult) or drainage of pancreas (H) (Anaes.) (Assist.)

442.25

30376

Laparotomy involving division of peritoneal adhesions (where no other intra-abdominal procedure is performed) (H) (Anaes.) (Assist.)

442.25

30378

Laparotomy involving division of adhesions in association with another intra-abdominal procedure where the time taken to divide the adhesions is between 45 minutes and 2 hours (H) (Anaes.) (Assist.)

444.30

30379

Laparotomy with division of extensive adhesions (duration greater than 2 hours) with or without insertion of long intestinal tube (H) (Anaes.) (Assist.)

787.55

30382

Enterocutaneous fistula, radical repair of, involving extensive dissection and resection of bowel (H) (Anaes.) (Assist.)

1 108.90

30384

Laparotomy for grading of lymphoma, including splenectomy, liver biopsies, lymph node biopsies and oophoropexy (H) (Anaes.) (Assist.)

932.85

30385

Laparotomy for control of post-operative haemorrhage, where no other procedure is performed (H) (Anaes.) (Assist.)

477.95

30387

Laparotomy involving operation on abdominal viscera (including pelvic viscera), not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

538.75

30388

Laparotomy for trauma involving 3 or more organs (H) (Anaes.) (Assist.)

1 355.45

30390

Laparoscopy, diagnostic (H) (Anaes.)

186.60

30391

Laparoscopy, with biopsy (H) (Anaes.) (Assist.)

241.25

30392

Radical or debulking operation for advanced
intra-abdominal malignancy, with or without omentectomy, as an independent procedure (H) (Anaes.) (Assist.)

572.30

30393

Laparoscopic division of adhesions in association with another intra-abdominal procedure where the time taken to divide the adhesions exceeds 45 minutes (H) (Anaes.) (Assist.)

444.30

30394

Laparotomy for drainage of subphrenic abscess, pelvic abscess, appendiceal abscess, ruptured appendix or for peritonitis from any cause, with or without appendicectomy (H) (Anaes.) (Assist.)

418.15

30396

Laparotomy for gross intra peritoneal sepsis requiring debridement of fibrin, with or without removal of foreign material or enteric contents, with lavage of the entire peritoneal cavity via a major abdominal incision with or without closure of abdomen and with or without mesh or zipper insertion (H) (Anaes.) (Assist.)

862.55

30397

Laparostomy, via wound previously made and left open or closed with zipper, involving change of dressings or packs, and with or without drainage of loculated collections (H) (Anaes.)

197.15

30399

Laparostomy, final closure of wound made at previous operation, after removal of dressings or packs and removal of mesh or zipper if previously inserted (H) (Anaes.) (Assist.)

271.20

30400

Laparotomy with insertion of portacath for administration of cytotoxic therapy including placement of reservoir (H) (Anaes.) (Assist.)

536.65

30402

Retroperitoneal abscess, drainage of, not involving laparotomy (H) (Anaes.) (Assist.)

394.20

30403

Ventral, incisional, or recurrent hernia or burst abdomen, repair of (H) (Anaes.) (Assist.)

442.25

30405

Ventral, or incisional hernia, repair of requiring muscle transposition, mesh hernioplasty or resection of strangulated bowel (H) (Anaes.) (Assist.)

776.30

30406

Paracentesis abdominis (Anaes.)

44.30

30408

Peritoneo venous (Leveen) shunt, insertion of (H) (Anaes.) (Assist.)

332.70

30409

Liver biopsy, percutaneous (Anaes.)

148.10

30411

Liver biopsy by wedge excision when performed in association with another intra-abdominal procedure (H) (Anaes.)

75.35

30412

Liver biopsy by core needle, when performed in conjunction with another intra-abdominal procedure (Anaes.)

44.40

30414

Liver, subsegmental resection of, (local excision), other than for trauma (H) (Anaes.) (Assist.)

585.30

30415

Liver, segmental resection of, other than for trauma (H) (Anaes.) (Assist.)

1 170.60

30416

Liver cyst, laparoscopic marsupialisation of, where the size of the cyst is greater than 5 cm in diameter (H) (Anaes.) (Assist.)

635.55

30417

Liver cysts, laparoscopic marsupialisation of 5 or more, including any cyst greater than 5 cm in diameter (H) (Anaes.) (Assist.)

953.25

30418

Liver, lobectomy of, other than for trauma (H) (Anaes.) (Assist.)

1 355.45

30419

Liver tumours, destruction of, by hepatic cryotherapy, not being a service associated with a service to which item 50950 or 50952 applies (Anaes.) (Assist.)

693.35

30421

Liver, tri-segmental resection (extended lobectomy) of, other than for trauma (H) (Anaes.) (Assist.)

1 694.10

30422

Liver, repair of superficial laceration of, for trauma (H) (Anaes.) (Assist.)

573.00

30425

Liver, repair of deep multiple lacerations of, or debridement of, for trauma (H) (Anaes.) (Assist.)

1 108.90

30427

Liver, segmental resection of, for trauma (H) (Anaes.) (Assist.)

1 324.50

30428

Liver, lobectomy of, for trauma (Anaes.) (Assist.)

1 416.95

30430

Liver, extended lobectomy (tri-segmental resection) of, for trauma (Anaes.) (Assist.)

1 971.35

30431

Liver abscess, open abdominal drainage of (Anaes.) (Assist.)

442.25

30433

Liver abscess (multiple), open abdominal drainage of (H) (Anaes.) (Assist.)

616.05

30434

Hydatid cyst of liver, peritoneum or viscus, complete removal of contents of, with or without suture of biliary radicles (H) (Anaes.) (Assist.)

499.05

30436

Hydatid cyst of liver, peritoneum or viscus, complete removal of contents of, with or without suture of biliary radicles, with omentoplasty or myeloplasty (H) (Anaes.) (Assist.)

554.45

30437

Hydatid cyst of liver, total excision of, by
cysto-pericystectomy (membrane plus fibrous wall) (H) (Anaes.) (Assist.)

690.05

30438

Hydatid cyst of liver, excision of, with drainage and excision of liver tissue (Anaes.) (Assist.)

976.50

30439

Operative cholangiography or operative pancreatography or intra operative ultrasound of the biliary tract (including 1 or more examinations performed during the 1 operation) (H) (Anaes.) (Assist.)

157.55

30440

Cholangiogram, percutaneous transhepatic, and biliary drainage, using interventional techniques — but not including imaging (Anaes.) (Assist.)

446.60

30441

Intra operative ultrasound for staging of intra abdominal tumours (H) (Anaes.)

115.60

30442

Choledochoscopy in conjunction with another procedure (H) (Anaes.)

157.55

30443

Cholecystectomy (H) (Anaes.) (Assist.)

627.30

30445

Laparoscopic cholecystectomy (H) (Anaes.) (Assist.)

627.30

30446

Laparoscopic cholecystectomy when procedure is completed by laparotomy (H) (Anaes.) (Assist.)

627.30

30448

Laparoscopic cholecystectomy, involving removal of common duct calculi via the cystic duct (H) (Anaes.) (Assist.)

825.55

30449

Laparoscopic cholecystectomy with removal of common duct calculi via laparoscopic choledochotomy (H) (Anaes.) (Assist.)

918.00

30450

Calculus of biliary or renal tract, extraction of, using interventional imaging techniques — not being a service associated with a service to which item 36627, 36630, 36645 or 36648 applies (Anaes.) (Assist.)

444.90

30451

Biliary drainage tube, exchange of, using interventional techniques — but not including imaging (Anaes.) (Assist.)

227.10

30452

Choledochoscopy with balloon dilatation of a stricture or passage of stent or extraction of calculi (H) (Anaes.) (Assist.)

320.35

30454

Choledochotomy (with or without cholecystectomy), with or without removal of calculi (H) (Anaes.) (Assist.)

731.80

30455

Choledochotomy (with or without cholecystectomy), with removal of calculi including biliary intestinal anastomosis (H) (Anaes.) (Assist.)

860.45

30457

Choledochotomy, intrahepatic, involving removal of intrahepatic bile duct calculi (Anaes.) (Assist.)

1 170.60

30458

Transduodenal operation on sphincter of Oddi, involving 1 or more of, removal of calculi, sphincterotomy, sphincteroplasty, biopsy, local excision of peri-ampullary or duodenal tumour, sphincteroplasty of the pancreatic duct, pancreatic duct septoplasty, with or without choledochotomy (H) (Anaes.) (Assist.)

860.45

30460

Cholecystoduodenostomy, cholecystoenterostomy, choledochojejunostomy or Roux-en-Y as a bypass procedure when no prior biliary surgery performed (H) (Anaes.) (Assist.)

731.80

30461

Radical resection of porta hepatis with biliary-enteric anastomoses, not being a service associated with a service to which item 30443, 30454, 30455, 30458 or 30460 applies (H) (Anaes.) (Assist.)

1 254.45

30463

Radical resection of common hepatic duct and right and left hepatic ducts, with 2 duct anastomoses (H) (Anaes.) (Assist.)

1 540.15

30464

Radical resection of common hepatic duct and right and left hepatic ducts involving more than 2 anastomoses or resection of segment or major portion of segment of liver (H) (Anaes.) (Assist.)

1 848.25

30466

Intrahepatic biliary bypass of left hepatic ductal system by Roux-en-Y loop to peripheral ductal system (H) (Anaes.) (Assist.)

1 065.80

30467

Intrahepatic bypass of right hepatic ductal system by Roux-en-Y loop to peripheral ductal system (H) (Anaes.) (Assist.)

1 318.35

30469

Biliary stricture, repair of, after 1 or more operations on the biliary tree (Anaes.) (Assist.)

1 460.15

30472

Hepatic or common bile duct, repair of, as the primary procedure subsequent to partial or total transection of bile duct or ducts (Anaes.) (Assist.)

788.55

30473

Oesophagoscopy (not being a service to which item 41816 or 41822 applies), gastroscopy, duodenoscopy or panendoscopy (1 or more such procedures), with or without biopsy, not being a service associated with a service to which item 30476 or 30478 applies (Anaes.)

150.30

30475

Endoscopy with balloon dilatation of gastric or gastroduodenal stricture (Anaes.)

271.75

30476

Oesophagoscopy (not being a service to which item 41816 or 41822 applies), gastroscopy, duodenoscopy or panendoscopy (1 or more such procedures), with endoscopic sclerosing injection or banding of oesophageal or gastric varices, not being a service associated with a service to which item 30473 or 30478 applies (Anaes.)

208.40

30478

Oesophagoscopy (not being a service to which item 41816, 41822 or 41825 applies), gastroscopy, duodenoscopy or panendoscopy (1 or more such procedures), with 1 or more of the following endoscopic procedures — polypectomy, removal of foreign body, diathermy, heater probe or laser coagulation, or sclerosing injection of bleeding upper gastrointestinal lesions, not being a service associated with a service to which item 30473 or 30476 applies (Anaes.)

208.40

30479

Endoscopic laser therapy for neoplasia and benign vascular lesions or strictures of the gastrointestinal tract (Anaes.)

403.95

30481

Percutaneous gastrostomy (initial procedure), including any associated imaging services (Anaes.)

302.95

30482

Percutaneous gastrostomy (repeat procedure), including any associated imaging services (Anaes.)

215.40

30483

Gastrostomy button, non-endoscopic insertion of, or
non-endoscopic replacement of (Anaes.)

150.25

30484

Endoscopic retrograde cholangio-pancreatography (Anaes.)

309.60

30485

Endoscopic sphincterotomy with or without extraction of stones from common bile duct (Anaes.)

477.95

30487

Small bowel intubation with biopsy (Anaes.)

153.50

30488

Small bowel intubation — as an independent procedure (Anaes.)

76.30

30490

Oesophageal prosthesis, insertion of, including endoscopy and dilatation (Anaes.)

446.60

30491

Bile duct, endoscopic stenting of (including endoscopy and dilatation) (Anaes.)

471.20

30493

Biliary manometry (Anaes.)

282.75

30494

Endoscopic biliary dilatation (H) (Anaes.)

356.75

30496

Vagotomy, truncal or selective, with or without pyloroplasty or gastroenterostomy (Anaes.) (Assist.)

499.05

30497

Vagotomy and antrectomy (H) (Anaes.) (Assist.)

595.00

30499

Vagotomy, highly selective (H) (Anaes.) (Assist.)

707.75

30500

Vagotomy, highly selective with duodenoplasty for peptic stricture (Anaes.) (Assist.)

757.75

30502

Vagotomy, highly selective, with dilatation of pylorus (H) (Anaes.) (Assist.)

836.40

30503

Vagotomy or antrectomy, or both, for peptic ulcer following previous operation for peptic ulcer (Anaes.) (Assist.)

936.50

30505

Bleeding peptic ulcer, control of, involving suture of bleeding point or wedge excision (H) (Anaes.) (Assist.)

468.20

30506

Bleeding peptic ulcer, control of, involving suture of bleeding point or wedge excision, and vagotomy and pyloroplasty or gastroenterostomy (H) (Anaes.) (Assist.)

819.45

30508

Bleeding peptic ulcer, control of, involving suture of bleeding point or wedge excision, and highly selective vagotomy (H) (Anaes.) (Assist.)

862.55

30509

Bleeding peptic ulcer, control of, involving gastric resection (other than wedge resection) (Anaes.) (Assist.)

862.55

30511

Morbid obesity, gastric reduction or gastroplasty for, by any method (H) (Anaes.) (Assist.)

720.85

30512

Morbid obesity, gastric bypass for, by any method including anastomosis (H) (Anaes.) (Assist.)

887.05

30514

Morbid obesity, surgical reversal of procedure to which item 30511 or 30512 applies (H) (Anaes.) (Assist.)

1 306.00

30515

Gastroenterostomy (including gastroduodenostomy) or enterocolostomy or enteroenterostomy (H) (Anaes.) (Assist.)

597.60

30517

Gastroenterostomy, pyloroplasty or gastroduodenostomy, reconstruction of (H) (Anaes.) (Assist.)

782.45

30518

Partial gastrectomy (H) (Anaes.) (Assist.)

837.90

30520

Gastric tumour, removal of, by local excision, not being a service to which item 30518 applies (H) (Anaes.) (Assist.)

573.00

30521

Gastrectomy, total, for benign disease (H) (Anaes.) (Assist.)

1 226.00

30523

Gastrectomy, sub-total radical, for carcinoma (including splenectomy when performed) (H) (Anaes.) (Assist.)

1 281.30

30524

Gastrectomy, total radical, for carcinoma (including extended node dissection and distal pancreatectomy and splenectomy when performed) (H) (Anaes.) (Assist.)

1 410.75

30526

Gastrectomy, total, and including lower oesophagus, performed by left thoraco-abdominal incision or opening of diaphragmatic hiatus (including splenectomy when performed) (H) (Anaes.) (Assist.)

1 829.65

30527

Antireflux operation by fundoplasty, via abdominal or thoracic approach, with or without closure of the diaphragmatic hiatus — not being a service to which item 30601 applies (H) (Anaes.) (Assist.)

739.30

30529

Antireflux operation by fundoplasty, with oesophagoplasty for stricture or short oesophagus (H) (Anaes.) (Assist.)

1 108.90

30530

Antireflux operation by cardiopexy, with or without fundoplasty (H) (Anaes.) (Assist.)

665.40

30532

Oesophagogastric myotomy (Heller’s operation) via abdominal or thoracic approach, with or without closure of the diaphragmatic hiatus, by laparoscopy or open operation (H) (Anaes.) (Assist.)

764.00

30533

Oesophagogastric myotomy (Heller’s operation) via abdominal or thoracic approach, with fundoplasty, with or without closure of the diaphragmatic hiatus, by laparoscopy or open operation (H) (Anaes.) (Assist.)

908.80

30535

Oesophagectomy with gastric reconstruction by abdominal mobilisation and thoracotomy (H) (Anaes.) (Assist.)

1 439.55

30536

Oesophagectomy involving gastric reconstruction by abdominal mobilisation, thoracotomy and anastomosis in the neck or chest — 1 surgeon (H) (Anaes.) (Assist.)

1 460.15

30538

Oesophagectomy involving gastric reconstruction by abdominal mobilisation, thoracotomy and anastomosis in the neck or chest — conjoint surgery, principal surgeon (including after-care) (H) (Anaes.) (Assist.)

1 010.40

30539

Oesophagectomy involving gastric reconstruction by abdominal mobilisation, thoracotomy and anastomosis in the neck or chest — conjoint surgery, co-surgeon (H) (Assist.)

739.30

30541

Oesophagectomy, by trans-hiatal oesophagectomy (cervical and abdominal mobilisation, anastomosis) with posterior or anterior mediastinal placement — 1 surgeon (H) (Anaes.) (Assist.)

1 287.60

30542

Oesophagectomy, by trans-hiatal oesophagectomy (cervical and abdominal mobilisation, anastomosis) with posterior or anterior mediastinal placement — conjoint surgery, principal surgeon (including after-care) (H) (Anaes.) (Assist.)

874.80

30544

Oesophagectomy, by trans-hiatal oesophagectomy (cervical and abdominal mobilisation, anastomosis) with posterior or anterior mediastinal placement — conjoint surgery, co-surgeon (H) (Assist.)

640.75

30545

Oesophagectomy with colon or jejunal anastomosis, (abdominal and thoracic mobilisation with thoracic anastomosis) — 1 surgeon (H) (Anaes.) (Assist.)

1 558.75

30547

Oesophagectomy with colon or jejunal anastomosis, (abdominal and thoracic mobilisation with thoracic anastomosis) — conjoint surgery, principal surgeon (including after-care) (Anaes.) (Assist.)

1 071.95

30548

Oesophagectomy with colon or jejunal anastomosis, (abdominal and thoracic mobilisation with thoracic anastomosis) — conjoint surgery, co-surgeon (Assist.)

800.85

 

30550

Oesophagectomy with colon or jejunal replacement (abdominal and thoracic mobilisation with anastomosis of pedicle in the neck) — 1 surgeon (H) (Anaes.) (Assist.)

1 749.70

30551

Oesophagectomy with colon or jejunal replacement (abdominal and thoracic mobilisation with anastomosis of pedicle in the neck) — conjoint surgery, principal surgeon (including after-care) (H) (Anaes.) (Assist.)

1 207.55

30553

Oesophagectomy with colon or jejunal replacement (abdominal and thoracic mobilisation with anastomosis of pedicle in the neck) — conjoint surgery, co-surgeon (Assist.)

893.20

30554

Oesophagectomy with reconstruction by free jejunal graft — 1 surgeon (H) (Anaes.) (Assist.)

1 946.80

30556

Oesophagectomy with reconstruction by free jejunal graft — conjoint surgery, principal surgeon (including after-care) (H) (Anaes.) (Assist.)

1 343.00

30557

Oesophagectomy with reconstruction by free jejunal graft — conjoint surgery, co-surgeon (H) (Assist.)

991.85

30559

Oesophagus, local excision for tumour of (Anaes.) (Assist.)

720.85

30560

Oesophageal perforation, repair of, by thoracotomy (H) (Anaes.) (Assist.)

800.85

30562

Enterosomy or colostomy, closure of — not involving resection of bowel (H) (Anaes.) (Assist.)

504.90

30563

Colostomy or ileostomy, refashioning of (Anaes.) (Assist.)

504.90

30564

Small bowel strictureplasty for chronic inflammatory bowel disease (H) (Anaes.) (Assist.)

655.30

30565

Small intestine, resection of, without anastomosis (including formation of stoma) (H) (Anaes.) (Assist.)

739.30

30566

Small intestine, resection of, with anastomosis (H) (Anaes.) (Assist.)

821.25

30568

Intraoperative enterotomy for visualisation of the small intestine by endoscopy (H) (Anaes.) (Assist.)

616.05

30569

Endoscopic examination of small bowel with flexible endoscope passed at laparotomy, with or without biopsies (H) (Anaes.) (Assist.)

314.10

30571

Appendicectomy, not being a service to which item 30574 applies (H) (Anaes.) (Assist.)

377.95

30572

Laparoscopic appendicectomy (H) (Anaes.) (Assist.)

377.95

30574

Appendicectomy, when performed in conjunction with any other intra-abdominal procedure through the same incision (H) (Anaes.)

104.60

30575

Pancreatic abscess, laparotomy and external drainage of, not requiring retro-pancreatic dissection (H) (Anaes.) (Assist.)

435.10

30577

Pancreatic necrosectomy for pancreatic necrosis or abscess formation requiring major pancreatic or
retro-pancreatic dissection, excluding after-care (H) (Anaes.) (Assist.)

924.15

30578

Endocrine tumour, exploration of pancreas or duodenum, followed by local excision of pancreatic tumour (H) (Anaes.) (Assist.)

973.40

30580

Endocrine tumour, exploration of pancreas or duodenum, followed by local excision of duodenal tumour (H) (Anaes.) (Assist.)

887.05

30581

Endocrine tumour, exploration of pancreas or duodenum for, but no tumour found (H) (Anaes.) (Assist.)

646.90

30583

Distal pancreatectomy (H) (Anaes.) (Assist.)

1 013.35

30584

Pancreatico-duodenectomy, Whipple’s operation, with or without preservation of pylorus (H) (Anaes.) (Assist.)

1 495.75

30586

Pancreatic cyst-anastomosis to stomach or duodenum — by open or endoscopic means (H) (Anaes.) (Assist.)

595.00

30587

Pancreatic cyst, anastomosis to Roux loop of jejunum (H) (Anaes.) (Assist.)

616.05

30589

Pancreatico-jejunostomy for pancreatitis or trauma (H) (Anaes.) (Assist.)

1 061.50

30590

Pancreatico-jejunostomy following previous pancreatic surgery (H) (Anaes.) (Assist.)

1 170.60

30593

Pancreatectomy, near total or total (including duodenum), with or without splenectomy (Anaes.) (Assist.)

1 601.80

30594

Pancreatectomy for pancreatitis following previously attempted drainage procedure or partial resection (H) (Anaes.) (Assist.)

1 848.25

30596

Splenorrhaphy or partial splenectomy (H) (Anaes.) (Assist.)

761.35

30597

Splenectomy (H) (Anaes.) (Assist.)

611.10

30599

Splenectomy, for massive spleen (weighing more than 1 500 gms) or involving thoraco-abdominal incision (H) (Anaes.) (Assist.)

1 108.90

30600

Diaphragmatic hernia, traumatic, repair of (H) (Anaes.) (Assist.)

659.40

30601

Diaphragmatic hernia, congenital, repair of, by thoracic or abdominal approach (H) (Anaes.) (Assist.)

812.25

30602

Portal hypertension, porto-caval shunt for (H) (Anaes.) (Assist.)

1 318.35

30603

Portal hypertension, meso-caval shunt for (Anaes.) (Assist.)

1 392.35

30605

Portal hypertension, selective spleno-renal shunt for (H) (Anaes.) (Assist.)

1 583.30

30606

Portal hypertension, oesophageal transection via stapler or oversew of gastric varices with or without devascularisation (H) (Anaes.) (Assist.)

942.55

30609

Femoral or inguinal hernia, laparoscopic repair of, not being a service associated with a service to which item 30612 or 30614 applies (H) (Anaes.) (Assist.)

394.10

30612

Femoral or inguinal hernia or infantile hydrocele, repair of, not being a service to which item 30403 or 30615 applies (G) (H) (Anaes.) (Assist.)

302.35

30614

Femoral or inguinal hernia or infantile hydrocele, repair of, not being a service to which item 30403 or 30615 applies (S) (H) (Anaes.) (Assist.)

394.10

30615

Strangulated, incarcerated or obstructed hernia, repair of, without bowel resection (H) (Anaes.) (Assist.)

442.25

30616

Umbilical, epigastric or linea alba hernia, repair of, in a person under 10 years of age (G) (H) (Anaes.)

225.15

30617

Umbilical, epigastric or linea alba hernia, repair of, in a person under 10 years of age (S) (H) (Anaes.)

302.35

30620

Umbilical, epigastric or linea alba hernia, repair of, in a person 10 years of age or over (G) (H) (Anaes.) (Assist.)

254.10

30621

Umbilical, epigastric or linea alba hernia, repair of, in a person 10 years of age or over (S) (H) (Anaes.) (Assist.)

345.80

30628

Hydrocele, tapping of

30.20

30631

Hydrocele, removal of, not being a service associated with a service to which items 30638, 30641 and 30644 apply (Anaes.)

200.80

30634

Varicocele, surgical correction of, not being a service associated with a service to which items 30638, 30641 and 30644 apply — 1 procedure (G) (H) (Anaes.) (Assist.)

199.45

30635

Varicocele, surgical correction of, not being a service associated with a service to which items 30638, 30641 and 30644 apply — 1 procedure (S) (H) (Anaes.) (Assist.)

247.65

30638

Orchidectomy, simple or subcapsular, unilateral with or without insertion of testicular prosthesis (G) (H) (Anaes.) (Assist.)

254.10

30641

Orchidectomy, simple or subcapsular, unilateral with or without insertion of testicular prosthesis (S) (H) (Anaes.) (Assist.)

345.80

30644

Exploration of spermatic cord, inguinal approach, with or without testicular biopsy and with or without excision of spermatic cord and testis (H) (Anaes.) (Assist.)

442.25

30653

Circumcision of a male under 6 months of age (Anaes.)

39.45

30656

Circumcision of a male under 10 years of age but not less than 6 months of age (Anaes.)

91.75

30659

Circumcision of a male 10 years of age or over (G) (Anaes.)

127.05

30660

Circumcision of a male 10 years of age or over (S) (Anaes.)

157.55

30663

Haemorrhage, arrest of, following circumcision requiring general anaesthesia (Anaes.)

122.50

30666

Paraphimosis, reduction of, under general anaesthesia, with or without dorsal incision, not being a service associated with a service to which another item in this group applies (Anaes.)

40.30

30672

Coccyx, excision of (H) (Anaes.) (Assist.)

377.95

30675

Pilonidal sinus or cyst, or sacral sinus or cyst, excision of (G) (Anaes.)

254.10

30676

Pilonidal sinus or cyst, or sacral sinus or cyst, excision of (S) (Anaes.)

321.65

30679

Pilonidal sinus, injection of sclerosant fluid under anaesthesia (Anaes.)

81.70

31000

Micrographically controlled serial excision of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure — 6 or fewer sections (Anaes.)

492.85

31001

Micrographically controlled serial excision of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure — 7 to 12 sections (inclusive) (Anaes.)

616.05

31002

Micrographically controlled serial excision of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure — 13 or more sections (Anaes.)

739.30

31200

Tumour (other than viral verrucae (common warts) and seborrheic keratoses), cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), removal by surgical excision (other than by shave excision) and suture from cutaneous or subcutaneous tissue or from mucous membrane, not being a service to which another item in this group applies

28.85

31205

Tumour (other than viral verrucae (common warts) and seborrheic keratoses), cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), lesion size up to 10 mm in diameter, removal by surgical excision (other than by shave excision) and suture from cutaneous or subcutaneous tissue or from mucous membrane, including excision to establish the diagnosis of tumours covered by items 31300 to 31335 — where the specimen excised is sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

80.95

31210

Tumour (other than viral verrucae (common warts) and seborrheic keratoses), cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), lesion size more than 10 mm and up to 20 mm in diameter, removal by surgical excision (other than by shave excision) and suture from cutaneous or subcutaneous tissue or from mucous membrane, including excision to establish the diagnosis of tumours covered by items 31300 to 31335 — where the specimen excised is sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

104.45

31215

Tumour (other than viral verrucae (common warts) and seborrheic keratoses), cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), lesion size more than 20 mm in diameter, removal by surgical excision (other than by shave excision) and suture from cutaneous or subcutaneous tissue or from mucous membrane, including excision to establish the diagnosis of tumours covered by items 31300 to 31335 — where the specimen excised is sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

121.75

31220

Tumours (other than viral verrucae (common warts) and seborrheic keratoses), cysts, ulcers or scars (other than scars removed during the surgical approach at an operation), lesion size up to 10 mm in diameter, removal of 4 to 10 lesions by surgical excision (other than by shave excision) and suture from cutaneous or subcutaneous tissue or from mucous membrane, including excision to establish the diagnosis of tumours covered by items 31300 to 31335 — if all specimens excised are sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

182.05

31225

Tumours (other than viral verrucae (common warts) and seborrheic keratoses), cysts, ulcers or scars (other than scars removed during the surgical approach at an operation), lesion size up to 10 mm in diameter, removal of more than 10 lesions by surgical excision (other than by shave excision) and suture from cutaneous or subcutaneous tissue or from mucous membrane, including excision to establish the diagnosis of tumours covered by items 31300 to 31335 — if all specimens excised are sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

323.55

31230

Tumour (other than viral verrucae (common warts) and seborrheic keratoses), cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), removal by surgical excision (other than by shave excision) and suture from nose, eyelid, lip, ear, digit or genitalia, including excision to establish the diagnosis of tumours covered by items 31300 to 31335 — where the specimen excised is sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

142.60

31235

Tumour (other than viral verrucae (common warts) and seborrheic keratoses), cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), removal by surgical excision (other than by shave excision) and suture from face, neck (anterior to the sternomastoid muscles) or lower leg (mid calf to ankle), including excision to establish the diagnosis of tumours covered by items 31300 to 31335, lesion size up to 10 mm in diameter — where the specimen excised is sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

121.75

31240

Tumour (other than viral verrucae (common warts) and seborrheic keratoses), cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), removal by surgical excision (other than by shave excision) and suture from face, neck (anterior to the sternomastoid muscles) or lower leg (mid calf to ankle), including excision to establish the diagnosis of tumours covered by items 31300 to 31335, lesion size more than 10 mm in diameter — where the specimen excised is sent for histological examination (not being a service to which item 30195 applies) (Anaes.)

142.60

31245

Skin and subcutaneous tissue, extensive excision of, in the treatment of suppurative hydradenitis (excision from axilla, groin or natal cleft) or sycosis barbae or nuchae (excision from face or neck) (Anaes.)

313.10

31250

Giant hairy or compound naevus, excision of an area at least 1% of body surface — where the specimen excised is sent for histological confirmation of diagnosis (Anaes.)

313.10

31255

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from nose, eyelid, lip, ear, digit or genitalia, tumour size up to 10 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

187.85

31260

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from nose, eyelid, lip, ear, digit or genitalia, tumour size more than 10 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

267.85

31265

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from face, neck (anterior to the sternomastoid muscles) or lower leg (mid calf to ankle), tumour size up to 10 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

156.50

31270

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from face, neck (anterior to the sternomastoid muscles) or lower leg (mid calf to ankle), tumour size more than 10 mm and up to 20 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

219.15

31275

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from face, neck (anterior to the sternomastoid muscles) or lower leg (mid calf to ankle), tumour size more than 20 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

253.90

31280

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from areas of the body not covered by item 31255 or 31265, tumour size up to 10 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

132.20

31285

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from areas of the body not covered by item 31260 or 31270, tumour size more than 10 mm and up to 20 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

180.75

31290

Basal cell carcinoma or squamous cell carcinoma (including keratocanthoma), removal from areas of the body not covered by item 31260 or 31275, tumour size more than 20 mm in diameter — where removal is by surgical excision (other than by shave excision) and suture, and where the initial specimen removed is sent for histological examination and malignancy confirmed, and any subsequently excised specimen is sent for histological examination (Anaes.)

208.65

31295

Basal cell carcinoma or squamous cell carcinoma, residual or recurrent (where lesion treated by previous surgery, serial cautery and curettage, radiotherapy or two prolonged freeze or thaw cycles of liquid nitrogen therapy), performed by a specialist in the practice of his or her specialty or by a practitioner other than the practitioner who provided the previous treatment, removal from the head or neck (anterior to the sternomastoid muscles) — where removal is by surgical excision and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

248.50

31300

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from nose, eyelid, lip, ear, digit or genitalia, tumour size up to 10 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

271.45

31305

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from nose, eyelid, lip, ear, digit or genitalia, tumour size more than 10 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

333.90

31310

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from face, neck (anterior to sternomastoid muscles) or lower leg (mid calf to ankle), tumour size up to 10 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

236.45

31315

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from face, neck (anterior to sternomastoid muscles) or lower leg (mid calf to ankle), tumour size more than 10 mm and up to 20 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

299.10

31320

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from face, neck (anterior to sternomastoid muscles) or lower leg (mid calf to ankle), tumour size more than 20 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

333.90

31325

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from areas of the body not covered by items 31300 and 31310 — tumour size up to 10 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

229.60

31330

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from areas of the body not covered by items 31305 and 31310 — tumour size more than 10 mm and up to 20 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

271.45

31335

Malignant melanoma, appendageal carcinoma, malignant fibrous tumour of skin, merkel cell carcinoma of skin or Hutchinson’s melanotic freckle-removal from areas of the body not covered by items 31305 and 31320 — tumour size more than 20 mm in diameter — where removal is by definitive surgical excision (with an adequate margin and as a result, no further surgery is indicated at the site of the primary tumour), and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

313.10

31340

Muscle, bone or cartilage, excision of 1 or more of, where clinically indicated, and where the specimen excised is sent for histological confirmation, performed in association with excision of malignant tumour of skin covered by item 31255, 31260, 31265, 31270, 31275, 31280, 31285, 31290, 31295, 31300, 31305, 31310, 31315, 31320, 31325, 31330 or 31335 (Anaes.)

Amount under rule 38

31345

Lipoma, removal of by surgical excision or liposuction, where lesion is subcutaneous and greater than 50 mm in diameter, or is sub-fascial, where the specimen excised is sent for histological confirmation of diagnosis (Anaes.)

178.90

31346

Liposuction (suction assisted lipolysis) to 1 regional area for treatment of contour problems of abdominal, upper arm or thigh fat due to repeated insulin injections, where the lesion is subcutaneous and greater than 50 mm in diameter (Anaes.)

178.90

31350

Benign tumour of soft tissue, removal of by surgical excision, where the specimen excised is sent for histological confirmation of diagnosis, not being a service to which another item in this group applies (Anaes.) (Assist.)

367.70

31355

Malignant tumour of soft tissue, removal of by surgical excision, where histological proof of malignancy has been obtained, not being a service to which another item in this group applies (Anaes.) (Assist.)

606.20

31400

Malignant upper aerodigestive tract tumour up to 20 mm in diameter (excluding tumour of the lip), excision of, where histological confirmation of malignancy has been obtained (Anaes.) (Assist.)

221.50

31403

Malignant upper aerodigestive tract tumour more than 20 mm and up to 40 mm in diameter (excluding tumour of the lip), excision of, where histological confirmation of malignancy has been obtained (H) (Anaes.) (Assist.)

255.65

31406

Malignant upper aerodigestive tract tumour more than 40 mm in diameter (excluding tumour of the lip), excision of, where histological confirmation of malignancy has been obtained (Anaes.) (Assist.)

426.10

31409

Parapharyngeal tumour, excision of, by cervical approach (H) (Anaes.) (Assist.)

1 323.75

31412

Recurrent or persistent parapharyngeal tumour, excision of, by cervical approach (H) (Anaes.) (Assist.)

1 630.55

31420

Lymph node of neck, biopsy of (Anaes.)

156.05

31423

Lymph nodes of neck, selective dissection of 1 or 2 lymph node levels involving removal of soft tissue and lymph nodes from one side of the neck (Anaes.) (Assist.)

340.85

31426

Lymph nodes of neck, selective dissection of 3 lymph node levels involving removal of soft tissue and lymph nodes from one side of the neck (H) (Anaes.) (Assist.)

681.75

31429

Lymph nodes of neck, selective dissection of 4 lymph node levels on one side of the neck with preservation of 1 or more of internal jugular vein, sternocleido-mastoid muscle or spinal accessory nerve (H) (Anaes.) (Assist.)

1 062.40

31432

Lymph nodes of neck, bilateral selective dissection of levels I, II and III (bilateral supraomohyoid dissections) (H) (Anaes.) (Assist.)

1 136.25

31435

Lymph nodes of neck, comprehensive dissection of all 5 lymph node levels on one side of the neck (H) (Anaes.) (Assist.)

835.15

31438

Lymph nodes of neck, comprehensive dissection of all 5 lymph node levels on one side of the neck with preservation of 1 or more of: internal jugular vein, sternocleido-mastoid muscle, or spinal accessory nerve (H) (Anaes.) (Assist.)

1 323.75

31441

Long-term implanted reservoir associated with the adjustable gastric band, repair, revision or
replacement of (Anaes.)

213.55

31450

Laparoscopic division of adhesions, as an independent procedure, where the time taken is 1 hour or less (H) (Anaes.) (Assist.)

345.05

31452

Laparoscopic division of adhesions, as an independent procedure, where the time taken is more than 1 hour (H) (Anaes.) (Assist.)

603.70

31454

Laparoscopy with drainage of pus, bile or blood, as an independent procedure (H) (Anaes.) (Assist.)

477.95

31456

Gastroscopy and insertion of nasogastric or nasoenteral feeding tube, where blind insertion of the feeding tube has failed or is inappropriate due to the patient’s medical condition (H) (Anaes.)

208.40

31458

Gastroscopy and insertion of nasogastric or nasoenteral feeding tube, where blind insertion of the feeding tube has failed or is inappropriate due to the patient’s medical condition, and where the use of imaging intensification is clinically indicated (H) (Anaes.)

250.05

31460

Percutaneous gastrostomy tube, jejunal extension to, including any associated imaging services (H) (Anaes.) (Assist.)

302.95

31462

Operative feeding jejunostomy performed in conjunction with major upper gastro-intestinal resection (H) (Anaes.) (Assist.)

442.25

31464

Antireflux operation by fundoplasty, via abdominal or thoracic approach, with or without closure of the diaphragmatic hiatus, by laparoscopic technique — not being a service to which item 30601 applies (H) (Anaes.) (Assist.)

739.30

31466

Antireflux operation by fundoplasty, via abdominal or thoracic approach, with or without closure of the diaphragmatic hiatus, revision procedure, by laparoscopy or open operation (H) (Anaes.) (Assist.)

1 108.95

31468

Para-oesophageal hiatus hernia, repair of, with complete reduction of hernia, resection of sac and repair of hiatus, with or without fundoplication (H) (Anaes.) (Assist.)

1 218.35

31470

Laparoscopic splenectomy (H) (Anaes.) (Assist.)

611.10

31472

Cholecystoduodenostomy, cholecystoenterostomy, choledochojejunostomy or Roux-en-y as a bypass procedure where prior biliary surgery has been performed (H) (Anaes.) (Assist.)

992.60

31500

Breast, benign lesion up to and including 50 mm in diameter, including simple cyst, fibroadenoma or fibrocystic disease, open surgical biopsy or excision of, with or without frozen section histology (Anaes.)

220.65

31503

Breast, benign lesion more than 50 mm in diameter, excision of (Anaes.) (Assist.)

294.25

31506

Breast, abnormality detected by mammography or ultrasound where guidewire or other localisation procedure is performed, excision biopsy of (H) (Anaes.) (Assist.)

331.00

31509

Breast, malignant tumour, open surgical biopsy of, with or without frozen section histology (Anaes.)

294.25

31512

Breast, malignant tumour, complete local excision of, with or without frozen section histology (H) (Anaes.) (Assist.)

551.70

31515

Breast, tumour site, re-excision of, following open biopsy or incomplete excision of malignant tumour (H) (Anaes.) (Assist.)

370.05

31518

Breast (female), total mastectomy (H) (Anaes.) (Assist.)

624.70

31521

Breast (male), total mastectomy, not being a service associated with a service to which item 45585 applies (Anaes.) (Assist.)

367.80

31524

Breast (female), subcutaneous mastectomy (H) (Anaes.) (Assist.)

882.70

31527

Breast (male), subcutaneous mastectomy, not being a service associated with a service to which item 45585 applies (Anaes.) (Assist.)

441.40

31530

Breast, biopsy of solid tumour or tissue of, using a vacuum-assisted breast biopsy device under imaging guidance, for histological examination, where imaging has demonstrated:

 (a) microcalcification of lesion; or

 (b) impalpable lesion less than 1 cm in diameter;

including pre-operative localisation of lesion where performed, not being a service associated with a service to which item 31539, 31545 or 31548 applies

505.40

31533

Fine needle aspiration of an impalpable breast lesion detected by mammography or ultrasound, imaging guided — but not including imaging (Anaes.)

117.00

31536

Breast, preoperative localisation of lesion of, by hookwire or similar device, using interventional imaging techniques, but not including imaging — not being a service associated with a service to which item 31539, 31542 or 31545 applies (Anaes.)

160.70

31539

Breast, biopsy of solid tumour or tissue of, using advanced breast biopsy instrumentation (ABBI), for histological examination, conducted by a qualified surgeon, where imaging has demonstrated an impalpable lesion of less than 15 mm in diameter, not being a service associated with a service to which item 31530, 31536 or 31548 applies (H) (Anaes.)

338.40

31542

Breast, initial guidewire localisation of lesion, by hookwire or similar device, conducted by a qualified radiologist, using interventional imaging techniques prior to advanced breast biopsy instrumentation (ABBI), including imaging — not being a service associated with a service to which item 31536 applies (Anaes.)

167.05

31545

Breast, biopsy of solid tumour or tissue of, using advanced breast biopsy instrumentation (ABBI), for histological examination, conducted by a qualified surgeon, where imaging has demonstrated an impalpable lesion of less than 15 mm in diameter, including initial guidewire localisation of lesion, by hookwire or similar device, using interventional imaging techniques and including imaging — not being a service associated with a service to which item 31530, 31536 or 31548 applies (Anaes.)

505.40

31548

Breast, biopsy of solid tumour or tissue of, using mechanical biopsy device, for histological examination, not being a service associated with a service to which item 31530, 31539 or 31545 applies (Anaes.)

117.00

31551

Breast, haematoma, seroma or inflammatory condition including abscess, granulomatous mastitis or similar, exploration and drainage of, when performed in the operating theatre of a hospital or approved day hospital facility, excluding after-care (Anaes.)

183.90

31554

Breast, microdochotomy of, for benign or malignant condition (H) (Anaes.) (Assist.)

367.80

31557

Breast central ducts, excision of, for benign condition (Anaes.) (Assist.)

294.25

31560

Accessory breast tissue, excision of (Anaes.) (Assist.)

294.25

31563

Inverted nipple, surgical eversion of (Anaes.)

220.45

31566

Accessory nipple, excision of (Anaes.)

110.30

Subgroup 2 — Colorectal

32000

Large intestine, resection of, without anastomosis, including right hemicolectomy (including formation of stoma) (H) (Anaes.) (Assist.)

875.10

32003

Large intestine, resection of, with anastomosis, including right hemicolectomy (H) (Anaes.) (Assist.)

915.45

32004

Large intestine, sub-total colectomy (resection of right colon, transverse colon and splenic flexure) without anastomosis, not being a service associated with a service to which item 32000, 32003, 32005 or 32006 applies (H) (Anaes.) (Assist.)

976.10

32005

Large intestine, sub-total colectomy (resection of right colon, transverse colon and splenic flexure) with anastomosis, not being a service associated with a service to which item 32000, 32003, 32004 or 32006 applies (H) (Anaes.) (Assist.)

1 102.70

32006

Left hemicolectomy, including the descending and sigmoid colon (including formation of stoma) (H) (Anaes.) (Assist.)

976.10

32009

Total colectomy and ileostomy (H) (Anaes.) (Assist.)

1 157.85

32012

Total colectomy and ileo-rectal anastomosis (H) (Anaes.) (Assist.)

1 279.00

32015

Total colectomy with excision of rectum and ileostomy — 1 surgeon (H) (Anaes.) (Assist.)

1 571.85

32018

Total colectomy with excision of rectum and ileostomy, combined synchronous operation — abdominal resection (including after-care) (H) (Anaes.) (Assist.)

1 332.80

32021

Total colectomy with excision of rectum and ileostomy, combined synchronous operation — perineal resection (H) (Assist.)

477.95

32024

Rectum, high restorative anterior resection with intraperitoneal anastomosis (of the rectum) greater than 10 cm from the anal verge — excluding resection of sigmoid colon alone, not being a service associated with a service to which item 32103, 32104 or 32106 applies (H) (Anaes.) (Assist.)

1 157.85

32025

Rectum, low restorative anterior resection with extraperitoneal anastomosis (of the rectum) less than 10 cm from the anal verge, with or without covering stoma, not being a service associated with a service to which item 32103, 32104 or 32106 applies (H) (Anaes.) (Assist.)

1 548.75

32026

Rectum, ultra low restorative resection, with or without covering stoma, where the anastomosis is sited in the anorectal region and is 6 cm or less from the anal verge (H) (Anaes.) (Assist.)

1 667.85

32028

Rectum, low or ultra low restorative resection, with peranal sutured coloanal anastomosis, with or without covering stoma (H) (Anaes.) (Assist.)

1 787.05

32029

Colonic reservoir, construction of, being a service associated with a service to which any other item in this subgroup applies (H) (Anaes.) (Assist.)

357.40

32030

Rectosigmoidectomy — (Hartmann’s operation) (H) (Anaes.) (Assist.)

875.10

32033

Restoration of bowel following Hartmann’s or similar operation, including dismantling of the stoma (H) (Anaes.) (Assist.)

1 279.00

32036

Sacrococcygeal and presacral tumour — excision of (H) (Anaes.) (Assist.)

1 622.20

32039

Rectum and anus, abdomino-perineal resection of — 1 surgeon (H) (Anaes.) (Assist.)

1 302.50

32042

Rectum and anus, abdomino-perineal resection of, combined synchronous operation, abdominal resection (H) (Anaes.) (Assist.)

1097.20

32045

Rectum and anus, abdomino-perineal resection of, combined synchronous operation — perineal resection (Assist.)

410.65

32046

Rectum and anus, abdomino-perineal resection of, combined synchronous operation — perineal resection where the perineal surgeon also provides assistance to the abdominal surgeon (H) (Assist.)

634.55

32047

Perineal proctectomy (Anaes.) (Assist.)

739.30

32051

Total colectomy with excision of rectum and ileoanal anastomosis with formation of ileal reservoir, with or without creation of temporary ileostomy — 1 surgeon (H) (Anaes.) (Assist.)

1 965.65

32054

Total colectomy with excision of rectum and ileoanal anastomosis with formation of ileal reservoir, with or without creation of temporary ileostomy — conjoint surgery, abdominal surgeon (including after-care) (H) (Anaes.) (Assist.)

1 804.05

32057

Total colectomy with excision of rectum and ileoanal anastomosis with formation of ileal reservoir — conjoint surgery, perineal surgeon (Assist.)

477.95

32060

Ileostomy closure with rectal resection and mucosectomy and ileoanal anastomosis with formation of ileal reservoir, with or without temporary loop ileostomy — 1 surgeon (H) (Anaes.) (Assist.)

1 965.65

32063

Ileostomy closure with rectal resection and mucosectomy and ileoanal anastomosis with formation of ileal reservoir, with or without temporary loop ileostomy — conjoint surgery, abdominal surgeon (including after-care) (H) (Anaes.) (Assist.)

1 804.05

32066

Ileostomy closure with rectal resection and mucosectomy and ileoanal anastomosis with formation of ileal reservoir, with or without temporary loop ileostomy — conjoint surgery, perineal surgeon (H) (Assist.)

477.95

32069

Ileostomy reservoir, continent type, creation of, including conversion of existing ileostomy where appropriate (Anaes.)

1 454.05

32072

Sigmoidoscopic examination (with rigid sigmoidoscope), with or without biopsy

40.65

32075

Sigmoidoscopic examination (with rigid sigmoidoscope), under general anaesthesia, with or without biopsy, not being a service associated with a service to which another item in this group applies (Anaes.)

63.70

32078

Sigmoidoscopic examination with diathermy or resection of 1 or more polyps where the time taken is less than or equal to 45 minutes (Anaes.)

143.00

32081

Sigmoidoscopic examination with diathermy or resection of 1 or more polyps where the time taken is greater than 45 minutes (Anaes.)

196.40

32084

Flexible fibreoptic sigmoidoscopy or fibreoptic colonoscopy up to the hepatic flexure, with or without biopsy (Anaes.)

94.50

32087

Flexible fibreoptic sigmoidoscopy or fibreoptic colonoscopy up to the hepatic flexure with removal of 1 or more polyps — not being a service to which item 32078 applies (Anaes.)

173.70

32090

Fibreoptic colonoscopy — examination of colon beyond the hepatic flexure with or without biopsy (Anaes.)

283.65

32093

Fibreoptic colonoscopy — examination of colon beyond the hepatic flexure with removal of 1 or more polyps (Anaes.)

398.10

32094

Endoscopic dilatation of colorectal strictures including colonoscopy (Anaes.)

468.20

32095

Endoscopic examination of small bowel with flexible endoscope passed by stoma, with or without biopsies (Anaes.)

108.50

32096

Rectal biopsy, full thickness, under general anaesthesia, or under epidural or spinal (intrathecal) nerve block (H) (Anaes.) (Assist.)

218.05

32099

Rectal tumour of 5 cm or less in diameter, per anal submucosal excision of (H) (Anaes.) (Assist.)

282.75

32102

Rectal tumour of greater than 5 cm in diameter, indicated by pathological examination, per anal submucosal excision of (H) (Anaes.) (Assist.)

538.50

32103

Rectal tumour of less than 4 cm in diameter, per anal excision of, using stereoscopic rectoscopy (incorporating stereoscopic and optic systems), where removal is unable to be performed during colonoscopy or by local excision, not being a service associated with a service to which item 32024, 32025, 32104 or 32106 applies (Anaes.) (Assist.)

655.30

32104

Rectal tumour of 4 cm or greater in diameter, per anal excision of, using stereoscopic rectoscopy (incorporating stereoscopic and optic systems), where removal is unable to be performed during colonoscopy or by local excision, not being a service associated with a service to which item 32024, 32025, 32103 or 32106 applies (Anaes.) (Assist.)

848.20

32105

Anorectal carcinoma — per anal full thickness excision of (Anaes.) (Assist.)

410.65

32106

Anterolateral intraperitoneal rectal tumour, per anal excision of, using stereoscopic rectoscopy (incorporating stereoscopic and optic systems), where removal is unable to be performed during colonoscopy and where removal requires dissection within the peritoneal cavity, not being a service associated with a service to which item 32024, 32025, 32103 or 32104 applies (Anaes.) (Assist.)

1 157.85

32108

Rectal tumour, trans-sphincteric excision of (Kraske or similar operation) (H) (Anaes.) (Assist.)

848.20

32111

Rectal prolapse, Delorme procedure for (H) (Anaes.) (Assist.)

538.50

32112

Rectal prolapse, perineal recto-sigmoidectomy for (H) (Anaes.) (Assist.)

655.30

32114

Rectal stricture, per anal release of (Anaes.)

148.10

32115

Rectal stricture, dilatation of (Anaes.)

107.65

32117

Rectal prolapse, abdominal rectopexy of (H) (Anaes.) (Assist.)

848.20

32120

Rectal prolapse, perineal repair of (Anaes.) (Assist.)

218.05

32123

Anal stricture, anoplasty for (Anaes.) (Assist.)

282.75

32126

Anal incontinence, Parks’ intersphincteric procedure for (H) (Anaes.) (Assist.)

410.65

32129

Anal sphincter, direct repair of (H) (Anaes.) (Assist.)

538.50

32131

Rectocele, transanal repair of rectocele (H) (Anaes.) (Assist.)

452.75

32132

Haemorrhoids or rectal prolapse — sclerotherapy for (Anaes.)

38.30

32135

Haemorrhoids or rectal prolapse — rubber band ligation of, with or without sclerotherapy, cryotherapy or infrared therapy for (Anaes.)

57.25

32138

Haemorrhoidectomy including excision of anal skin tags when performed (Anaes.)

312.00

32139

Haemorrhoidectomy involving third or fourth degree haemorrhoids, including excision of anal skin tags when performed (H) (Anaes.) (Assist.)

312.00

32142

Anal skin tags or anal polyps, excision of 1 or more of (Anaes.)

57.25

32145

Anal skin tags or anal polyps, excision of 1 or more of, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

114.60

32147

Perianal thrombosis, incision of (Anaes.)

38.30

32150

Operation for fissure-in-ano, including excision or sphincterotomy but excluding dilatation only (Anaes.) (Assist.)

218.05

32153

Anus, dilatation of, under general anaesthesia, with or without disimpaction of faeces, not being a service associated with a service to which another item in this group applies (Anaes.)

59.50

32156

Fistula-in-ano, subcutaneous, excision of (Anaes.)

111.75

32159

Anal fistula, treatment of, by excision or by insertion of a Seton, or by a combination of both procedures, involving the lower half of the anal sphincter mechanism (H) (Anaes.) (Assist.)

282.75

32162

Anal fistula, treatment of, by excision or by insertion of a Seton, or by a combination of both procedures, involving the upper half of the anal sphincter mechanism (H) (Anaes.) (Assist.)

410.65

32165

Anal fistula, repair of by mucosal flap advancement (Anaes.) (Assist.)

538.50

32166

Anal fistula — readjustment of Seton (Anaes.)

174.95

32168

Fistula wound, review of, under general or regional anaesthetic, as an independent procedure (H) (Anaes.)

111.75

32171

Anorectal examination, with or without biopsy, under general anaesthetic, not being a service associated with a service to which another item in this group applies (H) (Anaes.)

75.35

32174

Intra-anal, perianal or ischio-rectal abscess, drainage of (excluding after-care) (Anaes.)

75.35

32175

Intra-anal, perianal or ischio-rectal abscess, draining of, undertaken in the operating theatre of a hospital or approved day hospital facility (excluding after-care) (Anaes.)

138.00

32177

Anal warts, removal of, under general anaesthesia, or under regional or field nerve block (excluding pudendal block), where the time taken is less than or equal to 45 minutes — not being a service associated with a service to which item 35507 or 35508 applies (H) (Anaes.)

147.90

32180

Anal warts, removal of, under general anaesthesia, or under regional or field nerve block (excluding pudendal block), where the time taken is greater than 45 minutes — not being a service associated with a service to which item 35507 or 35508 applies (H) (Anaes.)

218.05

32183

Intestinal sling procedure prior to radiotherapy (H) (Anaes.) (Assist.)

476.60

32186

Colonic lavage, total, intra-operative (H) (Anaes.) (Assist.)

476.60

32200

Distal muscle, devascularisation of (Anaes.) (Assist.)

250.90

32203

Anal or perineal graciloplasty (H) (Anaes.) (Assist.)

538.75

32206

Stimulator and electrodes, insertion of, following previous graciloplasty (H) (Anaes.) (Assist.)

486.75

32209

Anal or perineal graciloplasty with insertion of stimulator and electrodes (H) (Anaes.) (Assist.)

782.25

32210

Gracilis neosphincter pacemaker, replacement of (Anaes.)

216.75

32212

Ano-rectal application of formalin in the treatment of radiation proctitis, where performed in the operating theatre of a hospital or approved day hospital facility, excluding after-care (Anaes.)

115.60

Subgroup 3 — Vascular

32500

Varicose veins where varicosity measures 2.5 mm or greater in diameter, multiple injections of sclerosant using continuous compression techniques, including associated consultation — 1 or both legs — not being a service associated with any other varicose vein operation on the same leg (excluding after-care) — to a maximum of 6 treatments in a 12 month period (Anaes.)

93.15

32501

Varicose veins where varicosity measures 2.5 mm or greater in diameter, multiple injections of sclerosant using continuous compression techniques, including associated consultation — 1 or both legs — not being a service associated with any other varicose vein operation on the same leg (excluding after-care) — where it can be demonstrated that truncal reflux in the long or short saphenous veins has been excluded by duplex examination and that a 7th or subsequent treatment (including any treatments to which item 32500 applies) is indicated in a 12 month period

93.15

32504

Varicose veins, multiple excision of tributaries, with or without division of 1 or more perforating veins — 1 leg — not being a service associated with a service to which item 32507, 32508, 32511, 32514 or 32517 applies in relation to the same leg (Anaes.)

227.10

32507

Varicose veins, sub-fascial surgical exploration of 1 or more incompetent perforating veins — 1 leg — not being a service associated with a service to which item 32508, 32511, 32514 or 32517 applies in relation to the same leg (Anaes.) (Assist.)

452.75

32508

Varicose veins, complete dissection at the
sapheno-femoral junction or sapheno-popliteal junction — 1 leg — with or without either ligation or stripping, or both, of the long or short saphenous vein on the same leg, for the first time, including excision or injection of either tributaries or incompetent perforating veins, or both (H) (Anaes.) (Assist.)

452.75

32511

Varicose veins, complete dissection at the sapheno-femoral junction and sapheno-popliteal junction — 1 leg — with or without either ligation or stripping, or both, of the long or short saphenous vein on the same leg, for the first time, including excision or injection of either tributaries or incompetent perforating veins, or both (H) (Anaes.) (Assist.)

673.15

32514

Varicose veins, ligation of the long or short saphenous vein on the same leg, with or without stripping, by
re-operation for recurrent veins in the same territory — 1 leg — including excision or injection of either tributaries or incompetent perforating veins, or both (H) (Anaes.) (Assist.)

786.35

32517

Varicose veins, ligation of the long and short saphenous veins on the same leg, with or without stripping, by
re-operation for recurrent veins in either territory — 1 leg — including excision or injection of either tributaries or incompetent perforating veins, or both (H) (Anaes.) (Assist.)

1 012.60

32700

Artery of neck, bypass using vein or synthetic material (H) (Anaes.) (Assist.)

1 218.70

32703

Internal carotid artery, transection and reanastomosis of, or resection of small length and reanastomosis of — with or without endarterectomy (H) (Assist.)

1 008.20

32708

Aortic bypass for occlusive disease using a straight
non-bifurcated graft (H) (Anaes.) (Assist.)

1 206.00

32710

Aortic bypass for occlusive disease using a bifurcated graft with 1 or both anastomoses to the iliac arteries (H) (Anaes.) (Assist.)

1 340.05

32711

Aortic bypass for occlusive disease using a bifurcated graft with 1 or both anastomoses to the common femoral or profunda femoris arteries (H) (Anaes.) (Assist.)

1 474.05

32712

Ilio-femoral bypass grafting (H) (Anaes.) (Assist.)

1 065.60

32715

Axillary or subclavian to femoral bypass grafting to 1 or both femoral arteries (H) (Anaes.) (Assist.)

1 065.60

32718

Femoro-femoral or ilio-femoral cross-over bypass grafting (H) (Anaes.) (Assist.)

1 008.20

32721

Renal artery, bypass grafting to (H) (Anaes.) (Assist.)

1 601.40

32724

Renal arteries (both), bypass grafting to (H) (Anaes.) (Assist.)

1 818.45

32730

Mesenteric vessel (single), bypass grafting to (H) (Anaes.) (Assist.)

1 378.20

32733

Mesenteric vessels (multiple), bypass grafting to (H) (Anaes.) (Assist.)

1 601.40

32736

Inferior mesenteric artery, operation on, when performed in conjunction with another intra-abdominal vascular operation (H) (Anaes.) (Assist.)

350.90

32739

Femoral artery bypass grafting using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with above knee anastomosis (H) (Anaes.) (Assist.)

1 097.45

32742

Femoral artery bypass grafting using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with distal anastomosis to below knee popliteal artery (H) (Anaes.) (Assist.)

1 257.05

32745

Femoral artery bypass grafting using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with distal anastomosis to tibio peroneal trunk or tibial or peroneal artery (H) (Anaes.) (Assist.)

1 435.60

32748

Femoral artery bypass grafting using vein, including harvesting of vein (when it is the ipsilateral long saphenous vein) with distal anastomosis within 5 cm of the ankle joint (H) (Anaes.) (Assist.)

1 556.85

32751

Femoral artery bypass grafting using synthetic graft, with lower anastomosis above or below the knee (H) (Anaes.) (Assist.)

1 008.20

32754

Femoral artery bypass grafting, using a composite graft (synthetic material and vein) with lower anastomosis above or below the knee, including use of a cuff or sleeve of vein at 1 or both anastomoses (H) (Anaes.) (Assist.)

1 257.05

32757

Femoral artery sequential bypass grafting (using a vein or synthetic material) where an additional anastomosis is made to separately revascularise more than 1 artery — each additional artery revascularised beyond a femoral bypass (H) (Anaes.) (Assist.)

350.90

32760

Vein, harvesting of, from leg or arm for bypass or replacement graft when not performed on the limb which is the subject of the bypass or graft — each vein (H) (Anaes.) (Assist.)

344.50

32763

Arterial bypass grafting, using vein or synthetic material, not being a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

1 008.20

32766

Arterial or venous anastomosis, not being a service to which another item in this subgroup applies, as an independent procedure (H) (Anaes.) (Assist.)

670.00

32769

Arterial or venous anastomosis not being a service to which another item in this subgroup applies, when performed in combination with another vascular operation (including graft to graft anastomosis) (H) (Anaes.) (Assist.)

232.25

33050

Bypass grafting to replace a popliteal aneurysm using vein, including harvesting vein (when it is the ipsilateral long saphenous vein) (H) (Anaes.) (Assist.)

1 234.80

33055

Bypass grafting to replace a popliteal aneurysm using a synthetic graft (H) (Anaes.) (Assist.)

990.25

33070

Aneurysm in the extremities, ligation, suture closure or excision of, without bypass grafting (Anaes.) (Assist.)

714.45

33075

Aneurysm in the neck, ligation, suture closure or excision of, without bypass grafting (H) (Anaes.) (Assist.)

908.85

33080

Intra-abdominal or pelvic aneurysm, ligation, suture closure or excision of, without bypass grafting (H) (Anaes.) (Assist.)

1 109.35

33100

Aneurysm of common or internal carotid artery, or both, replacement by graft of vein or synthetic material (Anaes.) (Assist.)

1 218.70

33103

Thoracic aneurysm, replacement by graft (H) (Anaes.) (Assist.)

1 709.90

33109

Thoraco-abdominal aneurysm, replacement by graft including re-implantation of arteries (Anaes.) (Assist.)

2 067.35

33112

Suprarenal abdominal aortic aneurysm, replacement by graft including re-implantation of arteries (H) (Anaes.) (Assist.)

1 792.95

33115

Infrarenal abdominal aortic aneurysm, replacement by tube graft not being a service associated with a service to which item 33116 applies (H) (Anaes.) (Assist.)

1 206.00

33118

Infrarenal abdominal aortic aneurysm, replacement by bifurcation graft to iliac arteries (with or without excision of common iliac aneurysms) not being a service associated with a service to which item 33119 applies (H) (Anaes.) (Assist.)

1 340.05

33121

Infrarenal abdominal aortic aneurysm, replacement by bifurcation graft to 1 or both femoral arteries (with or without excision or bypass of common iliac aneurysms) (H) (Anaes.) (Assist.)

1 474.05

33124

Aneurysm of iliac artery (common, external or internal), replacement by graft — unilateral (H) (Anaes.) (Assist.)

1 027.30

33127

Aneurysms of iliac arteries (common, external or internal), replacement by graft — bilateral (Anaes.) (Assist.)

1 346.30

33130

Aneurysm of visceral artery, excision and repair by direct anastomosis or replacement by graft (H) (Anaes.) (Assist.)

1 174.00

33133

Aneurysm of visceral artery, dissection and ligation of arteries without restoration of continuity (H) (Anaes.) (Assist.)

880.50

33136

False aneurysm, repair of, at aortic anastomosis following previous aortic surgery (H) (Anaes.) (Assist.)

2 220.35

33139

False aneurysm, repair of, in iliac artery and restoration of arterial continuity (H) (Anaes.) (Assist.)

1 346.30

33142

False aneurysm, repair of, in femoral artery and restoration of arterial continuity (Anaes.) (Assist.)

1 257.05

33145

Ruptured thoracic aortic aneurysm, replacement by graft (H) (Anaes.) (Assist.)

2 163.00

33148

Ruptured thoraco-abdominal aortic aneurysm, replacement by graft (H) (Anaes.) (Assist.)

2 686.20

33151

Ruptured suprarenal abdominal aortic aneurysm, replacement by graft (H) (Anaes.) (Assist.)

2 552.20

33154

Ruptured infrarenal abdominal aortic aneurysm, replacement by tube graft (H) (Anaes.) (Assist.)

1 888.70

33157

Ruptured infrarenal abdominal aortic aneurysm, replacement by bifurcation graft to iliac arteries (with or without excision or bypass of common iliac aneurysms) (H) (Anaes.) (Assist.)

2 105.55

33160

Ruptured infrarenal abdominal aortic aneurysm, replacement by bifurcation graft to 1 or both femoral arteries (H) (Anaes.) (Assist.)

2 105.55

33163

Ruptured iliac artery aneurysm, replacement by graft (H) (Anaes.) (Assist.)

1 786.70

33166

Ruptured aneurysm of visceral artery, replacement by anastomosis or graft (Anaes.) (Assist.)

1 786.70

33169

Ruptured aneurysm of visceral artery, simple ligation of (H) (Anaes.) (Assist.)

1 391.00

33172

Aneurysm of major artery, replacement by graft, not being a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

1 084.65

33175

Ruptured aneurysm in the extremities, ligation, suture closure or excision of, without bypass grafting (H) (Anaes.) (Assist.)

999.65

33178

Ruptured aneurysm in the neck, ligation, suture closure or excision of, without bypass grafting (H) (Anaes.) (Assist.)

1 271.20

33181

Ruptured intra-abdominal or pelvic aneurysm, ligation, suture closure or excision of, without bypass grafting (H) (Anaes.) (Assist.)

1 554.20

33500

Artery or arteries of neck, endarterectomy of, including closure by suture (where endarterectomy of 1 or more arteries is undertaken through 1 arteriotomy incision) (H) (Anaes.) (Assist.)

963.40

33506

Innominate or subclavian artery, endarterectomy of, including closure by suture (H) (Anaes.) (Assist.)

1 078.40

33509

Aortic endarterectomy, including closure by suture, not being a service associated with another procedure on
the aorta (H) (Anaes.) (Assist.)

1 206.00

33512

Aorto-iliac endarterectomy (1 or both iliac arteries), including closure by suture not being a service associated with a service to which item 33515 applies (H) (Anaes.) (Assist.)

1 340.05

33515

Aorto-femoral endarterectomy (1 or both femoral arteries) or bilateral ilio-femoral endarterectomy, including closure by suture, not being a service associated with a service to which item 33512 applies (H) (Anaes.) (Assist.)

1 474.05

33518

Iliac endarterectomy, including closure by suture, not being a service associated with another procedure on the iliac artery (Anaes.) (Assist.)

1 078.40

33521

Ilio-femoral endarterectomy (1 side), including closure by suture (H) (Anaes.) (Assist.)

1 167.60

33524

Renal artery, endarterectomy of (H) (Anaes.) (Assist.)

1 378.20

33527

Renal arteries (both), endarterectomy of (H) (Anaes.) (Assist.)

1 601.40

33530

Coeliac or superior mesenteric artery, endarterectomy of (H) (Anaes.) (Assist.)

1 378.20

33533

Coeliac and superior mesenteric artery, endarterectomy of (H) (Anaes.) (Assist.)

1 601.40

33536

Inferior mesenteric artery, endarterectomy of, not being a service associated with a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

1 142.20

33539

Artery of extremities, endarterectomy of, including closure by suture (H) (Anaes.) (Assist.)

823.10

33542

Extended deep femoral endarterectomy where the endarterectomy is at least 7 cm long (H) (Anaes.) (Assist.)

1 174.00

33545

Artery, vein or bypass graft, patch grafting to by vein or synthetic material where patch is less than 3 cm long (H) (Anaes.) (Assist.)

232.25

33548

Artery, vein or bypass graft, patch grafting to by vein or synthetic material where patch is 3 cm long or greater (H) (Anaes.) (Assist.)

472.30

33551

Vein, harvesting of from leg or arm for patch when not performed through same incision as operation (H) (Anaes.) (Assist.)

232.25

33554

Endarterectomy, in conjunction with an arterial bypass operation to prepare the site for anastomosis — each site (H) (Anaes.) (Assist.)

231.10

33800

Embolus, removal of, from artery of neck (Anaes.) (Assist.)

1 001.75

33803

Embolectomy or thrombectomy, by abdominal approach, of an artery or bypass graft of trunk (H) (Anaes.) (Assist.)

957.10

33806

Embolectomy or thrombectomy (including the infusion of thrombolytic or other agents) from an artery or bypass graft of extremities, or embolectomy of abdominal artery via the femoral artery (Anaes.) (Assist.)

689.10

33810

Inferior vena cava or iliac vein, closed thrombectomy by catheter via the femoral vein (Anaes.) (Assist.)

502.70

33811

Inferior vena cava or iliac vein, open removal of thrombus or tumour (H) (Anaes.) (Assist.)

1 496.50

33812

Thrombus, removal of, from femoral or other similar large vein (Anaes.) (Assist.)

791.20

33815

Major artery or vein of extremity, repair of wound of, with restoration of continuity, by lateral suture (H) (Anaes.) (Assist.)

727.40

33818

Major artery or vein of extremity, repair of wound of, with restoration of continuity, by direct anastomosis (H) (Anaes.) (Assist.)

848.65

33821

Major artery or vein of extremity, repair of wound of, with restoration of continuity, by interposition graft of synthetic material or vein (H) (Anaes.) (Assist.)

969.85

33824

Major artery or vein of neck, repair of wound of, with restoration of continuity, by lateral suture (H) (Anaes.) (Assist.)

925.15

33827

Major artery or vein of neck, repair of wound of, with restoration of continuity, by direct anastomosis (H) (Anaes.) (Assist.)

1 084.65

33830

Major artery or vein of neck, repair of wound of, with restoration of continuity, by interposition graft of synthetic material or vein (H) (Anaes.) (Assist.)

1 244.15

33833

Major artery or vein of abdomen, repair of wound of, with restoration of continuity by lateral suture (H) (Anaes.) (Assist.)

1 129.45

33836

Major artery or vein of abdomen, repair of wound of, with restoration of continuity by direct anastomosis (H) (Anaes.) (Assist.)

1 346.30

33839

Major artery or vein of abdomen, repair of wound of, with restoration of continuity by means of interposition graft (H) (Anaes.) (Assist.)

1 576.00

33842

Artery of neck, re-operation for bleeding or thrombosis after carotid or vertebral artery surgery (H) (Anaes.) (Assist.)

778.45

33845

Laparotomy for control of post operative bleeding or thrombosis after intra-abdominal vascular procedure, where no other procedure is performed (H) (Anaes.) (Assist.)

542.35

33848

Extremity, re-operation on, for control of bleeding or thrombosis after vascular procedure, where no other procedure is performed (H) (Anaes.) (Assist.)

542.35

34100

Major artery of neck, elective ligation or exploration of, not being a service associated with any other vascular procedure (H) (Anaes.) (Assist.)

599.85

34103

Great artery or great vein (including subclavian, axillary, iliac, femoral or popliteal), ligation of, or exploration of, not being a service associated with any other vascular procedure except those services to which item 32508, 32511, 32514 or 32517 applies (H) (Anaes.) (Assist.)

350.90

34106

Artery or vein (including brachial, radial, ulnar or tibial), ligation of, by elective operation, or exploration of, not being a service associated with any other vascular procedure except those services to which item 32508, 32511, 32514 or 32517 applies (Anaes.) (Assist.)

247.55

34109

Temporal artery, biopsy of (Anaes.) (Assist.)

287.05

34112

Arterio-venous fistula of an extremity, dissection and ligation (H) (Anaes.) (Assist.)

727.40

34115

Arterio-venous fistula of the neck, dissection and ligation (H) (Anaes.) (Assist.)

823.10

34118

Arterio-venous fistula of the abdomen, dissection and ligation (Anaes.) (Assist.)

1 174.00

34121

Arterio-venous fistula of an extremity, dissection and repair of, with restoration of continuity (H) (Anaes.) (Assist.)

937.90

34124

Arterio-venous fistula of the neck, dissection and repair of, with restoration of continuity (H) (Anaes.) (Assist.)

1 027.30

34127

Arterio-venous fistula of the abdomen, dissection and repair of, with restoration of continuity (H) (Anaes.) (Assist.)

1 346.30

34130

Surgically created arterio-venous fistula of an extremity, closure of (Anaes.) (Assist.)

421.15

34133

Scalenotomy (H) (Anaes.) (Assist.)

472.30

34136

First rib, resection of portion of (H) (Anaes.) (Assist.)

759.20

34139

Cervical rib, removal of, or other operation for removal of thoracic outlet compression, not being a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

759.20

34142

Coeliac artery, decompression of, for coeliac artery compression syndrome, as an independent procedure (H) (Anaes.) (Assist.)

937.90

 

34145

Popliteal artery, exploration of, for popliteal entrapment, with or without division of fibrous tissue and muscle (H) (Anaes.) (Assist.)

682.75

34148

Carotid associated tumour, resection of, with or without repair or reconstruction of internal or common carotid arteries, when tumour is 4 cm or less in maximum diameter (H) (Anaes.) (Assist.)

1 218.70

34151

Carotid associated tumour, resection of, with or without repair or reconstruction of internal or common carotid arteries, when tumour is greater than 4 cm in maximum diameter (H) (Anaes.) (Assist.)

1 665.35

34154

Recurrent carotid associated tumour, resection of, with or without repair or replacement of portion of internal or common carotid arteries (Anaes.) (Assist.)

1 984.40

34157

Neck, excision of infected bypass graft, including closure of vessel or vessels (H) (Anaes.) (Assist.)

1 008.20

34160

Aorto-duodenal fistula, repair of, by suture of aorta and repair of duodenum (H) (Anaes.) (Assist.)

1 888.70

34163

Aorto-duodenal fistula, repair of, by insertion of aortic graft and repair of duodenum (H) (Anaes.) (Assist.)

2 424.60

34166

Aorto-duodenal fistula, repair of, by oversewing of abdominal aorta, repair of duodenum and axillo bifemoral grafting (H) (Anaes.) (Assist.)

2 424.60

34169

Infected bypass graft from trunk, excision of, including closure of arteries (H) (Anaes.) (Assist.)

1 346.30

34172

Infected axillo-femoral or femoro-femoral graft, excision of, including closure of arteries (H) (Anaes.) (Assist.)

1 097.45

34175

Infected bypass graft from extremities, excision of including closure of arteries (H) (Anaes.) (Assist.)

1 008.20

34500

Arteriovenous shunt, external, insertion of (Anaes.) (Assist.)

261.65

34503

Arteriovenous anastomosis of upper or lower limb, in conjunction with another venous or arterial operation (H) (Anaes.) (Assist.)

350.90

34506

Arteriovenous shunt, external, removal of (H) (Anaes.) (Assist.)

178.60

34509

Arteriovenous anastomosis of upper or lower limb, not in conjunction with another venous or arterial operation (H) (Anaes.) (Assist.)

829.45

34512

Arteriovenous access device, insertion of (H) (Anaes.) (Assist.)

912.45

34515

Arteriovenous access device, thrombectomy of (H) (Anaes.) (Assist.)

650.80

34518

Stenosis of arteriovenous fistula or prosthetic arteriovenous access device, correction of (H) (Anaes.) (Assist.)

1 091.05

34521

Intra-abdominal artery or vein, cannulation of, for infusion chemotherapy, by open operation (excluding after-care) (H) (Anaes.) (Assist.)

670.25

34524

Arterial cannulation for infusion chemotherapy by open operation, not being a service to which item 34521 applies (excluding after-care) (H) (Anaes.) (Assist.)

350.90

34527

Central vein catheterisation by open technique, using subcutaneous tunnel with pump or access port as with Hickman or Broviac catheter or other chemotherapy delivery device, including any associated percutaneous central vein catheterisation (Anaes.)

468.05

34528

Central vein catheterisation by percutaneous technique, using subcutaneous tunnel with pump or access port as with Hickman or Broviac catheter or other chemotherapy delivery device (Anaes.)

231.10

34530

Hickman or Broviac catheter, or other chemotherapy device, removal of, by open surgical procedure in the operating theatre of a hospital or approved day hospital facility (Anaes.)

173.35

34533

Isolated limb perfusion, including cannulation of artery and vein at commencement of procedure, regional perfusion for chemotherapy, or other therapy, repair of arteriotomy and venotomy at conclusion of procedure (excluding after-care) (Anaes.) (Assist.)

1 052.75

34538

Central vein catheterisation by percutaneous technique, using subcutaneous tunnelled cuffed catheter or similar device, for the administration of haemodialysis or parenteral nutrition (Anaes.)

231.10

34539

Tunnelled cuffed catheter, or similar device, removal of, by open surgical procedure in the operating theatre of a hospital or approved day hospital facility (Anaes.)

173.35

34800

Inferior vena cava, plication, ligation, or application of caval clip (Anaes.) (Assist.)

689.10

34803

Inferior vena cava, reconstruction of or bypass by vein or synthetic material (H) (Anaes.) (Assist.)

1 518.65

34806

Cross leg bypass grafting, saphenous to iliac or femoral vein (H) (Anaes.) (Assist.)

823.10

34809

Saphenous vein anastomosis to femoral or popliteal vein for femoral vein bypass (H) (Anaes.) (Assist.)

823.10

34812

Venous stenosis or occlusion, vein bypass for, using vein or synthetic material, not being a service associated with a service to which item 34806 or 34809 applies (H) (Anaes.) (Assist.)

995.40

34815

Vein stenosis, patch angioplasty for, (excluding vein graft stenosis) — using vein or synthetic material (H) (Anaes.) (Assist.)

823.10

34818

Venous valve, plication or repair to restore valve competency (H) (Anaes.) (Assist.)

906.05

34821

Vein transplant to restore valvular function (Anaes.) (Assist.)

1 231.50

34824

External stent, application of, to restore venous valve competency to superficial vein — 1 stent (H) (Anaes.) (Assist.)

421.15

34827

External stents, application of, to restore venous valve competency to superficial vein or veins — more than 1 stent (H) (Anaes.) (Assist.)

510.45

34830

External stent, application of, to restore venous valve competency to deep vein — 1 stent (Anaes.) (Assist.)

599.85

34833

External stents, application of, to restore venous valve competency to deep vein or veins — more than 1 stent (H) (Anaes.) (Assist.)

778.45

35000

Lumbar sympathectomy (Anaes.) (Assist.)

599.85

35003

Cervical or upper thoracic sympathectomy by any surgical approach (H) (Anaes.) (Assist.)

778.45

35006

Cervical or upper thoracic sympathectomy, where operation is a re-operation for previous incomplete sympathectomy by any surgical approach (H) (Anaes.) (Assist.)

976.25

35009

Lumbar sympathectomy, where operation is following chemical sympathectomy or for previous incomplete surgical sympathectomy (H) (Anaes.) (Assist.)

759.20

35012

Sacral or pre-sacral sympathectomy (H) (Anaes.) (Assist.)

599.85

35100

Ischaemic limb, debridement of necrotic material, gangrenous tissue, or slough in, in the operating theatre of a hospital, when debridement includes muscle, tendon or bone (Anaes.) (Assist.)

312.75

35103

Ischaemic limb, debridement of necrotic material, gangrenous tissue, or slough in, in the operating theatre of a hospital, superficial tissue only (Anaes.)

199.05

35200

Operative arteriography or venography, 1 or more of, performed during the course of an operative procedure on an artery or vein — 1 site (H) (Anaes.)

145.55

35202

Major arteries or veins in the neck, abdomen or extremities, access to, as part of re-operation after prior surgery on these vessels (H) (Anaes.) (Assist.)

693.35

35300

Transluminal balloon angioplasty of 1 peripheral artery or vein of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)

437.35

35303

Transluminal balloon angioplasty of aortic arch branches, aortic visceral branches, or more than 1 peripheral artery or vein of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)

560.70

35304

Transluminal balloon angioplasty of 1 coronary artery, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding
after-care (H) (Anaes.) (Assist.)

437.35

35305

Transluminal balloon angioplasty of more than 1 coronary artery, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

560.70

35306

Transluminal stent insertion including associated balloon dilatation for 1 peripheral artery or vein of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding
after-care (Anaes.) (Assist.)

517.50

35309

Transluminal stent insertion including associated balloon dilatation for visceral arteries or veins, or more than 1 peripheral artery or vein of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)

646.90

35310

Transluminal stent insertion including associated balloon dilatation for coronary artery, percutaneous or by open exposure, excluding associated radiological services and preparation, and excluding after-care (H) (Anaes.) (Assist.)

646.90

35312

Peripheral arterial atherectomy including associated balloon dilatation of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

733.15

35315

Peripheral laser angioplasty including associated balloon dilatation of 1 limb, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

733.15

35317

Peripheral arterial or venous catheterisation with administration of thrombolytic or chemotherapeutic agents, by continuous infusion, using percutaneous approach, excluding associated radiological services or preparation, and excluding after-care (not being a service associated with a service to which an item in Subgroup 11 of Group T1 or item 35319 or 35320 applies, or associated with photodynamic therapy with verteporfin) (Anaes.) (Assist.)

301.90

35319

Peripheral arterial or venous catheterisation with administration of thrombolytic or chemotherapeutic agents, by pulse spray technique, using percutaneous approach, excluding associated radiological services or preparation, and excluding after-care (not being a service associated with a service to which an item in Subgroup 11 of Group T1 or item 35317 or 35320 applies, or associated with photodynamic therapy with verteporfin) (Anaes.) (Assist.)

541.20

35320

Peripheral arterial or venous catheterisation with administration of thrombolytic or chemotherapeutic agents, by open exposure, excluding associated radiological services or preparation, and excluding
after-care (not being a service associated with a service to which an item in Subgroup 11 of Group T1 or item 35317 or 35319 applies, or associated with photodynamic therapy with verteporfin) (Anaes.) (Assist.)

726.95

35321

Peripheral arterial or venous catheterisation to administer agents to occlude arteries, veins or arterio-venous fistulae or to arrest haemorrhage (but not for the treatment of uterine fibroids), percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (not being a service associated with photodynamic therapy with verteporfin) (Anaes.) (Assist.)

690.05

35324

Angioscopy not combined with any other procedure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

258.70

35327

Angioscopy combined with any other procedure, excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

346.75

35330

Insertion of inferior vena caval filter, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)

437.35

35335

Percutaneous transluminal rotational atherectomy of 1 coronary artery, including balloon angioplasty with no stent insertion, where:

 (a) no lesion of the coronary artery has been stented; and

 (b) each lesion of the coronary artery is complex and heavily calcified; and

 (c) balloon angioplasty with or without stenting is not suitable;

excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)

751.30

35338

Percutaneous transluminal rotational atherectomy of 1 coronary artery, including balloon angioplasty with insertion of 1 or more stents, where:

 (a) no lesion of the coronary artery has been stented; and

 (b) each lesion of the coronary artery is complex and heavily calcified; and

 (c) balloon angioplasty with or without stenting is not suitable;

excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

960.85

35341

Percutaneous transluminal rotational atherectomy of more than 1 coronary artery, including balloon angioplasty with no stent insertion, where:

 (a) no lesion of the coronary arteries has been stented; and

 (b) each lesion of the coronary arteries is complex and heavily calcified; and

 (c) balloon angioplasty with or without stenting is not suitable;

excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

1 031.60

35344

Percutaneous transluminal rotational atherectomy of more than 1 coronary artery, including balloon angioplasty with insertion of 1 or more stents, where:

 (a) no lesion of the coronary arteries has been stented; and

 (b) each lesion of the coronary arteries is complex and heavily calcified; and

 (c) balloon angioplasty with or without stenting is not suitable;

excluding associated radiological services or preparation, and excluding after-care (H) (Anaes.) (Assist.)

1 346.00

35347

Catheter based intravascular brachytherapy treatment of in-stent restenoses in 1 coronary artery, catheterisation for, using automated intravascular brachytherapy systems approved by the Therapeutic Goods Administration, including in the same artery balloon angioplasty, excluding associated radiological services or preparation, and excluding aftercare. The procedure must be performed by a cardiologist in association with a radiation oncologist, and be performed in association with items 15360 and 15541, or items 15363 and 15541 (Anaes.) (Assist.)

656.00

35350

Catheter based intravascular brachytherapy treatment of in-stent restenoses in 1 coronary artery, catheterisation for, using automated intravascular brachytherapy systems approved by the Therapeutic Goods Administration, including in the same artery balloon angioplasty and intravascular ultrasound, excluding associated radiological services or preparation, and excluding aftercare. The procedure must be performed by a cardiologist in association with a radiation oncologist, and be performed in association with items 15360 and 15541, or items 15363 and 15541 (Anaes.) (Assist.)

874.70

35353

Catheter based intravascular brachytherapy treatment of in-stent restenoses in 1 coronary artery, catheterisation for, using automated intravascular brachytherapy systems approved by the Therapeutic Goods Administration, including in the same artery balloon angioplasty and percutaneous transluminal rotational atherectomy, excluding associated radiological services or preparation, and excluding aftercare. The procedure must be performed by a cardiologist in association with a radiation oncologist, and be performed in association with items 15360 and 15541, or items 15363 and 15541 (Anaes.) (Assist.)

969.95

35356

Catheter based intravascular brachytherapy treatment of in-stent restenoses in 1 coronary artery, catheterisation for, using automated intravascular brachytherapy systems approved by the Therapeutic Goods Administration, including in the same artery balloon angioplasty, percutaneous transluminal rotational atherectomy and intravascular ultrasound, excluding associated radiological services or preparation, and excluding aftercare. The procedure must be performed by a cardiologist in association with a radiation oncologist, and be performed in association with items 15360 and 15541, or items 15363 and 15541 (Anaes.) (Assist.)

1 188.65

Subgroup 4 — Gynaecological

35500

Gynaecological examination under anaesthesia, not being a service associated with a service to which another item in this group applies (Anaes.)

68.90

35502

Intra-uterine contraceptive device, introduction of, for the control of idiopathic menorrhagia, including endometrial biopsy to exclude endometrial pathology, not being a service associated with a service to which another item in this group applies (Anaes.)

68.05

35503

Intra-uterine contraceptive device, introduction of, not being a service associated with a service to which another item in this group applies (Anaes.)

45.45

35506

Intra-uterine contraceptive device, removal of under general anaesthesia, not being a service associated with a service to which another item in this group applies (Anaes.)

45.55

35507

Vulval or vaginal warts, removal of under general anaesthesia, or under regional or field nerve block (excluding pudendal block), where the time taken is less than or equal to 45 minutes — not being a service associated with a service to which item 32177 or 32180 applies (H) (Anaes.)

148.10

35508

Vulval or vaginal warts, removal of under general anaesthesia, or under regional or field nerve block (excluding pudendal block), where the time taken is greater than 45 minutes — not being a service associated with a service to which item 32177 or 32180 applies (H) (Anaes.) (Assist.)

218.05

35509

Hymenectomy (Anaes.)

75.95

35512

Bartholin’s cyst, excision of (G) (Anaes.)

152.20

35513

Bartholin’s cyst, excision of (S) (Anaes.)

188.15

35516

Bartholin’s cyst or gland, marsupialisation of (G) (Anaes.)

98.75

35517

Bartholin’s cyst or gland, marsupialisation of (S) (Anaes.)

123.85

35518

Ovarian cyst aspiration, for cysts of at least 4 cm in diameter in premenopausal women and at least 2 cm in diameter in postmenopausal women, by abdominal or vaginal route, using interventional imaging techniques and not associated with services provided for assisted reproductive techniques (Anaes.)

176.30

35520

Bartholin’s abscess, incision of (Anaes.)

49.45

35523

Urethra or urethral caruncle, cauterisation of (Anaes.)

49.45

35526

Urethral caruncle, excision of (G) (Anaes.)

98.75

35527

Urethral caruncle, excision of (S) (Anaes.)

123.85

35530

Clitoris, amputation of, where medically indicated (H) (Anaes.) (Assist.)

228.90

35533

Vulvoplasty or labioplasty, where medically indicated, not being a service associated with a service to which item 35536 applies (Anaes.)

296.85

35536

Vulva, wide local excision of suspected malignancy or hemivulvectomy, 1 or both procedures (Anaes.) (Assist.)

295.65

35539

Colposcopically directed CO2 laser therapy for previously confirmed intraepithelial neoplastic changes of the cervix, vagina, vulva, urethra or anal canal, including any associated biopsies — 1 anatomical site (Anaes.)

231.60

35542

Colposcopically directed CO2 laser therapy for previously confirmed intraepithelial neoplastic changes of the cervix, vagina, vulva, urethra or anal canal, including any associated biopsies — 2 or more anatomical sites (Anaes.) (Assist.)

271.20

35545

Colposcopically directed CO2 laser therapy for condylomata, unsuccessfully treated by other methods (Anaes.)

155.85

35548

Vulvectomy, radical, for malignancy (H) (Anaes.) (Assist.)

707.75

35551

Pelvic lymph glands, excision of (radical) (H) (Anaes.) (Assist.)

580.25

35554

Vagina, dilatation of, as an independent procedure including any associated consultation (Anaes.)

36.90

35557

Vagina, removal of simple tumour — (including Gartner duct cyst) (Anaes.)

182.00

35560

Vagina, partial or complete removal of (H) (Anaes.) (Assist.)

580.25

35561

Vaginectomy, radical, for proven invasive malignancy — 1 surgeon (H) (Anaes.) (Assist.)

1 170.60

35562

Vaginectomy, radical, for proven invasive malignancy, conjoint surgery — abdominal surgeon (including
after-care) (H) (Anaes.) (Assist.)

961.05

35564

Vaginectomy, radical, for proven invasive malignancy, conjoint surgery — perineal surgeon (H) (Assist.)

443.70

35565

Vaginal reconstruction for congenital absence, gynatresia or urogenital sinus (H) (Anaes.) (Assist.)

580.25

35566

Vaginal septum, excision of, for correction of double vagina (H) (Anaes.) (Assist.)

337.10

35567

Vaginal repair including 1 or more of anterior, posterior or enterocele repair, with sacrospinous colpopexy (H) (Anaes.) (Assist.)

595.70

35569

Plastic repair to enlarge vaginal orifice (Anaes.)

136.45

35572

Colpotomy, not being a service to which another item in this group applies (H) (Anaes.)

105.05

35576

Anterior vaginal repair or posterior vaginal repair (involving repair of rectocele or enterocele or both), with or without mesh, not being a service associated with a service to which item 30405, 35580 or 35584 applies (H) (Anaes.) (Assist.)

360.60

35580

Anterior vaginal repair or posterior vaginal repair (involving repair of rectocele or enterocele or both), with or without mesh, not being a service associated with a service to which item 30405 or 35584 applies (H) (Anaes.) (Assist.)

454.80

35584

Manchester (Donald-Fothergill) operation or le Fort operation for genital prolapse, with or without mesh, not being a service associated with a service to which item 30405 applies (H) (Anaes.) (Assist.)

572.30

35587

Urethrocele, operation for (H) (Anaes.)

148.95

35590

Operation involving abdominal approach for repair of enterocele or suspension of vaginal vault or enterocele and suspension of vaginal vault, with or without mesh, not being a service associated with a service to which item 30405 applies (H) (Anaes.) (Assist.)

454.80

35593

Vaginal repair of enterocele, with or without repair of rectocele, with or without mesh, not being a service associated with a service to which item 30405, 35576, 35580, 35584, 35590, 35657, 35673, 35750 or 35753 applies, and where on a previous occasion there had been performed surgery reflected by a procedure to which item 35576, 35580, 35584, 35590, 35657, 35673, 35750 or 35753 applies (H) (Anaes.) (Assist.)

454.80

35596

Fistula between genital and urinary or alimentary tracts, repair of, not being a service to which item 37029, 37333 or 37336 applies (H) (Anaes.) (Assist.)

580.25

35599

Stress incontinence, sling operation for, with or without mesh or tape, not being a service associated with a service to which item 30405 applies (H) (Anaes.) (Assist.)

572.30

 

35600

Stress incontinence, vaginal procedure for, with or without mesh, not being a service associated with a service to which item 30405 applies (H) (Anaes.) (Assist.)

444.30

35602

Stress incontinence, combined synchronous
abdomino-vaginal operation for — abdominal procedure, with or without mesh, (including after-care), not being a service associated with a service to which item 30405 applies (H) (Anaes.) (Assist.)

572.30

35605

Stress incontinence, combined synchronous
abdomino-vaginal operation for — vaginal procedure, with or without mesh, (including after-care), not being a service associated with a service to which item 30405 applies (Anaes.) (Assist.)

310.50

35608

Cervix, cauterisation (other than by chemical means), ionisation, diathermy or biopsy of, with or without dilatation of cervix (Anaes.)

54.25

35611

Cervix, removal of polyp or polypi, with or without dilatation of cervix, not being a service associated with a service to which item 35608 applies (Anaes.)

54.25

35612

Cervix, residual stump, removal of, by abdominal approach (Anaes.) (Assist.)

429.30

35613

Cervix, residual stump, removal of, by vaginal approach (H) (Anaes.) (Assist.)

343.50

35614

Examination of lower female genital tract by a Hinselmann-type colposcope in a patient with a previous abnormal cervical smear or a history of maternal ingestion of oestrogen or where a patient, because of suspicious signs of cancer, has been referred by another medical practitioner (Anaes.)

54.15

35615

Vulva, biopsy of, when performed in conjunction with a service to which item 35614 applies

45.55

35616

Endometrium, endoscopic examination of and ablation of, by microwave or thermal balloon, for chronic refractory menorrhagia including any hysteroscopy performed on the same day, with or without uterine curettage (H) (Anaes.)

381.45

35617

Cervix, cone biopsy, amputation or repair of, not being a service to which item 35584 applies (G) (Anaes.)

147.35

35618

Cervix, cone biopsy, amputation or repair of, not being a service to which item 35584 applies (S) (Anaes.)

184.95

35620

Endometrial biopsy where malignancy is suspected in patients with abnormal uterine bleeding or post menopausal bleeding (Anaes.)

45.25

35622

Endometrium, endoscopic ablation of, by laser or diathermy, for chronic refractory menorrhagia including any hysteroscopy performed on the same day, with or without uterine curettage, not being a service associated with a service to which item 30390 applies (H) (Anaes.)

511.20

35623

Hysteroscopic resection of myoma, or myoma and uterine septum resection (where both are performed), followed by endometrial ablation by laser or diathermy (H) (Anaes.)

695.10

35626

Hysteroscopy, including biopsy, performed by a specialist in the practice of his or her specialty where the patient is referred to him or her for the investigation of suspected intrauterine pathology (with or without local anaesthetic), not being a service associated with a service to which item 35627 or 35630 applies

70.30

35627

Hysteroscopy with dilatation of the cervix performed in the operating theatre of a hospital or approved day hospital facility — not being a service associated with a service to which item 35626 or 35630 applies (Anaes.)

90.90

35630

Hysteroscopy, with endometrial biopsy, performed in the operating theatre of a hospital or approved day hospital facility — not being a service associated with a service to which item 35626 or 35627 applies (Anaes.)

155.30

35633

Hysteroscopy with uterine adhesiolysis or polypectomy or tubal catheterisation (including hysteroscopy for insertion of device for sterilisation) or removal of IUD which cannot be removed by other means — 1 or more of (Anaes.)

184.95

35634

Hysteroscopic resection of uterine septum followed by endometrial ablation by laser or diathermy (Anaes.)

581.80

35635

Hysteroscopy involving resection of the uterine septum (H) (Anaes.)

254.10

35636

Hysteroscopy, involving resection of myoma, or resection of myoma and uterine septum (where both are performed) (H) (Anaes.)

367.45

35637

Laparoscopy, involving puncture of cysts, diathermy of endometriosis, ventrosuspension, division of adhesions or similar procedure — 1 or more procedures with or without biopsy — not being a service associated with any other laparoscopic procedure or hysterectomy (H) (Anaes.) (Assist.)

345.05

35638

Complicated operative laparoscopy, including use of laser when required, for 1 or more of the following procedures — oophorectomy, ovarian cystectomy, myomectomy, salpingectomy or salpingostomy, ablation of moderate or severe endometriosis requiring more than 1 hour’s operating time, or division of utero-sacral ligaments for significant dysmenorrhoea — not being a service associated with any other intraperitoneal or retroperitoneal procedure except item 30393 (H) (Anaes.) (Assist.)

603.70

35639

Uterus, curettage of, with or without dilatation (including curettage for incomplete miscarriage) under general anaesthesia or under epidural or spinal (intrathecal) nerve block, including procedures to which item 35626, 35627 or 35630 applies, where performed (G) (H) (Anaes.)

114.50

35640

Uterus, curettage of, with or without dilatation (including curettage for incomplete miscarriage) under general anaesthesia or under epidural or spinal (intrathecal) nerve block, including procedures to which item 35626, 35627 or 35630 applies, where performed (S) (H) (Anaes.)

155.30

35641

Endometriosis level 4 or 5, laparoscopic resection of, involving any 2 of the following procedures:

 (a) resection of the pelvic side wall including dissection of endometriosis or scar tissue from the ureter;

 (b) resection of the Pouch of Douglas;

 (c) resection of an ovarian endometrioma greater than 2 cm in diameter;

1 054.40

 

 (d) dissection of bowel from uterus from the level of the endocervical junction or above;

where the operating time exceeds 90 minutes (H) (Anaes.) (Assist.)

 

35643

Evacuation of the contents of the gravid uterus by curettage or suction curettage not being a service to which item 35639 or 35640 applies, including procedures to which item 35626, 35627 or 35630 applies, where performed (Anaes.)

184.95

35644

Cervix, electrocoagulation diathermy with colposcopy, for previously confirmed intraepithelial neoplastic changes of the cervix, including any local anaesthesia and biopsies, not being a service associated with a service to which item 35639, 35640 or 35647 applies (Anaes.)

172.80

35645

Cervix, electrocoagulation diathermy with colposcopy, for previously confirmed intraepithelial neoplastic changes of the cervix, including any local anaesthesia and biopsies, in association with ablative therapy of additional areas of intraepithelial change in 1 or more sites of vagina, vulva, urethra or anus, not being a service associated with a service to which item 35649 applies (Anaes.)

270.45

35646

Cervix, colposcopy with radical diathermy of, with or without cervical biopsy, for previously confirmed intraepithelial neoplastic changes of the cervix, where performed in the operating theatre of a hospital or approved day hospital facility (Anaes.)

172.80

35647

Cervix, large loop excision of transformation zone together with colposcopy for previously confirmed intraepithelial neoplastic changes of the cervix, including any local anaesthesia and biopsies, not being a service associated with a service to which item 35644 applies (Anaes.)

172.80

35648

Cervix, large loop excision diathermy for previously confirmed intraepithelial neoplastic changes of the cervix, including any local anaesthesia and biopsies, in conjunction with ablative treatment of additional areas of intraepithelial change of 1 or more sites of vagina, vulva, urethra or anus, not being a service associated with a service to which item 35645 applies (Anaes.)

270.45

35649

Hysterotomy or uterine myomectomy, abdominal (H) (Anaes.) (Assist.)

454.80

35653

Hysterectomy, abdominal, sub-total or total, with or without removal of uterine adnexae (H) (Anaes.) (Assist.)

572.45

35657

Hysterectomy, vaginal, with or without uterine curettage, not being a service to which item 35673 applies (H) (Anaes.) (Assist.)

572.45

35658

Uterus (at least equivalent in size to a 10 week gravid uterus), debulking of, prior to vaginal removal at hysterectomy (H) (Anaes.) (Assist.)

353.00

35661

Hysterectomy, abdominal, requiring extensive retroperitoneal dissection with or without exposure of 1 or both ureters, for the management of severe endometriosis, pelvic inflammatory disease or benign pelvic tumours, with or without conservation of ovaries (H) (Anaes.) (Assist.)

739.30

35664

Radical hysterectomy with radical excision of pelvic lymph glands (with or without excision of uterine adnexae) for proven malignancy including excision of any 1 or more of parametrium, paracolpos, upper vagina or contiguous pelvic peritoneum and involving ureterolysis where performed (H) (Anaes.) (Assist.)

1 232.15

35667

Radical hysterectomy without gland dissection (with or without excision of uterine adnexae) for proven malignancy including excision of any 1 or more of parametrium, paracolpos, upper vagina or contiguous pelvic peritoneum and involving ureterolysis where performed (H) (Anaes.) (Assist.)

1 047.20

35670

Hysterectomy, abdominal, with radical excision of pelvic lymph glands, with or without removal of uterine adnexae (H) (Anaes.) (Assist.)

862.35

35673

Hysterectomy, vaginal, (with or without uterine curettage) with salpingectomy, oophorectomy or excision of ovarian cyst, 1 or more, 1 or both sides (H) (Anaes.) (Assist.)

642.95

35674

Ultrasound guided needling and injection of ectopic pregnancy

176.30

35676

Ectopic pregnancy, removal of (G) (H) (Anaes.) (Assist.)

360.60

35677

Ectopic pregnancy, removal of (S) (H) (Anaes.) (Assist.)

454.80

35678

Ectopic pregnancy, laparoscopic removal of (H) (Anaes.) (Assist.)

548.35

35680

Bicornuate uterus, plastic reconstruction for (Anaes.) (Assist.)

493.85

35683

Uterus, suspension or fixation of, as an independent procedure (G) (H) (Anaes.) (Assist.)

298.05

35684

Uterus, suspension or fixation of, as an independent procedure (S) (H) (Anaes.) (Assist.)

399.80

35687

Sterilisation by transection or resection of fallopian tubes, via abdominal or vaginal routes or via laparoscopy using diathermy or any other method (G) (H) (Anaes.) (Assist.)

276.00

35688

Sterilisation by transection or resection of fallopian tubes, via abdominal or vaginal routes or via laparoscopy using diathermy or any other method (S) (H) (Anaes.) (Assist.)

337.10

35691

Sterilisation by interruption of fallopian tubes when performed in conjunction with Caesarean section (H) (Anaes.) (Assist.)

134.65

35694

Tuboplasty (salpingostomy, salpingolysis or tubal implantation into uterus), unilateral or bilateral, 1 or more procedures (H) (Anaes.) (Assist.)

541.10

35697

Microsurgical tuboplasty (salpingostomy, salpingolysis or tubal implantation into uterus), unilateral or bilateral, 1 or more procedures (H) (Anaes.) (Assist.)

802.85

35700

Fallopian tubes, unilateral microsurgical anastomosis of, using operating microscope, for other than reversal of previous sterilisation (H) (Anaes.) (Assist.)

619.50

35703

Hydrotubation of fallopian tubes as a non-repetitive procedure, not being a service associated with a service to which another item in this subgroup applies (Anaes.)

57.25

35706

Rubin test for patency of fallopian tubes (Anaes.)

57.25

35709

Fallopian tubes, hydrotubation of, as a repetitive
post-operative procedure (Anaes.)

36.90

35710

Falloposcopy, unilateral or bilateral, including hysteroscopy and tubal catheterisation (H) (Anaes.) (Assist.)

393.15

35712

Laparotomy, involving oophorectomy, salpingectomy, salpingo-oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst — 1 such procedure, not being a service associated with hysterectomy (G) (H) (Anaes.) (Assist.)

307.30

35713

Laparotomy, involving oophorectomy, salpingectomy, salpingo-oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst — 1 such procedure, not being a service associated with hysterectomy (S) (H) (Anaes.) (Assist.)

384.25

35716

Laparotomy, involving oophorectomy, salpingectomy, salpingo-oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst — 2 or more such procedures, unilateral or bilateral, not being a service associated with hysterectomy (G) (H) (Anaes.) (Assist.)

368.55

35717

Laparotomy, involving oophorectomy, salpingectomy, salpingo-oophorectomy, removal of ovarian, parovarian, fimbrial or broad ligament cyst — 2 or more such procedures, unilateral or bilateral, not being a service associated with hysterectomy (S) (H) (Anaes.) (Assist.)

462.65

35720

Radical or debulking operation for advanced gynaecological malignancy, with or without omentectomy (H) (Anaes.) (Assist.)

572.30

35723

Retro-peritoneal lymph node biopsies from above the level of the aortic bifurcation, for staging or restaging of gynaecological malignancy (H) (Anaes.) (Assist.)

409.90

35726

Infra-colic omentectomy with multiple peritoneal biopsies for staging or restaging of gynaecological malignancy (H) (Anaes.) (Assist.)

409.90

35729

Ovarian transposition out of the pelvis, in conjunction with radical hysterectomy for invasive malignancy (H) (Anaes.)

184.80

35750

Laparoscopically assisted hysterectomy, including any associated laparoscopy (H) (Anaes.) (Assist.)

665.75

35753

Laparoscopically assisted hysterectomy, with 1 or more of the following procedures — salpingectomy, oophorectomy, excision of ovarian cyst or treatment of moderate endometriosis, 1 or both sides, including any associated laparoscopy (H) (Anaes.) (Assist.)

736.20

35754

Laparoscopically assisted hysterectomy which requires dissection of endometriosis, or other pathology, from the ureter, 1 or both sides, including any associated laparoscopy, including when performed with 1 or more of the following procedures — salpingectomy, oophorectomy, excision of ovarian cyst or treatment of endometriosis, not being a service to which item 35641 applies (H) (Anaes.) (Assist.)

926.40

35756

Laparoscopically assisted hysterectomy, when procedure is completed by open hysterectomy, including any associated laparoscopy (H) (Anaes.) (Assist.)

665.75

35759

Procedure for the control of post operative haemorrhage following gynaecological surgery, under general anaesthesia, utilising a vaginal or abdominal and vaginal approach where no other procedure is performed (H) (Anaes.) (Assist.)

477.95

Subgroup 5 — Urological

36500

Adrenal gland, excision of — partial or total (H) (Anaes.) (Assist.)

784.55

36502

Pelvic lymphadenectomy, open or laparoscopic, or both, unilateral or bilateral (H) (Anaes.) (Assist.)

580.25

36503

Renal transplant, not being a service to which item 36506 or 36509 applies (H) (Anaes.) (Assist.)

1 180.40

36506

Renal transplant, performed by vascular surgeon and urologist operating together — vascular anastomosis, including after-care (H) (Anaes.) (Assist.)

784.55

36509

Renal transplant, performed by vascular surgeon and urologist operating together — ureterovesical anastomosis, including after-care (H) (Assist.)

664.35

36516

Nephrectomy, complete (H) (Anaes.) (Assist.)

784.55

36519

Nephrectomy, complete, complicated by previous surgery on the same kidney (H) (Anaes.) (Assist.)

1 095.55

36522

Nephrectomy, partial (H) (Anaes.) (Assist.)

940.10

36525

Nephrectomy, partial, complicated by previous surgery on the same kidney (H) (Anaes.) (Assist.)

1 335.95

36526

Nephrectomy, radical with en bloc dissection of lymph nodes, with or without adrenalectomy, for a tumour of less than 10 cm in diameter, where performed if malignancy is clinically suspected but not confirmed by histopathological examination (Anaes.) (Assist.)

1 095.55

 

36527

Nephrectomy, radical with en bloc dissection of lymph nodes, with or without adrenalectomy, for a tumour of 10 cm or more in diameter, or complicated by previous open or laparoscopic surgery on the same kidney, where performed if malignancy is clinically suspected but not confirmed by histopathological examination (Anaes.) (Assist.)

1 352.00

36528

Nephrectomy, radical with en bloc dissection of lymph nodes, with or without adrenalectomy, for a tumour less than 10 cm in diameter (H) (Anaes.) (Assist.)

1 095.55

36529

Nephrectomy, radical with en bloc dissection of lymph nodes, with or without adrenalectomy, for a tumour 10 cm or more in diameter, or complicated by previous open or laparoscopic surgery on the same kidney (H) (Anaes.) (Assist.)

1352.00

36531

Nephro-ureterectomy, complete, including associated bladder repair and any associated endoscopic procedure (H) (Anaes.) (Assist.)

982.40

36532

Nephro-ureterectomy, for tumour, with or without en bloc dissection of lymph nodes, including associated bladder repair and any associated endoscopic procedures (H) (Anaes.) (Assist.)

1 410.10

36533

Nephro-ureterectomy, for tumour, with or without en bloc dissection of lymph nodes, including associated bladder repair and any associated endoscopic procedures, complicated by previous open or laparoscopic surgery on the same kidney or ureter (H) (Anaes.) (Assist.)

1 666.55

36537

Kidney or perinephric area, exploration of, with or without drainage of, by open exposure, not being a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

586.65

36540

Nephrolithotomy or pyelolithotomy, or both, through the same skin incision, for 1 or 2 stones (Anaes.) (Assist.)

940.10

36543

Nephrolithotomy or pyelolithotomy, or both, extended, for staghorn stone or 3 or more stones, including 1 or more of the following: nephrostomy, pyelostomy, pedicle control with or without freezing, calyorrhaphy or pyeloplasty (Anaes.) (Assist.)

1 095.55

36546

Extracorporeal shock wave lithotripsy (ESWL) to urinary tract and post-treatment care for 3 days, including
pre-treatment consultations, unilateral (Anaes.)

586.65

36549

Ureterolithotomy (H) (Anaes.) (Assist.)

706.85

36552

Nephrostomy or pyelostomy, open, as an independent procedure (H) (Anaes.) (Assist.)

629.15

36558

Renal cyst or cysts, excision or unroofing of (Anaes.) (Assist.)

551.35

36561

Renal biopsy (closed) (Anaes.)

146.35

36564

Pyeloplasty (plastic reconstruction of the pelvi-ureteric junction), by open exposure, laparoscopy or laparoscopic assisted techniques (H) (Anaes.) (Assist.)

784.55

36567

Pyeloplasty in a kidney that is congenitally abnormal in addition to the presence of pelvic-ureteric junction obstruction, or in a solitary kidney, by open exposure (H) (Anaes.) (Assist.)

862.35

36570

Pyeloplasty, complicated by previous surgery on the same kidney, by open exposure (H) (Anaes.) (Assist.)

1 095.55

36573

Divided ureter, repair of (H) (Anaes.) (Assist.)

784.55

36576

Kidney, exposure and exploration of, including repair or nephrectomy, for trauma, not being a service associated with any other procedure performed on the kidney, renal pelvis or renal pedicle (H) (Anaes.) (Assist.)

982.40

36579

Ureterectomy, complete or partial, with or without associated bladder repair, not being a service associated with a service to which item 37000 applies (H) (Anaes.) (Assist.)

629.15

36585

Ureter, transplantation of, into skin (H) (Anaes.) (Assist.)

629.15

36588

Ureter, reimplantation into bladder (H) (Anaes.) (Assist.)

784.55

36591

Ureter, reimplantation into bladder with psoas hitch or Boari flap or both (H) (Anaes.) (Assist.)

940.10

36594

Ureter, transplantation of, into intestine (H) (Anaes.) (Assist.)

784.55

36597

Ureter, transplantation of, into another ureter (H) (Anaes.) (Assist.)

784.55

36600

Ureter, transplantation of, into isolated intestinal segment, unilateral (Anaes.) (Assist.)

940.10

36603

Ureters, transplantation of, into isolated intestinal segment, bilateral (H) (Anaes.) (Assist.)

1 095.55

36604

Ureteric stent, passage of through percutaneous nephrostomy tube, using interventional imaging techniques (Anaes.)

227.10

36606

Intestinal urinary reservoir, continent, formation of, including formation of non-return valves and implantation of ureters (1 or both) into reservoir (H) (Anaes.) (Assist.)

1 964.95

36609

Intestinal urinary conduit or ureterostomy, revision of (H) (Anaes.) (Assist.)

629.15

36612

Ureter, exploration of, with or without drainage of, as an independent procedure (H) (Anaes.) (Assist.)

551.35

36615

Ureterolysis, with or without repositioning of ureter, for obstruction of the ureter, evident either radiologically or by proximal ureteric dilatation at operation, secondary to retroperitoneal fibrosis, or similar condition (H) (Anaes.) (Assist.)

629.15

36618

Reduction ureteroplasty (H) (Anaes.) (Assist.)

551.35

36621

Closure of cutaneous ureterostomy (H) (Anaes.) (Assist.)

394.10

36624

Nephrostomy, percutaneous, using interventional imaging techniques (Anaes.) (Assist.)

473.55

36627

Nephroscopy, percutaneous, with or without any 1 or more of stone extraction, biopsy or diathermy, not being a service to which item 36639, 36642, 36645 or 36648 applies (H) (Anaes.)

586.65

36630

Nephroscopy, being a service to which item 36627 applies, where, after a substantial portion of the procedure has been performed, it is necessary to discontinue the operation due to bleeding (H) (Anaes.) (Assist.)

289.80

36633

Nephroscopy, percutaneous, with incision of any 1 or more of renal pelvis, calyx or calyces or ureter and including antegrade insertion of ureteric stent, not being a service associated with a service to which item 36627, 36639, 36642, 36645 or 36648 applies (Anaes.) (Assist.)

629.15

36636

Nephroscopy, percutaneous, with incision of any 1 or more of renal pelvis, calyx or calyces or ureter and including antegrade insertion of ureteric stent, being a service associated with a service to which item 36627, 36639, 36642, 36645 or 36648 applies (H) (Anaes.) (Assist.)

339.35

36639

Nephroscopy, percutaneous, with destruction and extraction of 1 or 2 stones using ultrasound or electrohydraulic shock waves or lasers (not being a service to which item 36645 or 36648 applies) (H) (Anaes.)

706.85

36642

Nephroscopy, being a service to which item 36639 applies, where, after a substantial portion of the procedure has been performed, it is necessary to discontinue the operation due to bleeding (H) (Anaes.) (Assist.)

353.40

36645

Nephroscopy, percutaneous, with removal or destruction of a stone greater than 3 cm in any dimension, or for 3 or more stones (H) (Anaes.) (Assist.)

904.70

36648

Nephroscopy, being a service to which item 36645 applies, where, after a substantial portion of the procedure has been performed, it is necessary to discontinue the operation (H) (Anaes.) (Assist.)

805.80

36649

Nephrostomy drainage tube, exchange of — but not including imaging (Anaes.) (Assist.)

227.10

36652

Pyeloscopy, retrograde, of 1 collecting system, with or without any 1 or more of, cystoscopy, ureteric meatotomy, ureteric dilatation, not being a service associated with a service to which item 36803, 36812 or 36824 applies (H) (Anaes.) (Assist.)

551.35

36654

Pyeloscopy, retrograde, of 1 collecting system, being a service to which item 36652 applies, plus 1 or more of extraction of stone from the renal pelvis or calyces, or biopsy or diathermy of the renal pelvis or calyces, not being a service associated with a service performed in the same collecting system to which item 36656 applies (H) (Anaes.) (Assist.)

706.85

36656

Pyeloscopy, retrograde, of 1 collecting system, being a service to which item 36652 applies, plus extraction of 2 or more stones in the renal pelvis or calyces or destruction of stone with ultrasound, electrohydraulic or kinetic lithotripsy or laser in the renal pelvis or calyces, with or without extraction of fragments, not being a service associated with a service performed in the same collecting system to which item 36654 applies (H) (Anaes.) (Assist.)

904.70

36800

Bladder, catheterisation of, where no other procedure is performed (Anaes.)

23.45

36803

Ureteroscopy, of 1 ureter, with or without any 1 or more of cystoscopy, ureteric meatotomy, or ureteric dilatation, not being a service associated with a service to which item 36652, 36654, 36656, 36806, 36809, 36812, 36824, 36848 or 36857 applies (Anaes.) (Assist.)

395.70

36806

Ureteroscopy, of 1 ureter, with or without any 1 or more of, cystoscopy, ureteric meatotomy or ureteric dilatation, plus 1 or more of extraction of stone from the ureter, or biopsy or diathermy of the ureter, not being a service associated with a service to which item 36803 or 36812 applies, or a service associated with a service to which item 36809, 36824, 36848 or 36857 applies to a procedure performed on the same ureter (H) (Anaes.) (Assist.)

551.35

36809

Ureteroscopy, of 1 ureter, with or without any 1 or more of, cystoscopy, ureteric meatotomy or ureteric dilatation, plus destruction of stone in the ureter with ultrasound, electrohydraulic or kinetic lithotripsy or laser, with or without extraction of fragments, not being a service associated with a service to which item 36803 or 36812 applies, or a service associated with a service to which item 36806, 36824, 36848 or 36857 applies to a procedure performed on the same ureter (H) (Anaes.) (Assist.)

706.85

36811

Cystoscopy with insertion of urethral prosthesis (Anaes.)

274.40

36812

Cystoscopy with urethroscopy, with or without urethral dilatation, not being a service associated with any other urological endoscopic procedure on the lower urinary tract except a service to which item 37327 applies (Anaes.)

141.40

36815

Cystoscopy, with or without urethroscopy, for the treatment of penile warts or urethral warts, not being a service associated with a service to which item 30189 applies (Anaes.)

201.85

36818

Cystoscopy, with ureteric catheterisation including fluoroscopic imaging of the upper urinary tract, unilateral or bilateral, not being a service associated with a service to which item 36824 or 36830 applies (Anaes.) (Assist.)

234.65

36821

Cystoscopy with 1 or more of ureteric dilatation, insertion of ureteric stent, or brush biopsy of ureter or of renal pelvis, unilateral, not being a service associated with a service to which item 36824 or 36830 applies (Anaes.) (Assist.)

274.25

36824

Cystoscopy with ureteric catheterisation, unilateral or bilateral, not being a service associated with a service to which item 36818 or 36821 applies (Anaes.)

180.85

36825

Cystoscopy, with endoscopic incision of pelviureteric junction or ureteric stricture, including removal or replacement of ureteric stent, not being a service associated with a service to which item 36818, 36821, 36824, 36830 or 36833 applies (H) (Anaes.) (Assist.)

493.25

36827

Cystoscopy, with controlled hydro-dilatation of the bladder (Anaes.)

195.05

36830

Cystoscopy, with ureteric meatotomy (H) (Anaes.)

172.50

36833

Cystoscopy with removal of ureteric stent or other foreign body (Anaes.) (Assist.)

234.65

36836

Cystoscopy with biopsy of bladder, not being a service associated with a service to which item 36812, 36830, 36840, 36845, 36848, 36854, 37203, 37206 or 37215 applies (Anaes.)

195.05

36840

Cystoscopy, with resection, diathermy or visual laser destruction of bladder tumour or other lesion of the bladder, not being a service associated with a service to which item 36845 applies (Anaes.)

274.25

36842

Cystoscopy with lavage of blood clots from bladder including any associated diathermy of prostate or bladder and not being a service associated with a service to which item 36812, 36827 to 36863, 37203 or 37206 applies (H) (Anaes.) (Assist.)

276.00

36845

Cystoscopy, with diathermy, resection or visual laser destruction of multiple tumours in more than 2 quadrants of the bladder or solitary tumour greater than 2 cm in diameter (H) (Anaes.)

586.65

36848

Cystoscopy with resection of ureterocele (H) (Anaes.)

195.05

36851

Cystoscopy with injection into bladder wall (H) (Anaes.)

195.05

36854

Cystoscopy with endoscopic incision or resection of external sphincter, bladder neck or both (H) (Anaes.)

395.70

36857

Endoscopic manipulation or extraction of ureteric calculus (H) (Anaes.)

310.95

36860

Endoscopic examination of intestinal conduit or reservoir (Anaes.)

141.40

36863

Litholapaxy, with or without cystoscopy (H) (Anaes.) (Assist.)

395.70

37000

Bladder, partial excision of (H) (Anaes.) (Assist.)

629.15

37004

Bladder, repair of rupture (H) (Anaes.) (Assist.)

551.35

37008

Cystostomy or cystotomy, suprapubic, not being a service to which item 37011 applies and not being a service associated with other open bladder procedure (Anaes.)

353.40

37011

Suprapubic stab cystotomy, not being a service associated with a service to which items 37200 to 37221 apply (Anaes.)

79.15

37014

Bladder, total excision of (H) (Anaes.) (Assist.)

904.70

37020

Bladder diverticulum, excision or obliteration of (H) (Anaes.) (Assist.)

629.15

37023

Vesical fistula, cutaneous, operation for (H) (Anaes.)

353.40

37026

Cutaneous vesicostomy, establishment of (H) (Anaes.) (Assist.)

353.40

37029

Vesico-vaginal fistula, closure of, by abdominal approach (H) (Anaes.) (Assist.)

784.55

37038

Vesico-intestinal fistula, closure of, excluding bowel resection (H) (Anaes.) (Assist.)

587.00

37041

Bladder aspiration, by needle

39.55

37042

Bladder stress incontinence — sling procedure for, using autologous fascial sling, including harvesting of sling, with or without mesh, not being a service associated with a service to which item 30405 or 35599 applies (H) (Anaes.) (Assist.)

773.25

37043

Bladder stress incontinence, Stamey or similar type needle colposuspension, with or without mesh, not being a service associated with a service to which item 30405 or 35599 applies (H) (Anaes.) (Assist.)

572.30

37044

Bladder stress incontinence, suprapubic procedure for, eg Burch colposuspension, with or without mesh, not being a service associated with a service to which item 30405 or 35599 applies (H) (Anaes.) (Assist.)

587.00

37045

Mitrofanoff continent valve, formation of (H) (Anaes.) (Assist.)

1 212.30

37047

Bladder enlargement using intestine (H) (Anaes.) (Assist.)

1 413.65

37050

Bladder exstrophy closure, not involving sphincter reconstruction (H) (Anaes.) (Assist.)

629.15

37053

Bladder transection and re-anastomosis to trigone (H) (Anaes.) (Assist.)

726.95

37200

Prostatectomy, open (H) (Anaes.) (Assist.)

862.35

37201

Prostate, transurethral radio-frequency needle ablation of, with or without cystoscopy and with or without urethroscopy, in patients with moderate to severe lower urinary tract symptoms who are not medically fit for transurethral resection of the prostate (that is, prostatectomy using diathermy or cold punch) and including a service to which item 36854, 37203, 37206, 37207, 37208, 37303, 37321 or 37324 applies (H) (Anaes.)

703.35

37202

Prostate, transurethral radio-frequency needle ablation of, with or without cystoscopy and with or without urethroscopy, in patients with moderate to severe lower urinary tract symptoms who are not medically fit for transurethral resection of the prostate (that is prostatectomy using diathermy or cold punch) and including a service to which item 36854, 37303, 37321 or 37324 applies, continuation of, within 10 days of the procedure described by item 37201, 37203 or 37207 which had to be discontinued for medical reasons (Anaes.)

353.00

37203

Prostatectomy (endoscopic, using diathermy or cold punch), with or without cystoscopy, and with or without urethroscopy, and including services to which item 36854, 37201, 37202, 37207, 37208, 37303, 37321 or 37324 applies (H) (Anaes.)

884.20

37206

Prostatectomy (endoscopic, using diathermy or cold punch), with or without cystoscopy, and with or without urethroscopy, and including services to which item 36854, 37303, 37321 or 37324 applies, continuation of, within 10 days of the procedure described by item 37201, 37203 or 37207 which had to be discontinued for medical reasons (H) (Anaes.)

473.55

37207

Prostate, endoscopic non-contact (side firing) visual laser ablation, with or without cystoscopy, and with or without urethroscopy, and including services to which item 36854, 37201, 37202, 37203, 37206, 37303, 37321 or 37324 applies (H) (Anaes.)

735.20

37208

Prostate, endoscopic non-contact (side firing) visual laser ablation, with or without cystoscopy, and with or without urethroscopy, and including services to which item 36854, 37303, 37321 or 37324 applies, continuation of, within 10 days of the procedure described by item 37201, 37203 or 37207, which had to be discontinued for medical reasons (H) (Anaes.)

353.00

37209

Total excision (not being a service associated with a service to which item 37210 or 37211 applies) of any, or all of:

 (a) prostate; or

 (b) seminal vesicle, unilateral or bilateral; or

 (c) ampulla of vas, unilateral or bilateral

(H) (Anaes.) (Assist.)

1 095.55

37210

Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the bladder and bladder neck reconstruction, not being a service associated with a service to which item 35551, 36502 or 37375 applies (H) (Anaes.) (Assist.)

1 352.00

37211

Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the bladder and bladder neck reconstruction, with pelvic lymphadenectomy, not being a service associated with a service to which item 35551, 36502 or 37375 applies (H) (Anaes.) (Assist.)

1 642.05

37212

Prostate, open perineal biopsy or open drainage of abscess (H) (Anaes.) (Assist.)

234.65

37215

Prostate, biopsy of, endoscopic, with or without cystoscopy (Anaes.) (Assist.)

353.40

37218

Prostate, needle biopsy of, or injection into (Anaes.)

117.35

37219

Prostate, transrectal needle biopsy of, using transrectal prostatic ultrasound techniques and obtaining 1 or more prostatic specimens, being a service associated with a service to which item 55600 or 55603 applies (Anaes.) (Assist.)

238.30

37220

Prostate, radioactive seed implantation of, urological component, using transrectal ultrasound guidance, for localised prostatic malignancy at clinical stage T1, T2A or T2B, with a Gleason score of 6 or less and a prostate specific antigen (PSA) of 10ng/ml or less at the time of diagnosis, where the procedure is performed by a urologist at an approved site in association with a radiation oncologist, and being a service associated with a service to which item 55603 applies (H)

886.00

37221

Prostatic abscess, endoscopic drainage of (H) (Anaes.) (Assist.)

395.70

37223

Prostatic coil, insertion of, under ultrasound control (H) (Anaes.)

175.00

37224

Prostate, diathermy or visual laser destruction of lesion of, not being a service associated with a service to which item 37201, 37202, 37203, 37206, 37207, 37208 or 37215 applies (Anaes.)

274.25

37300

Urethral sounds, passage of, as an independent procedure (Anaes.)

39.55

37303

Urethral stricture, dilatation of (Anaes.)

62.85

37306

Urethra, repair of rupture of distal section (H) (Anaes.) (Assist.)

551.35

37309

Urethra, repair of rupture of prostatic or membranous segment (H) (Anaes.) (Assist.)

784.55

37315

Urethroscopy, as an independent procedure (Anaes.)

117.35

37318

Urethroscopy, with any 1 or more of biopsy, diathermy, visual laser destruction of stone or removal of foreign body or stone (Anaes.) (Assist.)

234.65

37321

Urethral meatotomy, external (Anaes.)

79.15

37324

Urethrotomy or urethrostomy, internal or external (H) (Anaes.)

195.05

37327

Urethrotomy, optical, for urethral stricture (H) (Anaes.) (Assist.)

274.25

37330

Urethrectomy, partial or complete, for removal of tumour (H) (Anaes.) (Assist.)

551.35

37333

Urethro-vaginal fistula, closure of (H) (Anaes.) (Assist.)

473.55

37336

Urethro-rectal fistula, closure of (H) (Anaes.) (Assist.)

629.15

37339

Periurethral or transurethral injection of materials for the treatment of urinary incontinence, including cystoscopy and urethroscopy (Anaes.)

203.55

37340

Urethral sling, division or removal of, for urethral obstruction or erosion, following previous surgery for urinary incontinence — vaginal approach, not being a service associated with a service to which item 37341 applies (H) (Anaes.) (Assist.)

360.60

37341

Urethral sling, division or removal of, for urethral obstruction or erosion, following previous surgery for urinary incontinence — suprapubic or vaginal approach, not being a service associated with a service to which item 37340 applies (H) (Anaes.) (Assist.)

773.25

37342

Urethroplasty — single stage operation (H) (Anaes.) (Assist.)

706.85

37343

Urethroplasty, single stage operation, transpubic approach via separate incisions above and below the symphysis pubis, excluding laparotomy, symphysectomy and suprapubic cystotomy, with or without re-routing of the urethra around the crura (H) (Anaes.) (Assist.)

1 180.40

37345

Urethroplasty — 2 stage operation — first stage (H) (Anaes.) (Assist.)

586.65

37348

Urethroplasty — 2 stage operation — second stage (H) (Anaes.) (Assist.)

586.65

37351

Urethroplasty, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

234.65

37354

Hypospadias, meatotomy and hemi-circumcision (H) (Anaes.) (Assist.)

274.25

37369

Urethra, excision of prolapse of (H) (Anaes.)

158.30

37372

Urethral diverticulum, excision of (H) (Anaes.) (Assist.)

395.70

37375

Urethral sphincter, reconstruction by bladder tubularisation technique or similar procedure (H) (Anaes.) (Assist.)

982.40

37381

Artificial urinary sphincter, insertion of cuff, perineal approach (H) (Anaes.) (Assist.)

629.15

37384

Artificial urinary sphincter, insertion of cuff, abdominal approach (H) (Anaes.) (Assist.)

982.40

37387

Artificial urinary sphincter, insertion of pressure regulating balloon and pump (H) (Anaes.) (Assist.)

274.25

37390

Artificial urinary sphincter, revision or removal of, with or without replacement (H) (Anaes.) (Assist.)

784.55

37393

Priapism, decompression by glanular stab caverno-sospongiosum shunt or penile aspiration with or without lavage (Anaes.)

195.05

37396

Priapism, shunt operation for, not being a service to which item 37393 applies (H) (Anaes.) (Assist.)

629.15

37402

Penis, partial amputation of (H) (Anaes.) (Assist.)

395.70

37405

Penis, complete or radical amputation of (H) (Anaes.) (Assist.)

784.55

37408

Penis, repair of laceration of cavernous tissue, or fracture involving cavernous tissue (H) (Anaes.) (Assist.)

395.70

37411

Penis, repair of avulsion (Anaes.) (Assist.)

784.55

37415

Penis, injection of, for the investigation and treatment of impotence — 2 services only in a period of 36 consecutive months

39.55

37417

Penis, correction of chordee, with or without excision of fibrous plaque or plaques and with or without grafting (H) (Anaes.) (Assist.)

473.55

37418

Penis, correction of chordee, with or without excision of fibrous plaque or plaques and with or without grafting, involving mobilisation of the urethra (Anaes.) (Assist.)

629.15

37420

Penis, surgery to inhibit rapid penile drainage causing impotence, by ligation of veins deep to Buck’s fascia including 1 or more deep cavernosal veins, with or without pharmacological erection test (H) (Anaes.) (Assist.)

310.95

37423

Penis, lengthening by translocation of corpora (H) (Anaes.) (Assist.)

784.55

37426

Penis, artificial erection device, insertion of, into 1 or both corpora (H) (Anaes.) (Assist.)

826.90

37429

Penis, artificial erection device, insertion of pump and pressure regulating reservoir (H) (Anaes.) (Assist.)

274.25

37432

Penis, artificial erection device, complete or partial revision or removal of components, with or without replacement (H) (Anaes.) (Assist.)

784.55

37435

Penis, frenuloplasty as an independent procedure (Anaes.)

79.15

37438

Scrotum, partial excision of (Anaes.) (Assist.)

234.65

37444

Ureterolithotomy complicated by previous surgery at the same site of the same ureter (Anaes.) (Assist.)

848.20

37601

Spermatocele or epididymal cyst, excision of, 1 or more of, on 1 side (Anaes.)

234.65

37604

Exploration of scrotal contents, with or without fixation and with or without biopsy, unilateral, not being a service associated with sperm harvesting for IVF (Anaes.)

234.65

37607

Retroperitoneal lymph node dissection, unilateral, not being a service associated with a service to which item 36528 applies (H) (Anaes.) (Assist.)

784.55

37610

Retroperitoneal lymph node dissection, unilateral, not being a service associated with a service to which item 36528 applies, following previous similar retroperitoneal dissection, retroperitoneal irradiation or chemotherapy (H) (Anaes.) (Assist.)

1 180.40

37613

Epididymectomy (Anaes.)

234.65

37616

Vasovasostomy or vasoepididymostomy, unilateral, using the operating microscope, for other than reversal of previous elective sterilisation, not being a service associated with sperm harvesting for IVF (H) (Anaes.) (Assist.)

586.65

37619

Vasovasostomy or vasoepididymostomy, unilateral, for other than reversal of previous elective sterilisation, not being a service associated with sperm harvesting for IVF (Anaes.) (Assist.)

234.65

37622

Vasotomy or vasectomy, unilateral or bilateral (G) (Anaes.)

163.95

37623

Vasotomy or vasectomy, unilateral or bilateral (S) (Anaes.)

195.05

37800

Patent urachus, excision of (H) (Anaes.) (Assist.)

442.25

37803

Undescended testis, orchidopexy for, not being a service to which item 37806 applies (H) (Anaes.) (Assist.)

442.25

37806

Undescended testis in inguinal canal close to deep inguinal ring or within abdominal cavity, orchidopexy for (Anaes.) (Assist.)

511.00

37809

Undescended testis, revision orchidopexy for (H) (Anaes.) (Assist.)

511.00

37812

Impalpable testis, exploration of groin for, not being a service associated with a service to which items 37803 to 37809 apply (H) (Anaes.) (Assist.)

471.80

37815

Hypospadias, examination under anaesthesia with erection test (H) (Anaes.)

78.65

37818

Hypospadias, glanuloplasty incorporating meatal advancement (Anaes.) (Assist.)

417.00

37821

Hypospadias, distal, 1 stage repair (H) (Anaes.) (Assist.)

706.85

37824

Hypospadias, proximal, 1 stage repair (H) (Anaes.) (Assist.)

982.85

37827

Hypospadias, staged repair, first stage (H) (Anaes.) (Assist.)

452.75

37830

Hypospadias, staged repair, second stage (Anaes.) (Assist.)

586.65

37833

Hypospadias, repair of post operative urethral fistula (H) (Anaes.) (Assist.)

280.00

37836

Epispadias, staged repair, first stage (H) (Anaes.) (Assist.)

589.75

37839

Epispadias, staged repair, second stage (H) (Anaes.) (Assist.)

668.30

37842

Exstrophy of bladder or epispadias, secondary repair with bladder neck tightening, with or without ureteric reimplantation (H) (Anaes.) (Assist.)

1 297.45

37845

Ambiguous genitalia with urogenital sinus, reduction clitoroplasty, with or without endoscopy (H) (Anaes.) (Assist.)

589.75

37848

Ambiguous genitalia with urogenital sinus, reduction clitoroplasty, with endoscopy and vaginoplasty (H) (Anaes.) (Assist.)

1 061.45

37851

Congenital adrenal hyperplasia, mixed gonadal dysgenesis or similar condition, vaginoplasty for, with or without endoscopy (H) (Anaes.) (Assist.)

786.35

37854

Urethral valve, destruction of, including cystoscopy and urethroscopy (H) (Anaes.) (Assist.)

310.95

Subgroup 6 — Cardio-Thoracic

38200

Right heart catheterisation, including fluoroscopy, oximetry, dye dilution curves, cardiac output measurement by any method, shunt detection and exercise stress test (Anaes.)

377.95

38203

Left heart catheterisation by percutaneous arterial puncture, arteriotomy or percutaneous left ventricular puncture, including fluoroscopy, oximetry, dye dilution curves, cardiac output measurements by any method, shunt detection and exercise stress test (H) (Anaes.)

451.00

38206

Right heart catheterisation with left heart catheterisation via the right heart or by any other procedure, including fluoroscopy, oximetry, dye dilution curves, cardiac output measurements by any method, shunt detection and exercise stress test (Anaes.)

545.25

38209

Cardiac electrophysiological study — up to and including 3 catheter investigation of any 1 or more of — syncope, atrio-ventricular conduction, sinus node function or simple ventricular tachycardia studies, not being a service associated with a service to which item 38212 or 38213 applies (Anaes.)

700.05

38212

Cardiac electrophysiological study:

 (a) 4 or more catheter supraventricular tachycardia investigation; or

 (b) complex tachycardia inductions; or

 (c) multiple catheter mapping; or

 (d) acute intravenous anti-arrhythmic drug testing with pre and post drug inductions; or

1 164.50

 

 (e) catheter ablation to intentionally induce complete AV block; or

 (f) intra-operative mapping; or

 (g) electrophysiological services during defibrillator implantation or testing;

not being a service associated with a service to which item 38209 or 38213 applies (Anaes.)

 

38213

Cardiac electrophysiological study, for follow-up testing of implanted defibrillator — not being a service associated with a service to which item 38209 or 38212 applies (Anaes.)

346.75

38215

Selective coronary angiography — placement of catheters and injection of opaque material into the native coronary arteries, not being a service associated with a service to which item 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

376.40

38218

Selective coronary angiography — placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography, not being a service associated with a service to which item 38215, 38220, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

564.55

38220

Selective coronary graft angiography — placement of 1 or more catheters and injection of opaque material into free coronary graft attached to the aorta (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (H) (Anaes.)

188.20

38222

Selective coronary graft angiography — placement of 1 or more catheters and injection of opaque material into direct internal mammary artery graft to 1 or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

376.40

38225

Selective coronary angiography — placement of catheters and injection of opaque material into the native coronary arteries and placement of 1 or more catheters and injection of opaque material into free coronary graft attached to the aorta (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

564.60

38228

Selective coronary angiography — placement of catheters and injection of opaque material into the native coronary arteries and placement of 1 or more catheters and injection of opaque material into direct internal mammary artery graft to 1 or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

752.85

38231

Selective coronary angiography — placement of catheters and injection of opaque material into the native coronary arteries and placement of 1 or more catheters and injection of opaque material into free coronary graft attached to the aorta (irrespective of the number of grafts), and placement of 1 or more catheters and injection of opaque material into direct internal mammary artery graft to 1 or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38234, 38237, 38240 or 38246 applies (Anaes.)

941.05

38234

Selective coronary angiography — placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of 1 or more catheters and injection of opaque material into free coronary graft attached to the aorta (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38237, 38240 or 38246 applies (Anaes.)

752.80

38237

Selective coronary angiography — placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of 1 or more catheters and injection of opaque material into direct internal mammary artery graft to 1 or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38240 or 38246 applies (Anaes.)

941.00

38240

Selective coronary angiography — placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of 1 or more catheters and injection of opaque material into free coronary graft attached to the aorta (irrespective of the number of grafts), and placement of 1 or more catheters and injection of opaque material into direct internal mammary artery graft to 1 or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38237 or 38246 applies (Anaes.)

1 129.10

38243

Placement of 1 or more catheters and injection of opaque material into any 1 or more coronary vessels or grafts prior to any coronary interventional procedure, not being a service associated with a service to which item 38246 applies (H) (Anaes.)

376.40

38246

Selective coronary angiography — placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography followed by placement of catheters prior to any coronary interventional procedure, not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38243 applies (Anaes.)

941.00

38256

Temporary transvenous pacemaking electrode, insertion of (H) (Anaes.)

226.70

38270

Balloon valvuloplasty or isolated atrial septostomy, including cardiac catheterisations before and after balloon dilatation (H) (Anaes.) (Assist.)

774.05

38275

Myocardial biopsy, by cardiac catheterisation (H) (Anaes.)

253.05

38278

Single chamber permanent transvenous electrode, insertion, removal or replacement of (Anaes.)

541.95

38281

Permanent cardiac pacemaker, insertion, removal or replacement of (Anaes.)

216.75

38284

Dual chamber permanent transvenous electrodes, insertion, removal or replacement of (Anaes.)

710.50

38285

Implantable ECG loop recorder, insertion of, for diagnosis of primary disorder, if:

 (a) the patient to whom the service is provided:

 (i) has recurrent unexplained syncope; and

 (ii) does not have a structural heart defect associated with a high risk of sudden cardiac death; and

 (b) a diagnosis has not been achieved through all other available cardiac investigations; and

 (c) a neurogenic cause is not suspected;

including initial programming and testing (H) (Anaes.)

163.70

38286

Implantable ECG loop recorder, removal of (H) (Anaes.)

147.40

38287

Ablation of arrhythmia circuit or focus or isolation procedure involving 1 atrial chamber (Anaes.) (Assist.)

1 780.45

38290

Ablation of arrhythmia circuits or foci, or isolation procedure involving both atrial chambers and including curative procedures for atrial fibrillation (H) (Anaes.) (Assist.)

2 267.15

38293

Ventricular arrhythmia with mapping and ablation, including all associated electrophysiological studies performed on the same day (Anaes.) (Assist.)

2 433.50

38400

Thoracic cavity, aspiration of, for diagnostic purposes, not being a service associated with a service to which item 38403 applies

32.70

38403

Thoracic cavity, aspiration of, with therapeutic drainage (paracentesis), with or without diagnostic sample

65.20

38406

Pericardium, paracentesis of (excluding after-care) (Anaes.)

113.35

38409

Intercostal drain, insertion of, not involving resection of rib (excluding after-care) (Anaes.)

113.35

38410

Intercostal drain, insertion of, with pleurodesis and not involving resection of rib (excluding after-care) (Anaes.)

139.65

38412

Percutaneous needle biopsy of lung (Anaes.)

177.50

38415

Empyema, radical operation for, involving resection of rib (Anaes.) (Assist.)

338.80

38418

Thoracotomy, exploratory, with or without biopsy (H) (Anaes.) (Assist.)

813.25

38421

Thoracotomy, with pulmonary decortication (H) (Anaes.) (Assist.)

1 299.90

38424

Thoracotomy, with pleurectomy or pleurodesis, or enucleation of hydatid cysts (H) (Anaes.) (Assist.)

813.25

38427

Thoracoplasty (complete) — 3 or more ribs (H) (Anaes.) (Assist.)

1 004.10

38430

Thoracoplasty (in stages) — each stage (H) (Anaes.) (Assist.)

517.50

38436

Thoracoscopy, with or without division of pleural adhesions, including insertion of intercostal catheter, where necessary, with or without biopsy (H) (Anaes.)

211.90

38438

Pneumonectomy or lobectomy or segmentectomy not being a service associated with a service to which item 38418 applies (H) (Anaes.) (Assist.)

1 299.90

38440

Lung, wedge resection of (H) (Anaes.) (Assist.)

973.40

38441

Radical lobectomy or pneumonectomy including resection of chest wall, diaphragm, pericardium, or formal mediastinal node dissection (H) (Anaes.) (Assist.)

1 540.15

38446

Thoracotomy or sternotomy, for removal of thymus or mediastinal tumour (H) (Anaes.) (Assist.)

1 004.10

38447

Pericardiectomy via sternotomy or anterolateral thoracotomy without cardiopulmonary bypass (H) (Anaes.) (Assist.)

1 299.90

38448

Mediastinum, cervical exploration of, with or without biopsy (H) (Anaes.) (Assist.)

308.05

38449

Pericardiectomy via sternotomy or anterolateral thoracotomy with cardiopulmonary bypass (H) (Anaes.) (Assist.)

1 818.55

38450

Pericardium, transthoracic drainage of (H) (Anaes.) (Assist.)

726.90

38452

Pericardium, sub-xyphoid drainage of (H) (Anaes.) (Assist.)

486.75

38453

Tracheal excision and repair without cardiopulmonary bypass (H) (Anaes.) (Assist.)

1 460.15

38455

Tracheal excision and repair of, with cardiopulmonary bypass (H) (Anaes.) (Assist.)

1 975.05

38456

Intrathoracic operation on heart, lungs, great vessels, bronchial tree, oesophagus or mediastinum, or on more than 1 of those organs, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

1 299.90

38457

Pectus excavatum or pectus carinatum, repair or radical correction of (H) (Anaes.) (Assist.)

1 213.60

38458

Pectus excavatum, repair of, with implantation of subcutaneous prosthesis (H) (Anaes.) (Assist.)

646.90

38460

Sternal wires or wires, removal of (H) (Anaes.)

233.70

38462

Sternotomy wound, debridement of, not involving reopening of the mediastinum (H) (Anaes.)

276.90

38464

Sternotomy wound, debridement of, involving curettage of infected bone with or without removal of wires but not involving reopening of the mediastinum (H) (Anaes.)

301.05

38466

Sternum, re-operation on, for dehiscence or infection involving reopening of the mediastinum, with or without rewiring (H) (Anaes.) (Assist.)

812.90

38468

Sternum and mediastinum, re-operation for infection of, involving muscle advancement flaps or greater omentum (H) (Anaes.) (Assist.)

1 252.55

38469

Sternum and mediastinum, re-operation for infection of, involving muscle advancement flaps and greater omentum (H) (Anaes.) (Assist.)

1 460.15

38470

Permanent myocardial electrode, insertion of, by thoracotomy or sternotomy (H) (Anaes.) (Assist.)

813.25

38473

Permanent pacemaker electrode, insertion by sub-xyphoid approach (H) (Anaes.) (Assist.)

486.75

38475

Valve annuloplasty without insertion of ring, not being a service associated with a service to which item 38480 or 38481 applies (H) (Anaes.) (Assist.)

705.80

38477

Valve annuloplasty with insertion of ring not being a service to which item 38478 applies (H) (Anaes.) (Assist.)

1 699.85

38478

Valve annuloplasty with insertion of ring performed in conjunction with item 38480 or 38481 (H) (Anaes.) (Assist.)

823.45

38480

Valve repair, 1 leaflet (H) (Anaes.) (Assist.)

1 699.85

38481

Valve repair, 2 or more leaflets (H) (Anaes.) (Assist.)

1 935.15

38483

Aortic valve leaflet or leaflets, decalcification of, not being a service to which item 38475, 38477, 38480, 38481, 38488 or 38489 applies (H) (Anaes.) (Assist.)

1 460.15

38485

Mitral annulus, reconstruction of, after decalcification, when performed in association with valve surgery (H) (Anaes.) (Assist.)

693.35

38487

Mitral valve, open valvotomy of (H) (Anaes.) (Assist.)

1 460.15

38488

Valve replacement with bioprosthesis or mechanical prosthesis (H) (Anaes.) (Assist.)

1 620.30

38489

Valve replacement with allograft (subcoronary or cylindrical implant), or unstented xenograft (H) (Anaes.) (Assist.)

1 926.95

38490

Sub-valvular structures, reconstruction and
re-implantation of, associated with mitral and tricuspid valve replacement (H) (Anaes.) (Assist.)

470.50

38493

Operative management of acute infective endocarditis, in association with heart valve surgery (H) (Anaes.) (Assist.)

1 661.05

38496

Artery harvesting (other than internal mammary), for coronary artery bypass (H) (Anaes.) (Assist.)

529.40

38497

Coronary artery bypass with cardiopulmonary bypass, using saphenous vein graft or grafts only, including harvesting of vein graft material where performed, not being a service associated with a service to which item 38498, 38500, 38501, 38503 or 38504 applies (H) (Anaes.) (Assist.)

1 737.35

38498

Coronary artery bypass with the aid of tissue stabilisers, performed without cardiopulmonary bypass, using saphenous vein graft or grafts only, including harvesting of vein graft material where performed, either by a median sternotomy or other minimally invasive technique, and where a stand-by perfusionist is present, not being a service associated with a service to which item 38497, 38500, 38501, 38503, 38504 or 38600 applies (H) (Anaes.) (Assist.)

1 737.35

38500

Coronary artery bypass with cardiopulmonary bypass, using single arterial graft, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, not being a service associated with a service to which item 38497, 38498, 38501, 38503 or 38504 applies (H) (Anaes.) (Assist.)

1 866.65

38501

Coronary artery bypass with the aid of tissue stabilisers, performed without cardiopulmonary bypass, using single arterial graft, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, either by a median sternotomy or other minimally invasive technique, and where a stand-by perfusionist is present, not being a service associated with a service to which item 38497, 38498, 38500, 38503, 38504 or 38600 applies (H) (Anaes.) (Assist.)

1 866.65

38503

Coronary artery bypass with cardiopulmonary bypass, using 2 or more arterial grafts, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, not being a service associated with a service to which item 38497, 38498, 38500, 38501 or 38504 applies (H) (Anaes.) (Assist.)

2 026.80

38504

Coronary artery bypass with the aid of tissue stabilisers, performed without cardiopulmonary bypass, using 2 or more arterial grafts, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, either by a median sternotomy or other minimally invasive technique, and where a stand-by perfusionist is present, not being a service associated with a service to which item 38497, 38498, 38500, 38501, 38503 or 38600 applies (H) (Anaes.) (Assist.)

2 026.80

38505

Coronary endarterectomy, by open operation, including repair with 1 or more patch grafts, each vessel (H) (Anaes.) (Assist.)

235.25

38506

Left ventricular aneurysm, plication of (H) (Anaes.) (Assist.)

1 379.90

38507

Left ventricular aneurysm resection with primary repair (H) (Anaes.) (Assist.)

1 619.95

38508

Left ventricular aneurysm resection with patch reconstruction of the left ventricle (H) (Anaes.) (Assist.)

2 026.80

38509

Ischaemic ventricular septal rupture, repair of (H) (Anaes.) (Assist.)

2 026.80

38512

Division of accessory pathway, isolation procedure, procedure on atrioventricular node or perinodal tissues involving 1 atrial chamber only (H) (Anaes.) (Assist.)

1 780.45

38515

Division of accessory pathway, isolation procedure, procedure on atrioventricular node or perinodal tissues involving both atrial chambers and including curative surgery for atrial fibrillation (H) (Anaes.) (Assist.)

2 267.15

38518

Ventricular arrhythmia with mapping and muscle ablation, with or without aneurysmeotomy (H) (Anaes.) (Assist.)

2 433.50

38521

Automatic defibrillator, insertion of patches for, or insertion of transvenous endocardial defibrillation electrode for — not being a service associated with a service to which item 38213 applies (H) (Anaes.) (Assist.)

893.20

38524

Automatic defibrillator generator, insertion or replacement of — not being a service associated with a service to which item 38213 applies (H) (Anaes.) (Assist.)

244.20

38550

Ascending thoracic aorta, repair or replacement of, not involving valve replacement or repair or coronary artery implantation (H) (Anaes.) (Assist.)

1 821.05

38553

Ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, without implantation of coronary arteries (H) (Anaes.) (Assist.)

2 307.70

38556

Ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, and implantation of coronary arteries (H) (Anaes.) (Assist.)

2 634.30

38559

Aortic arch and ascending thoracic aorta, repair or replacement of, not involving valve replacement or repair or coronary artery implantation (H) (Anaes.) (Assist.)

2 147.55

38562

Aortic arch and ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, without implantation of coronary arteries (H) (Anaes.) (Assist.)

2 634.30

38565

Aortic arch and ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, and implantation of coronary arteries (H) (Anaes.) (Assist.)

2 954.60

38568

Descending thoracic aorta, repair or replacement of, without shunt or cardiopulmonary bypass (H) (Anaes.) (Assist.)

1 580.70

38571

Descending thoracic aorta, repair or replacement of, using shunt or cardiopulmonary bypass (H) (Anaes.) (Assist.)

1 740.90

38572

Operative management of acute rupture or dissection, in conjunction with procedures on the thoracic aorta (H) (Anaes.) (Assist.)

1 686.05

38577

Cannulation for, and supervision and monitoring of, the administration of retrograde cerebral perfusion during deep hypothermic arrest (H) (Assist.)

470.50

38588

Cannulation of the coronary sinus for, and supervision of, the retrograde administration of blood or crystalloid for cardioplegia, including pressure monitoring (H) (Assist.)

353.00

38600

Central cannulation for cardiopulmonary bypass excluding post-operative management, not being a service associated with a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

1 299.90

38603

Peripheral cannulation for cardiopulmonary bypass excluding post-operative management (H) (Anaes.) (Assist.)

813.25

38606

Intra-aortic balloon pump, percutaneous insertion of (H) (Anaes.)

326.55

38609

Intra-aortic balloon pump, insertion of, by arteriotomy (H) (Anaes.) (Assist.)

406.55

38612

Intra-aortic balloon pump, removal of, with closure of artery by direct suture (Anaes.) (Assist.)

455.75

38613

Intra-aortic balloon pump, removal of, with closure of artery by patch graft (H) (Anaes.) (Assist.)

572.00

38615

Left or right ventricular assist device, insertion of (H) (Anaes.) (Assist.)

1 299.90

38618

Left and right ventricular assist device, insertion of (H) (Anaes.) (Assist.)

1 620.30

38621

Left or right ventricular assist device, removal of, as an independent procedure (H) (Anaes.) (Assist.)

646.90

38624

Left and right ventricular assist device, removal of, as an independent procedure (H) (Anaes.) (Assist.)

726.90

38627

Extra-corporeal membrane oxygenation, bypass or ventricular assist device cannulae, adjustment and
re-positioning of, by open operation, in patients supported by these devices (H) (Anaes.) (Assist.)

568.15

38637

Patent diseased coronary artery bypass vein graft or grafts, dissection, disconnection and oversewing of (H) (Anaes.) (Assist.)

470.50

38640

Re-operation via median sternotomy, for any procedure, including any divisions of adhesions where the time taken to divide the adhesions is 45 minutes or less (H) (Anaes.) (Assist.)

813.25

38643

Thoracotomy or sternotomy involving division of adhesions where the time taken to divide the adhesions exceeds 45 minutes (H) (Anaes.) (Assist.)

905.65

38647

Thoracotomy or sternotomy involving division of extensive adhesions where the time taken to divide the adhesions exceeds 2 hours (H) (Anaes.) (Assist.)

1 811.15

38650

Myomectomy or myotomy for hypertrophic obstructive cardiomyopathy (H) (Anaes.) (Assist.)

1 620.30

38653

Open heart surgery, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

1 620.30

38656

Thoracotomy or median sternotomy for post-operative bleeding (H) (Anaes.) (Assist.)

813.25

38670

Cardiac tumour, excision of, involving the wall of the atrium or inter-atrial septum, without patch or conduit reconstruction (H) (Anaes.) (Assist.)

1 619.95

38673

Cardiac tumour, excision of, involving the wall of the atrium or inter-atrial septum, requiring reconstruction with patch or conduit (H) (Anaes.) (Assist.)

1 823.35

38677

Cardiac tumour arising from ventricular myocardium, partial thickness excision of (H) (Anaes.) (Assist.)

1 705.75

38680

Cardiac tumour arising from ventricular myocardium, full thickness excision of including repair or reconstruction (Anaes.) (Assist.)

2 023.30

38700

Patent ductus arteriosus, shunt, collateral or other single large vessel, division or ligation of, without cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

905.65

38703

Patent ductus arteriosus, shunt, collateral or other single large vessel, division or ligation of, with cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 632.60

38706

Aorta, anastomosis or repair of, without cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 546.30

38709

Aorta, anastomosis or repair of, with cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38712

Aortic interruption, repair of, for congenital heart disease (H) (Anaes.) (Assist.)

2 174.80

38715

Main pulmonary artery, banding, debanding or repair of, without cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 447.80

38718

Main pulmonary artery, banding, debanding or repair of, with cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38721

Vena cava, anastomosis or repair of, without cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 269.10

38724

Vena cava, anastomosis or repair of, with cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38727

Intrathoracic vessels, anastomosis or repair of, without cardiopulmonary bypass, not being a service to which item 38700, 38703, 38706, 38709, 38712, 38715, 38718, 38721 or 38724 applies, for congenital heart disease (H) (Anaes.) (Assist.)

1 269.10

38730

Intrathoracic vessels, anastomosis or repair of, with cardiopulmonary bypass, not being a service to which item 38700, 38703, 38706, 38709, 38712, 38715, 38718, 38721 or 38724 applies, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38733

Systemic pulmonary or cavo-pulmonary shunt, creation of, without cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 269.10

38736

Systemic pulmonary or cavo-pulmonary shunt, creation of, with cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38739

Atrial septectomy, with or without cardiopulmonary bypass, for congenital heart disease (H) (Anaes.) (Assist.)

1 632.60

38742

Atrial septal defect, closure by open exposure and direct suture or patch, for congenital heart disease (H) (Anaes.) (Assist.)

1 632.60

38743

Atrial septal defect, closure using a septal occluder or similar device by transcatheter approach (Anaes.) (Assist.)

774.05

38745

Intra-atrial baffle, insertion of, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38748

Ventricular septectomy, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38751

Ventricular septal defect, closure by direct suture or patch, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38754

Intraventricular baffle or conduit, insertion of, for congenital heart disease (H) (Anaes.) (Assist.)

2 267.15

38757

Extracardiac conduit, insertion of, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38760

Extracardiac conduit, replacement of, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38763

Ventricular myectomy, for relief of ventricular obstruction, right or left, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

38766

Ventricular augmentation, right or left, for congenital heart disease (H) (Anaes.) (Assist.)

1 811.15

Subgroup 7 — Neurosurgical

39000

Lumbar puncture (Anaes.)

63.90

39003

Cisternal puncture (Anaes.)

72.70

39006

Ventricular puncture (not including burr-hole) (Anaes.)

135.30

39009

Subdural haemorrhage, tap for, each tap (H) (Anaes.)

50.35

39012

Burr-hole, single, preparatory to ventricular puncture or for inspection purpose — not being a service to which another item applies (H) (Anaes.)

201.60

39013

Injection under image intensification with 1 or more of contrast media, local anaesthetic or corticosteroid into 1 or more zygo-apophyseal or costo-transverse joints or 1 or more primary posterior rami of spinal nerves (Anaes.)

92.65

39015

Ventricular reservoir, external ventricular drain or intracranial pressure monitoring device, insertion of — including burr-hole (excluding after-care) (H) (Anaes.) (Assist.)

319.00

39018

Cerebrospinal fluid reservoir, insertion of (H) (Anaes.) (Assist.)

319.00

39100

Injection of primary branch of trigeminal nerve with alcohol, cortisone, phenol, or similar substance (Anaes.)

201.60

39106

Neurectomy, intracranial, for trigeminal neuralgia (H) (Anaes.) (Assist.)

1 008.20

39109

Trigeminal gangliotomy by radiofrequency, balloon or glycerol (Anaes.)

376.45

39112

Cranial nerve, intracranial decompression of, using microsurgical techniques (H) (Anaes.) (Assist.)

1 308.05

39115

Percutaneous neurotomy of posterior divisions (or rami) of spinal nerves by any method, including any associated spinal, epidural or regional nerve block (payable once only in a 30 day period) (Anaes.)

63.90

39118

Percutaneous neurotomy for facet joint denervation by radio-frequency probe or cryoprobe using radiological imaging control (Anaes.) (Assist.)

252.70

39121

Percutaneous cordotomy (Anaes.) (Assist.)

536.05

39124

Cordotomy or myelotomy, laminectomy for, or operation for dorsal root entry zone (Drez) lesion (H) (Anaes.) (Assist.)

1 371.80

39125

Spinal catheter, insertion of — for an automated infusion device (H) (Anaes.) (Assist.)

252.90

39126

Automated subcutaneous infusion device, insertion of (H) (Anaes.) (Assist.)

307.05

39127

Subcutaneous reservoir and spinal catheter for pain, insertion of (H) (Anaes.)

401.90

39128

Automated subcutaneous infusion device and spinal catheter, insertion of (H) (Anaes.) (Assist.)

559.95

39130

Epidural lead, percutaneous placement of, including intraoperative test stimulation, for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris — to a maximum of 4 leads (H) (Anaes.)

572.05

39131

Epidural or peripheral nerve electrodes, management, adjustment, and electronic programming of, by a medical practitioner, for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris — each day

108.50

39133

Spinal infusion device, revision of (Anaes.)

135.30

39134

Neurostimulator or receiver, subcutaneous placement of, including placement and connection of extension wires to epidural or peripheral nerve electrodes, for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris (H) (Anaes.) (Assist.)

289.00

39135

Neurostimulator or receiver that was inserted for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris, removal of, performed in the operating theatre of a hospital or approved day hospital facility (Anaes.)

135.30

39136

Epidural or peripheral nerve lead that was inserted for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris, removal of, performed in the operating theatre of a hospital or approved day hospital facility (Anaes.)

135.30

39137

Epidural or peripheral nerve lead that was inserted for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris, surgical repositioning of, to correct displacement or unsatisfactory positioning, including intraoperative test stimulation, not being a service to which item 39130, 39138 or 39139 applies (Anaes.)

513.70

39138

Peripheral nerve lead, surgical placement of 1 or more, including intraoperative test stimulation, for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris (Anaes.) (Assist.)

572.05

39139

Epidural lead, surgical placement of 1 or more of by laminectomy, including intraoperative test stimulation, for the management of chronic intractable neuropathic pain or pain from refractory angina pectoris — to a maximum of 4 leads (H) (Anaes.) (Assist.)

767.95

39140

Epidural catheter, insertion of, under imaging control, with epidurogram and epidural therapeutic injection for lysis of adhesions (Anaes.)

248.50

39300

Cutaneous nerve (including digital nerve), primary repair of, using microsurgical techniques (H) (Anaes.) (Assist.)

299.85

39303

Cutaneous nerve (including digital nerve), secondary repair of, using microsurgical techniques (H) (Anaes.) (Assist.)

395.50

39306

Nerve trunk, primary repair of, using microsurgical techniques (H) (Anaes.) (Assist.)

574.30

39309

Nerve trunk, secondary repair of, using microsurgical techniques (H) (Anaes.) (Assist.)

606.10

39312

Nerve trunk, internal (interfascicular), neurolysis of, using microsurgical techniques (H) (Anaes.) (Assist.)

338.15

39315

Nerve trunk, nerve graft to, (cable graft) including harvesting of nerve graft using microsurgical techniques (H) (Anaes.) (Assist.)

874.10

39318

Cutaneous nerve (including digital nerve), nerve graft to, using microsurgical techniques (H) (Anaes.) (Assist.)

542.35

39321

Nerve, transposition of (H) (Anaes.) (Assist.)

401.90

39323

Percutaneous neurotomy by cryotherapy or radiofrequency lesion generator, not being a service to which another item applies (Anaes.) (Assist.)

234.80

39324

Neurectomy, neurotomy or removal of tumour from superficial peripheral nerve, by open operation (Anaes.) (Assist.)

234.80

39327

Neurectomy, neurotomy or removal of tumour from deep peripheral nerve, by open operation (H) (Anaes.) (Assist.)

401.90

39330

Neurolysis by open operation without transposition, not being a service associated with a service to which item 39312 applies (H) (Anaes.) (Assist.)

234.80

39331

Carpal tunnel release (division of transverse carpal ligament), by any method (Anaes.)

234.80

39333

Brachial plexus, exploration of, not being a service to which another item in this group applies (Anaes.) (Assist.)

338.15

39500

Vestibular nerve, section of, via posterior fossa (H) (Anaes.) (Assist.)

1 078.40

39503

Facio-hypoglossal nerve or facio-accessory nerve, anastomosis of (H) (Anaes.) (Assist.)

810.30

39600

Intracranial haemorrhage, burr-hole craniotomy for — including burr-holes (H) (Anaes.) (Assist.)

401.90

39603

Intracranial haemorrhage, osteoplastic craniotomy or extensive craniectomy and removal of haematoma (H) (Anaes.) (Assist.)

1 014.50

39606

Fractured skull, depressed or comminuted, operation for (H) (Anaes.) (Assist.)

676.30

39609

Fractured skull, compound, without dural penetration, operation for (H) (Anaes.) (Assist.)

810.30

39612

Fractured skull, compound, depressed or complicated, with dural penetration and brain laceration, operation for (H) (Anaes.) (Assist.)

950.75

39615

Fractured skull with rhinorrhoea or otorrhoea, cranioplasty and repair of (H) (Anaes.) (Assist.)

1 014.50

39640

Tumour involving anterior cranial fossa, removal of, involving craniotomy, radical excision of the skull base, and dural repair (H) (Anaes.) (Assist.)

2 572.35

39642

Tumour involving anterior cranial fossa, removal of, involving frontal craniotomy with lateral rhinotomy for clearance of paranasal sinus extension, (intracranial procedure) (H) (Anaes.) (Assist.)

2 704.35

39646

Tumour involving anterior cranial fossa, removal of, involving frontal craniotomy with lateral rhinotomy and radical clearance of paranasal sinus and orbital fossa extensions, with intracranial decompression of the optic nerve, (intracranial procedure) (H) (Anaes.) (Assist.)

3 100.05

39650

Tumour involving middle cranial fossa and infra-temporal fossa, removal of, craniotomy and radical or sub-total radical excision, with division and reconstruction of zygomatic arch, (intracranial procedure) (H) (Anaes.) (Assist.)

2 242.50

39653

Petro-clival and clival tumour, removal of, by supra and infratentorial approaches for radical or sub-total radical excision (intracranial procedure), not being a service to which item 39654 or 39656 applies (H) (Anaes.) (Assist.)

3 990.55

39654

Petro-clival and clival tumour, removal of, by supra and infratentorial approaches for radical or sub-total radical excision (intracranial procedure), conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

2 902.25

39656

Petro-clival and clival tumour, removal of, by supra and infratentorial approaches for radical or sub-total radical excision (intracranial procedure), conjoint surgery,
co-surgeon (H) (Assist.)

2 176.65

39658

Tumour involving the clivus, radical or sub-total radical excision of, involving transoral or transmaxillary approach (H) (Anaes.) (Assist.)

2 572.35

39660

Tumour or vascular lesion of cavernous sinus, radical excision of, involving craniotomy with or without intracranial carotid artery exposure (H) (Anaes.) (Assist.)

2 572.35

39662

Tumour or vascular lesion of foramen magnum, radical excision of, via transcondylar or far lateral suboccipital approach (H) (Anaes.) (Assist.)

2 572.35

39700

Skull tumour, benign or malignant, excision of, excluding cranioplasty (H) (Anaes.) (Assist.)

472.30

39703

Intracranial tumour, cyst or other brain tissue, burr-hole and biopsy of, or drainage of, or both (H) (Anaes.) (Assist.)

440.25

39706

Intracranial tumour, biopsy or decompression of via osteoplastic flap or biopsy and decompression of via osteoplastic flap (H) (Anaes.) (Assist.)

944.20

39709

Craniotomy for removal of glioma, metastatic carcinoma or any other tumour in cerebrum, cerebellum or brain stem — not being a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

1 346.30

39712

Craniotomy for removal of meningioma, pinealoma, cranio-pharyngioma, intraventricular tumour or any other intracranial tumour — not being a service to which another item in this subgroup applies (H) (Anaes.) (Assist.)

2 430.95

39715

Pituitary tumour, removal of, by transcranial or transphenoidal approach (H) (Anaes.) (Assist.)

1 684.50

39718

Arachnoidal cyst, craniotomy for (H) (Anaes.) (Assist.)

740.15

39721

Craniotomy, involving osteoplastic flap, for re-opening post-operatively for haemorrhage, swelling, etc (H) (Anaes.) (Assist.)

676.30

39800

Aneurysm, clipping or reinforcement of sac (H) (Anaes.) (Assist.)

2 424.60

39803

Intracranial arteriovenous malformation, excision of (H) (Anaes.) (Assist.)

2 424.60

39806

Aneurysm, or arteriovenous malformation, intracranial proximal artery clipping of (H) (Anaes.) (Assist.)

1 091.05

39812

Intracranial aneurysm or arteriovenous fistula, ligation of cervical vessel or vessels (H) (Anaes.) (Assist.)

536.05

39815

Carotid-cavernous fistula, obliteration of — combined cervical and intracranial procedure (Anaes.) (Assist.)

1 550.45

39818

Extracranial to intracranial bypass using superficial temporal artery (H) (Anaes.) (Assist.)

1 550.45

39821

Extracranial to intracranial bypass using saphenous vein graft (H) (Anaes.) (Assist.)

1 841.05

39900

Intracranial infection, drainage of, via burr-hole — including burr-hole (H) (Anaes.) (Assist.)

440.25

39903

Intracranial abscess, excision of (H) (Anaes.) (Assist.)

1 346.30

39906

Osteomyelitis of skull or removal of infected bone flap, craniectomy for (H) (Anaes.) (Assist.)

676.30

40000

Ventriculo-cisternostomy (Torkildsen’s operation) (H) (Anaes.) (Assist.)

778.45

40003

Cranial or cisternal shunt diversion, insertion of (H) (Anaes.) (Assist.)

778.45

40006

Lumbar shunt diversion, insertion of (H) (Anaes.) (Assist.)

612.55

40009

Cranial, cisternal or lumbar shunt, revision or removal of (H) (Anaes.) (Assist.)

446.60

40012

Third ventriculostomy (open or endoscopic) with or without endoscopic septum pellucidotomy (H) (Anaes.) (Assist.)

874.10

40015

Subtemporal decompression (H) (Anaes.) (Assist.)

541.95

40018

Lumbar cerebrospinal fluid drain, insertion of (Anaes.)

135.30

40100

Meningocele, excision and closure of (H) (Anaes.) (Assist.)

587.00

40103

Myelomeningocele, excision and closure of, including skin flaps or Z plasty where performed (H) (Anaes.) (Assist.)

861.40

40106

Arnold-Chiari malformation, decompression of (H) (Anaes.) (Assist.)

874.10

40109

Encephalocoele, excision and closure of (H) (Anaes.) (Assist.)

944.20

40112

Tethered cord, release of, including lipomeningocele or diastematomyelia (H) (Anaes.) (Assist.)

1 212.30

40115

Craniostenosis, operation for — single suture (H) (Anaes.) (Assist.)

612.55

40118

Craniostenosis, operation for — more than 1 suture (H) (Anaes.) (Assist.)

810.30

40300

Intervertebral disc or discs, laminectomy for removal of (H) (Anaes.) (Assist.)

810.30

40301

Intervertebral disc or discs, microsurgical discectomy of (H) (Anaes.) (Assist.)

812.90

40303

Recurrent disc lesion or spinal stenosis, or both, laminectomy for — 1 level (H) (Anaes.) (Assist.)

925.15

40306

Spinal stenosis, laminectomy for, involving more than 1 vertebral interspace (disc level) (H) (Anaes.) (Assist.)

1 218.70

40309

Extradural tumour or abscess, laminectomy for (H) (Anaes.) (Assist.)

925.15

40312

Intradural lesion, laminectomy for, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

1 244.15

40315

Craniocervical junction lesion, transoral approach for (H) (Anaes.) (Assist.)

1 346.30

40316

Odontoid screw fixation (H) (Anaes.) (Assist.)

1 764.60

40318

Intramedullary tumour or arteriovenous malformation, laminectomy and radical excision of (H) (Anaes.) (Assist.)

1 684.50

40321

Posterior spinal fusion, not being a service to which items 40324 and 40327 apply (H) (Anaes.) (Assist.)

925.15

40324

Laminectomy followed by posterior fusion, performed by neurosurgeon and orthopaedic surgeon operating together — laminectomy, including after-care (H) (Anaes.) (Assist.)

542.35

40327

Laminectomy followed by posterior fusion, performed by neurosurgeon and orthopaedic surgeon operating together — posterior fusion, including after-care (H) (Assist.)

542.35

40330

Spinal rhizolysis involving exposure of spinal nerve roots — for lateral recess, exit foraminal stenosis, adhesive radiculopathy or extensive epidural fibrosis, at 1 or more levels — with or without laminectomy (H) (Anaes.) (Assist.)

810.30

40331

Cervical decompression of spinal cord with or without involvement of nerve roots, without fusion, 1 level, by any approach, not being a service to which item 40330 applies (H) (Anaes.) (Assist.)

810.30

40332

Cervical decompression of spinal cord with or without involvement of nerve roots, including anterior fusion, 1 level, not being a service to which item 40330 applies (H) (Anaes.) (Assist.)

1 322.25

40333

Cervical discectomy (anterior), without fusion (H) (Anaes.) (Assist.)

676.30

40334

Cervical decompression of spinal cord with or without involvement of nerve roots, without fusion, more than 1 level, by any approach, not being a service to which item 40330 applies (H) (Anaes.) (Assist.)

894.15

40335

Cervical decompression of spinal cord with or without involvement of nerve roots, including anterior fusion, more than 1 level, by any approach, not being a service to which item 40330 applies (H) (Anaes.) (Assist.)

1 642.25

40336

Intradiscal injection of chymopapain (discase) — 1 disc (H) (Anaes.) (Assist.)

268.05

40339

Hydromyelia, plugging of obex for, with or without duroplasty (H) (Anaes.) (Assist.)

1 346.30

40342

Hydromyelia, craniotomy and laminectomy for, with cavity packing and CSF shunt (H) (Anaes.) (Assist.)

1 244.15

40345

Thoracic decompression of spinal cord with or without involvement of nerve roots, via pedicle or costotransversectomy (H) (Anaes.) (Assist.)

1 158.25

40348

Thoracic decompression of spinal cord via thoracotomy with vertebrectomy, not including stabilisation procedure (H) (Anaes.) (Assist.)

1 470.50

40351

Thoraco-lumbar or high lumbar anterior decompression of spinal cord, not including stabilisation procedure (H) (Anaes.) (Assist.)

1 470.50

40600

Cranioplasty, reconstructive (H) (Anaes.) (Assist.)

810.30

40700

Corpus callosum, anterior section of, for epilepsy (H) (Anaes.) (Assist.)

1 480.35

40703

Corticectomy, topectomy or partial lobectomy for epilepsy (H) (Anaes.) (Assist.)

1 244.15

40706

Hemispherectomy for intractable epilepsy (Anaes.) (Assist.)

1 818.45

40709

Burr-hole placement of intracranial depth or surface electrodes (H) (Anaes.) (Assist.)

440.25

40712

Intracranial electrode placement via craniotomy (H) (Anaes.) (Assist.)

886.85

40800

Stereotactic anatomical localisation, as an independent procedure (Anaes.) (Assist.)

541.95

40801

Functional stereotactic procedure including computer assisted anatomical localisation, physiological localisation and lesion production in the basal ganglia, brain stem or deep white matter tracts, not being a service associated with deep brain stimulation for Parkinson’s disease (H) (Anaes.) (Assist.)

1 481.25

40803

Intracranial stereotactic procedure by any method, not being a service to which item 40800 or 40801 applies (Anaes.) (Assist.)

1 014.50

40903

Neuroendoscopy, for inspection of an intraventricular lesion, with or without biopsy including burr-hole (H) (Anaes.) (Assist.)

470.50

40905

Craniotomy, performed in association with items 45767, 45776, 45782 and 45785 for the correction of craniofacial abnormalities (Anaes.)

510.50

Subgroup 8 ear, nose and throat

41500

Ear, foreign body (other than ventilating tube) in, removal of, other than by simple syringing (Anaes.)

70.00

41503

Ear, removal of foreign body in, involving incision of external auditory canal (Anaes.)

202.65

41506

Aural polyp, removal of (Anaes.)

122.20

41509

External auditory meatus, surgical removal of keratosis obturans from, not being a service to which another item in this group applies (Anaes.)

138.30

41512

Meatoplasty involving removal of cartilage or bone or both cartilage and bone, not being a service to which item 41515 applies (Anaes.) (Assist.)

497.20

41515

Meatoplasty involving removal of cartilage or bone or both cartilage and bone, being a service associated with a service to which item 41530, 41548, 41560 or 41563 applies (H) (Anaes.) (Assist.)

326.25

41518

External auditory meatus, removal of exostoses in (H) (Anaes.) (Assist.)

788.05

41521

Correction of auditory canal stenosis, including meatoplasty, with or without grafting (H) (Anaes.) (Assist.)

839.05

41524

Reconstruction of external auditory canal, being a service associated with a service to which items 41557, 41560 and 41563 apply (Anaes.) (Assist.)

242.40

41527

Myringoplasty, trans-canal approach (Rosen incision) (Anaes.) (Assist.)

498.60

41530

Myringoplasty, post-aural or endaural approach with or without mastoid inspection (H) (Anaes.)

812.25

41533

Atticotomy without reconstruction of the bony defect, with or without myringoplasty (H) (Anaes.) (Assist.)

971.00

41536

Atticotomy with reconstruction of the bony defect with or without myringoplasty (H) (Anaes.) (Assist.)

1 087.55

41539

Ossicular chain reconstruction (H) (Anaes.) (Assist.)

924.80

41542

Ossicular chain reconstruction and myringoplasty (H) (Anaes.) (Assist.)

1 013.35

41545

Mastoidectomy (cortical) (H) (Anaes.) (Assist.)

442.25

41548

Obliteration of the mastoid cavity (H) (Anaes.) (Assist.)

587.00

41551

Mastoidectomy, intact wall technique, with myringoplasty (H) (Anaes.) (Assist.)

1 351.70

41554

Mastoidectomy, intact wall technique, with myringoplasty and ossicular chain reconstruction (H) (Anaes.) (Assist.)

1 592.55

41557

Mastoidectomy (radical or modified radical) (H) (Anaes.) (Assist.)

924.80

41560

Mastoidectomy (radical or modified radical) and myringoplasty (H) (Anaes.)

1 013.35

41563

Mastoidectomy (radical or modified radical), myringoplasty and ossicular chain reconstruction (H) (Anaes.) (Assist.)

1 254.45

41564

Mastoidectomy (radical or modified radical), obliteration of the mastoid cavity, blind sac closure of external auditory canal and obliteration of eustachian tube (H) (Anaes.) (Assist.)

1 622.20

41566

Revision of mastoidectomy (radical, modified radical or intact wall), including myringoplasty (H) (Anaes.) (Assist.)

924.80

41569

Decompression of facial nerve in its mastoid portion (H) (Anaes.) (Assist.)

1 013.35

41572

Labyrinthotomy or destruction of labyrinth (H) (Anaes.) (Assist.)

876.60

41575

Cerebello-pontine angle tumour, removal of by 2 surgeons operating conjointly, by transmastoid, translabyrinthine or retromastoid approach — transmastoid, translabyrinthine or retromastoid procedure (including after-care) (H) (Anaes.) (Assist.)

2 066.70

41576

Cerebello-pontine angle tumour, removal of, by transmastoid, translabyrinthine or retromastoid approach (intracranial procedure) (including after-care) not being a service to which item 41578 or 41579 applies (H) (Anaes.) (Assist.)

3 100.05

41578

Cerebello-pontine angle tumour, removal of, by transmastoid, translabyrinthine or retromastoid approach (intracranial procedure) — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

2 066.70

41579

Cerebello-pontine angle tumour, removal of, by transmastoid, translabyrinthine or retromastoid approach (intracranial procedure) — conjoint surgery, co-surgeon (H) (Assist.)

1 550.00

41581

Tumour involving infra-emporal fossa, removal of, involving craniotomy and radical excision of (Anaes.) (Assist.)

2 377.10

41584

Partial temporal bone resection for removal of tumour involving mastoidectomy with or without decompression of facial nerve (H) (Anaes.) (Assist.)

1 631.30

41587

Total temporal bone resection for removal of tumour (H) (Anaes.) (Assist.)

2 221.80

41590

Endolymphatic sac, transmastoid decompression with or without drainage of (H) (Anaes.) (Assist.)

1 013.35

41593

Translabyrinthine vestibular nerve section (H) (Anaes.) (Assist.)

1 320.70

41596

Retrolabyrinthine vestibular nerve section or cochlear nerve section, or both (H) (Anaes.) (Assist.)

1 476.00

41599

Internal auditory meatus, exploration by middle cranial fossa approach with cranial nerve decompression (H) (Anaes.) (Assist.)

1 476.00

41608

Stapedectomy (H) (Anaes.) (Assist.)

924.80

41611

Stapes mobilisation (H) (Anaes.) (Assist.)

595.00

41614

Round window surgery including repair of cochleotomy (Anaes.) (Assist.)

924.80

41615

Oval window surgery, including repair of fistula, not being a service associated with a service to which any other item in this group applies (Anaes.) (Assist.)

924.80

41617

Cochlear implant, insertion of, including mastoidectomy (H) (Anaes.) (Assist.)

1 608.10

41620

Glomus tumour, transtympanic removal of (H) (Anaes.) (Assist.)

699.60

41623

Glomus tumour, transmastoid removal of, including mastoidectomy (H) (Anaes.) (Assist.)

1 013.35

41626

Abscess or inflammation of middle ear, operation for (excluding after-care) (Anaes.)

122.20

41629

Middle ear, exploration of (Anaes.) (Assist.)

442.25

41632

Middle ear, insertion of tube for drainage of (including myringotomy) (Anaes.)

202.65

41635

Clearance of middle ear for granuloma, cholesteatoma and polyp, 1 or more, with or without myringoplasty (Anaes.) (Assist.)

971.00

41638

Clearance of middle ear for granuloma, cholesteatoma and polyp, 1 or more, with or without myringoplasty with ossicular chain reconstruction (H) (Anaes.) (Assist.)

1 211.95

41641

Perforation of tympanum, cauterisation or diathermy of (Anaes.)

40.30

41644

Excision of rim of eardrum perforation, not being a service associated with myringoplasty (Anaes.)

121.15

41647

Ear toilet requiring use of operating microscope and microinspection of tympanic membrane with or without general anaesthesia (Anaes.)

93.25

41650

Tympanic membrane, microinspection of 1 or both ears under general anaesthesia, not being a service associated with a service to which another item in this group applies (Anaes.)

93.25

41653

Examination of nasal cavity or post-nasal space or nasal cavity and post-nasal space, under general anaesthesia, not being a service associated with a service to which another item in this group applies (Anaes.)

61.05

41656

Nasal haemorrhage, posterior, arrest of, with posterior nasal packing with or without cauterisation and with or without anterior pack (excluding after-care) (Anaes.)

104.20

41659

Nose, removal of foreign body in, other than by simple probing (Anaes.)

65.85

41662

Nasal polyp or polypi (simple), removal of

70.00

41665

Nasal polyp or polypi, removal of (G) (H) (Anaes.)

146.35

41668

Nasal polyp or polypi, removal of (S) (H) (Anaes.)

186.60

41671

Nasal septum, septoplasty, submucous resection or closure of septal perforation (Anaes.)

410.05

41672

Nasal septum, reconstruction of (H) (Anaes.) (Assist.)

511.55

41674

Cauterisation (other than by chemical means) or cauterisation by chemical means when performed under general anaesthesia or diathermy of septum, turbinates or pharynx — 1 or more of these procedures (including any consultation on the same occasion) not being a service associated with any other operation on the nose (Anaes.)

85.25

41677

Nasal haemorrhage, arrest of during an episode of epistaxis by cauterisation or nasal cavity packing or both (Anaes.)

76.30

41680

Cryotherapy to nose in the treatment of nasal haemorrhage (Anaes.)

138.30

41683

Division of nasal adhesions, with or without stenting not being a service associated with any other operation on the nose and not performed during the post-operative period of a nasal operation (Anaes.)

99.35

41686

Dislocation of turbinate or turbinates, 1 or both sides, not being a service associated with a service to which another item in this group applies (Anaes.)

61.05

41689

Turbinectomy or turbinectomies, partial or total, unilateral (Anaes.)

115.80

41692

Turbinates, submucous resection of, unilateral (H) (Anaes.)

151.05

41695

Nasal turbinates, cryotherapy to (Anaes.)

84.85

41698

Maxillary antrum, proof puncture and lavage of (Anaes.)

27.55

41701

Maxillary antrum, proof puncture and lavage of — under general anaesthesia, not being a service associated with a service to which another item in this group applies (H) (Anaes.)

78.05

41704

Maxillary antrum, lavage of — each attendance at which the procedure is performed, including any associated consultation (Anaes.)

30.85

41707

Maxillary artery, transantral ligation of (Anaes.) (Assist.)

380.60

41710

Antrostomy (radical) (H) (Anaes.) (Assist.)

442.25

41713

Antrostomy (radical) with transantral ethmoidectomy or transantral vidian neurectomy (H) (Anaes.) (Assist.)

514.65

41716

Antrum, intranasal operation on or removal of foreign body from (Anaes.) (Assist.)

250.90

41719

Antrum, drainage of, through tooth socket (Anaes.)

99.70

41722

Oro-antral fistula, plastic closure of (Anaes.) (Assist.)

498.60

41725

Ethmoidal artery or arteries, transorbital ligation of (unilateral) (H) (Anaes.) (Assist.)

380.60

41728

Lateral rhinotomy with removal of tumour (H) (Anaes.) (Assist.)

761.35

41729

Dermoid of nose, excision of, with intranasal extension (H) (Anaes.) (Assist.)

482.50

41731

Fronto-nasal ethmoidectomy by external approach with or without sphenoidectomy (H) (Anaes.) (Assist.)

659.40

41734

Radical fronto-ethmoidectomy with osteoplastic flap (H) (Anaes.) (Assist.)

860.45

41737

Frontal sinus, or ethmoidal sinuses on the one side, intranasal operation on (Anaes.) (Assist.)

410.05

41740

Frontal sinus, catheterisation of (H) (Anaes.)

49.90

41743

Frontal sinus, trephine of (H) (Anaes.) (Assist.)

286.30

41746

Frontal sinus, radical obliteration of (Anaes.) (Assist.)

659.40

41749

Ethmoidal sinuses, external operation on (Anaes.) (Assist.)

514.65

41752

Sphenoidal sinus, intranasal operation on (H) (Anaes.) (Assist.)

250.90

41755

Eustachian tube, catheterisation of (Anaes.)

39.45

41758

Division of pharyngeal adhesions (Anaes.)

99.70

41761

Post nasal space, direct examination of, with or without biopsy (Anaes.)

104.20

41764

Nasendoscopy or sinoscopy or fibreoptic examination of nasopharynx and larynx, 1 or more of these procedures (Anaes.)

104.20

41767

Nasopharyngeal angiofibroma, transpalatal removal (Anaes.) (Assist.)

625.30

41770

Pharyngeal pouch, removal of, with or without cricopharyngeal myotomy (H) (Anaes.) (Assist.)

595.00

41773

Pharyngeal pouch, endoscopic resection of (Dohlman’s operation) (H) (Anaes.) (Assist.)

498.60

41776

Cricopharyngeal myotomy with or without inversion of pharyngeal pouch (H) (Anaes.) (Assist.)

497.20

41779

Pharyngotomy (lateral), with or without total excision of tongue (H) (Anaes.) (Assist.)

595.00

41782

Partial pharyngectomy via pharyngotomy (Anaes.) (Assist.)

807.85

41785

Partial pharyngectomy via pharyngotomy with partial or total glossectomy (H) (Anaes.) (Assist.)

1 002.20

41786

Uvulopalatopharyngoplasty, with or without tonsillectomy, by any means (H) (Anaes.) (Assist.)

625.30

41787

Uvulectomy and partial palatectomy with laser incision of the palate, with or without tonsillectomy, 1 or more stages, including any revision procedures within 12 months (Anaes.) (Assist.)

482.50

41788

Tonsils or tonsils and adenoids, removal of, in a person aged less than 12 years (G) (H) (Anaes.)

186.60

41789

Tonsils or tonsils and adenoids, removal of, in a person aged less than 12 years (S) (H) (Anaes.)

250.90

41792

Tonsils or tonsils and adenoids, removal of, in a person 12 years of age or over (G) (H) (Anaes.)

234.80

41793

Tonsils or tonsils and adenoids, removal of, in a person 12 years of age or over (S) (H) (Anaes.)

315.25

41796

Tonsils or tonsils and adenoids, arrest of haemorrhage requiring general anaesthesia, following removal of (G) (H) (Anaes.)

96.50

41797

Tonsils or tonsils and adenoids, arrest of haemorrhage requiring general anaesthesia, following removal of (S) (H) (Anaes.)

122.20

41800

Adenoids, removal of (G) (H) (Anaes.)

99.70

41801

Adenoids, removal of (S) (H) (Anaes.)

138.30

41804

Lingual tonsil or lateral pharyngeal bands, removal of (Anaes.)

76.30

41807

Peritonsillar abscess (quinsy), incision of (Anaes.)

59.50

41810

Uvulotomy or uvulectomy (Anaes.)

30.20

41813

Vallecular or pharyngeal cysts, removal of (Anaes.) (Assist.)

302.35

41816

Oesophagoscopy (with rigid oesophagoscope) (Anaes.)

157.55

41819

Dilatation of stricture of upper gastro-intestinal tract using bougie or balloon over endoscopically inserted guidewire, including endoscopy with flexible or rigid endoscope (Anaes.)

296.10

41820

Dilatation of stricture of upper gastro-intestinal tract using bougie or balloon over endoscopically inserted guidewire, including endoscopy with flexible or rigid endoscope, where the use of imaging intensification is clinically indicated (Anaes.)

355.35

41822

Oesophagoscopy (with rigid oesophagoscope) with biopsy (H) (Anaes.)

202.65

41825

Oesophagoscopy (with rigid oesophagoscope) with removal of foreign body (H) (Anaes.) (Assist.)

302.35

41828

Oesophageal stricture, dilatation of, without oesophagoscopy (Anaes.)

44.30

41831

Oesophagus, endoscopic pneumatic dilatation of (Anaes.) (Assist.)

302.95

41832

Oesophagus, balloon dilatation of, using interventional imaging techniques (Anaes.)

193.85

41834

Laryngectomy (total) (H) (Anaes.) (Assist.)

1 093.75

41837

Vertical hemi-laryngectomy including tracheostomy (H) (Anaes.) (Assist.)

1 048.75

41840

Supraglottic laryngectomy including tracheostomy (H) (Anaes.) (Assist.)

1 289.55

41843

Laryngopharyngectomy or primary restoration of alimentary continuity after laryngopharyngectomy using stomach or bowel (H) (Anaes.) (Assist.)

1 133.95

41846

Larynx, direct examination of the supraglottic, glottic and subglottic regions, not being a service associated with any other procedure on the larynx or with the administration of a general anaesthetic (Anaes.)

157.55

41849

Larynx, direct examination of, with biopsy (Anaes.) (Assist.)

231.55

41852

Larynx, direct examination of, with removal of tumour (Anaes.) (Assist.)

250.90

41855

Microlaryngoscopy (Anaes.) (Assist.)

244.55

41858

Microlaryngoscopy with removal of juvenile papillomata (Anaes.) (Assist.)

419.30

41861

Microlaryngoscopy with removal of papillomata by laser surgery (H) (Anaes.) (Assist.)

512.70

41864

Microlaryngoscopy with removal of tumour (H) (Anaes.) (Assist.)

345.80

41867

Microlaryngoscopy with arytenoidectomy (H) (Anaes.) (Assist.)

520.45

41868

Laryngeal web, division of, using microlarygoscopic techniques (H) (Anaes.)

329.85

41870

Injection of vocal cord by teflon, fat, collagen or gelfoam (H) (Anaes.) (Assist.)

385.95

41873

Larynx, fractured, operation for (Anaes.) (Assist.)

498.60

41876

Larynx, external operation on, or laryngofissure, with or without cordectomy (Anaes.) (Assist.)

498.60

41879

Laryngoplasty or tracheoplasty, including tracheostomy (H) (Anaes.) (Assist.)

807.85

41880

Tracheostomy by a percutaneous technique using sequential dilatation or partial splitting method to allow insertion of a cuffed tracheostomy tube (H) (Anaes.)

215.65

41881

Tracheostomy by open exposure of the trachea, including separation of the strap muscles or division of the thyroid isthmus, where performed (H) (Anaes.) (Assist.)

340.85

41884

Cricothyrostomy by direct stab or Seldinger technique, using Minitrach or similar device (H) (Anaes.)

77.25

41885

Trache-oesophageal fistula, formation of, as a secondary procedure following laryngectomy, including associated endoscopic procedures (Anaes.) (Assist.)

244.25

41886

Trachea, removal of foreign body in (Anaes.)

151.05

41889

Bronchoscopy, as an independent procedure (Anaes.)

151.05

41892

Bronchoscopy with 1 or more endobronchial biopsies or other diagnostic or therapeutic procedures (Anaes.)

199.45

41895

Bronchus, removal of foreign body in (H) (Anaes.) (Assist.)

312.00

41898

Fibreoptic bronchoscopy with 1 or more transbronchial lung biopsies, with or without bronchial or broncho-alveolar lavage, with or without the use of interventional imaging (Anaes.) (Assist.)

218.05

41901

Endoscopic laser resection of endobronchial tumours for relief of obstruction including any associated endoscopic procedures (H) (Anaes.) (Assist.)

512.70

41904

Bronchoscopy with dilatation of tracheal stricture (Anaes.)

209.10

41905

Trachea or bronchus, dilatation of stricture and endoscopic insertion of stent (H) (Anaes.) (Assist.)

384.70

41907

Nasal septum button, insertion of (Anaes.)

104.20

41910

Duct of major salivary gland, transposition of (H) (Anaes.) (Assist.)

331.10

Subgroup 9 — Ophthalmology

42503

Ophthalmological examination under general anaesthesia, not being a service associated with a service to which another item in this group applies (Anaes.)

86.95

42506

Eye, enucleation of, with or without sphere implant (Anaes.) (Assist.)

408.35

42509

Eye, enucleation of, with insertion of integrated implant (H) (Anaes.) (Assist.)

516.80

42510

Eye, enucleation of, with insertion of hydroxy apatite implant or similar coralline implant (Anaes.) (Assist.)

595.70

42512

Globe, evisceration of (Anaes.) (Assist.)

408.35

42515

Globe, evisceration of, and insertion of intrascleral ball or cartilage (Anaes.) (Assist.)

516.80

42518

Anophthalmic orbit, insertion of cartilage or artificial implant as a delayed procedure, or removal of implant from socket, or placement of a motility intergrating peg by drilling into existing orbital implant (Anaes.) (Assist.)

299.85

42521

Anophthalmic socket, treatment of, by insertion of a wired-in conformer, integrated implant or dermofat graft, as a secondary procedure (H) (Anaes.) (Assist.)

1 020.95

42524

Orbit, skin graft to, as a delayed procedure (Anaes.)

173.60

42527

Contracted socket, reconstruction including mucous membrane grafting and stent mould (Anaes.) (Assist.)

344.50

42530

Orbit, exploration with or without biopsy, requiring removal of bone (H) (Anaes.) (Assist.)

536.05

42533

Orbit, exploration of, with drainage or biopsy not requiring removal of bone (H) (Anaes.) (Assist.)

344.50

42536

Orbit, exenteration of, with or without skin graft and with or without temporalis muscle transplant (H) (Anaes.) (Assist.)

708.20

42539

Orbit, exploration of, with removal of tumour or foreign body, requiring removal of bone (Anaes.) (Assist.)

1 008.20

42542

Orbit, exploration of anterior aspect with removal of tumour or foreign body (Anaes.) (Assist.)

427.55

42543

Orbit, exploration of retrobulbar aspect with removal of tumour or foreign body (H) (Anaes.) (Assist.)

749.90

42545

Orbit, decompression of, for dysthyroid eye disease, by fenestration of 2 or more walls, or by the removal of intraorbital peribulbar and retrobulbar fat from each quadrant of the orbit, 1 eye (H) (Anaes.) (Assist.)

1 084.65

42548

Optic nerve meninges, incision of (H) (Anaes.) (Assist.)

644.40

42551

Eyeball, perforating wound of, not involving intraocular structures — repair involving suture of cornea or sclera, or both, not being a service to which item 42632 applies (Anaes.) (Assist.)

536.05

42554

Eyeball, perforating wound of, with incarceration or prolapse of uveal tissue — repair (Anaes.) (Assist.)

625.30

42557

Eyeball, perforating wound of, with incarceration of lens or vitreous — repair (H) (Anaes.) (Assist.)

874.10

42560

Intraocular foreign body, magnetic removal from anterior segment (Anaes.) (Assist.)

344.50

42563

Intraocular foreign body, nonmagnetic removal from anterior segment (Anaes.) (Assist.)

440.25

42566

Intraocular foreign body, magnetic removal from posterior segment (H) (Anaes.) (Assist.)

625.30

42569

Intraocular foreign body, nonmagnetic removal from posterior segment (H) (Anaes.) (Assist.)

874.10

42572

Orbital abscess or cyst, drainage of (Anaes.)

99.50

42573

Dermoid, periorbital, excision of (Anaes.)

193.00

42574

Dermoid, orbital, excision of (Anaes.) (Assist.)

410.05

42575

Tarsal cyst, extirpation of (Anaes.)

70.25

42578

Tarsal cartilage, excision of (Anaes.) (Assist.)

395.50

42581

Ectropion or entropion, tarsal cauterisation of (Anaes.)

99.50

42584

Tarsorrhaphy (Anaes.) (Assist.)

234.80

42587

Trichiasis, treatment of by cryotherapy, laser or electrolysis — each eyelid (Anaes.)

44.05

42590

Canthoplasty, medial or lateral (Anaes.) (Assist.)

287.05

42593

Lacrimal gland, excision of palpebral lobe (H) (Anaes.)

173.60

42596

Lacrimal sac, excision of, or operation on (Anaes.) (Assist.)

427.55

42599

Lacrimal canalicular system, establishment of patency by closed operation using silicone tubes or similar, 1 eye (Anaes.) (Assist.)

536.05

42602

Lacrimal canalicular system, establishment of patency by open operation, 1 eye (Anaes.) (Assist.)

536.05

42605

Lacrimal canaliculus, immediate repair of (Anaes.) (Assist.)

395.50

42608

Lacrimal drainage by insertion of glass tube, as an independent procedure (Anaes.) (Assist.)

255.20

42610

Nasolacrimal tube (unilateral), removal or replacement of, or lacrimal passages, probing for obstruction, unilateral, with or without lavage — under general anaesthesia (Anaes.)

81.65

42611

Nasolacrimal tube (bilateral), removal or replacement of, or lacrimal passages, probing for obstruction, bilateral, with or without lavage — under general anaesthesia (Anaes.)

122.50

42614

Nasolacrimal tube (unilateral), removal or replacement of, or lacrimal passages, probing to establish patency of, or probing for obstruction (or both), unilateral, including lavage, not being a service associated with a service to which item 42610 applies (excluding after-care)

40.95

42615

Nasolacrimal tube (bilateral), removal or replacement of, or lacrimal passages, probing for obstruction, bilateral, including lavage, not being a service associated with a service to which item 42611 applies (excluding
after-care)

61.25

42617

Punctum snip operation (Anaes.)

116.20

42620

Punctum, occlusion of, by use of a plug (Anaes.)

44.70

42621

Punctum, temporary occlusion of, by use of electrical cautery (Anaes.)

44.70

42622

Punctum, permanent occlusion of, by use of electrical cautery (Anaes.)

70.25

42623

Dacryocystorhinostomy (H) (Anaes.) (Assist.)

593.50

42626

Dacryocystorhinostomy where a previous dacryocystorhinostomy has been performed (Anaes.) (Assist.)

957.10

42629

Conjunctivorhinostomy including dacryocystorhinostomy and fashioning of conjunctival flaps (H) (Anaes.) (Assist.)

721.00

42632

Conjunctival peritomy or repair of corneal laceration by conjunctival flap (Anaes.)

99.50

42635

Corneal perforations, sealing of, with tissue adhesive (Anaes.) (Assist.)

255.20

42638

Conjunctival graft over cornea (Anaes.) (Assist.)

319.00

42641

Autoconjunctival transplant, or mucous membrane graft (Anaes.) (Assist.)

414.70

42644

Cornea or sclera, removal of imbedded foreign body from (excluding after-care) (Anaes.)

61.20

42647

Corneal scars, removal of, by partial keratectomy, not being a service associated with a service to which item 42686 applies (Anaes.)

173.60

42650

Cornea, epithelial debridement for corneal ulcer or corneal erosion (excluding after-care) (Anaes.)

61.20

42651

Cornea, epithelial debridement for eliminating band keratopathy (Anaes.)

136.40

42653

Cornea, transplantation of, full thickness (H) (Anaes.) (Assist.)

1 135.70

42656

Cornea, transplantation of, second and subsequent procedures (H) (Anaes.) (Assist.)

1 416.50

42659

Cornea, transplantation of, superficial or lamellar (Anaes.) (Assist.)

765.65

42662

Sclera, transplantation of, full thickness, including collection of donor material (Anaes.) (Assist.)

765.65

42665

Sclera, transplantation of, superficial or lamellar, including collection of donor material (Anaes.) (Assist.)

510.45

42667

Running corneal suture, manipulation of, performed within 4 months of corneal grafting, to reduce astigmatism where a reduction of 2 dioptres of astigmatism is obtained, including any associated consultation

120.45

42668

Corneal sutures, removal of, not earlier than 6 weeks after operation requiring use of slit lamp or operating microscope (Anaes.)

63.90

42672

Corneal incisions, to correct corneal astigmatism of more than 11/2 diopters following anterior segment surgery, including appropriate measurements and calculations, performed as an independent procedure (Anaes.) (Assist.)

765.65

42673

Additional corneal incisions, to correct corneal astigmatism of more than 11/2 diopters, including appropriate measurements and calculations, performed in conjunction with other anterior segment surgery (Anaes.) (Assist.)

382.80

42676

Conjunctiva, biopsy of, as an independent procedure

98.20

42677

Conjunctiva, cautery of, including treatment of pannus — each attendance at which treatment is given including any associated consultation (Anaes.)

51.70

42680

Conjunctiva, cryotherapy to, for melanotic lesions or similar using CO2 or N20 (Anaes.)

255.20

42683

Conjunctival cysts, removal of (H) (Anaes.)

102.10

42686

Pterygium, removal of (Anaes.)

232.25

42689

Pinguecula, removal of, not being a service associated with the fitting of contact lenses (Anaes.)

99.50

42692

Limbic tumour, removal of, excluding Pterygium (Anaes.) (Assist.)

234.80

42695

Limbic tumour, excision of, requiring keratectomy or sclerectomy, excluding Pterygium (Anaes.) (Assist.)

382.80

42698

Lens extraction, excluding surgery performed for the correction of refractive error except for anisometropia greater then 3 dioptres following the removal of cataract in the first eye (Anaes.)

597.20

42701

Artificial lens, insertion of, excluding surgery performed for the correction of refractive error except for anisometropia greater then 3 dioptres following the removal of cataract in the first eye (Anaes.)

333.00

42702

Lens extraction and insertion of artificial lens, excluding surgery performed for the correction of refractive error except for anisometropia greater then 3 dioptres following the removal of cataract in the first eye (Anaes.)

763.75

42703

Artificial lens, insertion of, into the posterior chamber and suture to the iris and sclera (Anaes.) (Assist.)

485.40

42704

Artificial lens, removal or repositioning of by open operation — not being a service associated with a service to which item 42701 applies (Anaes.)

395.50

42707

Artificial lens, removal of and replacement with a different lens (Anaes.)

676.30

42710

Artificial lens, removal of, and replacement with a lens inserted into the posterior chamber and sutured to the iris or sclera (H) (Anaes.) (Assist.)

765.65

42713

Intraocular lenses, repositioning of, by the use of a McCannell suture or similar (Anaes.) (Assist.)

319.00

42716

Cataract, juvenile, removal of, including subsequent needlings (Anaes.) (Assist.)

1 014.50

42719

Capsulectomy or removal of vitreous via the anterior chamber by any method, not being a service associated with a service to which item 42698, 42702 or 42716 applies (Anaes.) (Assist.)

440.25

42722

Capsulectomy by posterior chamber sclerotomy or removal of vitreous or vitreous bands from the anterior chamber by posterior chamber sclerotomy, by cutting and suction and replacement by saline, Hartmann’s or similar solution, not being a service associated with a service to which item 42698, 42702 or 42716 applies — 1 or both procedures (Anaes.) (Assist.)

481.65

42725

Vitrectomy by posterior chamber sclerotomy — including the removal of vitreous, division of bands or removal of pre-retinal membranes by cutting and suction and replacement by saline, Hartmann’s or similar solution (Anaes.) (Assist.)

1 135.70

42728

Cryotherapy of retina or other intraocular structures with an internal probe, being a service associated with a service to which item 42725 applies (H) (Anaes.)

191.45

42731

Capsulectomy or lensectomy by posterior chamber sclerotomy in conjunction with the removal of vitreous or division of vitreous bands or removal of pre-retinal membrane from the posterior chamber by cutting and suction and replacement by saline, Hartmann’s or similar solution, not being a service associated with any other intraocular operation (H) (Anaes.) (Assist.)

1 288.80

42734

Capsulotomy, other than by laser (Anaes.) (Assist.)

255.20

42737

Needling of posterior capsule (Anaes.) (Assist.)

255.20

42740

Paracentesis of anterior or posterior chamber or both,
for the injection of therapeutic substances, or the removal of aqueous or vitreous for diagnostic purposes, 1 or more of (Anaes.) (Assist.)

255.20

42743

Anterior chamber, irrigation of blood from, as an independent procedure (Anaes.) (Assist.)

536.05

42746

Glaucoma, filtering operation for (Anaes.) (Assist.)

810.30

42749

Glaucoma, filtering operation for, where previous filtering operation has been performed (H) (Anaes.) (Assist.)

1 014.50

42752

Glaucoma, insertion of Molteno valve for, 1 or more stages (H) (Anaes.) (Assist.)

1 135.70

42755

Glaucoma, removal of Molteno valve (Anaes.)

140.40

42758

Goniotomy (Anaes.) (Assist.)

593.50

42761

Division of anterior or posterior synechiae, as an independent procedure, other than by laser (Anaes.) (Assist.)

440.25

42764

Iridectomy (including excision of tumour of iris) or iridotomy, as an independent procedure, other than by laser (Anaes.) (Assist.)

440.25

42767

Tumour, involving ciliary body or ciliary body and iris, excision of (H) (Anaes.) (Assist.)

925.15

42770

Cyclodestructive procedures for the treatment of intractable glaucoma, treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period (Anaes.) (Assist.)

250.20

42771

Cyclodestructive procedures for the treatment of intractable glaucoma, treatment to 1 eye — where it can be demonstrated that a third or subsequent treatment to that eye (including any treatments to which item 42770 applies) is indicated in a 2 year period (H) (Anaes.) (Assist.)

246.25

42773

Detached retina, diathermy or cryotherapy for, not being a service associated with a service to which item 42776 applies (Anaes.) (Assist.)

765.65

42776

Detached retina, buckling or resection operation for (H) (Anaes.) (Assist.)

1 135.70

42779

Detached retina, revision operation for (H) (Anaes.) (Assist.)

1 416.50

42782

Laser trabeculoplasty — each treatment to 1 eye, to a maximum of 4 treatments to that eye in a 2 year period (Anaes.) (Assist.)

382.80

42783

Laser trabeculoplasty — each treatment to 1 eye — where it can be demonstrated that a 5th or subsequent treatment to that eye (including any treatments to which item 42782 applies) is indicated in a 2 year period (Anaes.) (Assist.)

382.80

42785

Laser iridotomy — each treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period (Anaes.) (Assist.)

299.85

42786

Laser iridotomy — each treatment to 1 eye — where it can be demonstrated that a 3rd or subsequent treatment to that eye (including any treatments to which item 42785 applies) is indicated in a 2 year period (Anaes.) (Assist.)

299.85

42788

Laser capsulotomy — each treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period (Anaes.) (Assist.)

299.85

42789

Laser capsulotomy — each treatment to 1 eye — where it can be demonstrated that a 3rd or subsequent treatment to that eye (including any treatments to which item 42788 applies) is indicated in a 2 year period (Anaes.) (Assist.)

299.85

42791

Laser vitreolysis or corticolysis of lens material or fibrinolysis — each treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period (Anaes.) (Assist.)

299.85

42792

Laser vitreolysis or corticolysis of lens material or fibrinolysis — each treatment to 1 eye — where it can be demonstrated that a 3rd or subsequent treatment to that eye (including any treatments to which item 42791 applies) is indicated in a 2 year period (Anaes.) (Assist.)

299.85

42794

Division of suture by laser following trabeculoplasty, each treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period (Anaes.)

57.40

42797

Laser coagulation of corneal or scleral blood vessels — each treatment to 1 eye, to a maximum of 4 treatments to that eye in a 2 year period (Anaes.)

57.40

42806

Iris tumour, laser photocoagulation of (Anaes.) (Assist.)

299.85

42807

Photomydriasis, laser

301.90

42808

Photoiridosyneresis, laser

301.90

42809

Retina, photocoagulation of, not being a service associated with photodynamic therapy with verteporfin (Anaes.) (Assist.)

382.80

42810

Phototherapeutic keratectomy, by laser, for corneal scarring or disease, excluding surgery for refractive error (Anaes.)

481.70

42812

Detached retina, removal of encircling silicone band from (Anaes.)

140.40

42815

Posterior chamber, removal of silicone oil from (H) (Anaes.) (Assist.)

536.05

42818

Retina, cryotherapy to, as an independent procedure, with external probe (Anaes.)

497.60

42821

Ocular transillumination, for the diagnosis and measurement of intraocular tumours, as an independent procedure (Anaes.)

76.60

42824

Retrobulbar injection of alcohol or other drug, as an independent procedure

59.30

42833

Squint, operation for, on 1 or both eyes, the operation involving a total of 1 or 2 muscles (Anaes.) (Assist.)

497.60

42836

Squint, operation for, on 1 or both eyes, the operation involving a total of 1 or 2 muscles where there have been 2 or more previous squint operations on the eye or eyes (H) (Anaes.) (Assist.)

618.90

42839

Squint, operation for, on 1 or both eyes, the operation involving a total of 3 or more muscles (H) (Anaes.) (Assist.)

593.50

42842

Squint, operation for, on 1 or both eyes, the operation involving a total of 3 or more muscles where there have been 2 or more previous squint operations on the eye or eyes (H) (Anaes.) (Assist.)

740.15

42845

Readjustment of adjustable sutures, 1 or both eyes, as an independent procedure following an operation for correction of squint (Anaes.)

160.70

42848

Squint, muscle transplant for (Hummelsheim type, or similar operation) (H) (Anaes.) (Assist.)

593.50

42851

Squint, muscle transplant for (Hummelsheim type, or similar operation) where there have been 2 or more previous squint operations on the eye or eyes (H) (Anaes.) (Assist.)

740.15

42854

Ruptured medial palpebral ligament or ruptured
extra-ocular muscle, repair of (Anaes.) (Assist.)

344.50

42857

Resuturing of wound following intraocular procedures with or without excision of prolapsed iris (Anaes.) (Assist.)

344.50

42860

Eyelid (upper or lower), scleral or Goretex or other
non-autogenous graft to, with recession of the lid retractors (Anaes.) (Assist.)

765.65

42863

Eyelid, recession of (Anaes.) (Assist.)

657.15

42866

Entropion or tarsal ectropion, repair of, by tightening, shortening or repair of inferior retractors by open operation across the entire width of the eyelid (Anaes.) (Assist.)

638.00

42869

Eyelid closure in facial nerve paralysis, insertion of foreign implant for (Anaes.) (Assist.)

465.85

42872

Eyebrow, elevation of, for paretic states (Anaes.)

204.20

Subgroup 10 — Operations for osteomyelitis

43500

Operation on phalanx (for acute osteomyelitis) (H) (Anaes.)

104.70

43503

Operation on sternum, clavicle, rib, ulna, radius, carpus, tibia, fibula, tarsus, skull, mandible or maxilla (other than alveolar margins) (for acute osteomyelitis) — 1 bone (H) (Anaes.)

173.70

43506

Operation on humerus or femur (for acute osteomyelitis) — 1 bone (H) (Anaes.) (Assist.)

302.35

43509

Operation on spine or pelvic bones (for acute osteomyelitis) — 1 bone (H) (Anaes.) (Assist.)

302.35

43512

Operation on scapula, sternum, clavicle, rib, ulna, radius, metacarpus, carpus, phalanx, tibia, fibula, metatarsus, tarsus, mandible or maxilla (other than alveolar margins) (for chronic osteomyelitis) — 1 bone or any combination of adjoining bones (H) (Anaes.) (Assist.)

302.35

43515

Operation on humerus or femur (for chronic osteomyelitis) — 1 bone (Anaes.) (Assist.)

302.35

43518

Operation on spine or pelvic bones (for chronic osteomyelitis) — 1 bone (H) (Anaes.) (Assist.)

498.60

43521

Operation on skull (for chronic osteomyelitis) (H) (Anaes.) (Assist.)

394.10

43524

Operation on any combination of adjoining bones, being bones referred to in item 43515, 43518 or 43521 (for chronic osteomyelitis) (Anaes.) (Assist.)

498.60

Subgroup 11 — Paediatric

43801

Intestinal malrotation with or without volvulus, laparotomy for, not involving bowel resection (H) (Anaes.) (Assist.)

812.25

43804

Intestinal malrotation with or without volvulus, laparotomy for, with bowel resection and anastomosis, with or without formation of stoma (H) (Anaes.) (Assist.)

864.85

43807

Duodenal atresia or stenosis, duodenoduodenostomy or duodenojejunostomy for (H) (Anaes.) (Assist.)

943.55

43810

Jejunal atresia, bowel resection and anastomosis for, with or without tapering (H) (Anaes.) (Assist.)

1 100.85

43813

Meconium ileus, laparotomy for, complicated by 1 or more of associated volvulus, atresia, intestinal perforation with or without meconium peritonitis (H) (Anaes.) (Assist.)

1 100.85

43816

Ileal atresia, colonic atresia or meconium ileus not being a service associated with a service to which item 43813 applies, laparotomy for (H) (Anaes.) (Assist.)

1 022.10

43819

Hirschsprung’s disease, laparotomy for, with or without frozen section biopsies and formation of stoma (H) (Anaes.) (Assist.)

825.60

43822

Anorectal malformation, laparotomy and colostomy for (H) (Anaes.) (Assist.)

825.60

43825

Neonatal alimentary obstruction, laparotomy for, not being a service to which any other item in this subgroup applies (H) (Anaes.) (Assist.)

943.55

43828

Acute neonatal necrotising enterocolitis, laparotomy for, with resection, including any anastomoses or stoma formation (H) (Anaes.) (Assist.)

1 042.40

43831

Acute neonatal necrotising enterocolitis where no definitive procedure is possible, laparotomy for (H) (Anaes.) (Assist.)

812.25

43834

Bowel resection for necrotising enterocolitis stricture or strictures, including any anastomoses or stoma formation (H) (Anaes.) (Assist.)

943.55

43837

Congenital diaphragmatic hernia, repair by thoracic or abdominal approach, with diagnosis confirmed in the first 24 hours of life (H) (Anaes.) (Assist.)

1 179.35

43840

Congenital diaphragmatic hernia, repair by thoracic or abdominal approach, diagnosed after the first day of life and before 20 days of age (H) (Anaes.) (Assist.)

1 022.10

43843

Oesophageal atresia (with or without repair of tracheo-oesophageal fistula), complete correction of, not being a service to which item 43846 applies (H) (Anaes.) (Assist.)

1 572.50

43846

Oesophageal atresia (with or without repair of tracheo-oesophageal fistula), complete correction of, in infant of birth weight less than 1 500 gms (H) (Anaes.) (Assist.)

1 690.40

43849

Oesophageal atresia, gastrostomy for (H) (Anaes.) (Assist.)

432.45

43852

Oesophageal atresia, thoracotomy for, and division of tracheo-oesophageal fistula without anastomosis (Anaes.) (Assist.)

1 375.90

43855

Oesophageal atresia, delayed primary anastomosis for (H) (Anaes.) (Assist.)

1 454.60

43858

Oesophageal atresia, cervical oesophagostomy for (Anaes.) (Assist.)

511.00

43861

Congenital cystadenomatoid malformation or congenital lobar emphysema, thoracotomy and lung resection for (H) (Anaes.) (Assist.)

1 415.30

43864

Gastroschisis, operation for (H) (Anaes.) (Assist.)

1 061.45

43867

Gastroschisis, secondary operation for, with removal of silo and closure of abdominal wall (H) (Anaes.) (Assist.)

589.75

43870

Exomphalos containing small bowel only, operation for (H) (Anaes.) (Assist.)

825.60

43873

Exomphalos containing small bowel and other viscera, operation for (H) (Anaes.) (Assist.)

1 100.85

43876

Sacrococcygeal teratoma, excision of, by posterior approach (H) (Anaes.) (Assist.)

943.55

43879

Sacrococcygeal teratoma, excision of, by combined posterior and abdominal approach (H) (Anaes.) (Assist.)

1 100.85

43882

Cloacal exstrophy, operation for (Anaes.) (Assist.)

1 415.30

43900

Tracheo-oesophageal fistula without atresia, division and repair of (H) (Anaes.) (Assist.)

943.55

43903

Oesophageal atresia or corrosive oesophageal stricture, oesophageal replacement for, utilising gastric tube, jejunum or colon (H) (Anaes.) (Assist.)

1 572.50

43906

Oesophagus, resection of congenital, anastomic or corrosive stricture and anastomosis, not being a service to which item 43903 applies (H) (Anaes.) (Assist.)

1 375.90

43909

Tracheomalacia, aortopexy for (H) (Anaes.) (Assist.)

1 375.90

43912

Thoracotomy and excision of 1 or more of bronchogenic or enterogenous cyst or mediastinal teratoma (H) (Anaes.) (Assist.)

1 299.90

43915

Eventration, plication of diaphragm for (Anaes.) (Assist.)

982.85

43930

Hypertrophic pyloric stenosis, pyloromyotomy for (H) (Anaes.) (Assist.)

377.95

43933

Idiopathic intussusception, laparotomy and manipulative reduction of (H) (Anaes.) (Assist.)

442.35

43936

Intussusception, laparotomy and resection with anastomosis (H) (Anaes.) (Assist.)

825.60

43939

Ventral hernia following neonatal closure of exomphalos or gastroschisis, repair of (H) (Anaes.) (Assist.)

629.05

43942

Abdominal wall vitello intestinal remnant, excision of (Anaes.)

196.65

43945

Patent vitello intestinal duct, excision of (H) (Anaes.) (Assist.)

825.60

43948

Umbilical granuloma, excision of, under general anaesthesia (Anaes.)

118.00

43951

Gastro-oesophageal reflux with or without hiatus hernia, laparotomy and fundoplication for, without gastrostomy (H) (Anaes.) (Assist.)

739.30

43954

Gastro-oesophageal reflux with or without hiatus hernia, laparotomy and fundoplication for, with gastrostomy (H) (Anaes.) (Assist.)

904.30

43957

Gastro-oesophageal reflux, laparotomy and fundoplication for, with or without hiatus hernia, in child with neurological disease, with gastrostomy (H) (Anaes.) (Assist.)

982.85

43960

Anorectal malformation, perineal anoplasty of (H) (Anaes.) (Assist.)

345.80

43963

Anorectal malformation, posterior sagittal anorectoplasty of (H) (Anaes.) (Assist.)

1 375.90

43966

Anorectal malformation, posterior sagittal anorectoplasty of, with laparotomy (H) (Anaes.) (Assist.)

1 572.50

43969

Persistent cloaca, total correction of, with genital repair using posterior sagittal approach, with or without laparotomy (H) (Anaes.) (Assist.)

2 162.25

43972

Choledochal cyst, resection of, with 1 duct anastomosis (H) (Anaes.) (Assist.)

1 572.50

43975

Choledochal cyst, resection of, with 2 duct anastomoses (H) (Anaes.) (Assist.)

1 847.75

43978

Biliary atresia, portoenterostomy for (H) (Anaes.) (Assist.)

1 572.50

43981

Nephroblastoma, neuroblastoma or other malignant tumour, laparotomy (exploratory), including associated biopsies, where no other intra-abdominal procedure is performed (H) (Anaes.) (Assist.)

432.45

43984

Nephroblastoma, radical nephrectomy for (H) (Anaes.) (Assist.)

1 100.85

43987

Neuroblastoma, radical excision of (H) (Anaes.) (Assist.)

1 218.75

43990

Hirschsprung’s disease, definitive resection with
pull-through anastomosis, with or without frozen section biopsies, when aganglionic segment extends to sigmoid colon (H) (Anaes.) (Assist.)

1 493.95

43993

Hirschsprung’s disease, definitive resection with
pull-through anastomosis, with or without frozen section biopsies, when aganglionic segment extends into descending or transverse colon with or without resiting of stoma (Anaes.) (Assist.)

1 611.85

43996

Hirschsprung’s disease, total colectomy for total colonic aganglionosis with ileoanal pull-through, with or without side to side ileocolonic anastomosis (Anaes.) (Assist.)

1 808.45

43999

Hirschsprung’s disease, anal sphincterotomy as an independent procedure for (H) (Anaes.) (Assist.)

226.15

44102

Rectum, examination of, under general anaesthesia with full thickness biopsy or removal of polyp or similar lesion (H) (Anaes.) (Assist.)

218.05

44105

Rectal prolapse, submucosal or perirectal injection for, under general anaesthesia (Anaes.)

38.30

44108

Inguinal hernia repair at age less than 3 months (H) (Anaes.) (Assist.)

417.00

44111

Obstructed or strangulated inguinal hernia, repair of, at age less than 3 months, including orchidopexy when performed (Anaes.) (Assist.)

488.40

44114

Inguinal hernia repair at age less than 3 months when orchidopexy also required (H) (Anaes.) (Assist.)

488.40

44130

Lymphadenectomy, for atypical mycobacterial infection or other granulomatous disease (Anaes.) (Assist.)

393.15

44133

Torticollis, open division of sternomastoid muscle for (H) (Anaes.) (Assist.)

312.00

44136

Ingrown toe nail, operation for, under general anaesthesia (Anaes.)

143.80

Subgroup 12  Amputations

44325

Hand, midcarpal or transmetacarpal, amputation of (Anaes.) (Assist.)

250.90

44328

Hand, forearm or through arm, amputation of (H) (Anaes.) (Assist.)

302.35

44331

Amputation at shoulder (H) (Anaes.) (Assist.)

498.60

44334

Interscapulothoracic amputation (Anaes.) (Assist.)

1 013.35

44338

1 digit of foot, amputation of (Anaes.)

122.20

44342

2 digits of 1 foot, amputation of (H) (Anaes.)

186.60

44346

3 digits of 1 foot, amputation of (H) (Anaes.) (Assist.)

215.50

44350

4 digits of 1 foot, amputation of (H) (Anaes.) (Assist.)

244.55

44354

5 digits of 1 foot, amputation of (H) (Anaes.) (Assist.)

279.85

44358

Toe, including metatarsal or part of metatarsal — each toe, amputation of (H) (Anaes.)

156.05

44359

One or more toes of 1 foot, amputation of, including if performed, excision of 1 or more metatarsal bones of the foot, performed for diabetic or other microvascular disease, excluding after-care (H) (Anaes.) (Assist.)

223.90

44361

Foot at ankle (Syme, Pirogoff types), amputation of (H) (Anaes.) (Assist.)

302.35

44364

Foot, midtarsal or transmetatarsal, amputation of (H) (Anaes.) (Assist.)

250.90

44367

Amputation through thigh, at knee or below knee (H) (Anaes.) (Assist.)

442.80

44370

Amputation at hip (H) (Anaes.) (Assist.)

611.10

44373

Hindquarter, amputation of (Anaes.) (Assist.)

1 254.45

44376

Amputation stump, re-amputation of, to provide adequate skin and muscle cover (Anaes.) (Assist.)

Amount under rule 16

Subgroup 13 — Plastic and reconstructive surgery

45000

Single stage local muscle flap repair, on eyelid, nose, lip, neck, hand, thumb, finger or genitals (Anaes.)

459.35

45003

Single stage local myocutaneous flap repair to 1 defect, simple and small (Anaes.)

510.45

45006

Single stage large myocutaneous flap repair to 1 defect (pectoralis major, latissimus dorsi, or similar large muscle) (H) (Anaes.) (Assist.)

880.50

45009

Single stage local muscle flap repair to 1 defect, simple and small (H) (Anaes.) (Assist.)

321.65

45012

Single stage large muscle flap repair to 1 defect (pectoralis major, gastrocnemius, gracilis or similar large muscle) (H) (Anaes.) (Assist.)

538.75

45015

Muscle or myocutaneous flap, delay of (H) (Anaes.)

255.20

45018

Dermis, dermofat or fascia graft (excluding transfer of fat by injection) (Anaes.) (Assist.)

401.90

45019

Full face chemical peel for severely sun-damaged skin, where it can be demonstrated that the damage affects 75% of the facial skin surface area involving photodamage (dermatoheliosis) typically consisting of solar keratoses, solar lentigines, freckling, yellowing and leathering of the skin, where at least medium depth peeling agents are used, performed in the operating theatre of a hospital or approved day hospital facility by a specialist in the practice of his or her specialty — 1 session only in a 12 month period (Anaes.)

336.55

45020

Full face chemical peel for severe chloasma or melasma refractory to all other treatments, where it can be demonstrated that the chloasma or melasma affects 75% of the facial skin surface area involving diffuse pigmentation visible at a distance of 4 metres, where at least medium depth peeling agents are used, performed in the operating theatre of a hospital or approved day hospital facility by a specialist in the practice of his or her specialty — 1 session only in a 12 month period (Anaes.)

336.55

45021

Abrasive therapy for severely disfiguring scarring resulting from trauma, burns or acne — limited to 1 aesthetic area (Anaes.)

150.55

45024

Abrasive therapy for severely disfiguring scarring resulting from trauma, burns or acne — more than 1 aesthetic area (Anaes.)

338.15

45025

Carbon dioxide laser or erbium laser resurfacing of the face or neck for severely disfiguring scarring resulting from trauma, burns or acne — limited to 1 aesthetic area (Anaes.)

150.55

45026

Carbon dioxide laser or erbium laser resurfacing of the face or neck for severely disfiguring scarring resulting from trauma, burns or acne — more than 1 aesthetic area (Anaes.)

338.15

45027

Angioma, cauterisation of or injection into, where undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

102.10

45030

Angioma (haemangioma or lymphangioma or both) of skin and subcutaneous tissue (excluding facial muscle or breast) or mucous surface, small, excision and suture of (Anaes.)

109.65

45033

Angioma (haemangioma or lymphangioma or both), large or involving deeper tissue including facial muscle or breast, excision and suture of (Anaes.)

204.20

45035

Angioma (haemangioma or lymphangioma or both) large and deep, involving muscles or nerves, excision of (H) (Anaes.) (Assist.)

595.70

45036

Angioma (haemangioma or lymphangioma or both) of neck, deep, excision of (H) (Anaes.) (Assist.)

957.10

45039

Arteriovenous malformation (3 cm or less) of superficial tissue, excision of (Anaes.)

204.20

45042

Arteriovenous malformation, (greater than 3 cm), excision of (Anaes.) (Assist.)

261.65

45045

Arteriovenous malformation on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals, excision of (Anaes.)

261.65

45048

Lymphoedematous tissue or lymphangiectasis, of lower leg and foot, or thigh, or upper arm, or forearm and hand, major excision of (H) (Anaes.) (Assist.)

657.15

45051

Contour reconstruction for pathological deformity, insertion of foreign implant (non biological but excluding injection of liquid or semisolid material) by open operation (H) (Anaes.) (Assist.)

402.00

45054

Limb or chest, decompression escharotomy of (including all incisions), for acute compartment syndrome secondary to burn (H) (Anaes.) (Assist.)

208.75

45200

Single stage local flap, where indicated to repair 1 defect, simple and small, excluding flap for male pattern baldness (Anaes.)

241.25

45203

Single stage local flap, where indicated to repair 1 defect, complicated or large, excluding flap for male pattern baldness (Anaes.) (Assist.)

344.50

45206

Single stage local flap where indicated to repair 1 defect, on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals (Anaes.)

325.50

45209

Direct flap repair (cross arm, abdominal or similar), first stage (Anaes.) (Assist.)

402.00

45212

Direct flap repair (cross arm, abdominal or similar), second stage (Anaes.)

199.45

45215

Direct flap repair, cross leg, first stage (H) (Anaes.) (Assist.)

860.45

45218

Direct flap repair, cross leg, second stage (Anaes.) (Assist.)

385.95

45221

Direct flap repair, small (cross finger or similar), first stage (Anaes.)

221.85

45224

Direct flap repair, small (cross finger or similar), second stage (Anaes.)

99.70

45227

Indirect flap or tubed pedicle, formation of (Anaes.) (Assist.)

377.95

45230

Direct or indirect flap or tubed pedicle, delay of (Anaes.)

188.90

45233

Indirect flap or tubed pedicle, preparation of intermediate or final site and attachment to the site (Anaes.) (Assist.)

402.00

45236

Indirect flap or tubed pedicle, spreading of pedicle, as a separate procedure (H) (Anaes.)

315.25

45239

Direct, indirect or local flap, revision of (Anaes.)

221.85

45400

Free grafting (split skin) of a granulating area, small (Anaes.)

173.70

45403

Free grafting (split skin) of a granulating area, extensive (Anaes.) (Assist.)

345.80

45406

Free grafting (split skin) to burns, including excision of burnt tissue — involving not more than 3% of total body surface (Anaes.) (Assist.)

382.80

45409

Free grafting (split skin) to burns, including excision of burnt tissue — involving 3% or more but less than 6% of total body surface (H) (Anaes.) (Assist.)

510.45

45412

Free grafting (split skin) to burns, including excision of burnt tissue — involving 6% or more but less than 9% of total body surface (H) (Anaes.) (Assist.)

701.90

45415

Free grafting (split skin) to burns, including excision of burnt tissue — involving 9% or more but less than 12% of total body surface (H) (Anaes.) (Assist.)

765.65

45418

Free grafting (split skin) to burns, including excision of burnt tissue — involving 12% or more but less than 15% of total body surface (H) (Anaes.) (Assist.)

829.45

45439

Free grafting (split skin) to 1 defect, including elective dissection, small (Anaes.)

241.25

45442

Free grafting (split skin) to 1 defect, including elective dissection, extensive (Anaes.) (Assist.)

497.60

45445

Free grafting (split skin) as inlay graft to 1 defect including elective dissection using a mould (including insertion of and removal of mould) (Anaes.) (Assist.)

472.30

45448

Free grafting (split skin) to 1 defect, including elective dissection on eyelid, nose, lip, ear, neck, hand, thumb, finger or genitals, not being a service to which item 45442 or 45445 applies (Anaes.)

319.00

45451

Free grafting (full thickness) to 1 defect, excluding grafts for male pattern baldness (Anaes.) (Assist.)

402.00

45460

Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — 1 surgeon (H) (Anaes.) (Assist.)

1 063.45

45461

Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

757.90

45462

Free grafting (split skin) to burns, including excision of burnt tissue, involving 15% or more but less than 20% of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

572.00

45464

Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — 1 surgeon (H) (Anaes.) (Assist.)

1 623.30

45465

Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

1 156.50

45466

Free grafting (split skin) to burns, including excision of burnt tissue, involving 20% or more but less than 30% of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

872.15

45468

Free grafting (split skin) to burns, including excision of burnt tissue, involving 30% or more but less than 40% of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

1 555.00

45469

Free grafting (split skin) to burns, including excision of burnt tissue, involving 30% or more but less than 40% of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

1 173.20

45471

Free grafting (split skin) to burns, including excision of burnt tissue, involving 40% or more but less than 50% of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

1 954.60

45472

Free grafting (split skin) to burns, including excision of burnt tissue, involving 40% or more but less than 50% of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

1 474.30

45474

Free grafting (split skin) to burns, including excision of burnt tissue, involving 50% or more but less than 60% of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

2 353.15

45475

Free grafting (split skin) to burns, including excision of burnt tissue, involving 50% or more but less than 60% of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

1 775.45

45477

Free grafting (split skin) to burns, including excision of burnt tissue, involving 60% or more but less than 70% of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

2 751.70

45478

Free grafting (split skin) to burns, including excision of burnt tissue, involving 60% or more but less than 70% of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

2 075.50

45480

Free grafting (split skin) to burns, including excision of burnt tissue, involving 70% or more but less than 80% of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

3 150.15

45481

Free grafting (split skin) to burns, including excision of burnt tissue, involving 70% or more but less than 80% of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

2 376.70

45483

Free grafting (split skin) to burns, including excision of burnt tissue, involving 80% or more of total body surface — conjoint surgery, principal surgeon (H) (Anaes.) (Assist.)

3 589.05

45484

Free grafting (split skin) to burns, including excision of burnt tissue, involving 80% or more of total body surface — conjoint surgery, co-surgeon (H) (Assist.)

2 708.00

45485

Free grafting (split skin) to burns, including excision of burnt tissue — upper eyelid, nose, lip, ear or palm of the hand (H) (Anaes.) (Assist.)

447.75

45486

Free grafting (split skin) to burns, including excision of burnt tissue — forehead, cheek, anterior aspect of the neck, chin, plantar aspect of the foot, heel or genitalia (H) (Anaes.) (Assist.)

382.80

45487

Free grafting (split skin) to burns, including excision of burnt tissue — whole of toe (Anaes.) (Assist.)

344.50

45488

Free grafting (split skin) to burns, including excision of burnt tissue — the whole of 1 digit of the hand (H) (Anaes.) (Assist.)

382.80

45489

Free grafting (split skin) to burns, including excision of burnt tissue — the whole of 2 digits of the hand (H) (Anaes.) (Assist.)

574.30

45490

Free grafting (split skin) to burns, including excision of burnt tissue — the whole of 3 digits of the hand (H) (Anaes.) (Assist.)

765.75

45491

Free grafting (split skin) to burns, including excision of burnt tissue — the whole of 4 digits of the hand (H) (Anaes.) (Assist.)

957.10

45492

Free grafting (split skin) to burns, including excision of burnt tissue — the whole of 5 digits of the hand (H) (Anaes.) (Assist.)

1 148.55

45493

Free grafting (split skin) to burns, including excision of burnt tissue — portion of digit of hand (H) (Anaes.) (Assist.)

344.50

45494

Free grafting (split skin) to burns, including excision of burnt tissue — whole of face (excluding ears) (H) (Anaes.) (Assist.)

1 390.40

45496

Flap, free tissue transfer using microvascular techniques — revision of, by open operation (H) (Anaes.)

353.00

45497

Flap, free tissue transfer using microvascular techniques — complete revision of, by liposuction (H) (Anaes.)

275.75

45498

Flap, free tissue transfer using microvascular techniques — staged revision of, by liposuction (first stage) (H) (Anaes.)

221.85

45499

Flap, free tissue transfer using microvascular techniques — staged revision of, by liposuction (second stage) (H) (Anaes.)

165.45

45500

Microvascular repair using microsurgical techniques, with restoration of continuity of artery or vein of distal extremity or digit (H) (Anaes.) (Assist.)

925.15

45501

Microvascular anastomosis of artery using microsurgical techniques, for re-implantation of limb or digit (H) (Anaes.) (Assist.)

1 505.85

45502

Microvascular anastomosis of vein using microsurgical techniques, for re-implantation of limb or digit (H) (Anaes.) (Assist.)

1 505.85

45503

Micro-arterial or micro-venous graft using microsurgical techniques (Anaes.) (Assist.)

1 722.80

45504

Microvascular anastomosis of artery using microsurgical techniques, for free transfer of tissue including setting in of free flap (H) (Anaes.) (Assist.)

1 505.85

45505

Microvascular anastomosis of vein using microsurgical techniques, for free transfer of tissue including setting in of free flap (H) (Anaes.) (Assist.)

1 505.85

45506

Scar, of face or neck, not more than 3 cm in length, revision of, where undertaken in the operating theatre of a hospital or approved day hospital facility, or where performed by a specialist in the practice of his or her specialty (Anaes.)

186.60

45512

Scar, of face or neck, more than 3 cm in length, revision of, where undertaken in the operating theatre of a hospital or approved day hospital facility, or where performed by a specialist in the practice of his or her specialty (Anaes.)

250.90

45515

Scar, other than on face or neck, not more than 7 cm in length, revision of, as an independent procedure, where undertaken in the operating theatre of a hospital or approved day hospital facility, or where performed by a specialist in the practice of his or her specialty (Anaes.)

158.25

45518

Scar, other than on face or neck, more than 7 cm in length, revision of, as an independent procedure, where undertaken in the operating theatre of a hospital or approved day hospital facility, or where performed by a specialist in the practice of his or her speciality (Anaes.)

191.45

45519

Extensive burn scars of skin (more than 1% of body surface area), excision of, for correction of scar contracture (H) (Anaes.) (Assist.)

364.05

45520

Reduction mammaplasty (unilateral) with surgical repositioning of nipple (H) (Anaes.) (Assist.)

764.00

45522

Reduction mammaplasty (unilateral) without surgical repositioning of nipple (Anaes.) (Assist.)

536.05

45524

Mammaplasty, augmentation, for significant breast asymmetry where the augmentation is limited to 1 breast (H) (Anaes.) (Assist.)

629.30

45527

Mammaplasty, augmentation, (unilateral), following mastectomy (H) (Anaes.) (Assist.)

629.30

45528

Mammaplasty, augmentation, bilateral, not being a service to which item 45527 applies, where it can be demonstrated that surgery is indicated because of malformation of breast tissue (excluding hypomastia), or disease or trauma of the breast (other than trauma resulting from previous elective cosmetic surgery) (H) (Anaes.) (Assist.)

943.85

45530

Breast reconstruction (unilateral), using a latissimus dorsi or other large muscle or myocutaneous flap, including repair of secondary skin defect, if required, excluding repair of muscular aponeurotic layer, not being a service associated with a service to which item 30165, 30168, 30171, 30174 or 30177 applies (H) (Anaes.) (Assist.)

932.85

45533

Breast reconstruction using breast sharing technique (first stage) including breast reduction, transfer of complex skin and breast tissue flap, split skin graft to pedicle of flap or other similar procedure, not being a service associated with a service to which item 30165, 30168, 30171, 30174, 30177 or 30178 applies (H) (Anaes.) (Assist.)

1 056.45

45536

Breast reconstruction using breast sharing technique (second stage) including division of pedicle, insetting of breast flap, with closure of donor site or other similar procedure (H) (Anaes.) (Assist.)

388.50

45539

Breast reconstruction (unilateral), following mastectomy, using tissue expansion — insertion of tissue expansion unit and all attendances for subsequent expansion injections (H) (Anaes.) (Assist.)

908.95

45542

Breast reconstruction (unilateral), following mastectomy, using tissue expansion — removal of tissue expansion unit and insertion of permanent prosthesis (H) (Anaes.) (Assist.)

520.45

45545

Nipple or areola or both, reconstruction of, by any surgical technique (Anaes.) (Assist.)

528.20

45546

Nipple or areola or both, intradermal colouration of, following breast reconstruction after mastectomy or for congenital absence of nipple

167.90

45548

Breast prosthesis, removal of, as an independent procedure (Anaes.)

234.80

45551

Breast prosthesis, removal of, with complete excision of fibrous capsule (H) (Anaes.) (Assist.)

376.45

45552

Breast prosthesis, removal of, with complete excision of fibrous capsule and replacement of prosthesis (Anaes.) (Assist.)

541.95

45554

Breast prosthesis, replacement of, following medical complications (such as rupture, migration of prosthetic material, or capsule formation), where new pocket is formed, including excision of fibrous capsule (Anaes.) (Assist.)

593.50

45555

Silicone breast prosthesis, removal of and replacement with prosthesis other than silicone gel prosthesis (H) (Anaes.) (Assist.)

541.95

45556

Breast ptosis, correction of (unilateral), to match the position of the contralateral breast (Anaes.) (Assist.)

649.95

45557

Breast ptosis, correction by mastopexy of (unilateral), following pregnancy and lactation, when performed not less than 1 year, and not more than 7 years, after the end of the most recent pregnancy of the patient, and where it can be demonstrated that the nipple is inferior to the
infra-mammary groove (H) (Anaes.) (Assist.)

649.95

45558

Breast ptosis, correction by mastopexy of (bilateral), following pregnancy and lactation, when performed not less than 1 year, and not more than 7 years, after the end of the most recent pregnancy of the patient, and where it can be demonstrated that the nipple is inferior to the
infra-mammary groove (H) (Anaes.) (Assist.)

974.90

45560

Hair transplantation for the treatment of alopecia of congenital or traumatic origin or due to disease, excluding male pattern baldness, not being a service to which another item in this group applies (Anaes.)

401.90

45562

Free transfer of tissue involving raising of tissue on vascular or neurovascular pedicle, including direct repair of secondary cutaneous defect if performed, excluding flap for male pattern baldness (Anaes.) (Assist.)

932.85

45563

Neurovascular island flap, including direct repair of secondary cutaneous defect if performed, excluding flap for male pattern baldness (Anaes.) (Assist.)

932.85

45564

Free transfer of tissue reconstructive surgery for the repair of major tissue defect due to congenital deformity, surgery or trauma, involving anastomoses of vessels using microvascular techniques and including raising of tissue on a vascular or neurovascular pedicle, preparation of recipient vessels, transfer of tissue, insetting of tissue at recipient site and direct repair of secondary cutaneous defect if performed, not being a service associated with a service to which item 30165, 30168, 30171, 30174, 30177, 45501, 45502, 45504, 45505 or 45562 applies — conjoint surgery, principal specialist surgeon (H) (Anaes.) (Assist.)

2 160.50

45565

Free transfer of tissue reconstructive surgery for the repair of major tissue defect due to congenital deformity, surgery or trauma, involving anastomoses of vessels using microvascular techniques and including raising of tissue on a vascular or neurovascular pedicle, preparation of recipient vessels, transfer of tissue, insetting of tissue at recipient site and direct repair of secondary cutaneous defect if performed, not being a service associated with a service to which item 30165, 30168, 30171, 30174, 30177, 45501, 45502, 45504, 45505 or 45562 applies — conjoint surgery, conjoint specialist surgeon (H) (Assist.)

1 620.45

45566

Tissue expansion not being a service to which item 45539 or 45542 applies — insertion of tissue expansion unit and all attendances for subsequent expansion injections (H) (Anaes.) (Assist.)

908.95

45568

Tissue expander, removal of, with complete excision of fibrous capsule (Anaes.) (Assist.)

376.45

45572

Intra-operative tissue expansion performed during an operation when combined with a service to which another item in Group T8 applies including expansion injections and excluding treatment of male pattern baldness (Anaes.)

247.55

45575

Facial nerve paralysis, free fascia graft for (Anaes.) (Assist.)

611.10

45578

Facial nerve paralysis, muscle transfer for (H) (Anaes.) (Assist.)

707.75

45581

Facial nerve palsy, excision of tissue for (Anaes.)

234.80

45584

Liposuction (suction assisted lipolysis) to 1 regional area (thigh, buttock, or similar), for treatment of
post-traumatic pseudolipoma (Anaes.)

536.05

45585

Liposuction (suction assisted lipolysis) to 1 regional area, not being a service associated with a service to which item 31521 or 31527 applies, where it can be demonstrated that the treatment is for pathological lipodystrophy of hips, buttocks, thighs, knees or lower legs (Barraquer-Simon’s syndrome), gynaecomastia or lymphoedema (Anaes.)

536.05

45586

Liposuction (suction assisted lipolysis) for reduction of a buffalo hump, where it can be demonstrated that the buffalo hump is secondary to an endocrine disorder or pharmacological treatment of a medical condition (H) (Anaes.)

536.05

45587

Meloplasty for correction of facial asymmetry due to soft tissue abnormality where the meloplasty is limited to 1 side of the face (Anaes.) (Assist.)

755.90

45588

Meloplasty (excluding browlifts and chinlift platysmaplasties), bilateral, where it can be demonstrated that surgery is indicated because of congenital conditions, disease or trauma (other than trauma resulting from previous elective cosmetic surgery) (H) (Anaes.) (Assist.)

1 133.90

45590

Orbital cavity, reconstruction of a wall or floor, with or without foreign implant (H) (Anaes.) (Assist.)

410.05

45593

Orbital cavity, bone or cartilage graft to orbital wall or floor including reduction of prolapsed or entrapped orbital contents (H) (Anaes.) (Assist.)

481.65

45596

Maxilla, total resection of (H) (Anaes.) (Assist.)

764.00

45597

Maxilla, total resection of both maxillae (Anaes.) (Assist.)

1 022.75

45599

Mandible, total resection of both sides, including condylectomies where performed (Anaes.) (Assist.)

794.70

45602

Mandible, including lower border, or maxilla, sub-total resection of (H) (Anaes.) (Assist.)

593.50

45605

Mandible or maxilla, segmental resection of, for tumours or cysts (H) (Anaes.) (Assist.)

498.60

45608

Mandible, hemi-mandibular reconstruction with bone graft, not being a service associated with a service to which item 45599 applies (H) (Anaes.) (Assist.)

701.90

45611

Mandible, condylectomy (H) (Anaes.) (Assist.)

402.00

45614

Eyelid, whole thickness reconstruction of, other than by direct suture only (Anaes.) (Assist.)

498.60

45617

Upper eyelid, reduction of, for skin redundancy obscuring vision (as evidenced by upper eyelid skin resting on lashes on straight ahead gaze), herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring, or the restoration of symmetry of contralateral upper eyelid in respect of 1 of these conditions (Anaes.)

199.45

45620

Lower eyelid, reduction of, for herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring, or, in respect of 1 of these conditions, the restoration of symmetry of the contralateral lower eyelid (Anaes.)

276.60

45623

Ptosis of eyelid (unilateral), correction of (Anaes.) (Assist.)

613.55

45624

Ptosis of eyelid, correction of, where previous ptosis surgery has been performed on that side (Anaes.) (Assist.)

795.40

45625

Ptosis of eyelid, correction of eyelid height by revision of levator sutures within 1 week of primary repair by levator resection or advancement, performed in the operating theatre of a hospital or approved day hospital facility (Anaes.)

159.10

45626

Ectropion or entropion, correction of (unilateral) (Anaes.)

276.60

45629

Symblepharon, grafting for (Anaes.) (Assist.)

402.00

45632

Rhinoplasty, correction of lateral or alar cartilages (Anaes.)

434.35

45635

Rhinoplasty, correction of bony vault only (Anaes.)

498.60

45638

Rhinoplasty, total, including correction of all bony and cartilaginous elements of the external nose, for correction of nasal obstruction or post-traumatic deformity (other than deformity resulting from previous elective cosmetic surgery), or both (Anaes.)

860.45

45639

Rhinoplasty, total, including correction of all bony and cartilaginous elements of the external nose, where it can be demonstrated that there is a need for correction of significant developmental deformity (Anaes.)

860.45

45641

Rhinoplasty involving nasal or septal cartilage graft, or nasal bone graft, or nasal bone and nasal cartilage graft (H) (Anaes.)

918.80

45644

Rhinoplasty involving autogenous bone or cartilage graft obtained from distant donor site, including obtaining of graft (Anaes.) (Assist.)

1 085.65

45645

Choanal atresia, repair of by puncture and dilatation (H) (Anaes.)

189.75

45646

Choanal atresia, correction by open operation with bone removal (Anaes.) (Assist.)

764.00

45647

Face, contour restoration of 1 region, using autogenous bone or cartilage graft (not being a service to which item 45644 applies) (H) (Anaes.) (Assist.)

1 085.65

45650

Rhinoplasty, secondary revision of (Anaes.)

125.45

45652

Rhinophyma, carbon dioxide laser or erbium laser excision — ablation of (Anaes.)

302.35

45653

Rhinophyma, shaving of (Anaes.)

302.35

45656

Composite graft (chondro-cutaneous or chondro-mucosal) to nose, ear or eyelid (Anaes.) (Assist.)

426.20

45659

Lop ear, bat ear or similar deformity, correction of (Anaes.)

442.25

45660

External ear, complex total reconstruction of, using multiple costal cartilage grafts to form a framework, including the harvesting and sculpturing of the cartilage and its insertion, for congenital absence, microtia or
post-traumatic loss of entire or substantial portion of pinna (first stage) — performed by a specialist in the practice of his or her specialty (H) (Anaes.) (Assist.)

2 442.65

45661

External ear, complex total reconstruction of, elevation of costal cartilage framework using cartilage previously stored in abdominal wall, including the use of local skin and fascia flaps and full thickness skin graft to cover cartilage (second stage) — performed by a specialist in the practice of his or her specialty (H) (Anaes.) (Assist.)

1 085.65

45662

Congenital atresia, reconstruction of external auditory canal (H) (Anaes.) (Assist.)

595.00

45665

Lip, eyelid or ear, full thickness wedge excision of, with repair by direct sutures (Anaes.)

276.60

45668

Vermilionectomy, by surgical excision (Anaes.)

276.60

45669

Vermilionectomy, using carbon dioxide laser or erbium laser excision — ablation (Anaes.)

276.60

45671

Lip or eyelid reconstruction using full thickness flap (Abbe or similar), first stage (Anaes.) (Assist.)

707.75

45674

Lip or eyelid reconstruction using full thickness flap (Abbe or similar), second stage (Anaes.)

205.85

45675

Macrocheilia or macroglossia, operation for (H) (Anaes.) (Assist.)

410.05

45676

Macrostomia, operation for (H) (Anaes.) (Assist.)

488.15

45677

Cleft lip, unilateral — primary repair, 1 stage, without anterior palate repair (H) (Anaes.) (Assist.)

459.35

45680

Cleft lip, unilateral — primary repair, 1 stage, with anterior palate repair (H) (Anaes.) (Assist.)

574.30

45683

Cleft lip, bilateral — primary repair, 1 stage, without anterior palate repair (H) (Anaes.) (Assist.)

638.00

45686

Cleft lip, bilateral — primary repair, 1 stage, with anterior palate repair (Anaes.) (Assist.)

753.00

45689

Cleft lip, lip adhesion procedure, unilateral or bilateral (H) (Anaes.) (Assist.)

222.05

45692

Cleft lip, partial revision, including minor flap revision alignment and adjustment, including revision of minor whistle deformity if performed (Anaes.)

255.20

45695

Cleft lip, total revision, including major flap revision, muscle reconstruction and revision of major whistle deformity (H) (Anaes.) (Assist.)

414.70

45698

Cleft lip, primary columella lengthening procedure, bilateral (H) (Anaes.)

389.20

45701

Cleft lip reconstruction using full thickness flap (Abbe or similar), first stage (H) (Anaes.) (Assist.)

701.90

45704

Cleft lip reconstruction using full thickness flap (Abbe or similar), second stage (Anaes.)

255.20

45707

Cleft palate, primary repair (H) (Anaes.) (Assist.)

663.50

45710

Cleft palate, secondary repair, closure of fistula using local flaps (H) (Anaes.)

414.70

45713

Cleft palate, secondary repair, lengthening procedure (H) (Anaes.) (Assist.)

472.30

45714

Oro-nasal fistula, plastic closure of, including services to which item 45200, 45203 or 45239 applies (H) (Anaes.) (Assist.)

663.50

45716

Velo-pharyngeal incompetence, pharyngeal flap for, or pharyngoplasty for (H) (Anaes.)

663.50

45720

Mandible or maxilla, unilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

820.30

45723

Mandible or maxilla, unilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (H) (Anaes.) (Assist.)

925.15

45726

Mandible or maxilla, bilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site (H) (Anaes.) (Assist.)

1 045.40

45729

Mandible or maxilla, bilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (H) (Anaes.) (Assist.)

1 174.00

45731

Mandible or maxilla, osteotomies or osteectomies of, involving 3 or more such procedures on the 1 jaw, including transposition of nerves and vessels and bone grafts taken from the same site (H) (Anaes.) (Assist.)

1 190.20

45732

Mandible or maxilla, osteotomies or osteectomies of, involving 3 or more such procedures on the 1 jaw, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

1 339.95

45735

Mandible and maxilla, osteotomies or osteectomies of, involving 2 such procedures of each jaw, including transposition of nerves and vessels and bone grafts taken from the same site (H) (Anaes.) (Assist.)

1 366.95

45738

Mandible and maxilla, osteotomies or osteectomies of, involving 2 such procedures of each jaw, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (H) (Anaes.) (Assist.)

1 537.80

45741

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of 1 jaw and 2 such procedures of the other jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site (H) (Anaes.) (Assist.)

1 503.80

45744

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of 1 jaw and 2 such procedures of the other jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (H) (Anaes.) (Assist.)

1 690.80

45747

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of each jaw, including genioplasty (when performed) and transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 640.60

45752

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of each jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

1 837.65

45753

Midfacial osteotomies — Le Fort II, Modified Le Fort III (Nasomalar), Modified Le Fort III (Malar-Maxillary), Le Fort III involving 3 or more osteotomies of the midface including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 848.60

45754

Midfacial osteotomies — Le Fort II, Modified Le Fort III (Nasomalar), Modified Le Fort III (Malar-Maxillary), Le Fort III involving 3 or more osteotomies of the midface including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (H) (Anaes.) (Assist.)

2 215.95

45755

Temporo-mandibular meniscectomy (Anaes.) (Assist.)

312.00

45758

Temporo-mandibular joint, arthroplasty (H) (Anaes.) (Assist.)

558.40

45761

Genioplasty, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

635.25

45767

Hypertelorism, correction of, intra-cranial (Anaes.) (Assist.)

2 131.10

45770

Hypertelorism, correction of, sub-cranial (H) (Anaes.) (Assist.)

1 632.45

45773

Treacher Collins Syndrome, periorbital correction of, with rib and iliac bone grafts (Anaes.) (Assist.)

1 487.75

45776

Orbital dystopia (unilateral), correction of, with total repositioning of 1 orbit, intra-cranial (H) (Anaes.) (Assist.)

1 487.75

45779

Orbital dystopia (unilateral), correction of, with total repositioning of 1 orbit, extra-cranial (H) (Anaes.) (Assist.)

1 093.75

45782

Fronto-orbital advancement, unilateral (Anaes.) (Assist.)

836.40

45785

Cranial vault reconstruction for oxycephaly, brachycephaly, turricephaly or similar condition — (bilateral fronto-orbital advancement) (H) (Anaes.) (Assist.)

1 415.35

45788

Glenoid fossa, zygomatic arch and temporal bone, reconstruction of, (Obwegeser technique) (H) (Anaes.) (Assist.)

1 399.25

45791

Absent condyle and ascending ramus in hemifacial microsomia, construction of, not including harvesting of graft material (H) (Anaes.) (Assist.)

755.90

45794

Osseo-integration procedure — extra-oral, implantation of titanium fixture (H) (Anaes.)

427.55

45797

Osseo-integration procedure, fixation of transcutaneous abutment (H) (Anaes.)

158.25

45799

Aspiration biopsy of 1 or more jaw cysts as an independent procedure to obtain material for diagnostic purposes, not being a service associated with an operative procedure on the same day (Anaes.)

25.00

45801

Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), in the oral and maxillofacial region, up to 3 cm in diameter, removal from cutaneous or subcutaneous tissue or from mucous membrane, where the removal is by surgical excision and suture, not being a service to which item 45803 applies (Anaes.)

107.70

45803

Tumour, cyst, ulcers or scar (other than a scar removed during the surgical approach at an operation), in the oral and maxillofacial region, up to 3 cm in diameter, removal from cutaneous or subcutaneous tissue or from mucous membrane, where the removal is by surgical excision and suture, and the procedure is performed on more than 3 but not more than 10 lesions (Anaes.) (Assist.)

276.60

45805

Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), in the oral and maxillofacial region, more than 3 cm in diameter, removal from cutaneous or subcutaneous tissue or from mucous membrane (Anaes.)

146.35

45807

Tumour, cyst (other than a cyst associated with a tooth or tooth fragment unless it has been established by radiological examination that there is a minimum of 5 mm separation between the cyst lining and tooth structure or where a tumour or cyst has been proven by positive histopathology), ulcer or scar (other than a scar removed during the surgical approach at an operation), in the oral and maxillofacial region, removal of, not being a service to which another item in this subgroup applies, involving muscle, bone, or other deep tissue (Anaes.)

209.10

45809

Tumour or deep cyst (other than a cyst associated with a tooth or tooth fragment unless it has been established by radiological examination that there is a minimum of 5 mm separation between the cyst lining and tooth structure or where a tumour or cyst has been proven by positive histopathology), in the oral and maxillofacial region, removal of, requiring wide excision, not being a service to which another item in this subgroup applies (Anaes.) (Assist.)

315.25

45811

Tumour, in the oral and maxillofacial region, removal of, from soft tissue (including muscle, fascia and connective tissue), extensive excision of, without skin or mucosal graft (Anaes.) (Assist.)

426.20

45813

Tumour, in the oral and maxillofacial region, removal of, from soft tissue (including muscle, fascia and connective tissue), extensive excision of, with skin or mucosal graft (Anaes.) (Assist.)

498.60

45815

Operation on mandible or maxilla (other than alveolar margins) for chronic osteomyelitis — 1 bone or in combination with adjoining bones (Anaes.) (Assist.)

302.35

45817

Operation on skull for osteomyelitis (Anaes.) (Assist.)

394.10

45819

Operation on any combination of adjoining bones in the oral and maxillofacial region, being bones referred to in item 45817 (Anaes.) (Assist.)

498.55

45821

Bone growth stimulator in the oral and maxillofacial region, insertion of (Anaes.) (Assist.)

323.10

45823

Arch bars, 1 or more, that were inserted for dental fixation purposes to the maxilla or mandible, removal of, requiring general anaesthesia where undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

92.40

45825

Mandibular or palatal exostosis, excision of (Anaes.) (Assist.)

287.05

45827

Mylohyoid ridge, reduction of (Anaes.) (Assist.)

274.40

45829

Maxillary tuberosity, reduction of (Anaes.)

209.30

45831

Papillary hyperplasia of the palate, removal of — less than 5 lesions (Anaes.) (Assist.)

274.40

45833

Papillary hyperplasia of the palate, removal of — 5 to 20 lesions (Anaes.) (Assist.)

344.50

45835

Papillary hyperplasia of the palate, removal of — more than 20 lesions (Anaes.) (Assist.)

427.55

45837

Vestibuloplasty, submucosal or open, including excision of muscle and skin or mucosal graft when performed — unilateral or bilateral (Anaes.) (Assist.)

497.60

45839

Floor of mouth lowering (Obwegeser or similar procedure), including excision of muscle and skin or mucosal graft when performed — unilateral (Anaes.) (Assist.)

497.60

45841

Alveolar ridge augmentation with bone or alloplast or both — unilateral (Anaes.) (Assist.)

401.90

45843

Alveolar ridge augmentation — unilateral, insertion of tissue expanding device into maxillary or mandibular alveolar ridge region (Anaes.) (Assist.)

246.45

45845

Osseo-integration procedure — intra-oral implantation of titanium fixture to facilitate restoration of the dentition following resection of part of the maxilla or mandible for benign or malignant tumours (Anaes.)

427.55

45847

Osseo-integration procedure — fixation of transmucosal abutment to fixtures placed following resection of part of the maxilla or mandible for benign or malignant tumours (Anaes.)

158.25

45849

Maxillary sinus, bone graft to floor of maxillary sinus following elevation of mucosal lining (sinus lift procedure), unilateral (Anaes.) (Assist.)

492.85

45851

Temporomandibular joint, manipulation of, performed in the operating theatre of a hospital or approved day hospital facility, not being a service associated with a service to which another item in this subgroup applies (Anaes.)

121.25

45853

Absent condyle and ascending ramus in hemifacial microsomia, construction of, not including harvesting of graft material (Anaes.) (Assist.)

755.90

45855

Temporomandibular joint, arthroscopy of, with or without biopsy, not being a service associated with any other arthroscopic procedure of that joint (Anaes.) (Assist.)

346.75

45857

Temporomandibular joint, arthroscopy of, removal of loose bodies, debridement, or treatment of adhesions — 1 or more of such procedures (Anaes.) (Assist.)

554.70

45859

Temporomandibular joint, arthrotomy of, not being a service to which another item in this subgroup applies (Anaes.) (Assist.)

279.65

45861

Temporomandibular joint, open surgical exploration of, with or without microsurgical techniques (Anaes.) (Assist.)

740.15

45863

Temporomandibular joint, open surgical exploration of, with condylectomy or condylotomy, with or without microsurgical techniques (Anaes.) (Assist.)

820.50

45865

Arthrocentesis, irrigation of temporomandibular joint after insertion of 2 cannuli into the appropriate joint space(s) (Anaes.) (Assist.)

246.45

45867

Temporomandibular joint, synovectomy of, not being a service to which another item in this subgroup applies (Anaes.) (Assist.)

265.00

45869

Temporomandibular joint, open surgical exploration of, with or without meniscus or capsular surgery, including meniscectomy when performed, with or without microsurgical techniques (Anaes.) (Assist.)

1 008.20

45871

Temporomandibular joint, open surgical exploration of, with meniscus, capsular and condylar head surgery, with or without microsurgical techniques (Anaes.) (Assist.)

1 135.70

45873

Temporomandibular joint, surgery of, involving procedures to which item 45863, 45867, 45869 or 45871 applies and also involving the use of tissue flaps, or cartilage graft, or allograft implants, with or without microsurgical techniques (Anaes.) (Assist.)

1 276.15

45875

Temporomandibular joint, stabilisation of, involving 1 or more of: repair of capsule, repair of ligament or internal fixation, not being a service to which another item in this subgroup applies (Anaes.) (Assist.)

399.35

45877

Temporomandibular joint, arthrodesis of, not being a service to which another item in this subgroup applies (Anaes.) (Assist.)

399.35

45879

Temporomandibular joint or joints, application of external fixator to, other than for treatment of fractures (Anaes.) (Assist.)

265.00

Subgroup 14 — Hand surgery

46300

Interphalangeal joint or metacarpophalangeal joint, arthrodesis of (H) (Anaes.) (Assist.)

287.10

46303

Carpometacarpal joint, arthrodesis of (H) (Anaes.) (Assist.)

319.10

46306

Interphalangeal joint or metacarpophalangeal joint — interposition arthroplasty of and including tendon transfers or realignment on the 1 ray (H) (Anaes.) (Assist.)

446.70

46307

Interphalangeal joint or metacarpophalangeal joint — volar plate arthroplasty for traumatic deformity including tendon transfers or realignment on the 1 ray (H) (Anaes.) (Assist.)

446.70

46309

Interphalangeal joint or metacarpophalangeal joint, total replacement arthroplasty or hemiarthroplasty of, including associated synovectomy, tendon transfer or realignment — 1 joint (H) (Anaes.) (Assist.)

446.70

46312

Interphalangeal joint or metacarpophalangeal joint, total replacement arthroplasty or hemiarthroplasty of, including associated synovectomy, tendon transfer or realignment — 2 joints (H) (Anaes.) (Assist.)

574.40

46315

Interphalangeal joint or metacarpophalangeal joint, total replacement arthroplasty or hemiarthroplasty of, including associated synovectomy, tendon transfer or realignment — 3 joints (H) (Anaes.) (Assist.)

765.80

46318

Interphalangeal joint or metacarpophalangeal joint, total replacement arthroplasty or hemiarthroplasty of, including associated synovectomy, tendon transfer or realignment — 4 joints (H) (Anaes.) (Assist.)

957.30

46321

Interphalangeal joint or metacarpophalangeal joint, total replacement arthroplasty or hemiarthroplasty of, including associated synovectomy, tendon transfer or realignment — 5 or more joints (H) (Anaes.) (Assist.)

1 148.80

46324

Carpal bone replacement arthroplasty including associated tendon transfer or realignment when performed (H) (Anaes.) (Assist.)

685.05

46325

Carpal bone replacement or resection arthroplasty using adjacent tendon or other soft tissue including associated tendon transfer or realignment when performed (H) (Anaes.) (Assist.)

714.85

46327

Interphalangeal joint or metacarpophalangeal joint, arthrotomy of (Anaes.)

172.40

46330

Interphalangeal joint or metacarpophalangeal joint, arthrotomy of, with ligamentous or capsular repair (H) (Anaes.) (Assist.)

293.65

46333

Interphalangeal joint or metacarpophalangeal joint, ligamentous repair of, using free tissue graft or implant (H) (Anaes.) (Assist.)

478.65

46336

Interphalangeal joint or metacarpophalangeal joint, synovectomy, capsulectomy or debridement of, not being a service associated with any other procedure related to that joint (Anaes.) (Assist.)

223.45

46339

Extensor tendons or flexor tendons of hand or wrist, synovectomy of (Anaes.) (Assist.)

395.60

46342

Distal radioulnar joint or carpometacarpal joint or joints, synovectomy of (H) (Anaes.) (Assist.)

395.60

46345

Distal radioulnar joint, reconstruction or stabilisation of, including fusion, or ligamentous arthroplasty and excision of distal ulna, when performed (H) (Anaes.) (Assist.)

478.65

46348

Digit, synovectomy of flexor tendon or tendons — 1 digit (Anaes.)

207.40

46351

Digit, synovectomy of flexor tendon or tendons — 2 digits (H) (Anaes.) (Assist.)

309.50

46354

Digit, synovectomy of flexor tendon or tendons — 3 digits (H) (Anaes.) (Assist.)

414.80

46357

Digit, synovectomy of flexor tendon or tendons — 4 digits (H) (Anaes.) (Assist.)

516.95

46360

Digit, synovectomy of flexor tendon or tendons — 5 digits (H) (Anaes.) (Assist.)

622.20

46363

Tendon sheath of hand or wrist, open operation on, for stenosing tenovaginitis (Anaes.)

178.70

46366

Dupuytren’s contracture, subcutaneous fasciotomy for — each hand (Anaes.)

108.55

46369

Dupuytren’s contracture, palmar fasciectomy for — 1 hand (Anaes.)

178.70

46372

Dupuytren’s contracture, fasciectomy for, from 1 ray, including dissection of nerves — 1 hand (Anaes.) (Assist.)

363.05

46375

Dupuytren’s contracture, fasciectomy for, from 2 rays, including dissection of nerves — 1 hand (H) (Anaes.) (Assist.)

430.80

46378

Dupuytren’s contracture, fasciectomy for, from 3 or more rays, including dissection of nerves — 1 hand (H) (Anaes.) (Assist.)

574.40

46381

Interphalangeal joint, joint capsule release when performed in conjunction with operation for Dupuytren’s contracture — each procedure (H) (Anaes.) (Assist.)

255.25

46384

Z plasty (or similar local flap procedure) when performed in conjunction with operation for Dupuytren’s contracture — 1 such procedure (H) (Anaes.) (Assist.)

255.25

46387

Dupuytren’s contracture, fasciectomy for, from 1 ray, including dissection of nerves — operation for recurrence in that ray (Anaes.) (Assist.)

526.55

46390

Dupuytren’s contracture, fasciectomy for, from 2 rays, including dissection of nerves — operation for recurrence in those rays (H) (Anaes.) (Assist.)

702.05

46393

Dupuytren’s contracture, fasciectomy for, from 3 or more rays, including dissection of nerves — operation for recurrence in those rays (H) (Anaes.) (Assist.)

813.70

46396

Phalanx or metacarpal of the hand, osteotomy or osteectomy of (Anaes.) (Assist.)

279.65

46399

Phalanx or metacarpal of the hand, osteotomy of, with internal fixation (H) (Anaes.) (Assist.)

439.40

46402

Phalanx or metacarpal, bone grafting of, for pseudarthrosis (non-union), including obtaining of graft material (H) (Anaes.) (Assist.)

439.40

46405

Phalanx or metacarpal, bone grafting of, for pseudarthrosis (non-union), involving internal fixation and including obtaining of graft material (H) (Anaes.) (Assist.)

536.15

46408

Tendon, reconstruction of, by tendon graft (H) (Anaes.) (Assist.)

587.20

46411

Flexor tendon pulley, reconstruction of, by graft (H) (Anaes.) (Assist.)

344.60

46414

Artificial tendon prosthesis, insertion of, in preparation for tendon grafting (Anaes.) (Assist.)

446.60

46417

Tendon transfer for restoration of hand function, each transfer (H) (Anaes.) (Assist.)

414.80

46420

Extensor tendon of hand or wrist, primary repair of, each tendon (Anaes.)

173.60

46423

Extensor tendon of hand or wrist, secondary repair of, each tendon (Anaes.) (Assist.)

277.60

46426

Flexor tendon of hand or wrist, primary repair of, proximal to A1 pulley, each tendon (H) (Anaes.) (Assist.)

287.10

46429

Flexor tendon of hand or wrist, secondary repair of, proximal to A1 pulley, each tendon (Anaes.) (Assist.)

351.00

46432

Flexor tendon of hand, primary repair of, distal to A1 pulley, each tendon (H) (Anaes.) (Assist.)

383.00

46435

Flexor tendon of hand, secondary repair of, distal to A1 pulley, each tendon (H) (Anaes.) (Assist.)

446.70

46438

Mallet finger, closed pin fixation of (Anaes.)

114.90

46441

Mallet finger, open repair of, including pin fixation when performed (Anaes.) (Assist.)

277.60

46442

Mallet finger with intra-articular fracture involving more than one-third of base of terminal phalanx — open reduction (H) (Anaes.) (Assist.)

238.30

46444

Boutonniere deformity without joint contracture, reconstruction of (H) (Anaes.) (Assist.)

414.80

46447

Boutonniere deformity with joint contracture, reconstruction of (H) (Anaes.) (Assist.)

516.95

46450

Extensor tendon, tenolysis of, following tendon injury, repair or graft (H) (Anaes.)

191.45

46453

Flexor tendon, tenolysis of, following tendon injury, repair or graft (H) (Anaes.) (Assist.)

319.10

46456

Finger, percutaneous tenotomy of (Anaes.)

82.95

46459

Operation for osteomyelitis on distal phalanx (Anaes.)

159.60

46462

Operation for osteomyelitis on middle or proximal phalanx, metacarpal or carpus (Anaes.) (Assist.)

255.25

46464

Amputation of a supernumerary complete digit (Anaes.)

191.45

46465

Amputation of single digit, proximal to nail bed, involving section of bone or joint and requiring soft tissue cover (Anaes.)

191.45

46468

Amputation of 2 digits, proximal to nail bed, involving section of bone or joint and requiring soft tissue cover (H) (Anaes.) (Assist.)

335.05

46471

Amputation of 3 digits, proximal to nail bed, involving section of bone or joint and requiring soft tissue cover (Anaes.) (Assist.)

478.65

46474

Amputation of 4 digits, proximal to nail bed, involving section of bone or joint and requiring soft tissue cover (H) (Anaes.) (Assist.)

622.20

46477

Amputation of 5 digits, proximal to nail bed, involving section of bone or joint and requiring soft tissue cover (H) (Anaes.) (Assist.)

765.80

46480

Amputation of single digit, proximal to nail bed, involving section of bone or joint and requiring soft tissue cover, including metacarpal (Anaes.) (Assist.)

319.10

46483

Revision of amputation stump to provide adequate soft tissue cover (Anaes.) (Assist.)

255.25

46486

Nail bed, accurate reconstruction of nail bed laceration using magnification, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

191.45

46489

Nail bed, secondary exploration and accurate repair of nail bed deformity using magnification, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.) (Assist.)

223.45

46492

Contracture of digits of hand, flexor or extensor, correction of, involving tissues deeper than skin and subcutaneous tissue (H) (Anaes.) (Assist.)

306.35

46494

Ganglion of hand, excision of, not being a service associated with a service to which another item in this group applies (Anaes.)

186.60

46495

Ganglion or mucous cyst of distal digit, excision of, not being a service associated with a service to which item 30106 or 30107 applies (Anaes.)

172.40

46498

Ganglion of flexor tendon sheath, excision of, not being a service associated with a service to which item 30106 or 30107 applies (Anaes.)

186.60

46500

Ganglion of dorsal wrist joint, excision of, not being a service associated with a service to which item 30106 or 30107 applies (Anaes.) (Assist.)

223.45

46501

Ganglion of volar wrist joint, excision of, not being a service associated with a service to which item 30106 or 30107 applies (Anaes.) (Assist.)

279.25

46502

Recurrent ganglion of dorsal wrist joint, excision of, not being a service associated with a service to which item 30106 or 30107 applies (Anaes.) (Assist.)

257.00

46503

Recurrent ganglion of volar wrist joint, excision of, not being a service associated with a service to which item 30106 or 30107 applies (Anaes.) (Assist.)

321.05

46504

Neurovascular island flap, for pulp innervation (Anaes.) (Assist.)

938.10

46507

Digit or ray, transposition or transfer of, on vascular pedicle, complete procedure (H) (Anaes.) (Assist.)

1 091.25

46510

Macrodactyly, surgical reduction of enlarged elements — each digit (H) (Anaes.) (Assist.)

297.85

46513

Digital nail of finger or thumb, removal of, not being a service to which item 46516 applies (Anaes.)

47.95

46516

Digital nail of finger or thumb, removal of, in the operating theatre of a hospital or approved day hospital facility (Anaes.)

95.80

46519

Middle palmar, thenar or hypothenar spaces of hand, drainage of (excluding after-care) (Anaes.)

119.85

46522

Flexor tendon sheath of finger or thumb — open operation and drainage for infection (H) (Anaes.) (Assist.)

357.40

46525

Pulp space infection, paronychia of hand, incision for, when performed in an operating theatre of a hospital or approved day hospital facility, not being a service to which another item in this group applies (excluding
after-care) (Anaes.)

47.95

46528

Ingrowing nail of finger or thumb, wedge resection for, including removal of segment of nail, ungual fold and portion of the nail bed (Anaes.)

143.80

46531

Ingrowing nail of finger or thumb, partial resection of nail, including phenolisation but not including excision of nail bed (Anaes.)

72.25

46534

Nail plate injury or deformity, radical excision of nail germinal matrix (Anaes.)

199.75

Subgroup 15 — Orthopaedic

47000

Mandible, treatment of dislocation of, by closed reduction (Anaes.)

60.00

47003

Clavicle, treatment of dislocation of, by closed reduction (Anaes.)

71.90

47006

Clavicle, treatment of dislocation of, by open reduction (Anaes.)

144.45

47009

Shoulder, treatment of dislocation of, requiring general anaesthesia, not being a service to which item 47012 applies (Anaes.)

143.80

47012

Shoulder, treatment of dislocation of, requiring general anaesthesia, open reduction (H) (Anaes.) (Assist.)

287.55

47015

Shoulder, treatment of dislocation of, not requiring general anaesthesia

71.90

47018

Elbow, treatment of dislocation of, by closed reduction (Anaes.)

167.65

47021

Elbow, treatment of dislocation of, by open reduction (H) (Anaes.) (Assist.)

223.70

47024

Radioulnar joint, distal or proximal, treatment of dislocation of, by closed reduction, not being a service associated with fracture or dislocation in the same region (Anaes.)

167.65

47027

Radioulnar joint, distal or proximal, treatment of dislocation of, by open reduction, not being a service associated with fracture or dislocation in the same region (H) (Anaes.) (Assist.)

223.70

47030

Carpus, or carpus on radius and ulna, or carpometacarpal joint, treatment of dislocation of, by closed reduction (Anaes.)

167.65

47033

Carpus, or carpus on radius and ulna, or carpometacarpal joint, treatment of dislocation of, by open reduction (Anaes.) (Assist.)

223.70

47036

Interphalangeal joint, treatment of dislocation of, by closed reduction (Anaes.)

71.90

47039

Interphalangeal joint, treatment of dislocation of, by open reduction (Anaes.)

95.80

47042

Metacarpophalangeal joint, treatment of dislocation of, by closed reduction (Anaes.)

95.80

47045

Metacarpophalangeal joint, treatment of dislocation of, by open reduction (Anaes.)

127.90

47048

Hip, treatment of dislocation of, by closed reduction (Anaes.)

275.60

47051

Hip, treatment of dislocation of, by open reduction (H) (Anaes.) (Assist.)

367.40

47054

Knee, treatment of dislocation of, by closed reduction (Anaes.) (Assist.)

275.60

47057

Patella, treatment of dislocation of, by closed reduction (Anaes.)

107.80

47060

Patella, treatment of dislocation of, by open reduction (Anaes.)

143.80

47063

Ankle or tarsus, treatment of dislocation of, by closed reduction (Anaes.)

215.70

47066

Ankle or tarsus, treatment of dislocation of, by open reduction (H) (Anaes.) (Assist.)

287.55

47069

Toe, treatment of dislocation of, by closed reduction (Anaes.)

60.00

47072

Toe, treatment of dislocation of, by open reduction (Anaes.)

79.75

47300

Distal phalanx of finger or thumb, treatment of fracture of, by closed reduction, including percutaneous fixation where used (Anaes.)

71.90

47303

Distal phalanx of finger or thumb, treatment of
intra-articular fracture of, by closed reduction (Anaes.)

83.90

47306

Distal phalanx of finger or thumb, treatment of fracture of, by open reduction (Anaes.)

95.80

47309

Distal phalanx of finger or thumb, treatment of
intra-articular fracture of, by open reduction (Anaes.)

119.85

47312

Middle phalanx of finger, treatment of fracture of, by closed reduction (Anaes.)

107.80

47315

Middle phalanx of finger, treatment of intra-articular fracture of, by closed reduction (Anaes.)

123.80

47318

Middle phalanx of finger, treatment of fracture of, by open reduction (Anaes.)

143.80

47321

Middle phalanx of finger, treatment of intra-articular fracture of, by open reduction (H) (Anaes.)

179.70

47324

Proximal phalanx of finger or thumb, treatment of fracture of, by closed reduction (Anaes.)

143.80

47327

Proximal phalanx of finger or thumb, treatment of
intra-articular fracture of, by closed reduction (Anaes.)

167.65

47330

Proximal phalanx of finger or thumb, treatment of fracture of, by open reduction (Anaes.)

191.75

47333

Proximal phalanx of finger or thumb, treatment of
intra-articular fracture of, by open reduction (H) (Anaes.) (Assist.)

239.55

47336

Metacarpal, treatment of fracture of, by closed reduction (Anaes.)

143.80

47339

Metacarpal, treatment of intra-articular fracture of, by closed reduction (Anaes.)

167.65

47342

Metacarpal, treatment of fracture of, by open reduction (Anaes.)

191.75

47345

Metacarpal, treatment of intra-articular fracture of, by open reduction (H) (Anaes.) (Assist.)

239.55

47348

Carpus (excluding scaphoid), treatment of fracture of, not being a service to which item 47351 applies (Anaes.)

79.75

47351

Carpus (excluding scaphoid), treatment of fracture of, by open reduction (Anaes.)

199.75

47354

Carpal scaphoid, treatment of fracture of, not being a service to which item 47357 applies (Anaes.)

143.80

47357

Carpal scaphoid, treatment of fracture of, by open reduction (Anaes.) (Assist.)

319.55

47360

Radius or ulna, distal end of, treatment of fracture of, by cast immobilisation, not being a service to which item 47363 or 47366 applies (Anaes.)

111.85

47363

Radius or ulna, distal end of, treatment of fracture of, by closed reduction (Anaes.)

167.65

47366

Radius or ulna, distal end of, treatment of fracture of, by open reduction (Anaes.) (Assist.)

223.70

47369

Radius, distal end of, treatment of Colles’, Smith’s or Barton’s fracture of, by cast immobilisation, not being a service to which item 47372 or 47375 applies (Anaes.)

143.80

47372

Radius, distal end of, treatment of Colles’, Smith’s or Barton’s fracture, by closed reduction (Anaes.)

239.55

47375

Radius, distal end of, treatment of Colles’, Smith’s or Barton’s fracture, by open reduction (H) (Anaes.) (Assist.)

319.55

47378

Radius or ulna, shaft of, treatment of fracture of, by cast immobilisation, not being a service to which item 47381, 47384, 47385 or 47386 applies (Anaes.)

143.80

47381

Radius or ulna, shaft of, treatment of fracture of, by closed reduction undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

215.70

47384

Radius or ulna, shaft of, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.)

287.55

47385

Radius or ulna, shaft of, treatment of fracture of, in conjunction with dislocation of distal radio-ulnar joint or proximal radio-humeral joint (Galeazzi or Monteggia injury), by closed reduction undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.) (Assist.)

247.60

47386

Radius or ulna, shaft of, treatment of fracture of, in conjunction with dislocation of distal radio-ulnar joint or proximal radio-humeral joint (Galeazzi or Monteggia injury), by open reduction or internal fixation (H) (Anaes.) (Assist.)

399.35

47387

Radius and ulna, shafts of, treatment of fracture of, by cast immobilisation, not being a service to which item 47390 or 47393 applies (Anaes.) (Assist.)

231.60

47390

Radius and ulna, shafts of, treatment of fracture of, by closed reduction, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

347.50

47393

Radius and ulna, shafts of, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.)

463.30

47396

Olecranon, treatment of fracture of, not being a service to which item 47399 applies (Anaes.)

159.75

47399

Olecranon, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.)

319.55

47402

Olecranon, treatment of fracture of, involving excision of olecranon fragment and reimplantation of tendon (Anaes.) (Assist.)

239.55

47405

Radius, treatment of fracture of head or neck of, closed management of (Anaes.)

159.75

47408

Radius, treatment of fracture of head or neck of, open management of, including internal fixation and excision where performed (H) (Anaes.) (Assist.)

319.55

47411

Humerus, treatment of fracture of tuberosity of, not being a service to which item 47417 applies (Anaes.)

95.80

47414

Humerus, treatment of fracture of tuberosity of, by open reduction (Anaes.)

191.75

47417

Humerus, treatment of fracture of tuberosity of, and associated dislocation of shoulder, by closed reduction (Anaes.) (Assist.)

223.70

47420

Humerus, treatment of fracture of tuberosity of, and associated dislocation of shoulder, by open reduction (H) (Anaes.) (Assist.)

439.40

47423

Humerus, proximal, treatment of fracture of, not being a service to which item 47426, 47429 or 47432 applies (Anaes.)

183.70

47426

Humerus, proximal, treatment of fracture of, by closed reduction, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

275.60

47429

Humerus, proximal, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.)

367.40

47432

Humerus, proximal, treatment of intra-articular fracture of, by open reduction (H) (Anaes.) (Assist.)

459.30

47435

Humerus, proximal, treatment of fracture of, and associated dislocation of shoulder, by closed reduction (Anaes.) (Assist.)

351.50

47438

Humerus, proximal, treatment of fracture of, and associated dislocation of shoulder, by open reduction (H) (Anaes.) (Assist.)

559.25

47441

Humerus, proximal, treatment of intra-articular fracture of, and associated dislocation of shoulder, by open reduction (H) (Anaes.) (Assist.)

699.00

47444

Humerus, shaft of, treatment of fracture of, not being a service to which item 47447 or 47450 applies (Anaes.)

191.75

47447

Humerus, shaft of, treatment of fracture of, by closed reduction, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

287.55

47450

Humerus, shaft of, treatment of fracture of, by internal or external (H) (Anaes.) (Assist.)

383.45

47451

Humerus, shaft of, treatment of fracture of, by intramedullary fixation (H) (Anaes.) (Assist.)

462.25

47453

Humerus, distal, (supracondylar or condylar), treatment of fracture of, not being a service to which item 47456 or 47459 applies (Anaes.) (Assist.)

223.70

47456

Humerus, distal (supracondylar or condylar), treatment of fracture of, by closed reduction, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

335.60

47459

Humerus, distal (supracondylar or condylar), treatment of fracture of, by open reduction, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.) (Assist.)

447.35

47462

Clavicle, treatment of fracture of, not being a service to which item 47465 applies (Anaes.)

95.80

47465

Clavicle, treatment of fracture of, by open reduction (Anaes.)

191.75

47466

Sternum, treatment of fracture of, not being a service to which item 47467 applies (Anaes.)

95.80

47467

Sternum, treatment of fracture of, by open reduction (H) (Anaes.)

191.75

47468

Scapula, neck or glenoid region of, treatment of fracture of, by open reduction (Anaes.) (Assist.)

367.40

47471

Ribs (1 or more), treatment of fracture of — each attendance

36.40

47474

Pelvic ring, treatment of fracture of, not involving disruption of pelvic ring or acetabulum

159.75

47477

Pelvic ring, treatment of fracture of, with disruption of pelvic ring or acetabulum

199.75

47480

Pelvic ring, treatment of fracture of, requiring traction (H) (Anaes.) (Assist.)

399.35

47483

Pelvic ring, treatment of fracture of, requiring control by external fixation (H) (Anaes.) (Assist.)

479.25

47486

Pelvic ring, treatment of fracture of, by open reduction and involving internal fixation of anterior segment, including diastasis of pubic symphysis (H) (Anaes.) (Assist.)

798.85

47489

Pelvic ring, treatment of fracture of, by open reduction and involving internal fixation of posterior segment (including sacro-iliac joint), with or without fixation of anterior segment (H) (Anaes.) (Assist.)

1 198.30

47492

Acetabulum, treatment of fracture of, and associated dislocation of hip (Anaes.)

199.75

47495

Acetabulum, treatment of fracture of, and associated dislocation of hip, requiring traction (Anaes.) (Assist.)

399.35

47498

Acetabulum, treatment of fracture of, and associated dislocation of hip, requiring internal fixation, with or without traction (H) (Anaes.) (Assist.)

599.05

47501

Acetabulum, treatment of single column fracture of, by open reduction and internal fixation, including any osteotomy, osteectomy or capsulotomy required for exposure and subsequent repair (H) (Anaes.) (Assist.)

798.85

47504

Acetabulum, treatment of T-shape fracture of, by open reduction and internal fixation, including any osteotomy, osteectomy or capsulotomy required for exposure and subsequent repair (Anaes.) (Assist.)

1 198.30

47507

Acetabulum, treatment of transverse fracture of, by open reduction and internal fixation, including any osteotomy, osteectomy or capsulotomy required for exposure and subsequent repair (H) (Anaes.) (Assist.)

1 198.30

47510

Acetabulum, treatment of double column fracture of, by open reduction and internal fixation, including any osteotomy, osteectomy or capsulotomy required for exposure and subsequent repair (H) (Anaes.) (Assist.)

1 198.30

47513

Sacro-iliac joint disruption, treatment of, requiring internal fixation, being a service associated with a service to which items 47501 to 47510 apply (H) (Anaes.) (Assist.)

319.55

47516

Femur, treatment of fracture of, by closed reduction or traction (Anaes.) (Assist.)

367.40

47519

Femur, treatment of trochanteric or subcapital fracture of, by internal fixation (H) (Anaes.) (Assist.)

734.95

47522

Femur, treatment of subcapital fracture of, by
hemi-arthroplasty (H) (Anaes.) (Assist.)

639.10

47525

Femur, treatment of fracture of, for slipped capital femoral epiphysis (H) (Anaes.) (Assist.)

734.95

47528

Femur, treatment of fracture of, by internal fixation or external fixation (H) (Anaes.) (Assist.)

639.10

47531

Femur, treatment of fracture of shaft, by intramedullary fixation and cross fixation (H) (Anaes.) (Assist.)

814.75

47534

Femur, condylar region of, treatment of intra-articular
(T-shaped condylar) fracture of, requiring internal fixation, with or without internal fixation of 1 or more osteochondral fragments (H) (Anaes.) (Assist.)

918.65

47537

Femur, condylar region of, treatment of fracture of, requiring internal fixation of 1 or more osteochondral fragments, not being a service associated with a service to which item 47534 applies (Anaes.) (Assist.)

367.40

47540

Hip spica or shoulder spica, application of, as an independent procedure (Anaes.)

183.70

47543

Tibia, plateau of, treatment of medial or lateral fracture of, not being a service to which item 47546 or 47549 applies (Anaes.)

191.75

47546

Tibia, plateau of, treatment of medial or lateral fracture of, by closed reduction (Anaes.)

287.55

47549

Tibia, plateau of, treatment of medial or lateral fracture of, by open reduction (H) (Anaes.) (Assist.)

383.45

47552

Tibia, plateau of, treatment of both medial and lateral fractures of, not being a service to which item 47555 or 47558 applies (Anaes.) (Assist.)

319.55

47555

Tibia, plateau of, treatment of both medial and lateral fractures of, by closed reduction (H) (Anaes.)

479.25

47558

Tibia, plateau of, treatment of both medial and lateral fractures of, by open reduction (H) (Anaes.) (Assist.)

639.10

47561

Tibia, shaft of, treatment of fracture of, by cast immobilisation, not being a service to which item 47564, 47567, 47570 or 47573 applies (Anaes.)

231.60

47564

Tibia, shaft of, treatment of fracture of, by closed reduction, with or without treatment of fibular fracture (Anaes.)

347.50

47565

Tibia, shaft of, treatment of fracture of, by internal fixation or external fixation (H) (Anaes.) (Assist.)

604.45

47566

Tibia, shaft of, treatment of fracture of, by intramedullary fixation and cross fixation (H) (Anaes.) (Assist.)

770.50

47567

Tibia, shaft of, treatment of intra-articular fracture of, by closed reduction, with or without treatment of fibular fracture (Anaes.) (Assist.)

403.35

47570

Tibia, shaft of, treatment of fracture of, by open reduction, with or without treatment of fibular fracture (Anaes.) (Assist.)

463.30

47573

Tibia, shaft of, treatment of intra-articular fracture of, by open reduction, with or without treatment of fibular fracture (H) (Anaes.) (Assist.)

579.10

47576

Fibula, treatment of fracture of (Anaes.)

95.80

47579

Patella, treatment of fracture of, not being a service to which item 47582 or 47585 applies (Anaes.)

135.85

47582

Patella, treatment of fracture of, by excision of patella or pole with reattachment of tendon (H) (Anaes.) (Assist.)

279.65

47585

Patella, treatment of fracture of, by internal fixation (H) (Anaes.) (Assist.)

359.55

47588

Knee joint, treatment of fracture of, by internal fixation of intra-articular fractures of femoral condylar or tibial articular surfaces and requiring repair or reconstruction of 1 or more ligaments (H) (Anaes.) (Assist.)

1 118.25

47591

Knee joint, treatment of fracture of, by internal fixation of intra-articular fractures of femoral condylar and tibial articular surfaces and requiring repair or reconstruction of 1 or more ligaments (H) (Anaes.) (Assist.)

1 358.15

47594

Ankle joint, treatment of fracture of, not being a service to which item 47597 applies (Anaes.)

183.70

47597

Ankle joint, treatment of fracture of, by closed reduction (Anaes.)

275.60

47600

Ankle joint, treatment of fracture of, by internal fixation of 1 of malleolus, fibula or diastasis (H) (Anaes.) (Assist.)

367.40

47603

Ankle joint, treatment of fracture of, by internal fixation of more than 1 of malleolus, fibula or diastasis (H) (Anaes.) (Assist.)

479.25

47606

Calcaneum or talus, treatment of fracture of, not being a service to which item 47609, 47612, 47615 or 47618 applies, with or without dislocation (Anaes.)

199.75

47609

Calcaneum or talus, treatment of fracture of, by closed reduction, with or without dislocation (Anaes.) (Assist.)

299.55

47612

Calcaneum or talus, treatment of intra-articular fracture of, by closed reduction, with or without dislocation (Anaes.) (Assist.)

347.50

47615

Calcaneum or talus, treatment of fracture of, by open reduction, with or without dislocation (Anaes.) (Assist.)

399.35

47618

Calcaneum or talus, treatment of intra-articular fracture of, by open reduction, with or without dislocation (H) (Anaes.) (Assist.)

499.35

47621

Tarso-metatarsal, treatment of intra-articular fracture of, by closed reduction, with or without dislocation (Anaes.) (Assist.)

347.50

47624

Tarso-metatarsal, treatment of fracture of, by open reduction, with or without dislocation (H) (Anaes.) (Assist.)

479.25

47627

Tarsus (excluding calcaneum or talus), treatment of fracture of (Anaes.)

135.85

47630

Tarsus (excluding calcaneum or talus), treatment of fracture of, by open reduction, with or without dislocation (Anaes.) (Assist.)

287.55

47633

Metatarsal, 1 of, treatment of fracture of (Anaes.)

95.80

47636

Metatarsal, 1 of, treatment of fracture of, by closed reduction (Anaes.)

143.80

47639

Metatarsal, 1 of, treatment of fracture of, by open reduction (Anaes.)

191.75

47642

Metatarsals, 2 of, treatment of fracture of (Anaes.)

127.90

47645

Metatarsals, 2 of, treatment of fracture of, by closed reduction (Anaes.)

191.75

47648

Metatarsals, 2 of, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.)

255.50

47651

Metatarsals, 3 or more of, treatment of fracture of (Anaes.)

199.75

47654

Metatarsals, 3 or more of, treatment of fracture of, by closed reduction (Anaes.) (Assist.)

299.55

47657

Metatarsals, 3 or more of, treatment of fracture of, by open reduction (H) (Anaes.) (Assist.)

399.35

47663

Phalanx of great toe, treatment of fracture of, by closed reduction (Anaes.)

119.85

47666

Phalanx of great toe, treatment of fracture of, by open reduction (Anaes.)

199.75

47672

Phalanx of toe (other than great toe), 1 of, treatment of fracture of, by open reduction (Anaes.)

95.80

47678

Phalanx of toe (other than great toe), more than 1 of, treatment of fracture of, by open reduction (Anaes.)

143.80

47681

Spine (excluding sacrum), treatment of fracture of transverse process, vertebral body, or posterior elements — each attendance

36.40

47684

Spine, treatment of fracture, dislocation or fracture-dislocation, without spinal cord involvement, including immobilisation by calipers (Anaes.) (Assist.)

639.10

47687

Spine, treatment of fracture, dislocation or fracture-dislocation, with spinal cord involvement, including immobilisation by calipers, and including up to 14 days post-operative care (H) (Assist.)

1 118.25

47690

Spine, treatment of fracture, dislocation or fracture-dislocation, without cord involvement, including immobilisation by calipers, requiring reduction by closed manipulation (H) (Anaes.) (Assist.)

878.70

47693

Spine, treatment of fracture, dislocation or fracture-dislocation, with cord involvement, including immobilisation by calipers, requiring reduction by closed manipulation, including up to 14 days post-operative care (H) (Assist.)

1 118.25

47696

Spine, reduction of fracture or dislocation of, without cord involvement, undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.) (Assist.)

319.55

47699

Spine, treatment of fracture, dislocation or fracture-dislocation without cord involvement requiring open reduction with or without internal fixation (H) (Anaes.) (Assist.)

1 278.15

47702

Spine, treatment of fracture, dislocation or fracture-dislocation with cord involvement requiring open reduction with or without internal fixation, including up to 14 days post-operative care (H) (Anaes.) (Assist.)

1 597.70

47703

Skull, treatment of fracture of, each attendance

36.40

47705

Skull calipers, insertion of, as an independent procedure (H) (Anaes.) (Assist.)

239.55

47708

Plaster jacket, application of, as an independent procedure (Anaes.)

183.70

47711

Halo, application of, as an independent procedure (H) (Anaes.) (Assist.)

271.70

47714

Halo, application of, in addition to spinal fusion for scoliosis, or other conditions (H) (Anaes.)

203.70

47717

Halo-thoracic traction — application of both halo and thoracic jacket (H) (Anaes.) (Assist.)

359.55

47720

Halo-femoral traction, as an independent procedure (Anaes.) (Assist.)

359.55

47723

Halo-femoral traction in conjunction with a major spine operation (Anaes.) (Assist.)

359.55

47726

Bone graft, harvesting of, via separate incision, in conjunction with another service, autogenous, small quantity (H) (Anaes.)

119.85

47729

Bone graft, harvesting of, via separate incision, in conjunction with another service, autogenous, large quantity (H) (Anaes.)

199.75

47732

Vascularised pedicle bone graft, harvesting of, in conjunction with another service (H) (Anaes.) (Assist.)

319.55

47735

Nasal bones, treatment of fracture of, not being a service to which item 47738 or 47741 applies — each attendance

36.40

47738

Nasal bones, treatment of fracture of, by reduction (Anaes.)

199.75

47741

Nasal bones, treatment of fracture of, by open reduction involving osteotomies (H) (Anaes.) (Assist.)

407.55

47753

Maxilla, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.)

345.05

47756

Mandible, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (H) (Anaes.) (Assist.)

345.05

47762

Zygomatic bone, treatment of fracture of, requiring surgical reduction by a temporal, intra-oral or other approach (Anaes.)

202.65

47765

Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at 1 site (H) (Anaes.) (Assist.)

332.70

47768

Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 2 sites (H) (Anaes.) (Assist.)

407.55

47771

Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 3 sites (H) (Anaes.) (Assist.)

468.20

47774

Maxilla, treatment of fracture of, requiring open operation (H) (Anaes.) (Assist.)

369.70

47777

Mandible, treatment of fracture of, requiring open reduction (H) (Anaes.) (Assist.)

369.70

47780

Maxilla, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (H) (Anaes.) (Assist.)

480.55

47783

Mandible, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.)

480.55

47786

Maxilla, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (H) (Anaes.) (Assist.)

609.85

47789

Mandible, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (H) (Anaes.) (Assist.)

609.85

47900

Bone cyst, injection into or aspiration of (Anaes.)

143.80

47903

Epicondylitis, open operation for (Anaes.)

199.75

47904

Digital nail of toe, removal of, not being a service to which item 47906 applies (Anaes.)

47.95

47906

Digital nail of toe, removal of, in the operating theatre of a hospital or approved day hospital facility (Anaes.)

95.80

47912

Pulp space infection, paronychia of foot, incision for, not being a service to which another item in this group applies (excluding after-care) (Anaes.)

47.95

47915

Ingrowing nail of toe, wedge resection for, including removal of segment of nail, ungual fold and portion of the nail bed (Anaes.)

143.80

47916

Ingrowing nail of toe, partial resection of nail, including phenolisation but not including excision of nail bed (Anaes.)

72.25

47918

Ingrowing toenail, radical excision of nailbed (Anaes.)

199.75

47920

Bone growth stimulator, insertion of (H) (Anaes.) (Assist.)

323.10

47921

Orthopaedic pin or wire, insertion of, as an independent procedure (Anaes.)

95.80

47924

Buried wire, pin or screw, 1 or more of, which were inserted for internal fixation purposes, removal of requiring incision and suture, not being a service to which item 47927 or 47930 applies — per bone (Anaes.)

31.90

47927

Buried wire, pin or screw, 1 or more of, which were inserted for internal fixation purposes, removal of, in the operating theatre of a hospital or approved day hospital facility — per bone (Anaes.)

119.85

47930

Plate, rod or nail and associated wires, pins or screws, 1 or more of, all of which were inserted for internal fixation purposes, removal of, not being a service associated with a service to which item 47924 or 47927 applies — per bone (H) (Anaes.) (Assist.)

223.70

47933

Exostosis of small bone, excision of, including simple removal of bunion and any associated bursa (Anaes.)

175.70

47936

Exostosis of large bone, excision of (H) (Anaes.) (Assist.)

215.70

47948

External fixation, removal of, in the operating theatre of a hospital or approved day hospital facility (Anaes.)

135.85

47951

External fixation, removal of, in conjunction with operations involving internal fixation or bone grafting or both (Anaes.)

159.75

47954

Tendon, repair of, not being a service to which another item in this group applies (Anaes.) (Assist.)

319.55

47957

Tendon, large, lengthening of, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

239.55

47960

Tenotomy, subcutaneous, not being a service to which another item in this group applies (Anaes.)

111.85

47963

Tenotomy, open, with or without tenoplasty, not being a service to which another item in this group applies (Anaes.)

183.70

47966

Tendon or ligament transfer, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

367.40

47969

Tenosynovectomy, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

223.70

47972

Tendon sheath, open operation for teno-vaginitis, not being a service to which another item in this group applies (H) (Anaes.)

178.70

47975

Forearm or calf, decompression fasciotomy of, for acute compartment syndrome, requiring excision of muscle and deep tissue (H) (Anaes.) (Assist.)

313.20

47978

Forearm or calf, decompression fasciotomy of, for chronic compartment syndrome, requiring excision of muscle and deep tissue (H) (Anaes.)

190.25

47981

Forearm, calf or interosseous muscle space of hand, decompression fasciotomy of, not being a service to which another item in this group applies (Anaes.)

127.70

47982

Forage (Drill decompression), of neck or head of femur, or both (H) (Anaes.) (Assist.)

309.60

48200

Femur, bone graft to (H) (Anaes.) (Assist.)

639.10

48203

Femur, bone graft to, with internal fixation (H) (Anaes.) (Assist.)

774.90

48206

Tibia, bone graft to (H) (Anaes.) (Assist.)

479.75

48209

Tibia, bone graft to, with internal fixation (H) (Anaes.) (Assist.)

615.10

48212

Humerus, bone graft to (H) (Anaes.) (Assist.)

479.75

48215

Humerus, bone graft to, with internal fixation (H) (Anaes.) (Assist.)

615.10

48218

Radius or ulna, bone graft to (H) (Anaes.) (Assist.)

479.75

48221

Radius and ulna, bone graft to, with internal fixation of 1 or both bones (H) (Anaes.) (Assist.)

639.10

48224

Radius or ulna, bone graft to (H) (Anaes.) (Assist.)

319.55

48227

Radius or ulna, bone graft to, with internal fixation of 1 or both bones (H) (Anaes.) (Assist.)

415.40

48230

Scaphoid, bone graft to, for non-union (H) (Anaes.) (Assist.)

359.55

48233

Scaphoid, bone graft to, for non-union, with internal fixation (H) (Anaes.) (Assist.)

519.25

48236

Scaphoid, bone graft to, for mal-union, including osteotomy, bone graft and internal fixation (H) (Anaes.) (Assist.)

679.00

48239

Bone graft, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

375.40

48242

Bone graft, with internal fixation, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

519.25

48400

Phalanx, metatarsal, accessory bone or sesamoid bone, osteotomy or osteectomy of, excluding services to which item 49848 or 49851 applies (H) (Anaes.) (Assist.)

279.65

48403

Phalanx or metatarsal, osteotomy or osteectomy of, with internal fixation (H) (Anaes.) (Assist.)

439.40

48406

Fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, osteotomy or osteectomy of (H) (Anaes.) (Assist.)

279.65

48409

Fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, osteotomy or osteectomy, with internal fixation (H) (Anaes.) (Assist.)

439.40

48412

Humerus, osteotomy or osteectomy of (H) (Anaes.) (Assist.)

535.10

48415

Humerus, osteotomy or osteectomy of, with internal fixation (H) (Anaes.) (Assist.)

679.00

48418

Tibia, osteotomy or osteectomy of (H) (Anaes.) (Assist.)

535.10

48421

Tibia, osteotomy or osteectomy of, with internal fixation (H) (Anaes.) (Assist.)

679.00

48424

Femur or pelvis, osteotomy or osteectomy of (H) (Anaes.) (Assist.)

639.10

48427

Femur or pelvis, osteotomy or osteectomy of, with internal fixation (H) (Anaes.) (Assist.)

774.90

48500

Femur, epiphysiodesis of (H) (Anaes.) (Assist.)

279.65

48503

Tibia and fibula, epiphysiodesis of (H) (Anaes.) (Assist.)

279.65

48506

Femur, tibia and fibula, epiphysiodesis of (H) (Anaes.) (Assist.)

415.40

48509

Epiphysiodesis, staple arrest of hemi-epiphysis (H) (Anaes.)

199.75

48512

Epiphysiolysis, operation to prevent closure of plate (H) (Anaes.) (Assist.)

758.85

48600

Spine, manipulation of, performed in the operating theatre of a hospital or approved day hospital facility (Anaes.)

79.75

48603

Spine, manipulation of, under epidural anaesthesia, with or without steroid injection, where the manipulation and the administration of the epidural anaesthetic are performed by the same medical practitioner in the operating theatre of a hospital or approved day hospital facility, not being a service associated with a service to which item 48600 or 50115 applies (Anaes.)

119.85

48606

Scoliosis or Kyphosis, spinal fusion for (without instrumentation) (H) (Anaes.) (Assist.)

1 118.25

48609

Scoliosis or Kyphosis, spinal fusion for, using Harrington or other non-segmental fixation (H) (Anaes.) (Assist.)

1 397.95

48612

Scoliosis, spinal fusion for, using segmental instrumentation (C D, Zielke, Luque, or similar) (H) (Anaes.) (Assist.)

2 076.95

48613

Scoliosis or Kyphosis, spinal fusion for, using segmental instrumentation, reconstruction using separate anterior and posterior approaches (H) (Anaes.) (Assist.)

2 954.25

48615

Scoliosis, re-exploration for, involving adjustment or removal of instrumentation or simple bone grafting procedure (H) (Anaes.) (Assist.)

375.40

48618

Scoliosis, revision of failed scoliosis surgery, involving more than 1 of multiple osteotomy, fusion or instrumentation (H) (Anaes.) (Assist.)

2 076.95

48621

Scoliosis, anterior correction of, with fusion and segmental fixation (Dwyer, Zielke, or similar) — not more than 4 levels (H) (Anaes.) (Assist.)

1 358.15

48624

Scoliosis, anterior correction of, with fusion and segmental fixation (Dwyer, Zielke or similar) — more than 4 levels (H) (Anaes.) (Assist.)

1 677.65

48627

Scoliosis, spinal fusion for, combined with segmental instrumentation (C D, Zielke or similar) down to and including pelvis (H) (Anaes.) (Assist.)

2 156.75

48630

Scoliosis, requiring anterior decompression of spinal cord with resection of vertebrae including bone graft and instrumentation in the presence of spinal cord involvement (H) (Anaes.) (Assist.)

2 396.45

48632

Scoliosis, congenital, vertebral resection and fusion for (H) (Anaes.) (Assist.)

1 324.70

48636

Percutaneous lumbar discectomy, 1 or more levels, not being a service associated with intradiscal electrothermal annuloplasty (Anaes.) (Assist.)

686.90

48639

Vertebral body, total or sub-total excision of, including bone grafting or other form of fixation (H) (Anaes.) (Assist.)

1 158.25

48640

Vertebral body, disease of, excision and spinal fusion for, using segmental instrumentation, reconstruction utilising separate anterior and posterior approaches (H) (Anaes.) (Assist.)

2 954.25

48642

Spine, posterior, bone graft to, not being a service to which item 48648 or 48651 applies — 1 or 2 levels (H) (Anaes.) (Assist.)

679.00

48645

Spine, posterior, bone graft to, not being a service to which item 48648 or 48651 applies — more than 2 levels (H) (Anaes.) (Assist.)

918.65

48648

Spine, bone graft to, (postero-lateral fusion) — 1 or 2 levels (H) (Anaes.) (Assist.)

918.65

48651

Spine, bone graft to, (postero-lateral fusion) — more than 2 levels (H) (Anaes.) (Assist.)

1 278.15

48654

Spinal fusion (posterior interbody), with laminectomy — 1 level (H) (Anaes.) (Assist.)

918.65

48657

Spinal fusion (posterior interbody), with laminectomy — more than 1 level (H) (Anaes.) (Assist.)

1 278.15

48660

Spinal fusion (anterior interbody) to cervical, thoracic or lumbar regions — 1 level (H) (Anaes.) (Assist.)

918.65

48663

Spinal fusion (anterior interbody) to cervical, thoracic or lumbar regions — 1 level (where an assisting surgeon performs the approach) — principal surgeon (H) (Anaes.) (Assist.)

686.90

48666

Spinal fusion (anterior interbody) to cervical, thoracic or lumbar regions — 1 level (where an assisting surgeon performs the approach) — assisting surgeon (H) (Assist.)

415.40

48669

Spinal fusion (anterior interbody) to cervical, thoracic or lumbar regions — more than 1 level (H) (Anaes.) (Assist.)

1 238.20

48672

Spinal fusion (anterior interbody) to cervical, thoracic or lumbar regions — more than 1 level (where an assisting surgeon performs the approach) — principal surgeon (H) (Anaes.) (Assist.)

926.75

48675

Spinal fusion (anterior interbody) to cervical, thoracic or lumbar regions — more than 1 level (where an assisting surgeon performs the approach) — assisting surgeon (H) (Assist.)

559.25

48678

Spine, simple internal fixation of, involving 1 or more of facetal screw, wire loop or similar, being a service associated with a service to which items 48642 to 48675 apply (H) (Anaes.) (Assist.)

479.75

48681

Spine, non-segmental internal fixation of (Harrington or similar), other than for scoliosis, being a service associated with a service to which any one of items 48642 to 48675 applies (H) (Anaes.) (Assist.)

798.85

48684

Spine, segmental internal fixation of, other than for scoliosis, being a service associated with a service to which any one of items 48642 to 48675 applies — 1 or 2 levels (H) (Anaes.) (Assist.)

798.85

48687

Spine, segmental internal fixation of, other than for scoliosis, being a service associated with a service to which items 48642 to 48675 apply — 3 or 4 levels (H) (Anaes.) (Assist.)

1 118.25

48690

Spine, segmental internal fixation of, other than for scoliosis, being a service associated with a service to which items 48642 to 48675 apply — more than 4 levels (H) (Anaes.) (Assist.)

1 278.15

48900

Shoulder, excision of coraco-acromial ligament or removal of calcium deposit from cuff or both (Anaes.) (Assist.)

239.55

48903

Shoulder, decompression of subacromial space by acromioplasty, excision of coraco-acromial ligament and distal clavicle, or any combination (H) (Anaes.) (Assist.)

479.25

48906

Shoulder, repair of rotator cuff, including excision of coraco-acromial ligament or removal of calcium deposit from cuff, or both — not being a service associated with a service to which item 48900 applies (H) (Anaes.) (Assist.)

479.25

48909

Shoulder, repair of rotator cuff, including decompression of subacromial space by acromioplasty, excision of coraco-acromial ligament and distal clavicle, or any combination, not being a service associated with a service to which item 48903 applies (H) (Anaes.) (Assist.)

639.10

48912

Shoulder, arthrotomy of (Anaes.) (Assist.)

279.65

48915

Shoulder, hemi-arthroplasty of (H) (Anaes.) (Assist.)

639.10

48918

Shoulder, total replacement arthroplasty of, including any associated rotator cuff repair (H) (Anaes.) (Assist.)

1 278.15

48921

Shoulder, total replacement arthroplasty, revision of (H) (Anaes.) (Assist.)

1 318.05

48924

Shoulder, total replacement arthroplasty, revision of, requiring bone graft to scapula or humerus, or both (H) (Anaes.) (Assist.)

1 517.85

48927

Shoulder prosthesis, removal of (H) (Anaes.) (Assist.)

311.45

48930

Shoulder, stabilisation procedure for recurrent anterior or posterior dislocation (H) (Anaes.) (Assist.)

639.10

48933

Shoulder, stabilisation procedure for multi-directional instability, anterior or posterior (or both) repair when performed (H) (Anaes.) (Assist.)

838.80

48936

Shoulder, synovectomy of, as an independent procedure (H) (Anaes.) (Assist.)

639.10

48939

Shoulder, arthrodesis of (H) (Anaes.) (Assist.)

918.65

48942

Shoulder, arthrodesis of, including removal of prosthesis, requiring bone grafting or internal fixation (H) (Anaes.) (Assist.)

1 198.30

48945

Shoulder, diagnostic arthroscopy of (including biopsy) — not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.)

231.60

48948

Shoulder, arthroscopic surgery of, involving any 1 or more of: removal of loose bodies; decompression of calcium deposit; debridement of labrum, synovium or rotator cuff; or chondroplasty — not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.)

519.25

48951

Shoulder, arthroscopic division of coraco-acromial ligament including acromioplasty — not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.)

758.85

48954

Shoulder, arthroscopic total synovectomy of, including release of contracture when performed — not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.)

798.85

48957

Shoulder, arthroscopic stabilisation of, for recurrent instability including labral repair or reattachment when performed — not being a service associated with any other arthroscopic procedure of the shoulder region (H) (Anaes.) (Assist.)

918.65

48960

Shoulder, reconstruction or repair of, including repair of rotator cuff by arthroscopic, arthroscopic assisted or mini open means; arthroscopic acromioplasty; or resection of acromioclavicular joint by separate approach when performed — not being a service associated with any other procedure of the shoulder region (H) (Anaes.) (Assist.)

798.85

49100

Elbow, arthrotomy of, involving 1 or more of lavage, removal of loose body or division of contracture (H) (Anaes.) (Assist.)

279.65

49103

Elbow, ligamentous stabilisation of (H) (Anaes.) (Assist.)

599.05

49106

Elbow, arthrodesis of (Anaes.) (Assist.)

798.85

49109

Elbow, total synovectomy of (H) (Anaes.) (Assist.)

599.05

49112

Elbow, silastic or other replacement of radial head (H) (Anaes.) (Assist.)

599.05

49115

Elbow, total joint replacement of (H) (Anaes.) (Assist.)

958.55

49118

Elbow, diagnostic arthroscopy of, including biopsy (H) (Anaes.) (Assist.)

231.60

49121

Elbow, arthroscopic surgery involving any 1 or more of: drilling of defect; removal of loose body; release of contracture or adhesions; chondroplasty; or osteoplasty — not being a service associated with any other arthroscopic procedure of the elbow (H) (Anaes.) (Assist.)

519.25

49200

Wrist, arthrodesis of, including bone graft, with or without internal fixation of the radiocarpal joint (H) (Anaes.) (Assist.)

694.90

49203

Wrist, limited arthrodesis of the intercarpal joint, including bone graft (H) (Anaes.) (Assist.)

519.25

49206

Wrist, proximal carpectomy of, including styloidectomy when performed (H) (Anaes.) (Assist.)

479.25

49209

Wrist, total replacement arthroplasty of (H) (Anaes.) (Assist.)

639.10

49212

Wrist, arthrotomy of (H) (Anaes.)

199.75

49215

Wrist, reconstruction of, including repair of single or multiple ligaments or capsules, including associated arthrotomy (H) (Anaes.) (Assist.)

551.25

49218

Wrist, diagnostic arthroscopy of, including radiocarpal or midcarpal joints, or both (including biopsy) — not being a service associated with any other arthroscopic procedure of the wrist joint (H) (Anaes.) (Assist.)

231.60

49221

Wrist, arthroscopic surgery of, involving any 1 or more of: drilling of defect; removal of loose body, release of adhesions; local synovectomy; or debridement of 1 area — not being a service associated with any other arthroscopic procedure of the wrist joint (H) (Anaes.) (Assist.)

519.25

49224

Wrist, arthroscopic debridement of: 2 or more distinct areas; or osteoplasty including excision of the distal ulna; or total synovectomy (H) (Anaes.) (Assist.)

599.05

49227

Wrist, arthroscopic pinning of osteochondral fragment or stabilisation procedure for ligamentous disruption — not being a service associated with any other arthroscopic procedure of the wrist joint (H) (Anaes.) (Assist.)

599.05

49300

Sacro-iliac joint — arthrodesis of (H) (Anaes.) (Assist.)

442.25

49303

Hip, arthrotomy of, including lavage, drainage or biopsy when performed (H) (Anaes.) (Assist.)

463.30

49306

Hip-arthrodesis of (H) (Anaes.) (Assist.)

918.65

49309

Hip, arthrectomy or excision arthroplasty of, including removal of prosthesis (Austin Moore or similar (non cement)) (H) (Anaes.) (Assist.)

639.10

49312

Hip, arthrectomy or excision arthroplasty of, including removal of prosthesis (cemented, porous coated or similar) (H) (Anaes.) (Assist.)

798.85

49315

Hip, arthroplasty of, unipolar or bipolar (H) (Anaes.) (Assist.)

719.00

49318

Hip, total replacement arthroplasty of, including minor bone grafting (H) (Anaes.) (Assist.)

1 118.25

49319

Hip, total replacement arthroplasty of, including associated minor grafting, if performed — bilateral (H) (Anaes.) (Assist.)

1 964.50

49321

Hip, total replacement arthroplasty of, including major bone grafting, including obtaining of graft (H) (Anaes.) (Assist.)

1 358.15

49324

Hip, total replacement arthroplasty of, revision procedure including removal of prosthesis (H) (Anaes.) (Assist.)

1 597.70

49327

Hip, total replacement arthroplasty of, revision procedure requiring bone grafting to acetabulum, including obtaining of graft (H) (Anaes.) (Assist.)

1 837.30

49330

Hip, total replacement arthroplasty of, revision procedure requiring bone grafting to femur, including obtaining of graft (H) (Anaes.) (Assist.)

1 837.30

49333

Hip, total replacement arthroplasty of, revision procedure requiring bone grafting to both acetabulum and femur, including obtaining of graft (H) (Anaes.) (Assist.)

2 076.95

49336

Hip, treatment of a fracture of the femur where revision total hip replacement is required as part of the treatment of the fracture (not including intra-operative fracture), being a service associated with a service to which items 49324 to 49333 apply (H) (Anaes.) (Assist.)

303.50

49339

Hip, revision total replacement of, requiring anatomic specific allograft of proximal femur greater than 5 cm in length (H) (Anaes.) (Assist.)

2 356.45

49342

Hip, revision total replacement of, requiring anatomic specific allograft of acetabulum (H) (Anaes.) (Assist.)

2 356.45

49345

Hip, revision total replacement of, requiring anatomic specific allograft of both femur and acetabulum (H) (Anaes.) (Assist.)

2 795.90

49346

Hip, revision arthroplasty with replacement of acetabular liner or ceramic head, not requiring removal of femoral component or acetabular shell (H) (Anaes.) (Assist.)

719.00

49360

Hip, diagnostic arthroscopy of (H) (Anaes.) (Assist.)

291.85

49363

Hip, diagnostic arthroscopy of, with synovial biopsy (H) (Anaes.) (Assist.)

351.45

49366

Hip, arthroscopic surgery of (Anaes.) (Assist.)

519.25

49500

Knee, arthrotomy of, involving 1 or more of; capsular release, biopsy or lavage, or removal of loose body or foreign body (H) (Anaes.) (Assist.)

319.55

49503

Knee, meniscectomy of, repair of collateral or cruciate ligament, patellectomy of, chondroplasty of, osteoplasty of, patello-femoral stabilisation or single transfer of ligament or tendon or any other single procedure (not being a service to which another item in this group applies) — any 1 procedure (H) (Anaes.) (Assist.)

415.40

49506

Knee, meniscectomy of, repair of collateral or cruciate ligament, patellectomy of, chondroplasty of, osteoplasty of, patello-femoral stabilisation or single transfer of ligament or tendon or any other single procedure (not being a service to which another item in this group applies) — any 2 or more procedures (H) (Anaes.) (Assist.)

623.10

49509

Knee, total synovectomy or arthrodesis of (H) (Anaes.) (Assist.)

639.10

49512

Knee, arthrodesis of, with removal of prosthesis (H) (Anaes.) (Assist.)

918.65

49515

Knee, removal of prosthesis, cemented or uncemented, including associated cement, as the first stage of a 2 stage procedure (H) (Anaes.) (Assist.)

719.00

49517

Knee, hemiarthroplasty of (H) (Anaes.) (Assist.)

1 023.60

49518

Knee, total replacement arthroplasty of (H) (Anaes.) (Assist.)

1 118.25

49519

Knee, total replacement arthroplasty of, including associated minor grafting, if performed — bilateral (H) (Anaes.) (Assist.)

1 964.50

49521

Knee, total replacement arthroplasty of, requiring major bone grafting to femur or tibia, including obtaining of graft (H) (Anaes.) (Assist.)

1 358.15

49524

Knee, total replacement arthroplasty of, requiring major bone grafting to femur and tibia, including obtaining of graft (H) (Anaes.) (Assist.)

1 597.70

49527

Knee, total replacement arthroplasty of, revision procedure, including removal of prosthesis (H) (Anaes.) (Assist.)

1 358.15

49530

Knee, total replacement arthroplasty of, revision procedure, requiring bone grafting to femur or tibia, including obtaining of graft and including removal of prosthesis (H) (Anaes.) (Assist.)

1 677.65

49533

Knee, total replacement arthroplasty of, revision procedure, requiring bone grafting to both femur and tibia, including obtaining of graft and including removal of prosthesis (H) (Anaes.) (Assist.)

1 917.25

49534

Knee, patello-femoral joint of, total replacement arthroplasty as a primary procedure (H) (Anaes.) (Assist.)

381.35

49536

Knee, repair or reconstruction of, for chronic instability (open or arthroscopic, or both) involving either cruciate or collateral ligaments, including notchplasty when performed (H) (Anaes.) (Assist.)

798.85

49539

Knee, reconstructive surgery of cruciate ligaments (open or arthroscopic, or both), including notchplasty when performed and surgery to other internal derangements, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

798.85

49542

Knee, reconstructive surgery of cruciate ligaments (open or arthroscopic, or both), including notchplasty, meniscus repair, extracapsular procedure and debridement when performed (H) (Anaes.) (Assist.)

1 118.25

49545

Knee, revision arthrodesis of (H) (Anaes.) (Assist.)

639.10

49548

Knee, revision of patello-femoral stabilisation (H) (Anaes.) (Assist.)

798.85

49551

Knee, revision of procedures to which item 49536, 49539 or 49542 applies (H) (Anaes.) (Assist.)

1 118.25

49554

Knee, revision of total replacement of, by anatomic specific allograft of tibia or femur (H) (Anaes.) (Assist.)

1 597.70

49557

Knee, diagnostic arthroscopy of (including biopsy, simple trimming of meniscal margin or plica) — not being a service associated with any other arthroscopic procedure of the knee region (H) (Anaes.) (Assist.)

231.60

49558

Knee, arthroscopic surgery of, involving 1 or more of debridement, osteoplasty or chrondroplasty — not associated with any other arthroscopic procedure of the knee region (H) (Anaes.) (Assist.)

231.60

49559

Knee, arthroscopic surgery of, involving chrondroplasty requiring multiple drilling or carbon fibre (or similar) implant, including any associated debridement or osteoplasty — not associated with any other arthroscopic procedure of the knee region (H) (Anaes.) (Assist.)

346.75

49560

Knee, arthroscopic surgery of, involving 1 or more of meniscectomy, removal of loose body or lateral release — not being a service associated with any other arthroscopic procedure of the knee region (H) (Anaes.) (Assist.)

468.05

49561

Knee, arthroscopic surgery of, involving 1 or more of meniscectomy, removal of loose body or lateral release, where the procedure includes associated debridement, osteoplasty or chrondroplasty — not associated with any other arthroscopic procedure of the knee region (H) (Anaes.) (Assist.)

571.95

49562

Knee, arthroscopic surgery of, involving 1 or more of meniscectomy, removal of loose body or lateral release, where the procedure includes chondroplasty requiring multiple drilling or carbon fibre (or similar) implant and associated debridement or osteoplasty — not associated with any other arthroscopic procedure of the knee region (H) (Anaes.) (Assist.)

624.05

49563

Knee, arthroscopic surgery of, involving 1 or more of meniscus repair, osteochondral graft; or chondral graft — not associated with any other arthroscopic procedure of the knee region (H) (Anaes.) (Assist.)

675.95

49564

Knee, patello-femoral stabilisation of, combined arthroscopic and open procedure, including lateral release, medial capsulorrhaphy and tendon transfer (H) (Anaes.) (Assist.)

779.75

49566

Knee, arthroscopic total synovectomy of (H) (Anaes.) (Assist.)

639.10

49569

Knee, mobilisation for post-traumatic stiffness, by multiple muscle or tendon release (quadricepsplasty) (H) (Anaes.) (Assist.)

639.10

49700

Ankle, diagnostic arthroscopy of, including biopsy (H) (Anaes.) (Assist.)

231.60

49703

Ankle, arthroscopic surgery of (H) (Anaes.) (Assist.)

519.25

49706

Ankle, arthrotomy of, involving 1 or more of: lavage, removal of loose body or division of contracture (H) (Anaes.) (Assist.)

279.65

49709

Ankle, ligamentous stabilisation of (H) (Anaes.) (Assist.)

599.05

49712

Ankle, arthrodesis of (H) (Anaes.) (Assist.)

639.10

49715

Ankle, total joint replacement of (H) (Anaes.) (Assist.)

958.55

49718

Ankle, Achilles’ tendon or other major tendon, repair of (H) (Anaes.) (Assist.)

319.55

49721

Ankle, Achilles’ tendon rupture managed by
non-operative treatment

199.75

49724

Ankle, Achilles’ tendon, secondary repair or reconstruction of (H) (Anaes.) (Assist.)

559.25

49727

Ankle, Achilles’ tendon, operation for lengthening (H) (Anaes.) (Assist.)

239.55

49800

Foot, flexor or extensor tendon, primary repair of (Anaes.)

111.85

49803

Foot, flexor or extensor tendon, secondary repair of (Anaes.)

143.80

49806

Foot, subcutaneous tenotomy of, 1 or more tendons (Anaes.)

111.85

49809

Foot, open tenotomy of, with or without tenoplasty (H) (Anaes.)

183.70

49812

Foot, tendon or ligament transplantation of, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

367.40

49815

Foot, triple arthrodesis of (H) (Anaes.) (Assist.)

639.10

49818

Foot, excision of calcaneal spur (H) (Anaes.) (Assist.)

231.60

49821

Foot, correction of hallux valgus or hallux rigidus by excision arthroplasty (Keller’s or similar procedure) — unilateral (H) (Anaes.) (Assist.)

367.40

49824

Foot, correction of hallux valgus or hallux rigidus by excision arthroplasty (Keller’s or similar procedure) — bilateral (H) (Anaes.) (Assist.)

643.10

49827

Foot, correction of hallux valgus by transfer of adductor hallucis tendon — unilateral (H) (Anaes.) (Assist.)

399.35

49830

Foot, correction of hallux valgus by transfer of adductor hallucis tendon — bilateral (H) (Anaes.) (Assist.)

699.00

49833

Foot, correction of hallux valgus by osteotomy of first metatarsal including internal fixation where performed — unilateral (H) (Anaes.) (Assist.)

439.40

49836

Foot, correction of hallux valgus by osteotomy of first metatarsal including internal fixation where performed — bilateral (H) (Anaes.) (Assist.)

758.85

49837

Foot, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, including internal fixation if performed — unilateral (H) (Anaes.) (Assist.)

549.20

49838

Foot, correction of hallux valgus by osteotomy of first metatarsal and transfer of adductor hallicus tendon, including internal fixation if performed — bilateral (H) (Anaes.) (Assist.)

948.45

49839

Foot, correction of hallux rigidus or hallux valgus by prosthetic arthroplasty — unilateral (H) (Anaes.) (Assist.)

439.40

49842

Foot, correction of hallux rigidus or hallux valgus by prosthetic arthroplasty — bilateral (H) (Anaes.) (Assist.)

758.85

49845

Foot, arthrodesis of, first metatarso-phalangeal joint (H) (Anaes.) (Assist.)

399.35

49848

Foot, correction of claw or hammer toe (Anaes.)

135.85

49851

Foot, correction of claw or hammer toe with internal fixation (H) (Anaes.)

175.70

49854

Foot, radical plantar fasciotomy or fasciectomy of (H) (Anaes.) (Assist.)

319.55

49857

Foot, metatarso-phalangeal joint replacement (H) (Anaes.) (Assist.)

295.55

49860

Foot, synovectomy of metatarso-phalangeal joint, single joint (H) (Anaes.) (Assist.)

239.55

49863

Foot, synovectomy of metatarso-phalangeal joint, 2 or more joints (H) (Anaes.) (Assist.)

359.55

49866

Foot, neurectomy for plantar or digital neuritis (Morton’s or Bett’s syndrome) (H) (Anaes.) (Assist.)

255.50

49878

Talipes equinovarus, calcaneo valgus or metatarsus varus, treatment by cast, splint or manipulation — each attendance (Anaes.)

47.95

50100

Joint, diagnostic arthroscopy of (including biopsy), not being a service to which another item in this group applies and not being a service associated with any other arthroscopic procedure (Anaes.) (Assist.)

231.60

50102

Joint, arthroscopic surgery of, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

519.25

50103

Joint, arthrotomy of, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

279.65

50104

Joint, synovectomy of, not being a service to which another item in this group applies (Anaes.) (Assist.)

265.00

50106

Joint, stabilisation of, involving 1 or more of: repair of capsule, repair of ligament or internal fixation, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

399.35

50109

Joint, arthrodesis of, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

399.35

50112

Cicatricial flexion or extension contraction of joint, correction of, involving tissues deeper than skin and subcutaneous tissue, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

306.35

50115

Joint or joints, manipulation of, performed in the operating theatre of a hospital or approved day hospital facility, not being a service associated with a service to which another item in this group applies (Anaes.)

119.85

50118

Subtalar joint, arthrodesis of (H) (Anaes.) (Assist.)

367.40

50121

Greater trochanter, transplantation of ileopsoas tendon to (H) (Anaes.) (Assist.)

719.00

50124

Joint or other synovial cavity, aspiration of, or injection into, or both of these procedures — payable on not more than 25 occasions in any 12 month period (Anaes.)

25.10

50125

Joint or other synovial cavity, aspiration of, or injection into, or both of these procedures — where it can be demonstrated that a 26th or subsequent treatment (including any treatments to which item 50124 applies) is indicated in a 12 month period (Anaes.)

25.10

50127

Joint or joints, arthroplasty of, by any technique not being a service to which another item applies (H) (Anaes.) (Assist.)

596.10

50130

Joint or joints, application of external fixator to, other than for treatment of fractures (H) (Anaes.) (Assist.)

265.00

50200

Aggressive or potentially malignant bone or deep soft tissue tumour, biopsy of (not including after-care) (Anaes.)

159.75

50201

Aggressive or potentially malignant bone or deep soft tissue tumour involving neurovascular structures, open biopsy of (not including after-care) (Anaes.) (Assist.)

279.55

50203

Bone or malignant deep soft tissue tumour, lesional or marginal excision of (Anaes.) (Assist.)

351.50

50206

Bone tumour, lesional or marginal excision of, combined with any 1 of the following:

 (a) liquid nitrogen freezing;

 (b) autograft;

 (c) allograft;

 (d) cementation

(H) (Anaes.) (Assist.)

519.25

50209

Bone tumour, lesional or marginal excision of, combined with any 2 or more of the following:

 (a) liquid nitrogen freezing;

 (b) autograft;

 (c) allograft;

 (d) cementation

(H) (Anaes.) (Assist.)

639.10

50212

Malignant or aggressive soft tissue tumour affecting the long bones of leg or arm, enbloc resection of, with compartmental or wide excision of soft tissue, without reconstruction (H) (Anaes.) (Assist.)

1 397.95

50215

Malignant or aggressive soft tissue tumour affecting the long bones of leg or arm, enbloc resection of, with compartmental or wide excision of soft tissue, with intercalary reconstruction (prosthesis, allograft or autograft) (H) (Anaes.) (Assist.)

1 757.45

50218

Malignant tumour of long bone, enbloc resection of, with replacement or arthrodesis of adjacent joint (H) (Anaes.) (Assist.)

2 316.65

50221

Malignant or aggressive soft tissue tumour of pelvis, sacrum or spine; or scapula and shoulder, enbloc resection of (H) (Anaes.) (Assist.)

2 156.75

50224

Malignant or aggressive soft tissue tumour of pelvis, sacrum or spine; or scapula and shoulder, enbloc resection of, with reconstruction by prosthesis, allograft or autograft (Anaes.) (Assist.)

2 396.45

50227

Malignant bone tumour, enbloc resection of, with massive anatomic specific allograft or autograft, with or without prosthetic replacement (H) (Anaes.) (Assist.)

2 795.90

50230

Benign tumour, resection of, requiring anatomic specific allograft, with or without internal fixation (H) (Anaes.) (Assist.)

1 437.85

50233

Malignant tumour, amputation for, hemipelvectomy or interscapulo-thoracic (H) (Anaes.) (Assist.)

1 837.30

50236

Malignant tumour, amputation for, hip disarticulation, shoulder disarticulation or proximal third femur (H) (Anaes.) (Assist.)

1 437.85

50239

Malignant tumour, amputation for, not being a service to which another item in this group applies (H) (Anaes.) (Assist.)

958.55

50300

Joint deformity, slow correction of, using ring fixator or similar device, including all associated attendances — payable only once in any 12 month period (H) (Anaes.) (Assist.)

982.25

50303

Limb lengthening, up to and including 5 cm, requiring slow distraction under general anaesthesia in the operating theatre of a hospital or approved day hospital facility, with or without application of a ring fixator or similar device, including all associated attendances — payable only once in any 12 month period (Anaes.) (Assist.)

1 341.10

50306

Limb lengthening, where the lengthening is bipolar, or bone transport is performed or where the fixator is extended to correct an adjacent joint deformity (Anaes.) (Assist.)

2 093.95

50309

Ring fixator or similar device, adjustment of, with or without insertion or removal of fixation pins, performed under general anaesthesia in the operating theatre of a hospital or approved day hospital facility, not being a service to which item 50303 or 50306 applies (Anaes.) (Assist.)

258.75

50312

Ankle, synovectomy of (H) (Anaes.) (Assist.)

594.05

50315

Talipes equinovarus, posterior release of (H) (Anaes.) (Assist.)

588.20

50318

Talipes equinovarus, medial release of (H) (Anaes.) (Assist.)

588.20

50321

Talipes equinovarus, combined postero-medial release of (H) (Anaes.) (Assist.)

788.15

50324

Talipes equinovarus, combined postero-medial release of, revision procedure (H) (Anaes.) (Assist.)

1 123.50

50327

Talipes equinovarus, bilateral procedures (H) (Anaes.) (Assist.)

1 370.45

50330

Talipes equinovarus, or talus, vertical congenital — post operative manipulation and change of plaster, performed under general anaesthesia in the operating theatre of a hospital or approved day hospital facility, not being a service to which item 50315, 50318, 50321, 50324 or 50327 applies (Anaes.)

194.05

50333

Tarsal coalition, excision of, with interposition of muscle, fat graft or similar graft (H) (Anaes.) (Assist.)

523.45

50336

Talus, vertical, congenital, combined anterior and posterior reconstruction (H) (Anaes.) (Assist.)

782.35

50339

Foot and ankle, tibialis anterior tendon (split or whole) transfer to lateral column (H) (Anaes.) (Assist.)

476.50

50342

Foot and ankle, tibialis or tibialis posterior tendon transfer, through the interosseous membrane to anterior or posterior aspect of foot (H) (Anaes.) (Assist.)

552.85

50345

Hyperextension deformity of toe, release incorporating
V-Y plasty of skin, lengthening of extensor tendons and release of capsule contracture (H) (Anaes.) (Assist.)

294.15

50348

Knee, deformity of, post-operative manipulation and change of plaster, performed under general anaesthesia in the operating theatre of a hospital or approved day hospital facility (Anaes.)

194.05

50349

Hip, congenital dislocation of, treatment of, by closed reduction (Anaes.) (Assist.)

135.85

50350

Hip, congenital dislocation of, open reduction of (H) (Anaes.) (Assist.)

719.00

50351

Hip, developmental dislocation of, open reduction of (H) (Anaes.) (Assist.)

847.00

50352

Hip, congenital dislocation of, treatment of, involving supervision of splint, harness or cast — each attendance (Anaes.)

47.95

50353

Hip spica, initial application of, for congenital dislocation of hip (excluding after-care) (H) (Anaes.) (Assist.)

301.05

50354

Tibia, pseudarthrosis of, congenital, resection and internal fixation (Anaes.) (Assist.)

1 111.65

50357

Knee, leg or thigh, rectus femoris tendon transfer or medial or lateral hamstring tendon transfer (H) (Anaes.) (Assist.)

476.50

50360

Knee, leg or thigh, combined medial and lateral hamstring tendon transfer (H) (Anaes.) (Assist.)

552.85

50363

Knee, contracture of, posterior release involving multiple tendon lengthening or tenotomies, unilateral (H) (Anaes.) (Assist.)

423.50

50366

Knee, contracture of, posterior release involving multiple tendon lengthening or tenotomies, bilateral (H) (Anaes.) (Assist.)

741.15

50369

Knee, contracture of, posterior release involving multiple tendon lengthening with or without tenotomies and release of joint capsule with or without cruciate ligaments, unilateral (H) (Anaes.) (Assist.)

552.85

50372

Knee, contracture of, posterior release involving multiple tendon lengthening with or without tenotomies and release of joint capsule with or without cruciate ligaments, bilateral (H) (Anaes.) (Assist.)

970.50

50375

Hip, contracture of, medial release, involving lengthening of, or division of the adductors and psoas with or without division of the obturator nerve, unilateral (H) (Anaes.) (Assist.)

423.50

50378

Hip, contracture of, medial release, involving lengthening of, or division of the adductors and psoas with or without division of the obturator nerve, bilateral (H) (Anaes.) (Assist.)

741.15

50381

Hip, contracture of, anterior release, involving lengthening of, or division of the hip flexors and psoas with or without division of the joint capsule, unilateral (H) (Anaes.) (Assist.)

552.85

50384

Hip, contracture of, anterior release, involving lengthening of, or division of the hip flexors and psoas with or without division of the joint capsule, bilateral (H) (Anaes.) (Assist.)

970.50

50387

Hip, iliopsoas tendon transfer to greater trochanter, or transfer of abdominal musculature to greater trochanter, or transfer or adductors to ischium (H) (Anaes.) (Assist.)

552.85

50390

Perthes, cerebral palsy, or other neuromuscular conditions, affecting hips or knees, application of cast under general anaesthesia, performed in the operating theatre of a hospital or approved day hospital facility (Anaes.)

194.05

50393

Pelvis, bone graft or shelf procedures for acetabular dysplasia (H) (Anaes.) (Assist.)

717.55

50394

Acetabular dysplasia, treatment of, by multiple
peri-acetabular osteotomy, including internal fixation where performed (H) (Anaes.) (Assist.)

2 356.45

50396

Hand, congenital abnormalities or duplication of digits, amputation or splitting of phalanx or phalanges, with ligament or joint reconstruction (H) (Anaes.) (Assist.)

394.15

50399

Forearm, radial aplasia or dysplasia (radial club hand), centralisation or radialisation of (H) (Anaes.) (Assist.)

782.35

50402

Torticollis, bipolar release of sternocleidomastoid muscle and associated soft tissue (H) (Anaes.) (Assist.)

358.80

50405

Elbow, flexorplasty, or tendon transfer to restore elbow function (H) (Anaes.) (Assist.)

488.20

50408

Shoulder, congenital or developmental dislocation, open reduction of (H) (Anaes.) (Assist.)

847.00

50411

Lower limb deficiency, treatment of congenital deficiency of the femur by resection of the distal femur and proximal tibia followed by knee fusion (Anaes.) (Assist.)

1 111.65

50414

Lower limb deficiency, treatment of congenital deficiency of the femur by resection of the distal femur and proximal tibia followed by knee fusion and rotationplasty (Anaes.) (Assist.)

1 499.85

50417

Lower limb deficiency, treatment of congenital deficiency of the tibia by reconstruction of the knee, involving transfer of fibula or tibia, and repair of quadriceps mechanism (Anaes.) (Assist.)

1 111.65

50420

Patella, congenital dislocation of, reconstruction of the quadriceps (H) (Anaes.) (Assist.)

917.55

50423

Tibia, fibula or both, congenital deficiency of, transfer of the fibula to tibia, with internal fixation (Anaes.) (Assist.)

847.00

50426

Diaphyseal aclasia, removal of lesion or lesions from bone — 1 approach (H) (Anaes.) (Assist.)

394.15

50950

Nonresectable hepatocellular carcinoma, destruction of, by percutaneous radiofrequency ablation, including any associated imaging services, not being a service associated with a service to which item 30419 or 50952 applies (Anaes.)

693.35

50952

Nonresectable hepatocellular carcinoma, destruction of, by open or laparoscopic radiofrequency ablation, where a multi-disciplinary team has assessed that percutaneous radiofrequency ablation cannot be performed or is not practical because of one or more of the following clinical circumstances:

 (a) percutaneous access cannot be achieved;

693.35

 

 (b) vital organs or tissues are at risk of damage from the percutaneous radiofrequency ablation procedure;

 (c) resection of one part of the liver is possible, however there is at least 1 primary liver tumour in a nonresectable section of the liver that is suitable for radiofrequency ablation;

including any associated imaging services, not being a service associated with a service to which item 30419 or 50950 applies (Anaes.)

 

Group T9 — Assistance at operations

51300

Assistance at any operation specified in an item in Group T8 that includes ‘(Assist.)’ for which the fee does not exceed $452.70 or at a series or combination of operations specified in items in Group T8 that include ‘(Assist.)’ for which the aggregate fee does not exceed $452.70

73.25

51303

Assistance at any operation specified in an item in Group T8 that includes ‘(Assist.)’ for which the fee exceeds $452.70 or at a series or combination of operations specified in items in Group T8 that include ‘(Assist.)’ for which the aggregate fee exceeds $452.70

Amount under rule 32

51306

Assistance at a delivery involving Caesarean section

105.85

51309

Assistance at a series or combination of operations that include ‘(Assist.)’ and assistance at a delivery involving Caesarean section

Amount under rule 33

51312

Assistance at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615, 16627 and 16633

Amount under rule 37

51315

Assistance at cataract and intraocular lens surgery covered by item 42698, 42701, 42702, 42704 or 42707, when performed in association with services covered by item 42551 to 42569, 42653, 42656, 42746, 42749, 42752, 42776 or 42779

231.10

51318

Assistance at cataract and intraocular lens surgery where patient has:

 (a) total loss of vision, including no potential for central vision, in the fellow eye; or

 (b) previous significant surgical complication in the fellow eye; or

 (c) pseudo exfoliation, subluxed lens, iridodonesis, phacodonesis, retinal detachment, corneal scarring, pre-existing uveitis, bound down miosed pupil, nanophthalmos, spherophakia, Marfan’s syndrome, homocysteinuria or previous blunt trauma causing intraocular damage

152.55

Oral and maxillofacial services

Group O1 — Consultations

51700

Professional attendance (other than a second or subsequent attendance in a single course of treatment) by an approved dental practitioner in the practice of oral and maxillofacial surgery, at consulting rooms, hospital or residential aged care facility where the patient is referred to him or her

72.60

51703

Professional attendance by an approved dental practitioner in the practice of oral and maxillofacial surgery, each attendance subsequent to the first in a single course of treatment at consulting rooms, hospital or residential aged care facility where the patient is referred to him or her

36.40

Group O2 — Assistance at operation

51800

Assistance by an approved dental practitioner in the practice of oral and maxillofacial surgery at any operation specified in an item that includes ‘(Assist.)’ for which the fee does not exceed $452.70 or at a series or combination of operations specified in items in Groups O3 to O9 that include ‘(Assist.)’ for which the aggregate fee does not exceed $452.70

73.25

51803

Assistance by an approved dental practitioner in the practice of oral and maxillofacial surgery at any operation specified in an item that includes ‘(Assist.)’ for which the fee exceeds $452.70 or at a series or combination of operations specified in items that include ‘(Assist.)’ where the aggregate fee exceeds $452.70

Amount under rule 32

Group O3 — General surgery

51900

Wound of soft tissue in the oral and maxillofacial region, deep or extensively contaminated, debridement of, under general anaesthesia or regional or field nerve block, including suturing of that wound when performed (Anaes.) (Assist.)

276.60

51902

Wounds of the oral and maxillofacial region, dressing of, under general anaesthesia, with or without removal of sutures, not being a service associated with a service to which another item in Groups O3 to O9 applies (Anaes.)

62.70

51904

Lipectomy — wedge excision of skin or fat — 1 excision (Anaes.) (Assist.)

385.95

51906

Lipectomy — wedge excision of skin or fat — 2 or more excisions (Anaes.) (Assist.)

587.00

52000

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, small (not more than 7 cm long), superficial (Anaes.)

70.00

52003

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, small (not more than 7 cm long), involving deeper tissue (Anaes.)

99.70

52006

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, large (more than 7 cm long), superficial (Anaes.)

99.70

52009

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, large (more than 7 cm long), involving deeper tissue (Anaes.)

157.55

52010

Full thickness laceration of ear, eyelid, nose or lip, repair of, with accurate apposition of each layer of tissue (Anaes.) (Assist.)

215.50

52012

Superficial foreign body, removal of, as an independent procedure (Anaes.)

19.90

52015

Subcutaneous foreign body, removal of, requiring incision and suture, as an independent procedure (Anaes.)

93.25

52018

Foreign body in muscle, tendon or other deep tissue, removal of, as an independent procedure (Anaes.) (Assist.)

234.80

52021

Aspiration biopsy of 1 or more jaw cysts as an independent procedure to obtain material for diagnostic purposes and not being a service associated with an operative procedure on the same day (Anaes.)

25.00

52024

Biopsy of skin or mucous membrane, as an independent procedure (Anaes.)

44.30

52025

Lymph node of neck, biopsy of (Anaes.)

156.05

52027

Biopsy of lymph gland, muscle or other deep tissue or organ, as an independent procedure and not being a service to which item 52025 applies (Anaes.)

127.05

52030

Sinus, excision of, involving superficial tissue only (Anaes.)

76.30

52033

Sinus, excision of, involving muscle and deep tissue (Anaes.)

156.05

52034

Premalignant lesions of the oral mucous, treatment by cryotherapy, diathermy or carbon dioxide laser

36.40

52035

Endoscopic laser therapy for neoplasia and benign vascular lesions of the oral cavity (Anaes.)

403.95

52036

Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), up to 3 cm in diameter, removal from cutaneous or subcutaneous tissue or from mucous membrane, where the removal is by surgical excision and suture, not being a service to which item 52039 applies (Anaes.)

107.70

52039

Tumours, cysts, ulcers or scars (other than a scar removed during the surgical approach at an operation), up to 3 cm in diameter, removal from cutaneous or subcutaneous tissue or from mucous membrane, where the removal is by surgical excision and suture, and the procedure is performed on more than 3 but not more than 10 lesions (Anaes.) (Assist.)

276.60

52042

Tumour, cyst, ulcer or scar (other than a scar removed during the surgical approach at an operation), more than 3 cm in diameter, removal from cutaneous or subcutaneous tissue or from mucous membrane (Anaes.)

146.35

52045

Tumour, cyst (other than a cyst associated with a tooth or tooth fragment unless it has been established by radiological examination that there is a minimum of 5 mm separation between the cyst lining and tooth structure or where a tumour or cyst has been proven by positive histopathology), ulcer or scar (other than a scar removed during the surgical approach at an operation), removal of, not being a service to which another item in Groups O3 to O9 applies, involving muscle, bone, or other deep tissue (Anaes.)

209.10

52048

Tumour or deep cyst (other than a cyst associated with a tooth or tooth fragment unless it has been established by radiological examination that there is a minimum of 5 mm separation between the cyst lining and tooth structure or where a tumour or cyst has been proven by positive histopathology), removal of, requiring wide excision, not being a service to which another item in Groups O3 to O9 applies (Anaes.) (Assist.)

315.25

52051

Tumour, removal of, from soft tissue (including muscle, fascia and connective tissue), extensive excision of, without skin or mucosal graft (Anaes.) (Assist.)

426.20

52054

Tumour, removal of, from soft tissue (including muscle, fascia and connective tissue), extensive excision of, with skin or mucosal graft (Anaes.) (Assist.)

498.60

52055

Haematoma, small abscess or cellulitis in the oral and maxillofacial region, not requiring admission to a hospital or day hospital facility, incision with drainage of (excluding after-care)

23.20

52056

Haematoma in the oral and maxillofacial region, aspiration of (Anaes.)

23.20

52057

Large haematoma, large abscess, carbuncle, cellulitis or similar lesion in the oral and maxillofacial region, incision with drainage of (excluding after-care) (H) (Anaes.)

138.30

52058

Percutaneous drainage of deep abscess in the oral and maxillofacial region, using interventional imaging techniques — but not including imaging (Anaes.)

201.60

52059

Abscess in the oral and maxillofacial region drainage tube, exchange of using interventional imaging techniques — but not including imaging (Anaes.)

227.10

52060

Muscle in the oral and maxillofacial region, excision of (Anaes.)

160.70

52061

Muscle, in the oral and maxillofacial region, ruptured, repair of (limited), not associated with external wound (Anaes.)

189.75

52062

Muscle, in the oral and maxillofacial region, ruptured, repair of (extensive), not associated with external wound (Anaes.) (Assist.)

250.90

52063

Bone tumour in the oral and maxillofacial region, innocent, excision of, not being a service to which another item in Groups O3 to O9 applies (Anaes.) (Assist.)

302.35

52064

Bone cyst in the oral and maxillofacial region, injection into or aspiration of (Anaes.)

143.80

52066

Submandibular gland, extirpation of (Anaes.) (Assist.)

377.95

52069

Sublingual gland, extirpation of (Anaes.)

168.50

52072

Salivary gland, dilatation or diathermy of duct (Anaes.)

49.90

52073

Salivary gland, repair of cutaneous fistula of (Anaes.)

127.05

52075

Salivary gland, removal of calculus from duct or meatotomy or marsupialisation, 1 or more such procedures (Anaes.)

127.05

52078

Tongue, partial excision of (Anaes.) (Assist.)

250.90

52081

Tongue tie, division or excision of frenulum (Anaes.)

39.45

52084

Tongue tie, mandibular frenulum or maxillary frenulum, division or excision of frenulum, in a person aged not less than 2 years (Anaes.)

101.35

52087

Ranula or mucous cyst of mouth, removal of (Anaes.)

173.70

52090

Operation on mandible or maxilla (other than alveolar margins) for chronic osteomyelitis — 1 bone or in combination with adjoining bones (Anaes.) (Assist.)

302.35

52092

Operation on skull for osteomyelitis (Anaes.) (Assist.)

394.10

52094

Operation on any combination of adjoining bones in the oral and maxillofacial region, being bones referred to in item 52092 (Anaes.) (Assist.)

498.55

52095

Bone growth stimulator in the oral and maxillofacial region, insertion of (Anaes.) (Assist.)

323.10

52096

Orthopaedic pin or wire, insertion of, into maxilla or mandible or zygoma, as an independent procedure (Anaes.)

95.80

52097

External fixation in the oral and maxillofacial region, removal of, in the operating theatre of a hospital or approved day hospital facility (Anaes.)

135.85

52098

External fixation in the oral and maxillofacial region, removal of, in conjunction with operations involving internal fixation or bone grafting or both (Anaes.)

159.75

52099

Buried wire, pin or screw, 1 or more, which were inserted for internal fixation purposes into maxilla or mandible or zygoma, removal of, requiring anaesthesia, incision, dissection and suturing, per bone, not being a service associated with a service to which item 52102 or 52105 applies (Anaes.)

119.85

52102

Buried wire, pin or screw, 1 or more, which were inserted for internal fixation purposes into maxilla or mandible or zygoma, removal of, requiring anaesthesia, incision, dissection and suturing, where undertaken in the operating theatre of a hospital or approved day hospital facility, per bone (Anaes.)

119.85

52105

Plate, 1 or more of, and associated screw and wire which were inserted for internal fixation purposes into maxilla or mandible or zygoma, removal of, requiring anaesthesia, incision, dissection and suturing, per bone, not being a service associated with a service to which item 52099 or 52102 applies (Anaes.) (Assist.)

223.70

52106

Arch bars, 1 or more, which were inserted for dental fixation purposes to the maxilla or mandible, removal of, requiring general anaesthesia where undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

92.40

52108

Lip, full thickness wedge excision of, with repair by direct sutures (Anaes.) (Assist.)

276.60

52111

Vermilionectomy (Anaes.) (Assist.)

276.60

52114

Mandible or maxilla, segmental resection of, for tumours or cysts (Anaes.) (Assist.)

498.60

52117

Mandible, including lower border, or maxilla, sub-total resection of (Anaes.) (Assist.)

593.50

52120

Mandible, hemimandiblectomy of, including condylectomy where performed (Anaes.) (Assist.)

699.60

52122

Mandible, hemi-mandibular reconstruction of, or maxilla reconstruction of, with bone graft, plate, tray or alloplast, not being a service associated with a service to which item 52123 applies (Anaes.) (Assist.)

701.90

52123

Mandible, total resection of both sides, including condylectomies where performed (Anaes.) (Assist.)

794.70

52126

Maxilla, total resection of (Anaes.) (Assist.)

764.00

52129

Maxilla, total resection of both maxillae (Anaes.) (Assist.)

1 022.75

52130

Bone graft in the oral and maxillofacial region, not being a service to which another item in Groups O3 to O9 applies (Anaes.) (Assist.)

375.40

52131

Bone graft with internal fixation, in the oral and maxillofacial region, not being a service to which another item in Groups O3 to O9 applies (Anaes.) (Assist.)

519.25

52132

Tracheostomy (Anaes.)

202.65

52133

Cricothyrostomy by direct stab or Seldinger technique, using Minitrach or similar device (Anaes.)

77.25

52135

Post-operative or post-nasal haemorrhage, or both, control of, where undertaken in the operating theatre of a hospital or approved day hospital facility (Anaes.)

122.50

52138

Maxillary artery, ligation of (Anaes.) (Assist.)

377.95

52141

Facial, mandibular or lingual artery or vein or artery and vein, ligation of, not being a service to which item 52138 applies (Anaes.) (Assist.)

376.45

52144

Foreign body, deep, removal of using interventional imaging techniques (Anaes.) (Assist.)

350.90

52147

Duct of major salivary gland, transposition of (Anaes.) (Assist.)

331.10

52148

Parotid duct, repair of, using micro-surgical techniques (Anaes.) (Assist.)

585.30

52158

Submandibular ducts, relocation of, for surgical control of drooling (Anaes.) (Assist.)

942.40

52180

Aggressive or potentially malignant bone or deep soft tissue tumour in the oral and maxillofacial region, biopsy of (not including after-care) (Anaes.)

159.75

52182

Bone or malignant deep soft tissue tumour in the oral and maxillofacial region, lesional or marginal excision of (Anaes.) (Assist.)

351.50

52184

Bone tumour in the oral and maxillofacial region, lesional or marginal excision of, combined with any 1 of liquid nitrogen freezing, autograft, allograft or cementation (Anaes.) (Assist.)

519.25

52186

Bone tumour in the oral and maxillofacial region, lesional or marginal excision of, combined with any 2 or more of liquid nitrogen freezing, autograft, allograft or cementation (Anaes.) (Assist.)

639.10

Group O4 — Plastic and reconstructive

52300

Single-stage local flap, where indicated, repair to 1 defect, with skin or mucosa (Anaes.) (Assist.)

241.25

52303

Single-stage local flap, where indicated, repair to 1 defect, with buccal pad of fat (Anaes.) (Assist.)

344.50

52306

Single-stage local flap, where indicated, repair to 1 defect, using temporalis muscle (Anaes.) (Assist.)

511.20

52309

Free grafting (mucosa or split skin) of a granulating area (Anaes.)

173.70

52312

Free grafting (mucosa, split skin or connective tissue) to 1 defect, including elective dissection (Anaes.) (Assist.)

241.25

52315

Free grafting, full thickness, to 1 defect (mucosa or skin) (Anaes.) (Assist.)

402.00

52318

Bone graft, harvesting of, via separate incision, being a service associated with a service to which another item in Groups O3 to O9 applies — Autogenous, small quantity (Anaes.)

119.85

52319

Bone graft, harvesting of, via separate incision, being a service associated with a service to which another item in Groups O3 to O9 applies — Autogenous, large quantity (Anaes.)

199.45

52321

Foreign implant (non-biological), insertion of, for contour reconstruction of pathological deformity, not being a service associated with a service to which item 52624 applies (Anaes.) (Assist.)

402.00

52324

Direct flap repair, using tongue, first stage (Anaes.) (Assist.)

402.00

52327

Direct flap repair, using tongue, second stage (Anaes.)

199.45

52330

Palatal defect (oro-nasal fistula), plastic closure of, including services to which item 52300, 52303, 52306 or 52324 applies (Anaes.) (Assist.)

663.50

52333

Cleft palate, primary repair (Anaes.) (Assist.)

663.50

52336

Cleft palate, secondary repair, closure of fistula using local flaps (Anaes.) (Assist.)

414.70

52337

Alveolar cleft (congenital) unilateral, grafting of, including plastic closure of associated oro-nasal fistulae and ridge augmentation (Anaes.) (Assist.)

907.10

52339

Cleft palate, secondary repair, lengthening procedure (Anaes.) (Assist.)

472.30

52342

Mandible or maxilla, unilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

820.30

52345

Mandible or maxilla, unilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

925.15

52348

Mandible or maxilla, bilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 045.40

52351

Mandible or maxilla, bilateral osteotomy or osteectomy of, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

1 174.00

52354

Mandible or maxilla, osteotomies or osteectomies of, involving 3 or more such procedures on the 1 jaw, including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 190.20

52357

Mandible or maxilla, osteotomies or osteectomies of, involving 3 or more such procedures on the 1 jaw, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

1 339.95

52360

Mandible and maxilla, osteotomies or osteectomies of, involving 2 such procedures of each jaw including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 366.95

52363

Mandible and maxilla, osteotomies or osteectomies of, involving 2 such procedures of each jaw, including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

1 537.80

52366

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of 1 jaw and 2 such procedures of the other jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 503.80

52369

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of 1 jaw and 2 such procedures of the other jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

1 690.80

52372

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of each jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 640.60

52375

Mandible and maxilla, complex bilateral osteotomies or osteectomies of, involving 3 or more such procedures of each jaw, including genioplasty when performed and transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

1 837.65

52378

Genioplasty including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

635.25

52379

Face, contour reconstruction of 1 region, using autogenous bone or cartilage graft (Anaes.) (Assist.)

1 084.65

52380

Midfacial osteotomies — Le Fort II, Modified Le Fort III (Nasomalar), Modified Le Fort III (Malar-Maxillary), Le Fort III involving 3 or more osteotomies of the midface including transposition of nerves and vessels and bone grafts taken from the same site (Anaes.) (Assist.)

1 848.60

52382

Midfacial osteotomies — Le Fort II, Modified Le Fort III (Nasomalar), Modified Le Fort III (Malar-Maxillary), Le Fort III involving 3 or more osteotomies of the midface including transposition of nerves and vessels and bone grafts taken from the same site and stabilisation with fixation by wires, screws, plates or pins, or any combination (Anaes.) (Assist.)

2 215.95

52420

Mandible, fixation by intermaxillary wiring, excluding wiring for obesity

204.60

52424

Dermis, dermofat or fascia graft (excluding transfer of fat by injection) in the oral and maxillofacial region (Anaes.) (Assist.)

401.90

52430

Microvascular repair of the oral and maxillofacial region using microsurgical techniques, with restoration of continuity of artery or vein of distal extremity or digit (Anaes.) (Assist.)

925.15

52440

Cleft lip, unilateral — primary repair, 1 stage, without anterior palate repair (Anaes.) (Assist.)

459.35

52442

Cleft lip, unilateral — primary repair, 1 stage, with anterior palate repair (Anaes.) (Assist.)

574.30

52444

Cleft lip, bilateral — primary repair, 1 stage, without anterior palate repair (Anaes.) (Assist.)

638.00

52446

Cleft lip, bilateral — primary repair, 1 stage, with anterior palate repair (Anaes.) (Assist.)

753.00

52450

Cleft lip, partial revision, including minor flap revision alignment and adjustment, including revision of minor whistle deformity if performed (Anaes.)

255.20

52452

Cleft lip, total revision, including major flap revision, muscle reconstruction and revision of major whistle deformity (Anaes.) (Assist.)

414.70

52456

Cleft lip reconstruction using full thickness flap (Abbe or similar), first stage (Anaes.) (Assist.)

701.90

52458

Cleft lip reconstruction using full thickness flap (Abbe or similar), second stage (Anaes.)

255.20

52460

Velo-pharyngeal incompetence, pharyngeal flap for, or pharyngoplasty for (Anaes.)

663.50

52480

Composite graft (chondro-cutaneous or chondro-mucosal) to nose, ear or eyelid (Anaes.) (Assist.)

426.20

52482

Macrocheilia or macroglossia, operation for (Anaes.) (Assist.)

410.05

52484

Macrostomia, operation for (Anaes.) (Assist.)

488.15

Group O5 — Preprosthetic

52600

Mandibular or palatal exostosis, excision of (Anaes.) (Assist.)

287.05

52603

Mylohyoid ridge, reduction of (Anaes.) (Assist.)

274.40

52606

Maxillary tuberosity, reduction of (Anaes.)

209.30

52609

Papillary hyperplasia of the palate, removal of — less than 5 lesions (Anaes.) (Assist.)

274.40

52612

Papillary hyperplasia of the palate, removal of — 5 to 20 lesions (Anaes.) (Assist.)

344.50

52615

Papillary hyperplasia of the palate, removal of — more than 20 lesions (Anaes.) (Assist.)

427.55

52618

Vestibuloplasty, submucosal or open, including excision of muscle and skin or mucosal graft when performed — unilateral or bilateral (Anaes.) (Assist.)

497.60

52621

Floor of mouth lowering (Obwegeser or similar procedure), including excision of muscle and skin or mucosal graft when performed — unilateral (Anaes.) (Assist.)

497.60

52624

Alveolar ridge augmentation with bone or alloplast or both — unilateral (Anaes.) (Assist.)

401.90

52626

Alveolar ridge augmentation — unilateral, insertion of tissue expanding device into maxillary or mandibular alveolar ridge region for (Anaes.) (Assist.)

246.45

52627

Osseo-integration procedure — extra oral implantation of titanium fixture (Anaes.) (Assist.)

427.55

52630

Osseo-integration procedure — fixation of transcutaneous abutment (Anaes.)

158.25

52633

Osseo-integration procedure — intra-oral implantation of titanium fixture to facilitate restoration of the dentition following resection of part of the maxilla or mandible for benign or malignant tumours (Anaes.)

427.55

52636

Osseo-integration procedure — fixation of transmucosal abutment to fixtures placed following resection of part of the maxilla or mandible for benign or malignant tumours (Anaes.)

158.25

Group O6 — Neurosurgical

52800

Neurolysis by open operation, without transposition, not being a service associated with a service to which item 52803 applies (Anaes.) (Assist.)

234.80

52803

Nerve trunk, internal (interfascicular), neurolysis of, using microsurgical techniques (Anaes.) (Assist.)

338.15

52806

Neurectomy, neurotomy or removal of tumour from superficial peripheral nerve (Anaes.) (Assist.)

234.80

52809

Neurectomy, neurotomy or removal of tumour from deep peripheral nerve (Anaes.) (Assist.)

402.00

52812

Nerve trunk, primary repair of, using microsurgical techniques (Anaes.) (Assist.)

574.30

52815

Nerve trunk, secondary repair of, using microsurgical techniques (Anaes.) (Assist.)

606.10

52818

Nerve, transposition of (Anaes.) (Assist.)

402.00

52821

Nerve graft to nerve trunk (cable graft) including harvesting of nerve graft using microsurgical techniques (Anaes.) (Assist.)

874.10

52824

Peripheral branches of the trigeminal nerve, cryosurgery of, for pain relief (Anaes.) (Assist.)

376.45

52826

Injection of primary branch of trigeminal nerve with alcohol, cortisone, phenol, or similar substance (Anaes.)

201.60

52828

Cutaneous nerve, primary repair of, using microsurgical techniques (Anaes.) (Assist.)

299.85

52830

Cutaneous nerve, secondary repair of, using microsurgical techniques (Anaes.) (Assist.)

395.50

52832

Cutaneous nerve, nerve graft to, using microsurgical techniques (Anaes.) (Assist.)

542.35

Group O7 — Ear, nose and throat

53000

Maxillary antrum, proof puncture and lavage of (Anaes.)

27.55

53003

Maxillary antrum, proof puncture and lavage of, under general anaesthesia, not being a service associated with a service to which another item in Groups O3 to O9 applies (H) (Anaes.)

78.05

53004

Maxillary antrum, lavage of — each attendance at which the procedure is performed, including any associated consultation (Anaes.)

28.50

53006

Antrostomy (radical) (Anaes.) (Assist.)

442.25

53009

Antrum, intranasal operation on or removal of foreign body from (Anaes.) (Assist.)

250.90

53012

Antrum, drainage of, through tooth socket (Anaes.)

99.70

53015

Oro-antral fistula, plastic closure of (Anaes.) (Assist.)

498.60

53016

Nasal septum, septoplasty, submucous resection or closure of septal perforation (Anaes.) (Assist.)

410.05

53017

Nasal septum, reconstruction of (Anaes.) (Assist.)

511.55

53019

Maxillary sinus, bone graft to floor of maxillary sinus following elevation of mucosal lining (sinus lift procedure), unilateral (Anaes.) (Assist.)

492.85

53052

Post-nasal space, direct examination of, with or without biopsy (Anaes.)

104.20

53054

Nasendoscopy or sinoscopy or fibreoptic examination of nasopharynx — 1 or more of these procedures (Anaes.)

104.15

53056

Examination of nasal cavity or post-nasal space, or nasal cavity and post-nasal space, under general anaesthesia, not being a service associated with a service to which another item in this group applies (Anaes.)

61.05

53058

Nasal haemorrhage, posterior, arrest of, with posterior nasal packing with or without cauterisation and with or without anterior pack (excluding after-care) (Anaes.)

104.15

53060

Cauterisation (other than by chemical means) or cauterisation by chemical means when performed under general anaesthesia or diathermy of septum or turbinates for obstruction or haemorrhage secondary to surgery (or trauma) — 1 or more of these procedures (including any consultation on the same occasion) not being a service associated with any other operation on the nose (Anaes.)

85.25

53062

Post-surgical nasal haemorrhage, arrest of during an episode of epistaxis by cauterisation or nasal cavity packing or both (Anaes.)

76.30

53064

Cryotherapy to nose in the treatment of nasal haemorrhage (Anaes.)

138.30

53068

Turbinectomy or turbinectomies, partial or total, unilateral (Anaes.)

114.45

53070

Turbinates, submucous resection of, unilateral (Anaes.)

151.05

Group O8 — Temporomandibular joint

53200

Mandible, treatment of a dislocation of, not requiring open reduction (Anaes.)

60.00

53203

Mandible, treatment of a dislocation of, requiring open reduction (Anaes.)

100.80

53206

Temporomandibular joint, manipulation of, performed in the operating theatre of a hospital or approved day hospital facility, not being a service associated with a service to which another item in Groups O3 to O9 applies (Anaes.)

121.25

53209

Glenoid fossa, zygomatic arch and temporal bone, reconstruction of (Obwegeser technique) (Anaes.) (Assist.)

1 399.25

53212

Absent condyle and ascending ramus in hemifacial microsomia, construction of, not including harvesting of graft material (Anaes.) (Assist.)

755.90

53215

Temporomandibular joint, arthroscopy of, with or without biopsy, not being a service associated with any other arthroscopic procedure of that joint (Anaes.) (Assist.)

346.75

53218

Temporomandibular joint, arthroscopy of, removal of loose bodies, debridement, or treatment of adhesions — 1 or more of such procedures (Anaes.) (Assist.)

554.70

53220

Temporomandibular joint, arthrotomy of, not being a service to which another item in this group applies (Anaes.) (Assist.)

279.65

53221

Temporomandibular joint, open surgical exploration of, with or without microsurgical techniques (Anaes.) (Assist.)

740.15

53224

Temporomandibular joint, open surgical exploration of, with condylectomy or condylotomy, with or without microsurgical techniques (Anaes.) (Assist.)

820.50

53225

Arthrocentesis, irrigation of temporomandibular joint after insertion of 2 cannuli into the appropriate joint space(s) (Anaes.) (Assist.)

246.45

53226

Temporomandibular joint, synovectomy of, not being a service to which another item in this group applies (Anaes.) (Assist.)

265.00

53227

Temporomandibular joint, open surgical exploration of, with or without meniscus or capsular surgery, including meniscectomy when performed, with or without microsurgical techniques (Anaes.) (Assist.)

1 008.20

53230

Temporomandibular joint, open surgical exploration of, with meniscus, capsular and condylar head surgery, with or without microsurgical techniques (Anaes.) (Assist.)

1 135.70

53233

Temporomandibular joint, surgery of, involving procedures to which item 53224, 53226, 53227 or 53230 applies and also involving the use of tissue flaps, or cartilage graft, or allograft implants, with or without microsurgical techniques (Anaes.) (Assist.)

1 276.15

53236

Temporomandibular joint, stabilisation of, involving 1 or more of: repair of capsule, repair of ligament or internal fixation, not being a service to which another item in this group applies (Anaes.) (Assist.)

399.35

53239

Temporomandibular joint, arthrodesis of, not being a service to which another item in this group applies (Anaes.) (Assist.)

399.35

53242

Temporomandibular joint or joints, application of external fixator to, other than for treatment of fractures (Anaes.) (Assist.)

265.00

Group O9 — Treatment of fractures

53400

Maxilla, unilateral or bilateral, treatment of fracture of, not requiring splinting

109.60

53403

Mandible, treatment of fracture of, not requiring splinting

133.90

53406

Maxilla, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.)

345.05

53409

Mandible, treatment of fracture of, requiring splinting, wiring of teeth, circumosseous fixation or external fixation (Anaes.) (Assist.)

345.05

53410

Zygomatic bone, treatment of fracture of, not requiring surgical reduction

72.70

53411

Zygomatic bone, treatment of fracture of, requiring surgical reduction, by temporal, intra-oral or other approach (Anaes.)

202.65

53412

Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation at 1 site (Anaes.) (Assist.)

332.70

53413

Zygomatic bone, treatment of fracture of, requiring surgical reduction and involving internal or external fixation or both at 2 sites (Anaes.) (Assist.)

406.55

53414

Zygomatic bone, treatment of, requiring surgical reduction and involving internal or external fixation or both at 3 sites (Anaes.) (Assist.)

468.20

53415

Maxilla, treatment of fracture of, requiring open reduction (Anaes.) (Assist.)

369.70

53416

Mandible, treatment of fracture of, requiring open reduction (Anaes.) (Assist.)

369.70

53418

Maxilla, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.)

480.55

53419

Mandible, treatment of fracture of, requiring open reduction and internal fixation not involving plate(s) (Anaes.) (Assist.)

480.55

53422

Maxilla, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.)

609.85

53423

Mandible, treatment of fracture of, requiring open reduction and internal fixation involving plate(s) (Anaes.) (Assist.)

609.85

53424

Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.)

523.25

53425

Mandible, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction not involving plate(s) (Anaes.) (Assist.)

523.25

53427

Maxilla, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of plate(s) (Anaes.) (Assist.)

714.65

53429

Mandible, treatment of a complicated fracture of, involving viscera, blood vessels or nerves, requiring open reduction involving the use of plate(s) (Anaes.) (Assist.)

714.65

53439

Mandible, treatment of a closed fracture of, involving a joint surface (Anaes.)

202.65

53453

Orbital cavity, reconstruction of a wall or floor with or without foreign implant (Anaes.) (Assist.)

410.05

53455

Orbital cavity, bone or cartilage graft to orbital wall or floor including reduction of prolapsed or entrapped orbital contents (Anaes.) (Assist.)

481.65

53458

Nasal bones, treatment of fracture of, not being a service to which item 53459 or 53460 applies

36.45

53459

Nasal bones, treatment of fracture of, by reduction (Anaes.)

199.75

53460

Nasal bones, treatment of fractures of, by open reduction involving osteotomies (Anaes.) (Assist.)

407.55

Group O10 — Diagnostic procedures and investigations

53600

Skin sensitivity testing for allergens to anaesthetics and materials used in oral and maxillofacial surgery, using 1 to 20 allergens

33.05

Group O11 — Regional or field nerve blocks

53700

Trigeminal nerve, primary division of, injection of an anaesthetic agent

105.95

53702

Trigeminal nerve, peripheral branch of, injection of an anaesthetic agent

53.05

53704

Facial nerve, injection of an anaesthetic agent

31.90

53706

Nerve branch in the oral and maxillofacial region, destruction by a neurolytic agent, not being a service to which any other item in this group applies

105.95

Cleft lip and cleft palate services

Group C1 — Orthodontic services

75001

Initial professional attendance in a single course of treatment by an accredited orthodontist (AO)

72.60

75004

Professional attendance by an accredited orthodontist subsequent to the first professional attendance by the orthodontist in a single course of treatment (AO)

36.40

75006

Production of dental study models (not being a service associated with a service to which item 75004 applies) prior to provision of a service to which:

 (a) item 75030, 75033, 75034, 75036, 75037, 75039, 75045 or 75051 applies; or

 (b) an item in Group T8 or Groups O3 to O9 applies;

in a single course of treatment (AO)

64.70

75009

Orthodontic radiography — orthopantomography (panoramic radiography), including any consultation on the same occasion (AOS) (AO)

57.85

75012

Orthodontic radiography — anteroposterior cephalometric radiography with cephalometric tracings or lateral cephalometric radiography with cephalometric tracings including any consultation on the same occasion (AOS) (AO)

91.65

75015

Orthodontic radiography — anteroposterior and lateral cephalometric radiography, with cephalometric tracings including any consultation on the same occasion (AOS) (AO)

126.05

75018

Orthodontic radiography — anteroposterior and lateral cephalometric radiography, with cephalometric tracings and orthopantomography including any consultation on the same occasion (AOS) (AO)

160.55

75021

Orthodontic radiography — hand-wrist studies (including growth prediction) including any consultation on the same occasion (AOS) (AO)

196.90

75023

Intraoral radiography — single area, periapical or bitewing film (AOS) (AO)

39.40

75024

Pre-surgical infant maxillary arch repositioning, including supply of appliances and all adjustments of appliances and supervision — where 1 appliance is used (AO)

509.20

75027

Pre-surgical infant maxillary arch repositioning, including supply of appliances and all adjustments of appliances and supervision — where 2 appliances are used (AO)

698.20

75030

Maxillary ach expansion not being a service associated with a service to which item 75039, 75042, 75045 or 75048 applies, including supply of appliances, all adjustments of the appliances, removal of the appliances and retention (AO)

621.75

75033

Mixed dentition treatment — incisor alignment using fixed appliances in maxillary arch, including supply of appliances, all adjustments of appliances, removal of the appliances and retention (AO)

1 018.95

75034

Mixed dentition treatment — incisor alignment with or without lateral arch expansion using a removable appliance in the maxillary arch, including supply of appliances, associated adjustments and retention (AO)

518.65

75036

Mixed dentition treatment — lateral arch expansion and incisor alignment using fixed appliances in maxillary arch, including supply of appliances, all adjustments of appliances, removal of appliances and retention (AO)

1 407.45

75037

Mixed dentition treatment — lateral arch expansion and incisor correction — 2 arch (maxillary and mandibular) using fixed appliances in both maxillary and mandibular arches, including supply of appliances, all adjustments of appliances, removal of appliances and retention (AO)

1 772.65

75039

Permanent dentition treatment — single arch (mandibular or maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — initial 3 months of active treatment (AO)

471.10

75042

Permanent dentition treatment — single arch (mandibular or maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — each 3 months of active treatment (including all adjustments and maintenance and removal of the appliances) after the first for a maximum of a further 33 months (AO)

176.15

75045

Permanent dentition treatment — 2 arch (mandibular and maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — initial 3 months of active treatment (AO)

943.15

75048

Permanent dentition treatment — 2 arch (mandibular and maxillary) treatment (correction and alignment) using fixed appliances, including supply of appliances — each subsequent 3 months of active treatment (including all adjustments and maintenance, and removal of the appliances) after the first for a maximum of a further 33 months (AO)

241.85

75049

Retention, fixed or removable, single arch (mandibular or maxillary) — supply of retainer and supervision of retention (AO)

283.05

75050

Retention, fixed or removable, 2-arch (mandibular and maxillary) — supply of retainers and supervision of retention (AO)

546.45

75051

Jaw growth guidance using removable or functional appliances, including supply of appliances and all adjustments to appliances (AO)

838.90

Group C2 — Oral and maxillofacial services

75150

Initial professional attendance in a single course of treatment by an accredited oral and maxillofacial surgeon where the patient is referred to the surgeon by an accredited orthodontist (AOS)

72.60

75153

Professional attendance by an accredited oral and maxillofacial surgeon subsequent to the first professional attendance by the surgeon in a single course of treatment where the patient is referred to the surgeon by an accredited orthodontist (AOS)

36.40

75156

Production of dental study models (not being a service associated with a service to which item 75153 applies) prior to provision of a service:

 (a) to which item 52321, 53212 or 75618 applies; or

 (b) to which an item in the series 52330 to 52382, 52600 to 52630, 53400 to 53409 or 53415 to 53429 applies;

in a single course of treatment, where the patient is referred by an accredited orthodontist (AOS)

64.70

75200

Removal of tooth or tooth fragment (not being treatment to which item 75400, 75403, 75406, 75409, 75412 or 75415 applies), where the patient is referred by an accredited orthodontist (AD)

46.60

75203

Removal of tooth or tooth fragment under general anaesthesia, where the patient is referred by an accredited orthodontist (AD)

69.95

75206

Removal of each additional tooth or tooth fragment at the same attendance at which a service to which item 75200 or 75203 applies is rendered, where the patient is referred by an accredited orthodontist (AD)

23.20

75400

Surgical removal of erupted tooth, where the patient is referred by an accredited orthodontist (AOS)

139.85

75403

Surgical removal of tooth with soft tissue impaction, where the patient is referred by an accredited orthodontist (AOS)

160.55

75406

Surgical removal of tooth with partial bone impaction, where the patient is referred by an accredited orthodontist (AOS)

183.00

75409

Surgical removal of tooth with complete bone impaction, where the patient is referred by an accredited orthodontist (AOS)

207.25

75412

Surgical removal of tooth fragment requiring incision of soft tissue only, where the patient is referred by an accredited orthodontist (AOS)

115.75

75415

Surgical removal of tooth fragment requiring removal of bone, where the patient is referred by an accredited orthodontist (AOS)

139.85

75600

Surgical exposure, stimulation and packing of unerupted tooth, where the patient is referred by an accredited orthodontist (AOS)

196.90

75603

Surgical exposure of unerupted tooth for the purpose of fitting a traction device, where the patient is referred by an accredited orthodontist (AOS)

231.40

75606

Surgical repositioning of unerupted tooth, where the patient is referred by an accredited orthodontist (AOS)

231.40

75609

Transplantation of tooth bud, where the patient is referred by an accredited orthodontist (AOS)

345.45

75612

Surgical procedure for intra oral implantation of osseointegrated fixture (first stage), where the patient is referred by an accredited orthodontist (AOS)

427.55

75615

Surgical procedure for fixation of trans-mucosal abutment (second stage of osseointegrated implant), where the patient is referred by an accredited orthodontist (AOS)

158.25

75618

Provision and fitting of a bite rising appliance or dental splint for the management of temporomandibular joint dysfunction syndrome, where the patient is referred by an accredited orthodontist (AOS)

196.55

75621

The provision and fitting of surgical template in conjunction with orthognathic surgical procedures in association with:

 (a) an item in the series 52342 to 52375; or

 (b) item 52380 or 52382;

where the patient is referred by an accredited orthodontist (AOS)

196.55

Group C3 — General and prosthodontic services

75800

Attendance comprising consultation, preventive treatment and prophylaxis, of not less than 30 minutes duration — each attendance to a maximum of 3 attendances in any period of 12 months (AD)

69.95

75803

Provision and fitting of acrylic base partial denture, including retainers — 1 tooth (AD)

279.80

75806

Provision and fitting of acrylic base partial denture, including retainers — 2 teeth (AD)

328.15

75809

Provision and fitting of acrylic base partial denture, including retainers — 3 teeth (AD)

388.60

75812

Provision and fitting of acrylic base partial denture, including retainers — 4 teeth (AD)

431.75

75815

Provision and fitting of acrylic base partial denture, including retainers — 5 to 9 teeth (AD)

526.80

75818

Provision and fitting of acrylic base partial denture, including retainers — 10 to 12 teeth (AD)

621.75

75821

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 1 tooth (AD)

500.75

75824

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 2 teeth (AD)

578.55

75827

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 3 teeth (AD)

664.95

75830

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 4 teeth (AD)

734.05

75833

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 5 to 9 teeth (AD)

898.00

75836

Provision and fitting of cast metal base (cobalt chromium alloy) partial denture including casting and retainers — 10 to 12 teeth (AD)

1 027.55

75839

Provision and fitting of retainers (not being treatment associated with treatment to which item 75803, 75806, 75809, 75812, 75815, 75818, 75821, 75824, 75827, 75830, 75833 or 75836 applies) — each retainer (AD)

23.20

75842

Adjustment of partial denture (not being treatment associated with treatment to which item 75803, 75806, 75809, 75812, 75815, 75818, 75821, 75824, 75827, 75830, 75833 or 75836 applies) (AD)

34.55

75845

Relining of partial denture by laboratory process and associated fitting (AD)

172.80

75848

Remodelling and fitting of partial denture of more than 4 teeth (AD)

207.25

75851

Repair to cast metal base of partial denture — 1 or more points (AD)

103.65

75854

Addition of a tooth or teeth to a partial denture to replace extracted tooth or teeth, including taking of necessary impression (AD)

103.65

Part 4 Non-medicare services

 1. Endoluminal gastroplication, for the treatment of
gastro-oesophageal reflux disease

 2. Endovenous laser treatment, for varicose veins

 3. Gamma knife surgery

 4. Intradiscal electro thermal arthroplasty

 5. Intravascular ultrasound (except where used in conjunction with intravascular brachytherapy)

 6. Intro-articular viscosupplementation, for the treatment of osteoarthritis of the knee

 7. Low intensity ultrasound treatment, for the acceleration of bone fracture healing, using a bone growth stimulator

 8. Lung volume reduction surgery, for advanced emphysema

 9. Photodynamic therapy, for skin and mucosal cancer

 10. Placement of artificial bowel sphincters, in the management of faecal incontinence

 11. Sacral nerve stimulation, for urinary incontinence

 12. Selective internal radiation therapy, for hepatic metastases

 13. Specific mass measurement of bone alkaline phosphatase

 14. Transmyocardial laser revascularisation

 15. Vertebral axial decompression therapy, for chronic back pain

Note

1. Notified in the Commonwealth of Australia Gazette on 29 October 2004.