Medicare Benefits Schedule - 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

(Anaes.) (Assist.)

Fee: $1,218.25 Benefit: 75% = $913.70

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