Medicare Benefits Schedule - Item 45635

Rhinoplasty, partial, involving correction of bony vault only, if:

(a) the indication for surgery is:

(i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity; and

(b) photographic and/or NOSE Scale evidence demonstrating the clinical need for this service is documented in the patient notes

Multiple Operation Rule

(Anaes.)

Fee: $669.40 Benefit: 75% = $502.05 85% = $570.70

(See para TN.8.104 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $535.55

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Benefits are payable for septoplasty (item 41671) where performed in conjunction with rhinoplasty. 

A Medicare benefit for items 45632 – 45644 and 45650 is payable where the indication for surgery is for:

(i) airway obstruction and the patient has a self-reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity.

The NOSE Scale refers to the Nasal Obstruction Symptom Evaluation Scale, as published in:

Stewart, M.G., Witsell, D.L., Smith, T.L., Weaver, E.M., Yueh, B. and Hannley, M.T. (2004), Development and Validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale. Otolaryngology–Head and Neck Surgery, 130: 157-163.

The NOSE Scale can be accessed here: https://www.entnet.org/wp-content/uploads/files/NOSE-Instrument.pdf

Full clinical details must be documented in patient notes, including pre-operative photographic and / or NOSE Scale evidence demonstrating the clinical need for the service as this may be subject to audit.

Related Items: 41671 45632 45635 45641 45644 45650