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Mammaplasty, augmentation (unilateral) in the context of:

(a) breast cancer; or

(b) developmental abnormality of the breast, if there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least:

(i) 20% in normally shaped breasts; or

(ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds.

Applicable only once per occasion on which the service is provided, other than a service associated with a service to which item 45006 or 45012 applies (H)

Multiple Operation Rule

Fee: $816.35 Benefit: 75% = $612.30

(See para TN.8.96 of explanatory notes to this Category)

• Previous - Item 45523
• Next - Item 45527

Breast reconstruction (unilateral), following mastectomy, using a permanent prosthesis, other than a service associated with a service to which item 45006 or 45012 applies (H)

Multiple Operation Rule

Fee: $1,179.10 Benefit: 75% = $884.35

(See para TN.8.97 of explanatory notes to this Category)

• Previous - Item 45524
• Next - Item 45528

Mammaplasty, augmentation, bilateral (other than a service to which item 45527 applies), if:

(a) reconstructive surgery is indicated because of:

(i) developmental malformation of breast tissue (excluding hypomastia); or

(ii) disease of or trauma to the breast (other than trauma resulting from previous elective cosmetic surgery); or

(iii) amastia secondary to a congenital endocrine disorder; and

(b) photographic or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes

other than a service associated with a service to which item 45006 or 45012 applies (H)

Multiple Operation Rule

Fee: $1,224.35 Benefit: 75% = $918.30

• Previous - Item 45527
• Next - Item 45529