Schedule - Part B - Human Tissue List February 2014

Billing Code Facility  Minimum Benefit  Maximum Benefit

CARDIO-THORACIC

Conduit - Aortic

TBV56 Donor Tissue Bank of Victoria $1,117.00

Conduit - Aortic + Valve

QHV09 The Prince Charles Hospital - Queensland Heart Valve Bank $6,300.00

Conduit - Arterial

SHV03 Sydney Heart Valve Bank, St. Vincent's Hospital $1,263.00

Conduit - Pulmonary

TBV03 Donor Tissue Bank of Victoria $1,116.00

Conduit - Pulmonary + Valve

QHV08 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00

Conduit - Pulmonary large

QHV07 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00

Patch - Mitral

QHV03 The Prince Charles Hospital - Queensland Heart Valve Bank $1,743.00

Patch - Pericardium

QHV05 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00

Patch - Tricuspid

QHV04 The Prince Charles Hospital - Queensland Heart Valve Bank $1,743.00

Pericardium

TBV50 Donor Tissue Bank of Victoria $540.00

Thoracic Aorta

QHV11 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00

Valve - Aortic

QHV01 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00

RPH01 Royal Perth Hospital T/A Heart Valve Bank $6,406.00

SHV01 Sydney Heart Valve Bank, St. Vincent's Hospital $6,842.00

TBV01 Donor Tissue Bank of Victoria $7,278.00

Valve - Mitral

 Page 1 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

QHV10 The Prince Charles Hospital - Queensland Heart Valve Bank $6,300.00

Valve - Pulmonary

QHV02 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00

RPH02 Royal Perth Hospital T/A Heart Valve Bank $6,406.00

SHV02 Sydney Heart Valve Bank, St. Vincent's Hospital $6,842.00

TBV02 Donor Tissue Bank of Victoria $7,278.00

DERMATOLOGIC

Skin < 25cm² - acellular dermal matrix allograft from human origin

SYN03 Synthes Australia Pty Ltd $2,200.00

Skin > 300cm² - acellular dermal matrix allograft from human origin

SYN07 Synthes Australia Pty Ltd $27,000.00

Skin 100cm² - frozen skin graft from human origin

QBB72 The Queensland Bone Bank $477.00

Skin 121 to 300cm² - acellular dermal matrix allograft from human origin

SYN06 Synthes Australia Pty Ltd $14,000.00

Skin 200cm² - frozen skin graft from human origin

QBB73 The Queensland Bone Bank $705.00

Skin 26 to 60cm² - acellular dermal matrix allograft from human origin

SYN04 Synthes Australia Pty Ltd $3,500.00

Skin 50cm² - frozen skin graft from human origin

QBB71 The Queensland Bone Bank $248.00

Skin 61 to 120cm² - acellular dermal matrix allograft from human origin

SYN05 Synthes Australia Pty Ltd $5,700.00

OPHTHALMIC

Amniotic Membrane

LEM03 Lions Eye Donation Service $770.00

Cornea

LEM01 Lions Eye Donation Service $2,000.00

LEN01 Lions NSW Eye Bank $2,026.00

LEW01 Lions Eye Bank of Western Australia $2,500.00

QEB01 Queensland Eye Bank $2,100.00

SAE01 The Eye Bank of South Australia $1,890.00

 Page 2 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

Cornea for Endothelial Keratoplasty

LEW03 Lions Eye Bank of Western Australia $3,000.00

SAE03 The Eye Bank of South Australia $2,849.00

Cornea for Endothelial Lamellar Keratoplasty

LEM04 Lions Eye Donation Service $2,660.00

Cornea For Lamellar

LEN03 Lions NSW Eye Bank $1,216.00

Sclera

LEM02 Lions Eye Donation Service $150.00

LEN02 Lions NSW Eye Bank $304.00

LEW02 Lions Eye Bank of Western Australia $250.00

QEB02 Queensland Eye Bank $298.00

SAE02 The Eye Bank of South Australia $230.00

ORTHOPAEDIC

Autologous Skull Flap

MVS23 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $1,396.00

QBB60 The Queensland Bone Bank $1,568.00

RNB02 Hunter New England Bone Bank $1,470.00

Autologous Skull Flap - processed

QBB56 The Queensland Bone Bank $1,986.00

Bone - Cancellous Bone Matrix, Lyophilised 40cc

TBV52 Victorian Institute of Forensic Medicine $683.00

Bone - Cancellous Bone Matrix, Lyophilised 80cc

TBV53 Victorian Institute of Forensic Medicine $1,364.00

Bone - Cancellous Crunch 15cc

NBB62 New South Wales Bone Bank $903.00

Bone - Cancellous Crunch 30cc

NBB61 New South Wales Bone Bank $1,647.00

Bone - Cancellous Crunch 60cc

NBB60 New South Wales Bone Bank $2,498.00

Bone - Cancellous Cubes (6) Freeze Dried

QBB09 The Queensland Bone Bank $1,609.00

 Page 3 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

Bone - Cancellous Strips (2) Freeze Dried

QBB10 The Queensland Bone Bank $680.00

Bone - Chips/cubes 40cc

TBV09 Donor Tissue Bank of Victoria $1,073.00

Bone - Chips/cubes 80cc

TBV10 Donor Tissue Bank of Victoria $2,044.00

Bone - Cortico-Cancellous Crunch (40/60) 15cc

NBB65 New South Wales Bone Bank $903.00

Bone - Cortico-Cancellous Crunch (40/60) 30cc

NBB64 New South Wales Bone Bank $1,647.00

Bone - Cortico-Cancellous Crunch (40/60) 60cc

NBB63 New South Wales Bone Bank $2,498.00

Bone Cortico-Cancellous Crunch <20g Sterile

AUB08 Australian Biotechnologies $2,215.00

Bone Cortico-Cancellous Crunch <30g

AUB04 Australian Biotechnologies $2,070.00

Bone - Demineralised Bone Matrix, DBX Putty, 10cc

SYN02 Synthes Australia Pty Ltd $3,400.00

Bone - Demineralised Bone Matrix, DBX Putty, 5cc

SYN01 Synthes Australia Pty Ltd $2,650.00

Bone - Demineralised Bone Matrix, Lyophilised 10g

TBV55 Donor Tissue Bank of Victoria $1,157.00

Bone - Demineralised Bone Matrix, Lyophilised 5g

TBV54 Donor Tissue Bank of Victoria $578.00

Bone - Milled <30g Freeze Dried

PBT37 Perth Bone and Tissue Bank $750.00

Bone - Milled <5 gr (<10cc equivalent)

PBT62 Perth Bone and Tissue Bank $550.00

Bone - Milled >50gr (100cc equivalent)

PBT10 Perth Bone and Tissue Bank $3,745.00

Bone - Milled 10-19 gr (20-38cc equivalent)

PBT64 Perth Bone and Tissue Bank $1,850.00

 Page 4 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

Bone - Milled 20-29gr (22-60cc equivalent)

PBT08 Perth Bone and Tissue Bank $2,709.00

Bone - Milled 20g

QBB45 The Queensland Bone Bank $1,993.00

Bone - Milled 20g Freeze Dried

QBB03 The Queensland Bone Bank $2,524.00

Bone - Milled 30 - 50gr (60 - 100cc equivalent)

PBT09 Perth Bone and Tissue Bank $3,330.00

Bone - Milled 30-50g Freeze Dried

PBT38 Perth Bone and Tissue Bank $900.00

Bone - Milled 40cc

TBV11 Donor Tissue Bank of Victoria $1,285.00

Bone - Milled 5-9 gr (10-18cc equivalent)

PBT63 Perth Bone and Tissue Bank $950.00

Bone - Milled 80cc

TBV12 Donor Tissue Bank of Victoria $2,299.00

Bone - Milled Femoral Head

AUB02 Australian Biotechnologies $2,457.00

Bone - Ronguered Chips

QBB68 The Queensland Bone Bank $2,022.00

Bone - Ronguered Chips Freeze Dried

QBB67 The Queensland Bone Bank $2,524.00

Bone Plug/Dowel - Cancellous

NBB05 New South Wales Bone Bank $1,224.00

PBT03 Perth Bone and Tissue Bank $500.00

TBV07 Donor Tissue Bank of Victoria $762.00

Bone Plug/Dowel - Tricortical

TBV08 Donor Tissue Bank of Victoria $827.00

Cartilage - costal segments

PBT11 Perth Bone and Tissue Bank $300.00

QBB12 The Queensland Bone Bank $210.00

TBV17 Donor Tissue Bank of Victoria $430.00

 Page 5 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

Cortical Strut

AUB05 Australian Biotechnologies $2,451.00

QBB52 The Queensland Bone Bank $441.00

TBV14 Donor Tissue Bank of Victoria $842.00

Cortical Strut >15 - 20cm

PBT07 Perth Bone and Tissue Bank $2,664.00

Cortical Strut >20cm

PBT48 Perth Bone and Tissue Bank $3,032.00

Cortical Struts 10-15cm

PBT06 Perth Bone and Tissue Bank $1,981.00

Disc - Freeze Dried

QBB04 The Queensland Bone Bank $713.00

Elbow - joint

QBB14 The Queensland Bone Bank $2,205.00

TBV18 Donor Tissue Bank of Victoria $5,787.00

Fascia Lata

NBB09 New South Wales Bone Bank $922.00

TBV21 Donor Tissue Bank of Victoria $889.00

Fascia Lata - Large (15cm x 10cm)

PBT15 Perth Bone and Tissue Bank $1,590.00

Fascia Lata - per sq cm

QBB11 The Queensland Bone Bank $5.00

Fascia Lata - Small (10cm x 5cm)

PBT16 Perth Bone and Tissue Bank $854.00

Femoral Head

ACT01 ACT Bone Bank $2,432.00

APH01 The Avenue Private Hospital Bone Bank $1,131.00

AUB03 Australian Biotechnologies $2,354.00

CSA01 Rachel Forster Bone Bank $802.00

DHR01 Barwon Health Bone Bank $3,028.00

HBB01 The Hobart Private Hospital Bone Bank $2,113.00

LPH01 Lingard Private Hospital Bone Bank $1,103.00

MMH01 Mater Misericordiae Hospital Bone Bank Theatres $400.00

 Page 6 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

MVS05 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,370.00

NBB16 New South Wales Bone Bank $2,354.00

PBT22 Perth Bone and Tissue Bank $2,932.00

QBB27 The Queensland Bone Bank $2,163.00

RNB01 Hunter New England Bone Bank $2,250.00

SVN01 Mater Hospital $731.00

TBV26 Donor Tissue Bank of Victoria $2,596.00

Femoral Head - Autologous

QBB61 The Queensland Bone Bank $2,163.00

Femoral Head - Freeze Dried

QBB28 The Queensland Bone Bank $2,163.00

Femoral Hemi-condyle

NBB59 New South Wales Bone Bank $2,271.00

PBT21 Perth Bone and Tissue Bank $2,295.00

TBV46 Donor Tissue Bank of Victoria $1,330.00

Femoral Rings

NBB17 New South Wales Bone Bank $1,606.00

PBT24 Perth Bone and Tissue Bank $1,662.00

QBB30 The Queensland Bone Bank $1,591.00

Femoral Rings - Freeze Dried

QBB31 The Queensland Bone Bank $670.00

Femoral Shaft

QBB23 The Queensland Bone Bank $2,247.00

Femoral Shaft - Freeze Dried

QBB66 The Queensland Bone Bank $2,811.00

Femoral Shaft - Half

NBB57 New South Wales Bone Bank $2,778.00

Femoral Shaft - Middle Third

NBB13 New South Wales Bone Bank $2,507.00

TBV24 Donor Tissue Bank of Victoria $2,357.00

Femoral Shaft - Segment

NBB56 New South Wales Bone Bank $1,687.00

Femoral Shaft - Third

 Page 7 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

NBB55 New South Wales Bone Bank $1,687.00

Femoral Shaft/Tibial Shaft - Middle third

PBT19 Perth Bone and Tissue Bank $2,791.00

Femur - Distal (Shaft & Condyles)

MVS02 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT17 Perth Bone and Tissue Bank $3,771.00

TBV22 Donor Tissue Bank of Victoria $4,251.00

Femur - Distal Half

NBB10 New South Wales Bone Bank $2,778.00

QBB20 The Queensland Bone Bank $2,800.00

Femur - Distal third

NBB11 New South Wales Bone Bank $2,606.00

Femur - Entire

MVS03 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB12 New South Wales Bone Bank $6,200.00

QBB22 The Queensland Bone Bank $4,268.00

TBV23 Donor Tissue Bank of Victoria $7,120.00

Femur - Entire head removed

PBT18 Perth Bone and Tissue Bank $5,882.00

Femur - Proximal (shaft, trochanter, neck)

MVS04 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT20 Perth Bone and Tissue Bank $3,771.00

TBV25 Donor Tissue Bank of Victoria $4,220.00

Femur - Proximal half

NBB15 New South Wales Bone Bank $2,921.00

QBB25 The Queensland Bone Bank $3,020.00

Femur - Proximal third

NBB14 New South Wales Bone Bank $1,306.00

Femur - Proximal with femoral head

TBV51 Donor Tissue Bank of Victoria $4,095.00

Fibula - Entire

MVS07 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB18 New South Wales Bone Bank $6,041.00

 Page 8 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

PBT25 Perth Bone and Tissue Bank $2,967.00

QBB32 The Queensland Bone Bank $2,651.00

TBV27 Donor Tissue Bank of Victoria $6,863.00

Fibula - Segment

NBB54 New South Wales Bone Bank $2,359.00

PBT28 Perth Bone and Tissue Bank $1,472.00

Fibula - Segment (12cm)

MVS14 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

TBV29 Donor Tissue Bank of Victoria $1,164.00

Fibula - Segment (6cm)

MVS13 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

TBV28 Donor Tissue Bank of Victoria $762.00

Fibular Shaft

TBV30 Donor Tissue Bank of Victoria $2,419.00

Hemipelvis - Acetabulum

NBB21 New South Wales Bone Bank $2,905.00

PBT29 Perth Bone and Tissue Bank $2,940.00

QBB33 The Queensland Bone Bank $2,762.00

TBV31 Donor Tissue Bank of Victoria $3,300.00

Hemipelvis - Complete

MVS08 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB24 New South Wales Bone Bank $6,500.00

PBT30 Perth Bone and Tissue Bank $5,411.00

QBB37 The Queensland Bone Bank $4,268.00

TBV32 Donor Tissue Bank of Victoria $7,487.00

Hemipelvis - iliac crest

NBB22 New South Wales Bone Bank $2,705.00

PBT31 Perth Bone and Tissue Bank $1,174.00

QBB34 The Queensland Bone Bank $2,478.00

TBV33 Donor Tissue Bank of Victoria $2,984.00

Hemipelvis - Tricortical iliac wedge

NBB23 New South Wales Bone Bank $1,195.00

PBT32 Perth Bone and Tissue Bank $1,067.00

 Page 9 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

QBB35 The Queensland Bone Bank $1,195.00

TBV34 Donor Tissue Bank of Victoria $1,149.00

Hemipelvis - Tricortical iliac wedge Freeze Dried

QBB36 The Queensland Bone Bank $735.00

Humeral Head

TBV37 Donor Tissue Bank of Victoria $1,823.00

Humeral Head Addition

NBB26 New South Wales Bone Bank $1,545.00

Humeral Shaft

NBB50 New South Wales Bone Bank $3,090.00

QBB39 The Queensland Bone Bank $1,612.00

Humeral Shaft - Half

NBB51 New South Wales Bone Bank $1,671.00

Humerus - Distal

MVS19 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB25 New South Wales Bone Bank $2,359.00

TBV49 Donor Tissue Bank of Victoria $2,472.00

Humerus - Entire

MVS20 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB29 New South Wales Bone Bank $3,142.00

QBB43 The Queensland Bone Bank $3,035.00

Humerus - Entire with rotator cuff

NBB30 New South Wales Bone Bank $3,182.00

PBT33 Perth Bone and Tissue Bank $3,343.00

Humerus - Proximal

NBB27 New South Wales Bone Bank $2,769.00

PBT35 Perth Bone and Tissue Bank $1,174.00

TBV36 Donor Tissue Bank of Victoria $3,054.00

Humerus - Proximal half with rotator cuff

NBB28 New South Wales Bone Bank $2,778.00

Humerus - Proximal with rotator cuff

MVS09 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT34 Perth Bone and Tissue Bank $2,886.00

 Page 10 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

TBV35 Donor Tissue Bank of Victoria $2,919.00

Humerus - Ring

NBB53 New South Wales Bone Bank $1,448.00

Ligament - Medial

NBB31 New South Wales Bone Bank $1,781.00

TBV38 Donor Tissue Bank of Victoria $1,964.00

Meniscal Graft

PBT47 Perth Bone and Tissue Bank $1,921.00

Meniscus

QBB05 The Queensland Bone Bank $1,400.00

TBV40 Donor Tissue Bank of Victoria $1,306.00

Meniscus with Ligaments

TBV39 Donor Tissue Bank of Victoria $2,368.00

Osteotomy Wedge

PBT60 Perth Bone and Tissue Bank $1,567.00

Patella

QBB47 The Queensland Bone Bank $788.00

TBV41 Donor Tissue Bank of Victoria $1,125.00

Patellar unit whole with or without tibial block

PBT40 Perth Bone and Tissue Bank $2,954.00

Radius

MVS18 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB06 New South Wales Bone Bank $3,024.00

PBT13 Perth Bone and Tissue Bank $1,800.00

QBB15 The Queensland Bone Bank $2,258.00

TBV19 Donor Tissue Bank of Victoria $3,436.00

Radius - Ring

NBB49 New South Wales Bone Bank $1,854.00

Radius - Shaft

NBB47 New South Wales Bone Bank $2,975.00

Rib (5cm)

MVS21 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $382.00

 Page 11 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

PBT41 Perth Bone and Tissue Bank $300.00

TBV43 Donor Tissue Bank of Victoria $537.00

Spinal Ring

AUB07 Australian Biotechnologies $1,854.00

Tendon

AUB10 Australian Biotechnologies $2,184.00

Tendon - Achilles

NBB01 New South Wales Bone Bank $1,922.00

PBT61 Perth Bone and Tissue Bank $1,985.00

QBB62 The Queensland Bone Bank $1,922.00

TBV05 Donor Tissue Bank of Victoria $1,129.00

Tendon - Achilles Hemi

QBB65 The Queensland Bone Bank $1,433.00

Tendon - Achilles with bone block

NBB02 New South Wales Bone Bank $2,228.00

PBT01 Perth Bone and Tissue Bank $2,601.00

QBB01 The Queensland Bone Bank $1,922.00

TBV06 Donor Tissue Bank of Victoria $2,300.00

Tendon - Achilles with bone plug

AUB09 Australian Biotechnologies $2,228.00

Tendon - Achilles with machined conical bone block

NBB69 New South Wales Bone Bank $2,728.00

Tendon - EHL

QBB69 The Queensland Bone Bank $1,922.00

Tendon - Gracilis

QBB59 The Queensland Bone Bank $1,922.00

Tendon - Patellar

QBB48 The Queensland Bone Bank $2,055.00

Tendon - Patellar Hemi

QBB63 The Queensland Bone Bank $1,570.00

Tendon - Patellar split with bone plugs

PBT02 Perth Bone and Tissue Bank $1,918.00

 Page 12 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

Tendon - Patellar with bone plugs

NBB33 New South Wales Bone Bank $2,147.00

TBV42 Donor Tissue Bank of Victoria $2,368.00

Tendon - Patellar with machined conical bone plug

NBB68 New South Wales Bone Bank $2,647.00

Tendon - Patellar with Quads

NBB72 New South Wales Bone Bank $2,184.00

Tendon - Peroneus Longus

NBB73 New South Wales Bone Bank $2,184.00

Tendon - Semi tendinosis

NBB70 New South Wales Bone Bank $2,185.00

QBB70 The Queensland Bone Bank $1,922.00

Tendon - Single (ant and post tibilias, FDL, EDL, hamstring, gracilis)

PBT46 Perth Bone and Tissue Bank $2,698.00

Tendon - Tibialis Anterior

NBB67 New South Wales Bone Bank $2,184.00

QBB58 The Queensland Bone Bank $1,922.00

TBV57 Donor Tissue Bank of Victoria $2,300.00

Tendon - Tibialis Posterior

NBB71 New South Wales Bone Bank $2,184.00

QBB57 The Queensland Bone Bank $1,922.00

Tibia - Condyles only

TBV47 Donor Tissue Bank of Victoria $1,832.00

Tibia - Distal

MVS17 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

QBB51 The Queensland Bone Bank $1,892.00

TBV48 Donor Tissue Bank of Victoria $2,401.00

Tibia - Plateau (prox 1/3)

NBB35 New South Wales Bone Bank $2,518.00

Tibia - Proximal

NBB36 New South Wales Bone Bank $2,551.00

PBT45 Perth Bone and Tissue Bank $2,635.00

 Page 13 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

QBB54 The Queensland Bone Bank $2,365.00

Tibia - Proximal 16-25cm

TBV45 Donor Tissue Bank of Victoria $2,722.00

Tibia - Proximal 7-15cm

TBV44 Donor Tissue Bank of Victoria $2,826.00

Tibia - Proximal half

MVS11 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

Tibia Proximal third

AUB06 Australian Biotechnologies $2,562.00

Tibia - Proximal with Patella

QBB08 The Queensland Bone Bank $2,800.00

Tibia - Proximal with Patella & Tendon

PBT44 Perth Bone and Tissue Bank $4,118.00

Tibia - Proximal with Patellar Tendon

NBB46 New South Wales Bone Bank $3,986.00

Tibia - Ring

NBB45 New South Wales Bone Bank $1,448.00

Tibia - Whole

MVS16 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB37 New South Wales Bone Bank $4,065.00

QBB55 The Queensland Bone Bank $4,248.00

Tibia - Whole with Patella

QBB64 The Queensland Bone Bank $4,268.00

Tibia - Whole with Patellar Tendon

NBB44 New South Wales Bone Bank $5,455.00

Tibia Shaft

QBB53 The Queensland Bone Bank $992.00

Tibial Shaft

NBB41 New South Wales Bone Bank $3,747.00

Tibial Shaft - half

NBB43 New South Wales Bone Bank $2,450.00

Tibial Shaft - third

 Page 14 of 15


Billing Code Facility  Minimum Benefit  Maximum Benefit

NBB42 New South Wales Bone Bank $2,645.00

Tibial Shaft Freeze Dried

QBB02 The Queensland Bone Bank $872.00

Tri Cortical Osteotomy

NBB66 New South Wales Bone Bank $1,208.00

Ulna

MVS15 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB07 New South Wales Bone Bank $2,787.00

PBT14 Perth Bone and Tissue Bank $1,500.00

QBB16 The Queensland Bone Bank $2,258.00

TBV20 Donor Tissue Bank of Victoria $3,167.00

Ulna - Ring

NBB40 New South Wales Bone Bank $1,854.00

Ulna - Shaft

NBB38 New South Wales Bone Bank $2,450.00

Grand Total: 287 Records

 Page 15 of 15