Medicare Benefits Schedule - Note CN.0.11

Benefits are payable for items 75002 to 75621 only where the service has been rendered to a patient who has been referred by letter of referral by a medical practitioner or referring dentist. 

Item 75621 may be claimed in association with items 46150 to 46161 where the service is performed by a practitioner holding a FRACDS (OMS) qualification.

Related Items: 46150 46151 46152 46153 46154 46155 46156 46157 46158 46159 46160 46161 75621

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The fabrication and fitting of surgical splint or guide in conjunction with orthognathic surgical procedures and implant treatment, if provided in association with a service to which:

(a) any item in the following series applies:

(i) any of items 46150 to 46161 apply; or
(ii) any of items 52342 to 52375 apply; or

(b) item 52380 or 52382 applies; 

(c) item 75610 applies

Fee: $254.90 Benefit: 75% = $191.20 85% = $216.70

(See para CN.0.11, CN.2.1 of explanatory notes to this Category)

Multiple Operation Rule

Mandible or maxilla, procedure for advancement, retrusion or alteration of tilt, by osteotomy in standard planes, including fixation by any means (including application of distractors if used)—one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,463.70 Benefit: 75% = $1,097.80

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Multiple Operation Rule

Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,595.95 Benefit: 75% = $1,197.00

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Multiple Operation Rule

Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,196.95 Benefit: 75% = $897.75

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Multiple Operation Rule

Mandible and maxilla (bimaxillary), procedure for advancement, retrusion or alteration of tilt, or combination of these, by osteotomies in standard planes, including fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,994.80 Benefit: 75% = $1,496.10

(See para CN.0.11, TN.8.107, TN.8.269 of explanatory notes to this Category)

Multiple Operation Rule

Maxilla, procedure for reshaping arch of, by complex segmental osteotomies, including fixation by any means (including application of distractors if used), one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,670.50 Benefit: 75% = $1,252.90

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Multiple Operation Rule

Mandible, procedure for reshaping arch of, by complex segmental osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used), one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,670.50 Benefit: 75% = $1,252.90

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Multiple Operation Rule

Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, principal specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,907.10 Benefit: 75% = $1,430.35

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Multiple Operation Rule

Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—conjoint surgery, conjoint specialist surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $1,430.30 Benefit: 75% = $1,072.75

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Multiple Operation Rule

Mandible and maxilla (bimaxillary), procedure for any combination of arch reshaping, advancement, retrusion or tilting of, involving complex segmental osteotomies, with or without standard osteotomies, including genioplasty (if performed) and fixation by any means (including application of distractors if used)—single surgeon, one service per patient on the same occasion (H)

(Anaes.) (Assist.)

Fee: $2,383.80 Benefit: 75% = $1,787.85

(See para CN.0.11, TN.8.107 of explanatory notes to this Category)

Multiple Operation Rule

Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, principal specialist surgeon (H)

(Anaes.) (Assist.)

Fee: $2,109.05 Benefit: 75% = $1,581.80

(See para CN.0.11 of explanatory notes to this Category)

Multiple Operation Rule

Midfacial osteotomies, Le Fort II or Le Fort III—conjoint surgery, conjoint specialist surgeon (H)

(Anaes.) (Assist.)

Fee: $1,581.75 Benefit: 75% = $1,186.35

(See para CN.0.11 of explanatory notes to this Category)

Multiple Operation Rule

Midfacial osteotomies, Le Fort II or Le Fort III—single surgeon (H)

(Anaes.) (Assist.)

Fee: $2,636.25 Benefit: 75% = $1,977.20

(See para CN.0.11 of explanatory notes to this Category)