Medicare Benefits Schedule - Note TN.8.235

If the procedure is for glandular high grade abnormality or any suspected invasive cancer the procedure should be performed by a gynaecological oncologist or only after discussion with, or review by, a gynaecological oncologist or gynaecological oncology multidisciplinary team (MDT).

Related Items: 35536 35548 35560 35561 35562 35564 35609 35610 35647 35648 35667 35668 35720 35721 35723 35724

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Multiple Operation Rule

Vulva, wide local excision or hemivulvectomy, one or both procedures, for suspected malignancy or vulval lesions with a high risk of malignancy

(Anaes.) (Assist.)

Fee: $381.65 Benefit: 75% = $286.25 85% = $324.45

(See para TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

VULVECTOMY, radical, for malignancy (H)

(Anaes.) (Assist.)

Fee: $1,370.20 Benefit: 75% = $1,027.65

(See para TN.8.235, TN.8.239 of explanatory notes to this Category)

Multiple Operation Rule

Partial or complete vaginectomy, for either or both of the following:
(a) deeply infiltrating vaginal endometriosis, if accompanied by histological confirmation from excised tissue;
(b) pre-invasive or invasive lesions
Not being a service associated with hysterectomy for non invasive indications (H) 

(Anaes.) (Assist.)

Fee: $749.05 Benefit: 75% = $561.80

(See para TN.8.235, TN.8.238 of explanatory notes to this Category)

Multiple Operation Rule

VAGINECTOMY, radical, for proven invasive malignancy - 1 surgeon (H)

(Anaes.) (Assist.)

Fee: $1,681.20 Benefit: 75% = $1,260.90

(See para TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

VAGINECTOMY, radical, for proven invasive malignancy, conjoint surgery - abdominal surgeon (including aftercare) (H)

(Anaes.) (Assist.)

Fee: $1,416.30 Benefit: 75% = $1,062.25

(See para TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

VAGINECTOMY, radical, for proven invasive malignancy, conjoint surgery - perineal surgeon (H)

(Assist.)

Fee: $708.15 Benefit: 75% = $531.15

(See para TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Cervix, cone biopsy or amputation

(Anaes.)

Fee: $238.75 Benefit: 75% = $179.10 85% = $202.95

(See para TN.8.2, TN.8.233, TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Cervix, cone biopsy for histologically proven malignancy

(Anaes.)

Fee: $417.80 Benefit: 75% = $313.35 85% = $355.15

(See para TN.8.2, TN.8.233, TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Cervix, complete excision of the endocervical transformation zone, using large loop or laser therapy, including any local anaesthesia and biopsies 

(Anaes.)

Fee: $223.05 Benefit: 75% = $167.30 85% = $189.60

(See para TN.8.45, TN.8.233, TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Cervix, complete excision of the endocervical transformation zone, using large loop or laser therapy, including any local anaesthesia and biopsies, in conjunction with ablative treatment of additional areas of biopsy-proven high grade intraepithelial lesions of one or more sites of the vagina, vulva, urethra or anus 

(Anaes.)

Fee: $349.05 Benefit: 75% = $261.80 85% = $296.70

(See para TN.8.45, TN.8.233, TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Radical hysterectomy or radical trachelectomy (with or without excision of uterine adnexae) for proven malignancy, including excision of any one or more of the following:
(a) parametrium;
(b) paracolpos;
(c) upper vagina;
(d) contiguous pelvic peritoneum;
utilising nerve sparing techniques and involving ureterolysis, if performed (H) 

(Anaes.) (Assist.)

Fee: $1,745.20 Benefit: 75% = $1,308.90

(See para TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Hysterectomy, radical (with or without excision of uterine adnexae) including excision of any one or more of the following:
(a) parametrium;
(b) paracolpos;
(c) upper vagina;
(d) contiguous pelvic peritoneum;
utilising nerve sparing techniques and involving ureterolysis, if performed in a patient with malignancy and previous pelvic radiation or chemotherapy treatment (H) 

(Anaes.) (Assist.)

Fee: $2,027.60 Benefit: 75% = $1,520.70

(See para TN.8.2, TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Radical debulking, involving the radical excision of a macroscopically disseminated gynaecological malignancy from the pelvic cavity, including resection of peritoneum from the following:
(a) the pelvic side wall;
(b) the pouch of Douglas;
(c) the bladder;
for macroscopic disease confined to the pelvis, not being a service associated with a service to which item 35721 applies (H) 

(Anaes.) (Assist.)

Fee: $1,746.80 Benefit: 75% = $1,310.10

(See para TN.8.57, TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Radical debulking, involving the radical excision of a macroscopically disseminated gynaecological malignancy from the abdominal and pelvic cavity, where cancer has extended beyond the pelvis, including any of the following:
(a) resection of peritoneum over any of the following:
         (i) the diaphragm;
         (ii) the paracolic gutters;
         (iii) the greater or lesser omentum;
         (iv) the porta hepatis;
(b) cytoreduction of recurrent gynaecological malignancy from the abdominal cavity following previous abdominal surgery, radiation or chemotherapy;
(c) cytoreduction of recurrent gynaecological malignancy from the pelvic cavity following previous pelvic surgery, radiation or chemotherapy;
not being a service to which a service associated with a service to which item 35720 or 35726 applies (H) 

(Anaes.) (Assist.)

Fee: $3,493.65 Benefit: 75% = $2,620.25

(See para TN.8.2, TN.8.235, TN.8.236 of explanatory notes to this Category)

Multiple Operation Rule

Para-aortic lymph node dissection from above the level of the aortic bifurcation (unilateral), for staging or restaging of gynaecological malignancy (H) 

(Anaes.) (Assist.)

Fee: $1,519.15 Benefit: 75% = $1,139.40

(See para TN.8.233, TN.8.235 of explanatory notes to this Category)

Multiple Operation Rule

Para-aortic lymph node dissection (pelvic or above the aortic bifurcation) after prior similar dissection, radiotherapy or chemotherapy for malignancy (H) 

(Anaes.) (Assist.)

Fee: $2,285.45 Benefit: 75% = $1,714.10

(See para TN.8.2, TN.8.233, TN.8.235 of explanatory notes to this Category)