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Upper eyelid, reduction of, if:

(a) the reduction is for any of the following:

(i) history of a demonstrated visual impairment;

(ii) intertriginous inflammation of the eyelid;

(iii) herniation of orbital fat in exophthalmos;

(iv) facial nerve palsy;

(v) post‑traumatic scarring;

(vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and

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

Multiple Operation Rule

Fee: $267.80 Benefit: 75% = $200.85 85% = $227.65

(See para TN.8.103 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $214.25

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Lower eyelid, reduction of, if:

(a) the reduction is for:

(i) herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring; or

(ii) the restoration of symmetry of the contralateral lower eyelid in respect of one of these conditions; and

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

Multiple Operation Rule

Fee: $371.45 Benefit: 75% = $278.60 85% = $315.75

(See para TN.8.103 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $297.20

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