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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: $274.25 Benefit: 75% = $205.70 85% = $233.15

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

Extended Medicare Safety Net Cap: $219.40

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