Understand the whole cost pathway, not just one number.

Weight loss surgery H51

Abdominal lipectomy (abdominoplasty)

Surgery to remove loose skin and fat (abdominoplasty/tummy tuck/lipectomy) from the lower abdomen after a lot of weight loss for medical purposes only. The specialist may also fix muscle layers.

Open procedure pathway →

Heart and vascular system H150

Ablation of arrythmia

Surgery to remove a small area in the heart to stop abnormal rhythm.

Open procedure pathway →

Tonsils adenoids and grommets H62

Adenoids

A surgical procedure to remove patches of tissue which are located at the back of the nasal cavity. The adenoids are part of the immune system and they help to trap and destroy germs.

Open procedure pathway →

Digestive system H127

Anal fissure treatment

Surgery to fix the ring of muscle (anus) which controls the release of food waste from the bowels and bottom.

Open procedure pathway →

Digestive system H78

Anal skin tags and polyp removal

A procedure to remove non-cancerous growths from the skin or internal lining around the anus.

Open procedure pathway →

Bone joint and muscle H162

Ankle arthrodesis

Keyhole surgery to remove damaged joint surfaces and fix the bones together with metal plates, screws and rods.

Open procedure pathway →

Joint reconstructions H163

Ankle arthroscopy

Keyhole surgery to perform, cartilage treatment, remove loose bones, remove membrane that lines a joint or remove bony lumps in the ankle.

Open procedure pathway →

Joint replacements H42

Ankle replacement

A surgical procedure where a damaged ankle joint is removed and replaced with an artificial joint made of metal and plastic.

Open procedure pathway →

Ear nose and throat H110

Antrostomy (maxillary sinus clearing)

A surgical procedure to clear the opening to the hollow spaces in the bone underneath the cheekbones. This helps unblock and drain the spaces to stop infection. It is sometimes called FESS (functional endoscopic sinus surgery).

Open procedure pathway →

Joint reconstructions H164

Arthrodesis of first metatarsophalangeal joint

Following removal of damaged joint, the bones are fixed together with metal plates, screws, and rods.

Open procedure pathway →

Joint reconstructions H67

Arthroscopic coracoacromial

Keyhole surgery to cut a shoulder ligament and remove a small piece of shoulder bone.

Open procedure pathway →

Breast surgery (medically necessary) H98

Axilla lymph node biopsy (armpit) with or without excision in the setting of breast cancer

A procedure to remove a piece of lymph tissue from the armpit. The tissue is tested for cancer cells.

Open procedure pathway →

Breast surgery (medically necessary) H126

Bilateral mastectomy for gynecomastia

Surgery to remove excessive breast tissue in a male (not due to obesity). This may include liposuction.

Open procedure pathway →

Plastic and reconstructive surgery (medically necessary) H129

Bilateral otoplasty

Surgery to correct a deformity of the ear which has been present from birth which makes the ear stick out. This is for a person less than 18 years old.

Open procedure pathway →

Breast surgery (medically necessary) H128

Bilateral removal of breast prosthesis and capsulectomy

Surgery to remove a breast implant or breast tissue expander. Any tissue removed is sent for testing. This is often performed on both breasts. This procedure does not apply when a breast implant is re-inserted.

Open procedure pathway →

Breast surgery (medically necessary) H24

Breast biopsy

A procedure where a sample of tissue is taken from the breast. The tissue is tested for abnormal cells.

Open procedure pathway →

Breast surgery (medically necessary) H95

Breast reconstruction using prosthesis and muscle flap

A breast reconstruction using a local muscle and skin flap from the back to cover a permanent implant and reconstruct a single breast. This can be done at the same as a mastectomy, or as a separate procedure after the breast has been removed.

Open procedure pathway →

Breast surgery (medically necessary) H97

Breast reconstruction with removal of tissue expansion unit and insertion of prosthesis

The second of two surgeries to reconstruct one breast. The specialist will remove the tissue expander and insert a permanent implant to recreate the breast. This surgery follows 3 to 6 months after the service “Breast reconstruction with tissue expansion”.

Open procedure pathway →

Breast surgery (medically necessary) H182

Breast reconstruction with removal of tissue expansion unit and insertion of prosthesis (double)

The second of two surgeries to reconstruct both breasts following mastectomy. This surgery follows 3 to 6 months after the service “Breast reconstruction with tissue expansion (double)”. The specialist will remove the tissue expanders and insert permanent implants to recreate the breasts.

Open procedure pathway →

Breast surgery (medically necessary) H96

Breast reconstruction with tissue expansion

The first of two surgeries to recreate one breast. At the same time as, or after a mastectomy, the specialist inserts an expandable/empty breast implant. They inflate the expander over 6-8 weeks, until it reaches the size you both agree on. Once ready, the expander is replaced with a definitive implant. The procedure is followed 3-6 months later with “Breast reconstruction with removal of tissue expansion unit and insertion of prosthesis”.

Open procedure pathway →

Breast surgery (medically necessary) H183

Breast reconstruction with tissue expansion (double)

The first of two surgeries required to reconstruct both breasts following mastectomy. This surgery can be completed at the same time as a mastectomy or separately at a later time. The specialist inserts an expandable tissue implant under the skin after removing the breast. An expandable tissue implant is a deflated balloon which the surgeon will inflate about 3-6 times. After about 6 to 8 weeks, it will reach the breast size agreed with surgeon. The second of two surgeries occurs about 3 to 6 months later. It is called “Breast reconstruction with removal of tissue expansion unit and insertion of prosthesis (double)”.

Open procedure pathway →

Breast surgery (medically necessary) H122

Breast reduction

Surgery to make the breasts smaller for medical purposes only. It also involves repositioning of the nipple.

Open procedure pathway →

Breast surgery (medically necessary) H185

Breast tumour excision - lumpectomy (cancerous) with breast reshaping

Surgery to cut out a cancerous growth of the breast (lumpectomy). During the surgery, the breast is also re-shaped.

Open procedure pathway →

Heart and vascular system H111

Bronchoscopy

A procedure to look inside the airways. Thoracic surgery is often performed in combination. Costs may be higher for more complex procedures.

Open procedure pathway →

Pregnancy and birth H44

Caesarean section (complex)

Delivery of a baby by caesarean section (C-section) where there are conditions which may complicate the labour or birth.

Open procedure pathway →

Pregnancy and birth H45

Caesarean section (no complications)

Delivery of a baby by caesarean section (C-section) where there are no complications with the labour or birth.

Open procedure pathway →

Heart and vascular system H100

Cardiac electrophysiological studies

A test to measure the electrical activity and electrical pathways of the heart. This is to work out why there are abnormal heart beats or rhythms and to decide on a suitable treatment.

Open procedure pathway →

Bone joint and muscle H112

Carpal tunnel release

Surgery to divide a ligament in the wrist to help reduce pressure on the nerve in that area.

Open procedure pathway →

Cataracts H37

Cataract surgery

Surgery to remove a clouded lens (cataract) from the eye.

Open procedure pathway →

Cataracts H138

Cataract surgery with glaucoma stent

Surgery to remove a clouded lens (cataract) from the eye and insert a device to help drain fluid.

Open procedure pathway →

Gynaecology H83

Cervical excision

Surgery to remove abnormal cells in the cervix and vagina using a loop of wire or laser. This is because the cells may become cancerous. The surgeon may take a sample of tissue for testing (biopsy).

Open procedure pathway →

Chemotherapy radiotherapy and immunotherapy for cancer H172

Chemotherapy or immunotherapy for cancer

An injection of a medicine into a vein to treat cancer. Treatment is given as an infusion.

Open procedure pathway →

Digestive system H6

Cholecystectomy

Surgery to remove the gallbladder.

Open procedure pathway →

Implantation of hearing devices H101

Cochlear implant

Surgery to place an implant into the inner ear to help improve hearing. The air spaces in the bone behind the ear are also removed.

Open procedure pathway →

Digestive system H7

Colon resection

Surgery to remove a part of the large intestine. The remaining healthy ends of intestine are joined together.

Open procedure pathway →

Gastrointestinal endoscopy H9

Colonoscopy

A procedure using a specialised tube to look inside the large intestine. The specialist might remove polyps. They might also take a tissue sample for testing (biopsy).

Open procedure pathway →

Digestive system H132

Complex anal fistula treatment

Surgery to treat an infection in the anal canal (abscess). The infection connects the anal canal to the upper part of the anal sphincter and the surrounding skin.

Open procedure pathway →

Digestive system H133

Complex ventral hernia repair

Surgery to repair a hernia that is in the middle of the abdomen. The abdominal muscles are moved in the process. This is for a patient 10 years or over.

Open procedure pathway →

Eye (not cataracts) H147

Corneal graft surgery

Surgery to remove damaged or diseased cornea and replace with a donor cornea.

Open procedure pathway →

Heart and vascular system H28

Coronary artery bypass graft (CABG)

A procedure to improve blood flow and oxygen supply to the heart. Cardiac surgery is often performed in combination. Costs may be higher for more complex procedures.

Open procedure pathway →

Miscarriage and termination of pregnancy H18

Curette

Surgery with pain management to end pregnancy. This is done by scraping or suctioning the contents out of the womb.

Open procedure pathway →

Kidney and bladder H70

Cystoscopy (small bladder tumour resection)

Surgery using a specialised tube to look inside the bladder. A tumour or other growth (cancerous or non-cancerous) is removed by cutting, heat or laser.

Open procedure pathway →

Kidney and bladder H1

Cystoscopy inspection only

A procedure using a specialised tube to look inside the bladder and the lower urinary tract. This may involve widening of the tract. The procedure is performed either in-hospital or at the specialist's room.

Open procedure pathway →

Kidney and bladder H69

Cystoscopy with biopsy (examine bladder)

A procedure where a flexible tube with a camera is used to look at the inside of the bladder. A sample of abnormal or unusual tissue is removed for testing.

Open procedure pathway →

Gynaecology H11

Diagnostic hysteroscopy

A procedure using a specialised tube to look inside the womb. A sample of the lining may be taken for testing (endometrial biopsy).

Open procedure pathway →

Dialysis for chronic kidney failure H43

Dialysis

A regular procedure that helps filter the blood when the kidneys are not working correctly. There are two types - haemodialysis where a machine is used, or peritoneal dialysis where the lining of the abdomen is used.

Open procedure pathway →

Plastic and reconstructive surgery (medically necessary) H142

Droopy eyebrow surgery

Surgery to correct vision problems caused by sagging or lowering of the eyebrow.

Open procedure pathway →

Plastic and reconstructive surgery (medically necessary) H143

Droopy eyelid surgery

Surgery to fix a drooping upper eyelid.

Open procedure pathway →

Bone joint and muscle H125

Dupuytren's fasciectomy (multiple fingers)

Surgery to treat a condition that causes deformity of multiple fingers. The specialist may need to perform a full thickness graft.

Open procedure pathway →

Bone joint and muscle H124

Dupuytren's fasciectomy (one finger)

Surgery to treat a condition that causes deformity of one finger. The specialist may need to perform a full thickness graft.

Open procedure pathway →

Assisted reproductive services H104

Embryo or oocyte transfer (hospital admitted procedures only)

A type of fertility treatment where frozen or donor embryos, donor eggs or sperm and egg are placed into the uterus (womb) or fallopian tubes.

Open procedure pathway →

Heart and vascular system H31

Endarterectomy (removal artery lining blockage)

Surgery to remove a blockage in one or more arteries located in the neck.

Open procedure pathway →

Ear nose and throat H109

Endoscopy examination of nose sinus pharynx or larynx

A procedure using a specialised tube to look inside one or both sides of the nose, the throat or the voice box.

Open procedure pathway →

Gastrointestinal endoscopy H80

Endoscopy of bile ducts and pancreas (ERCP) & related procedures

Surgery using a specialised tube and x-rays to diagnose problems in the ducts which carry bile from the gallbladder and hormones from the pancreas. If gallstones are present, they may be removed or if the bile duct is narrowed it may be widened at the same time.

Open procedure pathway →

Plastic and reconstructive surgery (medically necessary) H144

Excess upper eyelid skin surgery

Surgery to reduce the amount of upper eyelid tissue.  Usually done on both eyes at the same time.

Open procedure pathway →

Breast surgery (medically necessary) H137

Excision of breast tumour/lumpectomy (cancerous)

Surgery to cut out a cancerous growth of the breast (lumpectomy). You may need an ultrasound or mammogram on the day of surgery to help the surgeon find your tumour, if they cannot feel a lump. The whole tissue is sent for testing (biopsy).

Open procedure pathway →

Breast surgery (medically necessary) H23

Excision of breast tumour/lumpectomy (non-cancerous)

Surgery to cut out a non-cancerous growth of the breast (open biopsy or excision of benign lesion) which is up to 50 mm in size. This includes benign lesions such as fibroadenomas.

Open procedure pathway →

Bone joint and muscle H165

Excision of bunions

The surgical removal of a bony lump in a joint in the foot or ankle.

Open procedure pathway →

Skin H148

Excision of large squamous or basal cell carcinoma

Surgery to remove a non-cancerous or cancerous lesion, cyst, scar, or ulcer from the skin of the face, scalp, neck, nipple area, lower leg, or forearm. The area may be repaired with either a flap of muscle, skin or muscle and skin from another part of the body directly after. The procedure is performed either in-hospital or at the specialist's room.

Open procedure pathway →

Skin H116

Excision of medium melanoma on trunk

Surgery to remove a cancerous area of skin between 15 mm and 30 mm in size. The sample is sent for testing to look at the cells. The procedure is performed either in-hospital or at the specialist's room.

Open procedure pathway →

Skin H115

Excision of small basal cell carcinoma on the face

Surgery to remove a cancerous area of skin less than 14 mm in size from the face. The sample is sent for testing to look at the cells.The procedure is performed either in-hospital or at the specialist's room.

Open procedure pathway →

Digestive system H131

Excisional hemorrhoidectomy

Surgery to remove swollen blood vessels in the anus. The doctor makes small cuts or wraps small bands around the swollen blood vessels of non-cancerous growths. These growths are on the skin or in the internal lining of the anus (anal skin tags).

Open procedure pathway →

Eye (not cataracts) H146

Eyelid cyst surgery

Surgery to remove an eyelid cyst.

Open procedure pathway →

Pain management H92

Facet joint denervation (nerve disruption) using a percutaneous probe (via skin)

A treatment using heat from radio waves or extreme cold to destroy nerves around joints in the spine. Imaging is used to guide the treatment.

Open procedure pathway →

Hernia and appendix H8

Femoral or inguinal hernia repair

Surgery to fix a weak spot in the groin (femoral hernia) and the abdominal muscles (inguinal hernia). The procedure may also be to correct fluid that has collected between the groin and testicles (infantile hydrocele). The patient is aged 10 years or older.

Open procedure pathway →

Weight loss surgery H53

Gastric band

Surgery where a band is placed around the top of the stomach to help with weight loss in a person with severe obesity.

Open procedure pathway →

Weight loss surgery H52

Gastric bypass

Surgery to reduce the size of the stomach to help with weight loss in a person with severe obesity.

Open procedure pathway →

Gastrointestinal endoscopy H10

Gastroscopy

A procedure using a specialised tube to look inside the upper intestine and stomach. Samples of tissue (biopsy) may be taken at the same time.

Open procedure pathway →

Tonsils adenoids and grommets H63

Grommets/myringotomy

A procedure to drain fluid from behind the eardrum.

Open procedure pathway →

Heart and vascular system H25

Heart angiogram with or without heart catheterisation

A procedure, using an x-ray, where a doctor injects dye into the coronary arteries. The dye shows up on an x-ray screen.

Open procedure pathway →

Heart and vascular system H29

Heart valve replacement (not TAVI)

A procedure to replace a problematic heart valve. Cardiac surgery is often performed in combination. Costs may be higher for more complex procedures.

Open procedure pathway →

Bone joint and muscle H166

Hip arthroscopy

A procedure where a thin tube with a camera is inserted in the hip joint to enable treatment or diagnosis.

Open procedure pathway →

Joint replacements H38

Hip replacement

Surgery to replace a hip joint with an artificial joint. The surgery also includes minor bone grafting.

Open procedure pathway →

Joint replacements H39

Hip replacement (bilateral)

Surgery to replace both hip joints with artificial joints. The surgery also includes minor bone grafting.

Open procedure pathway →

Male reproductive system H75

Holmium laser ablation (removal of tissue for enlarged prostate - HoLEP)

A procedure using a laser to reduce the size of the prostate. At the same time, a specialised tube may be used to look inside the bladder or the urinary tract.

Open procedure pathway →

Gynaecology H84

Hysteroscopy

A procedure using a specialised tube to look inside the womb. It is to remove an intrauterine device (IUD), growths or to treat scar tissue.

Open procedure pathway →

Heart and vascular system H151

Insertion, removal or replacement of permanent electrodes

A procedure to insert, remove or replace a pacemaker device and electrodes in the heart. This is to treat chronic heart failure.

Open procedure pathway →

Gynaecology H85

Intrauterine device implant and removal

A procedure to insert or remove a device which sits in the uterus/womb and prevents pregnancy or helps control heavy bleeding.

Open procedure pathway →

Eye (not cataracts) H105

Intravitreal injections/eye injections (IVI)

A needle is used to remove fluid or inject medication into the eye.

Open procedure pathway →

Eye (not cataracts) H149

Intravitreal injections/eye injections (IVI) with anaesthesia

A needle is used to remove fluid or inject medication into the right eye for diagnosis or treatment under anaesthesia. The procedure is performed in-hospital.

Open procedure pathway →

Joint reconstructions H64

Knee arthroscopy

A procedure where a thin tube with a camera passes through a small cut into a knee joint. This helps diagnose and treat some joint problems.

Open procedure pathway →

Joint reconstructions H167

Knee reconstruction

Surgery to rebuild ligaments that help the knee joint move correctly. Other procedures may also be done at the same time.

Open procedure pathway →

Joint replacements H40

Knee replacement

Surgery to replace the knee joint.

Open procedure pathway →

Gynaecology H136

Laparoscopic hysterectomy

Keyhole surgery to remove the womb and to take a tissue sample for testing. The surgery may include removal of one, or both, fallopian tubes and ovaries. It may otherwise treat moderate endometriosis or remove a cyst from ovary.

Open procedure pathway →

Gynaecology H82

Laparoscopic resection of endometriosis

Keyhole surgery to treat severe endometriosis. The surgery removes excess uterine tissue growing outside the womb in nearby parts of the body. The surgeon may use a specialised tube to look inside the uterus (hysteroscopy) and take a tissue sample for testing.

Open procedure pathway →

Gynaecology H14

Laparoscopy

Keyhole surgery on the womb to treat minimal endometriosis or scar tissue. The surgery may also be used as a form of permanent contraception.

Open procedure pathway →

Lung and chest H158

Lung wedge resection

A procedure to remove a part of the lung. Thoracic surgery is often performed in combination.  Costs may be higher for more complex procedures.

Open procedure pathway →

Ear nose and throat H108

Lymph node biopsy (neck)

Surgery to remove lymph tissue from the neck for testing.

Open procedure pathway →

Ear nose and throat H107

Lymph node removal (neck)

Surgery to remove one or many lymph nodes from the neck.

Open procedure pathway →

Breast surgery (medically necessary) 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.

Open procedure pathway →

Male reproductive system H2

Male contraception (e.g. vasectomy)

Surgery to cut one or both tubes that carry sperm from the testicles. It is done to prevent future pregnancies.

Open procedure pathway →

Miscarriage and termination of pregnancy H87

Management of loss of pregnancy

Care of a person following a miscarriage of a pregnancy between 14 and 16 weeks (approximately).

Open procedure pathway →

Breast surgery (medically necessary) H180

Nipple sparing mastectomy and breast reconstruction with prosthesis

Surgery to remove all breast tissue from one breast keeping the nipple (mastectomy). A sample of the tissue is sent for testing (biopsy). This is followed by an immediate breast reconstruction to recreate the breast using a permanent implant. This is where the same doctor performs all the surgery. If the breast removal and the breast reconstruction are done by separate doctors, then they incur separate fees.

Open procedure pathway →

Breast surgery (medically necessary) H181

Nipple sparing mastectomy and breast reconstruction with prosthesis (double)

Surgery to remove all breast tissue from both breasts keeping the nipples (mastectomy). A sample of the tissue is sent for testing (biopsy). This is followed by an immediate breast reconstruction to recreate the breasts using permanent implants. This is where the same doctor performs all the surgery. If the breast removal and the breast reconstruction are done by separate doctors, then they incur separate fees.

Open procedure pathway →

Assisted reproductive services H103

Oocyte retrieval (hospital admitted procedures only)

A procedure to collect eggs from the ovaries for treatment to help get pregnant. The eggs will be used in a fertility treatment such as IVF.

Open procedure pathway →

Gynaecology H13

Open abdominal hysterectomy

Surgery to remove part or all the womb (hysterectomy) via the abdomen. The surgeon may also remove the fallopian tubes and/or the ovaries.

Open procedure pathway →

Joint reconstructions H168

Open ganglion excision surgery (wrist)

A surgical procedure to remove fluid on a joint or tendon.

Open procedure pathway →

Heart and vascular system H27

Pacemaker

Surgery to insert, remove or replace a small device in the chest which helps to control heart rhythm (cardiac pacemaker).

Open procedure pathway →

Kidney and bladder H118

Partial nephrectomy

Surgery to remove part of the kidney. This is usually performed to treat conditions such as cancer.

Open procedure pathway →

Joint reconstructions H66

Patella stabilisation

A procedure using keyhole surgery to clean a knee bone to improve movement of that kneecap/knee.

Open procedure pathway →

Heart and vascular system H152

Percutaneous coronary intervention

A procedure used to increase the flow of blood through a narrowed artery. It involves placing a long thin tube (catheter) into a blood vessel to place a small balloon at the site of the narrowing. When the balloon is inflated, the blood vessel should open and allow a healthy flow of blood.

Open procedure pathway →

Heart and vascular system H153

Percutaneous coronary intervention with angiography

A procedure used to increase the flow of blood through a narrowed artery. It involves placing a long thin tube (catheter) into a blood vessel to place a small balloon at the site of the narrowing. When the balloon is inflated, the blood vessel should open and allow a healthy flow of blood.

Open procedure pathway →

Lung and chest H159

Pneumonectomy or lobectomy

A procedure to remove a part, or all, of the lung. Thoracic surgery is often performed in combination. Costs may be higher for more complex procedures.

Open procedure pathway →

Male reproductive system H3

Prostatectomy (transurethral resection of the prostate -TURP)

Surgery using a specialised tube and heat to remove part of the prostate. Usually to relieve a blockage. The most common procedure is TURP (transurethral resection of the prostate).

Open procedure pathway →

Eye (not cataracts) H57

Pterygium surgery

Surgery to remove a fleshy overgrowth from the surface (conjunctiva) of the eye.

Open procedure pathway →

Kidney and bladder H119

Radical nephrectomy

Surgery to remove the kidney. This is usually performed to treat conditions such as cancer.

Open procedure pathway →

Digestive system H77

Rectal resection

Surgery to remove the lower bowel and upper part of the rectum. The remaining intestine are joined together.

Open procedure pathway →

Skin H19

Removal of skin lesion

Surgery to remove a non-cancerous or cancerous skin tumour, lesion, lipoma, cyst, scar, or ulcer from the skin of the head, neck, genitals, hand or fingers, lower leg, or foot. A sample of the tissue is sent for testing.

Open procedure pathway →

Eye (not cataracts) H141

Retinal detachment repair - gas injection

Injection of a gas bubble to fix a retina which has separated from the back of the eye. The procedure is performed either in-hospital or at the specialist's room.

Open procedure pathway →

Eye (not cataracts) H140

Retinal detachment repair - surgery

Surgery to fix a retina which has separated from the back of the eye.

Open procedure pathway →

Eye (not cataracts) H56

Retinal laser

Laser to treat the retina.

Open procedure pathway →

Plastic and reconstructive surgery (medically necessary) H123

Rhinoplasty

Surgery to straighten or fix the outside shape of the nose for medical purposes. May include a graft using cartilage or bone from the nose.

Open procedure pathway →

Digestive system H117

Rubber band ligation/haemorrhoids

A procedure to treat haemorrhoids. A small rubber band is tied around the area to cut off blood supply (ligation). The procedure is performed either in-hospital or at the specialist's room.

Open procedure pathway →

Ear nose and throat H58

Septoplasty

Surgery to repair the cartilage and bones of the nose to help straighten the septum.

Open procedure pathway →

Joint reconstructions H68

Shoulder reconstruction or repair, including rotator cuff repair

Surgery to repair the muscles and tendons around the shoulder joint.

Open procedure pathway →

Joint replacements H41

Shoulder replacement

Surgery to replace a shoulder joint with an artificial joint. The surgery includes repair to the muscles and tendons around the shoulder.

Open procedure pathway →

Digestive system H130

Simple anal fistula treatment

Surgery to treat an infection in the anal canal (abscess). The infection connects the anal canal to the lower part of the anal sphincter and the surrounding skin.

Open procedure pathway →

Ear nose and throat H60

Sinus surgery

Surgery on the air pockets in the bones of the upper jaw and nose.

Open procedure pathway →

Skin H93

Skin flap repair

Surgery to move a piece of healthy muscle, skin, or both, to repair a nearby area after removal of a skin growth. The procedure is performed either in-hospital or at the specialist's room.

Open procedure pathway →

Sleep studies H55

Sleep studies

An overnight sleep study to diagnose a sleep disorder in a person aged 18 years older. Many body functions like heartbeat, oxygen levels, breathing rate and brain activity are measured continuously during the study.

Open procedure pathway →

Weight loss surgery H54

Sleeve gastrectomy (partial stomach removal)

Surgery to remove part of the stomach to help with weight loss in a person with severe obesity. **Using the Medical Costs Finder** **About the Department of Health, Disability and Ageing** **For medical specialists** **Help us improve** We are always looking for ways to improve our website. The Department of Health, Disability and Ageing acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to elders both past and present. © Commonwealth of Australia | Department of Health, Disability and Ageing

Open procedure pathway →

Assisted reproductive services H102

Sperm retrieval (by needle or open surgery)

Surgery to collect sperm from a testicle or the tubes around it using either a needle or an incision into the scrotum. The sperm is then tested or injected into an egg as part of a fertility treatment such as IVF.

Open procedure pathway →

Joint reconstructions H169

Stabilisation of ankle

A procedure to clean an ankle bone to improve mobility.

Open procedure pathway →

Kidney and bladder H72

Stone procedures (pyeloscopy)

A procedure using a specialised tube to remove or break down two or more stones in the body. The procedure can be combined with items such as imaging or insertion of stents. It is often done as a staged procedure and may need to be repeated several times.

Open procedure pathway →

Gynaecology H17

Stress incontinence

Surgery to stop leakage from the bladder caused by weak or damaged muscles.

Open procedure pathway →

Bone joint and muscle H170

Synovectomy of the shoulder

Removal of the membrane that lines a shoulder joint.

Open procedure pathway →

Lung and chest H161

Thoracoscopy

A procedure to look inside the chest with a telescope. Thoracic surgery is often performed in combination. Costs may be higher for more complex procedures.

Open procedure pathway →

Ear nose and throat H106

Thyroid tumour - total or partial thyroid removal

Surgery to remove part or all of the thyroid gland.

Open procedure pathway →

Tonsils adenoids and grommets H121

Tonsillectomy with or without adenoidectomy (12 years of age and over)

Surgery for a person who is 12 years or older to remove tonsils, or the tonsils and adenoids.

Open procedure pathway →

Tonsils adenoids and grommets H61

Tonsillectomy with or without adenoidectomy (under 12 years of age)

Surgery for a person who is younger than 12 years old to remove tonsils, or the tonsils and adenoids.

Open procedure pathway →

Breast surgery (medically necessary) H22

Total mastectomy

Surgery to remove an entire single breast (mastectomy). This includes removal of skin and nipple.

Open procedure pathway →

Breast surgery (medically necessary) H184

Total mastectomy (double)

Surgery to remove both breasts (mastectomy). This includes removal of skin and nipple resulting in a flat chest wall.

Open procedure pathway →

Male reproductive system H4

Total prostatectomy

Surgery to remove the whole prostate. This is usually performed to treat conditions such as cancer. The surgeon rebuilds the base of the bladder.

Open procedure pathway →

Male reproductive system H134

Total prostatectomy with lymphadenectomy

Surgery to remove the whole prostate and lymph nodes of the pelvis. This is usually performed to treat conditions such as cancer. The surgeon rebuilds the base of the bladder.

Open procedure pathway →

Heart and vascular system H154

Transluminal stent insertion

A procedure to insert one or more small tubes into blood vessels of the abdomen or a limb. This also includes using a balloon to open up the blocked blood vessel.

Open procedure pathway →

Male reproductive system H73

Transperineal prostate biopsy

A procedure using a needle to take samples of the prostate for testing (biopsy). An ultrasound guides the needle, which passes through the skin between the legs.

Open procedure pathway →

Male reproductive system H120

Transrectal prostate biopsy

A procedure using a needle to take samples of the prostate for testing (biopsy). An ultrasound guides the needle, which passes through the rectum.

Open procedure pathway →

Male reproductive system H74

Transurethral needle ablation (removal of tissue for enlarged prostate - TUNA)

A procedure using radio waves to reduce the size of the prostate. A specialised tube may be used to look inside the bladder or the urinary tract.

Open procedure pathway →

Ear nose and throat H59

Turbinectomy (remove small nasal bones)

Surgery to remove small bones in the nostrils to help treat a blocked nose.

Open procedure pathway →

Plastic and reconstructive surgery (medically necessary) H139

Turned in or out eyelid surgery

Surgery to the lower eyelid to fix an eyelid that rolls in (entropion) or out (ectropion) not requiring muscle repair.

Open procedure pathway →

Plastic and reconstructive surgery (medically necessary) H36

Turned in or out eyelid surgery (complex)

Surgery to repair muscles in the lower eyelid to fix an eyelid that rolls in (entropion) or out (ectropion).

Open procedure pathway →

Digestive system H5

Umbilical hernia repair

Surgery to fix a weak spot in the abdominal muscles around the navel (umbilical hernia), or above the navel area (epigastric or linea alba hernia). The surgery will involve specialised mesh or other structure. This is for a patient aged 10 years or older.

Open procedure pathway →

Breast surgery (medically necessary) H21

Unilateral breast reduction

Surgery to make one breast smaller and to change the position of the nipple. This is a reduction mammoplasty. The surgery is usually done on the non-cancerous breast so that it is more symmetrical with the reconstructed breast. This procedure can be done at the same time as the mastectomy or at a later date.

Open procedure pathway →

Pregnancy and birth H46

Vaginal delivery (complex)

Delivery of a baby via the vagina where there are conditions which may complicate the labour or birth.

Open procedure pathway →

Pregnancy and birth H47

Vaginal delivery (no complications)

Delivery of a baby via the vagina. There are no complications with the labour or birth.

Open procedure pathway →

Gynaecology H135

Vaginal hysterectomy

Surgery through the vagina to remove the womb.

Open procedure pathway →

Gynaecology H15

Vaginal repair

Surgery to repair weak muscles in the front and back of the vagina. This is to support organs in the pelvis and prevent them from collapsing. A specialised tube may be used to look inside the bladder (cystoscopy) and the lower urinary tract (urethroscopy).

Open procedure pathway →

Heart and vascular system H157

Valve repair

A procedure to repair a problematic heart valve. Cardiac surgery is often performed in combination. Costs may be higher for more complex procedures.

Open procedure pathway →

Heart and vascular system H30

Varicose veins

Surgery to correct varicose veins. The surgery may include removal or blocking of these faulty veins to improve blood flow in the leg.

Open procedure pathway →

Digestive system H114

Ventral hernia repair

Surgery to repair a hernia which is in the middle of the abdomen. This is for a patient 10 years or over.

Open procedure pathway →

Heart and vascular system H155

Ventricular ablation

Surgery to restore a regular heart rhythm when the heart is beating too quickly.

Open procedure pathway →

Male reproductive system H76

Visual laser ablation (removal of tissue for enlarged prostate)

A procedure using a laser to reduce the size of the prostate. A specialised tube may be used to look inside the bladder or the urinary tract.

Open procedure pathway →

Eye (not cataracts) H145

Vitreous removal surgery

Surgery to remove the gel-like fluid inside the eye.

Open procedure pathway →

Skin H20

Wound debridement

A procedure to clean out a soft tissue wound. Pain relief may be given, and stitches may be used to close the wound.

Open procedure pathway →

Joint reconstructions H171

Wrist arthroscopy

Keyhole surgery to perform, cartilage treatment, remove loose bones, remove membrane that lines a joint or remove bony lumps in the wrist.

Open procedure pathway →

2023-24Q11003

MBS 11003 · OH

89% no out-of-pocket cost · typical patient cost $190 · high $395

Open source-period record ↗

2023-24H55

MBS 12203 · IH

96% no out-of-pocket cost · typical patient cost $20 · high $120

Open source-period record ↗

2023-24Q12203

MBS 12203 · OH

67% no out-of-pocket cost · typical patient cost $225 · high $385

Open source-period record ↗

2023-24Q12250

MBS 12250 · OH

86% no out-of-pocket cost · typical patient cost $150 · high $238

Open source-period record ↗

2023-24Q12254

MBS 12254 · OH

62% no out-of-pocket cost · typical patient cost $363 · high $553

Open source-period record ↗