Confirm the medical name
Ask the specialist exactly which procedure or service is proposed and whether it is in hospital or out of hospital.
Breast surgery (medically necessary) · Government service H113
Lymph nodes axilla excision
Surgery to remove the lymph nodes in the armpit (axilla). This procedure is often performed with other breast operations. The addition surgeries may include removal of the breast or removal of a cancerous growth in the breast and incur separate fees.
The information on the Medical Costs Finder is a guide only and should not be used as a quote or medical diagnosis. The description above comes from the government catalogue. It is not medical advice and it does not confirm that this is the procedure you need.
Before relying on a cost
Match the procedure, MBS items and setting first.
A specialist quote can include several clinicians, MBS items, hospital or theatre charges, imaging, pathology, anaesthesia and other services. A Medical Costs Finder result is a planning guide, not the total bill.
Ask for MBS item numbers
Use the item numbers to cross-check Medicare benefits and to discuss cover with a private health insurer.
Ask for a written estimate
The specialist or practice should tell you the expected fee and any out-of-pocket amount they can identify.
Check the other providers
For hospital treatment, ask about anaesthetist, assistant, hospital, imaging, pathology and insurer gap arrangements where relevant.
Safety Nets and GPG
Apply the correct Medicare rule to the service.
The OMSN, EMSN and Greatest Permissible Gap use different calculations. The PBS Safety Net is separate and applies to eligible medicine costs.
OMSN
$594.4
100% of the MBS schedule fee for eligible out-of-hospital services.
Official source → EMSN_GENERAL$2699.1
80% of eligible out-of-pocket costs, subject to EMSN benefit caps where they apply.
Official source → EMSN_CONCESSIONAL_FTBA$861.2
80% of eligible out-of-pocket costs, subject to EMSN benefit caps where they apply.
Official source → PBSSeparate medicine Safety Net
Private prescriptions do not count towards the PBS Safety Net.
Official source →Connected checks
Use the rest of Core AU to complete the cost picture.
A procedure page is only the starting point. The same episode can involve MBS items, medicines, specialist roles and private-cover questions.
MBS
Search likely Medicare items
Use the procedure name as a starting search, then confirm the exact item numbers with the provider.
Search MBS → PBSCheck medicine costs separately
If treatment includes prescribed medicines, PBS listing and restrictions are a separate cost layer.
Search PBS → CAREUnderstand the clinician roles
ClinicalAtlas AU maps 83 clinician roles so you can distinguish specialist, diagnostic and allied-health providers.
Open clinician directory → COVERCheck private-health cover
Use the fund directory as a navigation aid, then verify the actual product, hospital agreement and benefit with your insurer.
Open fund directory →Official live result
Open the current Medical Costs Finder fee page.
Live typical-cost and specialist information is maintained by the Department of Health, Disability and Ageing. Compass intentionally does not freeze those dynamic figures into a static entitlement record.
Before the conversation
Keep a small evidence pack for the cost discussion.
- Referral or specialist letter, if you have one.
- The exact procedure, test or appointment name.
- Any MBS item numbers or Medical Costs Finder service code already supplied.
- A current medication list and PBS item code if a medicine cost is part of the question.
- Private health insurer and product details for planned private treatment.
- A short list of questions: provider fee, Medicare benefit, hospital charge, other clinicians, likely out-of-pocket amount and what could change the estimate.