Medicare Benefits Schedule - Note TN.8.25

Therapeutic biopsy or excision of breast lesions, abnormalities or tumours under Items: 31500, 31503, 31506, 31509, 31512, 31515 either singularly or in combination should not be claimed when using the Advanced Breast Biopsy Instrumentation (ABBI) procedure, or any other large core breast biopsy device.

Related Items: 31500 31503 31506 31509 31515

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Multiple Operation Rule

BREAST, BENIGN LESION up to and including 50mm in diameter, including simple cyst, fibroadenoma or fibrocystic disease, open surgical biopsy or excision of, with or without frozen section histology

(Anaes.)

Fee: $296.20 Benefit: 75% = $222.15 85% = $251.80

(See para TN.8.25, TN.8.280 of explanatory notes to this Category)

Multiple Operation Rule

BREAST, BENIGN LESION more than 50mm in diameter, excision of

(Anaes.) (Assist.)

Fee: $395.00 Benefit: 75% = $296.25 85% = $335.75

(See para TN.8.25, TN.8.280 of explanatory notes to this Category)

Multiple Operation Rule

BREAST, ABNORMALITY detected by mammography or ultrasound where guidewire or other localisation procedure is performed, excision biopsy of

(Anaes.) (Assist.)

Fee: $444.45 Benefit: 75% = $333.35

(See para TN.8.25, TN.8.280 of explanatory notes to this Category)

Multiple Operation Rule

BREAST, MALIGNANT TUMOUR, open surgical biopsy of, with or without frozen section histology

(Anaes.)

Fee: $395.00 Benefit: 75% = $296.25 85% = $335.75

(See para TN.8.25, TN.8.280 of explanatory notes to this Category)

Multiple Operation Rule

BREAST, TUMOUR SITE, re-excision of following open biopsy or incomplete excision of malignant tumour

(Anaes.) (Assist.)

Fee: $496.90 Benefit: 75% = $372.70

(See para TN.8.25, TN.8.280 of explanatory notes to this Category)