Medicare Benefits Schedule - Item 45072

Developmental breast abnormality, 2 stage correction of, second stage, involving surgery on one breast with exchange of a tissue expander for an implant (which must have at least a 10% volume difference), if:

(a) there is a difference in breast volume with the other breast, 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; and

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

Applicable only once per occasion on which the service is provided (H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $734.05 Benefit: 75% = $550.55

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