Private Health Insurance (Prostheses) Rules 2010 (No. 2) (Cth)
Made under item 4 of the table in section 333-20 of the
This compilation was prepared on 19 January 2011 taking into account amendments up to the
Prepared by the Department of Health and Ageing, Canberra .
9. Minister may have regard to recommendations and advice 7
10. Listing criteria for prostheses to be listed on Part C of the Schedule 7
1. Name of Rules These Rules are the
Private Health Insurance (Prostheses) Rules 20 10 (No. 2) .
These Rules commence on 14 August 2010.
These Rules revoke the
Private Health Insurance (Prostheses) Rules 2010 (No. 1).
4. Definitions Note: Terms used in these Rules have the same meaning as in the Act―see section 13 of the
Legislative Instruments Act 2003 . These terms include:complying health insurance policy
hospital-substitute treatment
hospital treatment
medicare benefit
In these rules:
accredited podiatrist has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973 .
Act means thePrivate Health Insurance Act 2007 .
certified overnight Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.
certified Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.
consultant physician has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973.
gap permitted prosthesis means a prosthesis listed in the Schedule where an amount is specified for that prosthesis in the column under the heading 'Minimum Benefit' and a different amount is specified in the column under the heading 'Maximum Benefit'.
implantable cardiac event recorder includes a component of an implantable cardiac event recorder.
insulin infusion pump includes a component of an insulin infusion pump.
listing application has the same meaning as in subsection 72-10(6) of the Act.
listing criteria has the same meaning as in subsection 72-10(6) of the Act.
no gap prosthesis means a prosthesis listed in the Schedule where an amount is specified for that prosthesis in the column under the heading 'Minimum Benefit' and no amount is specified in the column under the heading 'Maximum Benefit'.
private hospital means a hospital in respect of which there is in force a statement under subsection 121-5(8) of the Act that the hospital is a private hospital.Note: Section 15 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals withthe status ofcertainhospitals for which a declaration had been made before the commencement of the Act.
professional attendance has the same meaning as in clause 1.2.3 of theHealth Insurance (General Medical Services Table) Regulations 2010 .
professional service has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973 .
Schedule means the Schedule in these Rules.
5. Listing of, and benefits, for prostheses For item 4 of the table in subsection 72-1 (2) of the Act:
(a) the Schedule lists the prostheses (
listed prostheses ) the Minister has listed under subsection 72-10 (5) of the Act and section 12 of thePrivate Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 ; andNote: Section 12 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals with the listing of a prosthesis that was a no gap prosthesis or a gap permitted prosthesis for the purposes of theNational Health Act 1953 immediately before the commencement of the Act.(b) rule 6 sets out the method for working out the minimum benefit and maximum benefit for hospital treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis in circumstances where:
(i) a medicare benefit is payable in respect of the professional service associated with the provision of the prosthesis; or
(ii) the provision of the prosthesis is associated with podiatric treatment by an accredited podiatrist; or
(iii) for a prosthesis that is an insulin infusion pump:
(A) the insulin infusion pump is provided during a professional service for which a medicare benefit is payable; and
(B) the professional service is a professional attendance by a consultant physician in the practice of his or her specialty; and
(C) the professional service is provided as a certified Type C procedure or certified overnight Type C procedure; and
(D) the insulin infusion pump is provided for the purpose of administering insulin; and
(c) rule 7 sets out the method for working out the minimum benefit and maximum benefit for hospital-substitute treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis in circumstances where a medicare benefit is payable in respect of the professional service associated with the provision of the prosthesis; and
(d) rule 10 sets out listing criteria for the purposes of subsection 72-10(6) of the Act in relation to the granting of a listing application for listing of a kind of prosthesis on Part C of the Schedule.
(1) For a no gap prosthesis provided as part of an episode of hospital treatment by a private hospital in the circumstances mentioned in paragraph 5(b), the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.
(2) For a gap permitted prosthesis provided as part of an episode of hospital treatment by a private hospital in the circumstances mentioned in paragraph 5(b):
(a) the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and
(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.
(3) For a no gap prosthesis provided as part of an episode of hospital treatment by a public hospital in the circumstances mentioned in paragraph 5(b):
(a) the minimum benefit is the lesser of the following amounts:
(i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or
(ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and
(b) the maximum benefit is the amount for that prosthesis listed in the column under the heading 'Minimum Benefit'.
(4) For a gap permitted prosthesis provided as part of an episode of hospital treatment by a public hospital in the circumstances mentioned in paragraph 5(b):
(a) the minimum benefit is the lesser of the following amounts:
(i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or
(ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and
(b) the maximum benefit is the amount for that prosthesis listed in the column under the heading ‘Maximum Benefit’ in the Schedule.
(1) For a no gap prosthesis provided as part of an episode of hospital-substitute treatment in the circumstances mentioned in paragraph 5(c) the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.
(2) For a gap permitted prosthesis provided as part of an episode of hospital-substitute treatment in the circumstances mentioned in paragraph 5(c):
(a) the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and
(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.
Note: Private health insurers cannot cover, as part of hospital-substitute treatment, a service for which medicare benefit is payable unless the service is specified in the
Private Health Insurance (Health Insurance Business) Rules 2007― see paragraph 121-10 (3) (a) of the Act.
As a matter of normal administrative practice, applications made under subsection 72-10 (2) of the Act will be considered after they have been received and, if the Minister decides to grant the application, the prosthesis will be listed in the Schedule the next time the Minister makes or varies the Rules.
Note 1: Under subsection 72-10 (5) of the Act the Minister must list the kind of prosthesis, set out the minimum benefit and, if the Minister considers it appropriate, the maximum benefit for the prosthesis in these Rules on the next occasion that the Minister makes or varies the Rules after he or she grants an application and the applicant has paid to the Commonwealth any initial listing fee within 14 days of being informed of the Minister's decision to grant the application.
Note 2: Under subsection 72-15 (3) of the Act, the Minister may remove a prosthesis from the list in the Rules if the applicant fails to pay an ongoing listing fee.
(1) In making the decision under subsection 72-10 of the Act, the Minister may have regard to a recommendation from the Prostheses and Devices Committee.
(2) In setting the minimum and the maximum (if any) amounts for a prosthesis, the Minister may have regard to the amounts as negotiated between the Prostheses and Devices Negotiating Group and the applicant.
10. Listing criteria for prostheses to be listed on Part C of the Schedule For a listing application to list a kind of prosthesis on Part C of the Schedule, the listing criteria are that the kind of prosthesis is an:
(i) insulin infusion pump; or
(ii) implantable cardiac event recorder.
Note: The Minister may refuse to grant a listing application even if the listing
criteria are satisfied.
The
Private Health Insurance (Prostheses) Rules 2010 (No.2) as shown in this compilation are amended as indicated in the tables below.
| 30 July 2010 (see F2010L02191) | 14 August 2010 | ||
| 22 September 2010 (see F2010L02500) | 5 October 2010 | ||
| 13 January 2011 (see F2011L00092) | 14 January 2011 |
| |
|
|
|
2011 No. F2011L00092 2011 No. F2011L00092 2011 No. F2011L00092
|
1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the
Legislative Instruments Act 2003 .SeeA - Prostheses List August 2010
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
Group 1- Cardiothoracic Mechanical Valves
Group 1c - Bi-Leaflet, rotatable
Advanced Biomedical Pty Ltd AB002 ATS medical open pivot heart valve Pyrolythic Carbon, Double Velour 16-33mm $6,000.00
model 500FA standard flexi-cuff aortic Polyester, Titanium
valve series, ATS medical open pivot
heart valve model 500DM standard
flexi-cuff mitral valve series
AB064 ATS medical open pivot heart valve Pyrolythic Carbon, Double Velour 16-33mm $6,000.00
model 501DA advanced performance Polyester, Titanium
(AP) aortic valve series, ATS medical
open pivot heart valve model 501DM
advanced performance (AP) mitral valve
Medtronic Australasia Pty Ltd MC292 Advantage Heart Valve - Aortic Model A7760 - Pyrolytic carbon, PET Diameter 19-31 mm $6,000.00
A7760
MC324 Advantage Supra Aortic Heart Valve Mechanical Heart Valve Pyrolite Carbon Diameter (mm): 19 - 25 $6,000.00
leaflets Pyrolite carbon ring
MC681 Advantage Mitral Mechanical Heart Valve 23mm-33mm $6,000.00
Reid Healthcare RH001 Aortic On-X Prosthetic Heart Valve 27-29mm, 19mm, 21mm, $6,000.00
Models ONXA-19; ONXA-21; ONXA- 23mm, 25mm, 25-33mm, 27-
23; ONXA-25; ONXA-27/29; ONXM- 29mm, 31-33mm, 23mm,
23; ONXM-25; ONXM-27/29;
ONXM31/33; ONXMC25/33
Sorin Group SA129 Optiform Mechanical Valve 19mm to 33mm $6,000.00
Prostheses List by Category, Groups and Sponsor Page 1 of 866
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
St. Jude Medical Australia Pty Ltd SJ037 St Jude Medical Aortic Expanded Cuff Aortic Expanded Cuff, Aortic Aortic Expanded 19 -31mm, $6,000.00
Heart Valve; St Jude Medical Aortic Hemodynamic Plus Cuff, Mitral Aortic Hemodynamic 17 -
Hemodynamic Plus Cuff Heart Valve; St Hemodynamic Cuff, Aortic & Mitral 27mm, Mitral Hemodynamic 17
Jude Medical Mitral Hemodynamic Plus -27mm, Rotatable 17 - 33mm
Cuff Heart Valve; St Jude Medical
Mechanical Heart Valve Masters Series
SJ039 Regent Prosthestic Heart Valves Standard Cuff - Model 17AGFN-751 - Standard cuff - 17-23mm, Flex $6,500.00
23AGFN-751, Flex Cuff - Mode cuff - 17-23mm
17AGFN-756 - 23AGFN-756
SJ116 Regent Prosthestic Heart Valves Standard Cuff - Model 25AGFN-751 - Standard cuff - 25-29mm, Flex $6,000.00
29AGFN-751, Flex Cuff - Mode cuff - 25-29mm
25AGFN-756 - 29AGFN-756
Group 1e - Tilting Disc, rotatable
Medtronic Australasia Pty Ltd MC013 Medtronic Hall Heart Valve Aortic Model A7700/M7700 Titanium. Pyrolite. A7700 - Diameter 20-31mm, $5,100.00 $5,625.00
A7700, Medtronic Hall Heart Valve Dacron, A7700EZ/M7700EZ Titanium. M7700 - Diameter 23-33mm,
Mitral Model M7700, Hall Easy Fit A7700EZ - Diameter 19-29mm,
Aortic Heart Valve Model A7700, Hall M7700EZ - Diameter 23-31mm
Easy Fit Mitral Heart Valve Model M7700
Group 1: Single Chamber ICD's
Generation 3
Guidant Australia Pty Ltd GU148 Vitality 2 EL VR - Model T177 Single Chamber ICD 35cc; 90g $40,560.00
GU151 Vitality 2 VR - Model T 175 Single Chamber ICD 30cc; 82g $40,560.00
Sorin Group SA139 OVATIO VR 6250 Titanium, single chamber, sterile, VR 29cc $40,560.00
6250, 34J
a
Sorin Group SA149 PARADYM VR 8250 Single Chamber implantable cardioverter Dimensions: 58.4 x 73.4 x $42,640.00
defibrillator with rate response 11mm; Weight: 90 grams;
Prostheses List by Category, Groups and Sponsor Page 2 of 866
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
St. Jude Medical Australia Pty Ltd SJ066 Atlas + VR - C Model V-193C ICD Single chamber implantable cardio-verter 38cc, 77g $42,640.00
defibrillator
SJ114 Atlas II VR-168 Single chamber cardioverter defibrillator 38cc, 77g $42,640.00
SJ121 Current VR 1107-36 Single Chamber Cardioverter Defibrillator 38cc 76g $42,640.00
a, d
St. Jude Medical Australia Pty Ltd SJ142 Analyst VR CD1217-36 Single Chamber Cardioverter Defibrillator 79g, 41cc $42,640.00 $44,640.00
with RF Telemetry and ST Segment
Monitoring
A,C,D
Medtronic Australasia Pty Ltd MC722 Virtuoso VR ModelImplantable Cardioverter 37cc, 68g $42,640.00
Defibrillator, Single Chamber
A,D
Biotronik Australia Pty Ltd BT090 Lumax 340 VR-T ICD-VR 34 J with bidirectional Home One size only $42,640.00 $45,640.00
Monitoring. Single chamber
BT098 Lumax 340 VR-T XL ICD-VR with 40 J output, bidirectional One Size Only $42,640.00 $45,640.00
Home Monitoring and High Longevity
Boston Scientific Australia Pty Ltd BS136 TELIGEN 100 HE VR DF-1/IS-1 Single chamber ICD, High Energy with RF 31.5cc, 9.9mm $42,640.00
Medtronic Australasia Pty Ltd MC939 Virtuoso II VR Model - Implantable Cardioverter 37cc, 68g $42,640.00
Defibrillator, Single Chamber
St. Jude Medical Australia Pty Ltd SJ124 Current RF VR 1207-36 Single Chamber Cardioverter Defibrillator 79g, 41cc $42,640.00
with RF Telemetry
A,D,E
Boston Scientific Australia Pty Ltd BS132 Teligen 100 HE VR 4-SITE Single chamber ICD, high energy with 30.5cc, 9.9mm $43,390.00
Prostheses List by Category, Groups and Sponsor Page 3 of 866
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
D
Biotronik Australia Pty Ltd BT087 Lumax 300 VR-T ICD-VR with bidirectional Home One Size Only $40,560.00 $43,560.00
Monitoring. Single chamber
St. Jude Medical Australia Pty Ltd SJ216 AnalyST VR CD1217-30 Single chamber cardioverter defibrillator 73g, 37cc $40,560.00 $42,560.00
with RF telemetry and ST segment
Generation 4
a, d, e
St. Jude Medical Australia Pty Ltd SJ232 Current Accel VR CD1215-36Q Single Chamber Cardioverter Defibrillator 80g, 42cc $44,670.00
with RF Telemetry and SJ4 connector
SJ237 AnalyST Accel VR CD1219-36Q Single Chamber Cardioverter Defibrillator 79g, 41cc $44,670.00
with RF Telemetry and ST Segment
Monitoring and SJ4 connector.
A,D
Biotronik Australia Pty Ltd BT100 LUMAX 540 VR-T High Energy, Single-Chamber ICD Diamensions: 66*55*13 mm $43,920.00 $45,640.00
(Implantable Cardiac Defibrillator) with Volume/Weight: 37.2cc/92g
Advanced Patient Management Via unique
Home Monitoring Technology
incorporatin Automatic Threshold
Monitoring and Extended Longevity.
Medtronic Australasia Pty Ltd MC813 Secura VR Fully Automatic, Wireless Implantable 37cc $43,920.00
cardioverter defibrillator with high energy
capability and therapies for ventricular
tachyarrhythmia
St. Jude Medical Australia Pty Ltd SJ147 Current Accel VR RF CD1215-36 Single Chamber Cardioverter Defibrillator 79g, 38cc $43,920.00 $44,640.00
with RF Telemetry
SJ154 AnalyST Accel VR CD1219-36 Single Chamber Cardioverter Defibrillator 79g, 41cc $43,920.00 $44,640.00
with RF Telemetry and ST Segment
Monitoring
Prostheses List by Category, Groups and Sponsor Page 4 of 866
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
D
St. Jude Medical Australia Pty Ltd SJ212 AnalyST Accel VR CD1219-30 Single chamber cardioverter defibrillator 73g, 37cc $41,820.00 $44,560.00
with RF telemetry and ST segment
SJ213 Current Accel VR RF CD1215-30 Single chamber cardioverter defibrillator 73g, 37cc $41,820.00 $44,560.00
with RF telemetry
Group 10: Pacemaker/ICD Extenders
Medtronic Australasia Pty Ltd MC831 Medtronic Lead Extender Kit Model: Silicone 37 - 50cm $530.00
6984M, 6981M, 6985M,6986m
Group 11: Pacemaker/Lead Accessories
Medtronic Australasia Pty Ltd MC036 Medtronic Lead End Cap Kit Model: Pin Plug Kits to Seal Unused Pacemaker One Size Per Model $80.00
5867-3M; Medtronic DF-1 Port Pin or Defibrillator Port; Sizing Sleeve -
Plug Kit: Model 6719, Medtronic IS-1 Silicone or Polyurethane
Port Pin Plug Kit: Model 6725;
Medtronic Upsizing Sleeve: Model 5866-
Group 12: Coronary Stents
Sub-Group 1: General Purpose Drug eluting stents
Abbott Australasia Pty Ltd AY023 Xience Everolimus Eluting Stent System Everolimus Eluting Stent System 2.25mm to 4.0mm widths, 8mm $3,450.00
to 28mm lengths
Prostheses List by Category, Groups and Sponsor Page 5 of 866
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations AY037 Xience PRIME LL Everolimus Eluting Coronary Artery Stent, Drug Eluting XIENCE PRIME LL 2.50; 2.75; $3,450.00
Coronary Stent; Xience PRIME 3.00; 3.50; 4.0 x 33MM;
Everolimus Eluting Coronary Stent; XIENCE PRIME LL 2.50; 2.75;
Xience PRIME SV Everolimus Eluting 3.00; 3.50; 4.0 x 38MM;
XIENCE PRIME SV 2.25 x 08;
12; 15; 18; 23; 28MM; XIENCE
PRIME 2.50 x 08; 12; 15; 18;
23; 28MM; XIENCE PRIME
2.75 x 08; 12; 15; 18; 23;
28MM; XIENCE PRIME 3.00 x
08; 12; 15; 18; 23; 28MM; XIENCE PRIME 3.50 x 08; 12;
15; 18; 23; 28MM; XIENCE
PRIME 4.00 x 08; 12; 15; 18;
23; 28MM
Boston Scientific Australia Pty Ltd BS099 Taxus Liberte Paclitaxel-Eluting 316L Stainless Steel Stent with Translute 2.0mm-5.0mm & 8.0mm-38mm $3,450.00
Coronary Stent System Polymer and Paclitaxel
BS125 Promus Everolimus Coronary Stent Cobalt chromium alloy stent coated with 2.25mm to 4.0mm diameter, $3,450.00
a blended polymer mixed with Everolimus. 8mm to 28mm length
BS175 PROMUS Element Platinum chromium alloy stent coated 8mm to 38mm with a reference $3,450.00
with a blended polymer mixed with vessel diameter of 2.25mm -
4.0mm.
BS176 Taxus Element Platinum chromium alloy stent coated (8mm to 38mm) with a $3,450.00
with a blended polymer mixed with reference vessel diameter of
JJ302 CYPHER Sirolimus-Eluting Stent & Stainless steel coronary stent with Diameter 2.25 - 5.0mm, length $3,450.00
CRS - 23300, Rapamycin (an immunosuppressive and 8-33mm
08225, 08250, 08275, 08300, 28225, antiproliferative drug) bound to the stent
28250, 28275, 28300, 33225, 33250,
33275, 33300, 13225, 13250, 13275,
18225, 18250, 18275, 18300, 23225,
23250, 23275, 23350, 23400, 08350,
08400, 2835
JJ481 CYPHER SELECT Sirolimus-Eluting Stainless steel coronary stent with Diameter 2.25 - 5.0mm, length 8 $3,450.00
Stent & Delivery System Sirolimus (an immunosuppressive and - 33mm
anti-proliferative drug) bound to the stent
by a polymer. Model CRA-23300, 08225,
08250, 08275, 08300, 28225, 28250,
28275, 28300, 33225, 33250, 33275,
Prostheses List by Category, Groups and Sponsor Page 6 of 866
JJ587 CYPHER Select Plus Sirolimus Eluting Stainless steel coronary stent with Diameter 2.25 - 5.00mm, $3,450.00
Coronary Stent Sirolimus bound to the stent by a polymer Length 8 - 33mm
MC732 Endeavour Drug Eluting Coronary Stent Cobalt Alloy, ABT - 578 Diameter: 2.25mm-4.5mm; $3,450.00
System Length: 8.00mm-38.0mm
MC769 Endeavor Sprint Drug Eluting Stent Cobals Alloym ABT - 578 Diameter: 2.25mm-4.0mm; $3,450.00
Length: 8.0mm-30.0mm
MC816 Endeavor Resolute Drug Eluting Cobalt Alloy, ABT - 578, BioLinx Diameter:2.25mm-4.0mm; $3,450.00
Coronary Stent System Length: 8.00mm-30.0mm
AY025 Stents ACS Multilink Coronary Stent; ACS 1.5mm - 8.0mm $1,248.00
Megalink Peripheral Stent; ACS RX
Herculink Peripheral Stent. Stainless steel
AY026 Multilink Coronary Stent System Stainless Steel Length 1.5mm - 8.0mm $1,248.00
AY028 Multilink Coronary Stent System - Cobalt chrome stent 2.25mm to 4.0mm widths, 8mm $1,248.00
to 38mm lengths
AC030 Cinatra Cobalt Chromium Coronary The Cinatra Cobalt Chromium Coronary Diameter range: 2.5mm - $1,248.00 $1,372.00
Stent System Stent System consists of a balloon 3.5mm. Length range: 8mm -
expandable Cobalt Chromium stent
premounted on a rapid exchange system
BE001 Gazelle Coronary Stent Stainless Steel Diam 2.25-4.0mm Length 8- $1,248.00
BT082 PRO-Kinetic Cobalth Chromium coronary stent system 8-40mm length 2-5mm diameter $1,200.00
Prostheses List by Category, Groups and Sponsor Page 7 of 866
BT107 PRO-Kinetic Energy The PRO-Kinetic Energey stent is a The PRO-Kinetic Energy stent is $1,248.00
tubular, balloon-expandable stent sculpted available in 66 different
by laser from a single tube of L-605 diameter/length combinations. It
The stent is available in lengths from
consists of circular segments at each end 8mm to 40mm. It is
followed by a transition zone and premounted on a delivery
helicoidally arranged struts in the middle. system which has nominal
Each loop of the helix is connected to the balloon diameters between
The 2.0mm and 5.0mm.
stent surface is fully coated with a layer
of amorphous hydrogen-rich silicon
This material has
semiconducting properties that efficiently
prevent the electron transfer from
Thereby the conversion from fibrinogen
to fibrin and it's depoisition at the stent
Additionally, aSiC:H -
coated stents exhibit a lower adhesion
and activation of blood platelets and
Finally, the release of
potentially allergenic ions from a silicon
carbide coated stent is substantially
reduced in comparison to an uncoated
This coating is used on all
Biotronik coronary stents producedso far
BS069 Liberte Coronary Stent System Consists of a balloon expandable stent, Stent lengths: 8,12,16,20,24,28 $1,248.00
pre-mounted on a Maverick 2 Monorail & 32 mm Stent diameters: 2.25,
delivery catheter. 2.5, 2.75, 3.0, 3.5, 4.0, 4.5 &
IX001 Amazonia CroCo Balloon expandable intracoronary cobalt Lengths: 8mm, 12mm, 16mm, $1,248.00
chromium stent premounted onto a rapid 20mm, 24mm, 28mm, 32, 36,
exchange delivery catheter and 40mm. Diameters:
2.25mm, 2.5mm, 2.75mm,
3.0mm, 3.5mm, 4.0mm, 4.50
and 5.00 mm in all lengths
JJ026 BX Velocity with Hepacoat System Balloon expandable, stainless steel,. $1,220.00
heparin coated
JJ200 BX Velocity Stent and Delivery System Stainless steel stent Diameter: 2.25-5.0 mm; Length $1,220.00
8 - 33 mm
Prostheses List by Category, Groups and Sponsor Page 8 of 866
JJ239 BX Sonic Stainless steel coronary stent mounted on Dia 2.25 - 4.0mm, lengths 8 - $1,220.00
a balloon delivery system
JJ670 Presillion CoCr Coronary Stent on RX Cobalt Chromium, bare metal coronary Stent Length (mm) x Stent $1,248.00
System Diameter (mm) 8 x 2.50, 2.75,
3.0, 3.50, 4.0; 12 x 2.50, 2.75,
3.0, 3.50, 4.0; 17 x 2.50, 2.75,
3.0, 3.50, 4.0; 24 x 2.75, 3.0,
3.50, 4.0; 33 x 2.75, 3.0, 3.50,
MC329 Medtronic Driver, Micro Driver Cobalt Alloy Driver Stent: diameter (2.25 - $1,248.00
Coronary Stent System 4.5mm), length (8-30mm);
Micro-Driver Stent: diameter
(2.25 - 2.75mm), length (8 -
MC932 Driver Sprint Coronary Stent System Cobalt Alloy Diameter: 2.25 - 4.5 mm; $1,248.00
Length: 8-30mm
MC956 Integrity Coronary Stent System Cobalt Alloy Coronary Stent Diameter: 2.25 - 4.5mm; Length: $1,248.00
8 - 30mm
NM003 R Stent Evolution 2 Coronary Delivery 316LVM Stainless Steel Balloon Lengths - 9-33mm; Diameters - $1,144.00
System Expandable Stent (Tubular) 2.5-4.0mm
NM004 Blazer Coronary Stent Delivery System L605 Cobalt Chromium alloy balloon Expanded Stent Diameter 2.5 to $1,248.00
expandable vascular prosthesis 4.0mm, Stent Length 9 to 33mm
TU001 Tsunami Gold Stainless Steel mounted on balloon Diameter 2.0mm - 4.0mm, $1,248.00
Length 8mm - 30mm length
AY012 JoStent Coronary Stent Graft Stainless Steel/PTFE 9 - 26 mm x 2.5 - 5 mm $3,222.00
IX003 Minvasys Nile Delta Coronary Stent Balloon expandable Amazonia Nile Delta 2.50mm diameter x $1,248.00
intracoronary cobalt chromium stent 8mm length; Nile Delta 3.00mm
premounted onto a rapid exchange diameter x 8mm length
delivery catheter with tapered balloon.
Prostheses List by Category, Groups and Sponsor Page 9 of 866
AY027 Multilink Coronary Stent System - 316L Stainless steel stent Length 1.5 - 8.0mm $2,200.00
IX002 Nile CroCo Intracoronary stent pre-mounted on two Diameter: 2.50 - 3.50mm. MB $1,750.00
rapid exchange delivery systems for and 2.00-3.00mm SB
bifurcation lesions treatment Lengths 18 mm and 24 mm
ME065 Amplatzer Duct Occluder Nitinol Wire Mesh 5 - 24mm $10,200.00
ME066 Amplatzer Septal Occluder Nitinol Wire Mesh 4mm - 40mm $10,200.00
ME067 Amplatzer Muscular VSD Occluder Nitinol Wire Mesh 4 - 24mm $10,200.00
ME068 Amplatzer PFO Occluder Nitinol Wire Mesh 25mm & 35mm $10,200.00
ME074 Amplatzer Membranous VSD Occluder Nitinol wire mesh, double disc occluder 4-24mm, Length 7-10mm $10,200.00
and delivery system
ME187 AMPLATZER Duct Occluder II Self expandable multiple Nitinol wire Waist diameter 3-6mm, Nominal $10,200.00
mesh PDA occlusion device length 4-6mm
PI020 'STARflex Rapid Transport Plus System The STARFlex Rapid Transport Plus 23mm, 28mm, 33mm and $10,200.00
System consists of two primary
components: 1) The device, a permanent
implant, which is constructed primarily of
a metal MP35N framework to which
polyester fabric is attached, and 2) The
delivery catheter, a Pebax based catheter
designed specifically to facilitate
attachment, loading, delivery and
deployment of the device to the defect.
The device and delivery catheter can be
packaged separately or pre-attached as a
SJ091 Premere PFO Closure System Percutaneous, transcatheter, self- Left Atrial Anchor diameter $10,036.00
expanding, dual anchor, occlusion and 20mm, 25mm and 30mm
Prostheses List by Category, Groups and Sponsor Page 10 of 866
GT223 Helex 1.5 Septal Occluder The GORE HELEX Septal Occluder Diameters: 15, 20, 25, 30 and $10,200.00
consists of an implantable endoprosthesis 35mm
The
Occluder is comprised of a nickel-
titanium (Nitinol) wire frame covered
with expanded polytetrafluoroethylene
The ePTFE is treated with
DW001 Nit-Occlud PDA Occlusion System Nitinol spiral coil and delivery system for Distal x Proximal Coil Diameter: $1,900.00
transcatheter occlusion of PDA 4x4mm, 5x4mm, 6x5mm,
10x6mm, 12x6mm, 14x6mm;
Introducer Sheath: 4F, 5F;
Length Introducer: 85cm,
105cm; Coil Length
configurated +-0.5mm: 3.5mm,
DW002 Nit-Occlud PDA Occlusion System Nitinol spiral coil and delivery system for Distal x Proximal Coil Diameter: $1,650.00
(Medium) transcatheter occlusion of PDA 7 x 6mm, 9 x 6mm, 11 x 6mm,
12 x 6mm, 14 x 6mm;
5F; Length
Introducer: 85cm, 105cm; Coil
Length configurated +-0.5mm:
MC763 Reveal XT Reveal XT Insertable Cardiac Monitor 61 x 19 x 8 mm with a volume $3,900.00
of 9cc
MC768 Reveal DX Insertable Cardiac Monitor 61 x 19 x 8 mm with a volume $3,900.00
of 9cc
SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with atrial 6.5cc, 12g $3,900.00 Temporary Listing
fibrillation monitoring.
SJ159 SJM Confirm Model DM2100 Implantable cardiac monitor 6.5cc, 12g $3,900.00 Temporary Listing
Prostheses List by Category, Groups and Sponsor Page 11 of 866
SJ127 Proxis Embolic Protection System - Proximal embolic protection device and 6F and 7F $2,100.00
Long Sheath delivery system
EL032 Baxter Edwards Prima Plus Stentless Edwards Prima Plus. Porcine Valve; 19mm-29mm $4,841.00
Bioprosthesis Model 2500P Prosthetic Woven Polyester Cloth.
Heart Valve
MC950 Mosaic Ultra Cinch II Small Aortic Root Bioprosthesis 19mm - 29mm $4,445.00 $5,650.00
MC962 Mosaic Cinch II Aortic Bioprosthesis 19mm -29mm $4,445.00 $5,345.00
SJ141 SJM Epic Supra Valve triple composite Bioprosthetic heart valve Tissue Annulus Diameter - 19- $4,445.00
for supra-annular placement in the aortic 23mm
Total Height - 14-16mm
SJ156 SJM Epic Valve Triple composite bioprosthetic heart valve Aortic valve 21-29mm tissue $4,445.00
annulus diameter
14-20 total height
Mitral Valves 25-33mm tissue
annulus diameter
15-20mm total height
Prostheses List by Category, Groups and Sponsor Page 12 of 866
SJ069 St Jude Medical Biocor Porcine St Jude Medical Biocor Porcine Aortic Valves - Tissue Annulus $4,445.00
Prosthetic Heart Valve Prosthetic Heart Valve is manufactured Diameter - 21-29mm, Implant
from selected procine aortic valve cusps Height - 11-15c; Mitral Valves -
that have been cross-linked with a Tissue Annulus Diameter - 25-
35mm, Implant Height - 8-
SJ136 SJM Biocor Heart Valve Stented Porcine tissue valve Aortic Valves - Tissue Annulus $4,445.00
Mitral Valves -
Tissue Annulus Diameter - 25-
35mm
SJ192 Epic Flexfit Triple-composite Bioprosthetic heart Aortic Valves 21-29mm tissue $4,445.00
annulus diameter, 14-20mm total
height. Mitral Valves 25-33mm
tissue annulus diameter, 15-
20mm total height.
SJ201 Epic FlexFit Supra Triple-composite Bioprosthetic heart Tissue Annulus Diameter - $4,445.00
valve for supra-annular placement in the 19mm-23mm. Total Height
aortic position
EL030 CE Supra Annular Aortic Valve Model Carpentier-Edwards SAV Bioprosthesis. 19mm-33mm $4,445.00
2650 Carpentier-Edwards S.A.V Composition: Porcine Valve; Elgiloy
Bioprosthesis Model 6650 Mitral Valve Alloy; Silicone Rubber,
MC701 Mosaic Cinch, Aortic, Mitral Models 305cxx, 310cxx 19mm - 35mm $4,445.00 $5,345.00
MC771 Mosaic Ultra Small Aortic Root Bioprosthesis 19mm-29mm $4,445.00 $5,650.00
EL056 Magna Mitral Carpentier-Edwards PERIMOUNT 25, 27, 29, 31 and 33mm $5,000.00 $5,690.00
Magna Mitral Bioprosthesis, Model
SA130 Mitroflow Pericardial Bioprosthesis 19-27mm $5,000.00
Prostheses List by Category, Groups and Sponsor Page 13 of 866
EL058 Magna Ease Carpentier - Edwards PERIMOUNT 19, 21, 23, 25, 27 and 29mm $5,000.00 $6,100.00
Magna Ease Bioprosthesis, Model
EL031 Carpentier-Edwards Perimount Carpentier-Edwards Pericardial Models 2900/6900 19-33mm, $5,000.00
Pericardial Bioprosthesis - Models Bioprosthesis. Composition: Bovine Model 6900P 25, 27, 29, 31,
Carpentier-Edwards Pericardium; Elgiloy Alloy; Silicone
Perimount Plus Pericardial Bioprosthesis Rubber, Polytetrafluoroethylene
Mitral - Model 6900P
EL039 Edwards Perimount Magna Model 3000 Carpentier-Edwards Perimount Magna 19MM Aortic Pericardial Tissue $5,000.00 $5,690.00
composition: Glutaraldehyde treated Valve; 21MM Aortic Pericardial
bovine pericardium/elgiloy wireform Tissue Valve; 23MM Aortic
stent/polyester band/silicone rubber Pericardial Tissue Valve; 25MM
suture ring/polytetrafluoroethylene Aortic Pericardial Tissue Valve;
cloth/polyester cloth. 27MM Aortic Pericardial Tissue
Valve; 29MM Aortic Pericardial
Tissue Valve
MC015 Freestyle bioprosthesis Models 995xx, 995MSxx 19 - 35mm $5,110.00 $5,350.00
SJ038 St Jude Medical Toronto SPV Valve Tissue Heart Valves, Bioimplant TSPV: 21 - 29mm, Bioimplant $4,900.00
Model SPA-101, St Jude Medical Aortic: 21-27mm, Bioimplant
Bioimplant Heart Valve Mitral: 27-32mm
AB070 ATS 3f Aortic Bioprosthesis (EQUINE) Model 1000 - EQUINE Pericardium 19 - 29 mm $5,000.00
Bioprostheseis (non stented)
Prostheses List by Category, Groups and Sponsor Page 14 of 866
GU149 Vitality 2 DR - Model T165 Dual Chamber ICD 30cc; 82g $43,680.00
GU150 Vitality 2 EL DR - Model T167 Dual Chamber ICD 30cc; 82g $43,680.00
SA140 OVATIO DR 6550 Titanium dual chamber ICD, 29 cc 29cc $43,680.00
BS128 Confient RF HE Dual chamber ICD, high energy with RF 44cc, 87.5g $45,760.00
SA147 Paradym DR 8550 Dual Chamber, High Energy, Implantable Weight: 90 grams; Volume: $45,760.00
Cardioverter Defibrillator with rate 32.6cc; Dimensions: 58.4 x 73.4
SJ115 Atlas II+ DR V-268 Dual Chamber Cardioverter Defibrillator 39cc, 78g $45,760.00
SJ123 Current DR 2107 Dual Chamber Cardio-verter Defibrillator 39cc 78g $45,760.00
MC721 Virtuoso DR ModelImplantable Cardioverter 37cc, 68g $45,760.00
Defibrillator, Dual Chamber
MC938 Virtuoso II DR Model - Implantable Cardioverter 37cc, 68g $45,760.00
Defibrillator, Dual Chamber
BT086 Lumax 340 DR-T ICD-DR 34 J with bidirectional Home One Size Only $45,760.00 $48,760.00
Monitoring. Dual chamber
BT101 Lumax 540 DR-T High Energy, Dual-Chamber ICD Diamensions: 66*55*13mm, $45,760.00 $48,760.00
(Implantable Cardiac Defibrillator) with Volume/Weight: 37.2cc/92g
Advanced Patient Management Via unique
Home Monitoring Technology
incorporating Automatic Ventricular
Prostheses List by Category, Groups and Sponsor Page 15 of 866
BS135 Teligen 100 DR DF-1/IS-1 Dual chamber ICD, high energy with RF 31.5cc, 9.9mm $45,760.00
SJ120 Current DR RF 2207 Dual Chamber Cardioverter Defibrillator 80g, 42cc $45,760.00
with RF Telemetry
SJ144 AnalyST DR Model CD2217-36 Dual Chamber cardioverter defibrillator 80g, 42cm $45,760.00 $47,760.00
with RF telemetry and ST Segment
BS134 TELIGEN 100 HE DR 4-SITE Dual Chamber ICD, high energy with RF 31.55cc, 9.9mm $46,510.00
GU157 Vitality AVT - Model A155 Dual Chamber ICD with atrial therapies 30cc $43,680.00
BT091 Lumax 300 DR-T ICD-DR with bidirectional Home One size only $43,680.00 $46,680.00
SJ215 AnalyST DR CD2217-30 Dual chamber cardioverter defribillator 74g, 38cc $43,680.00 $45,680.00
with RF telemetry and ST segment
SJ235 AnalyST Accel DR CD2219-36Q Dual chamber cardioverter defibrillator 80g, 41cc $47,880.00
with RF telemetry and ST segment
monitoring and SJ4 connector
SJ239 Current Accel DR CD2215-36Q Dual Chamber Cardioverter Defibrillator 80g, 41cc $47,880.00
with RF Telemetry and SJ4 connector
MC814 Secura DR Fully Automatic, Wireless Implantable 37cc $47,130.00
cardioverter defibrillator with high energy
capability and therapies for ventricular
and atrial tachyarrhythmia
Prostheses List by Category, Groups and Sponsor Page 16 of 866
SJ143 AnalyST Accel DR CD2219-36 Dual Chamber cardioverter defibrillator 80g, 42cc $47,130.00 $48,480.00
with RF telemetry and ST Segment
SJ153 Current Accel DR RF CD2215-36 Dual Chamber Cardioverter Defibrillator 80g, 42cc $47,130.00 $48,480.00
with RF Telemetry
SJ214 Current Accel DR RF CD2215-30 Dual chamber cardioverter defribillator 74g, 38cc $46,030.00
with RF telemetry
SJ217 AnalyST Accel DR CD2219-30 Dual Chamber cardioverter defibrillator 74g, 38cc $46,030.00
with RF telemetry and ST segment
AB001 ATS Medical open pivot aortic valved Pyrolythic Carbon, Double Velour 21- 33mm $6,950.00
graft model 502AG Polyester, Titanium
MC198 Medtronic Hall rotatable aortic valved Titanium, pyrolite, dacron 20 - 33mm $6,950.00
collagen impregnated conduit Model
SA128 CarboSeal Ascending Aortic Prosthesis, Mechanical Conduit AP 21-33mm, CP 21 - 33mm $6,950.00
sterile, CarboSeal Ascending Aortic
Prosthesis with Handle Model AP21,
Model AP23, Model AP25, Model AP27,
Model AP29, Model AP31, Model
AP33, Carboseal Valsalva
SJ036 St Jude Medical Coated Aortic Valved Coated Aortic Valved Graft 21mm - 33mm $6,950.00
SJ104 SJM Masters Series Aortic Valved St Jude Medical Mechanical Heart Valve Annulus Diameter 19-29mm $6,950.00
Prosthesis - VAVGJ sewn into the base of a woven polyester
fibre graft which has been impregnated
with bovine-derived gelatin
Prostheses List by Category, Groups and Sponsor Page 17 of 866
MC012 Medtronic Hancock Valved Conduit Porcine bioprosthesis, dacron 12, 14, 16, 18, 20, 22, 25, $5,900.00 $6,800.00
Model 100/150
BS129 LIVIAN CRT-D CRT-D with RF 40cc, 79.5g, 14.5mm $45,760.00
GU147 Contak Renewal 4 CRT-D Model H190, CRT-D One Size only $45,760.00
Model H195
SA138 OVATIO CRT-D 6750 Titanium, dual chamber ICD with CRT 30cc $45,760.00
BS130 LIVIAN CRT-D HE CRT-D, high energy with RF 44cc, 87.5g, 14.5mm $47,840.00
GU144 Contak Renewal 4 HE CRT-D Model CRT-D high energy One size only $47,840.00
H197, Model H199
SA145 PARADYM CRT-D 8750 Implantable Cardioverter Defibrillator 34cc, 94 grams; 61.8 x 73.4 x $47,840.00
with Cardiac Resynchronisation therapy, 11mm
High Energy
SJ109 Atlas II+ HF V-367 Cardiac Resynchronisation Therapy 41cc, 79g $47,840.00
Defibrillator with V-V Timing
Programmability
SJ117 Promote CRT-D 3107 Cardiac Resynchronisation Therapy 41cc, 80g $47,840.00
Defibrillator
Prostheses List by Category, Groups and Sponsor Page 18 of 866
GU155 Contak Renewal 4 AVT HE CRT - D - Implantable Cardioverter Defibrillator 40cc; 89g $47,840.00
Model M177, M179 with cardiac resynchronisation Therapy
MC720 Concerto CRT-D Implantable Cardioverter Defibrillator 38cc $47,840.00 $50,000.00
with Cardiac Resynchronisation Therapy
MC937 Concerto II Fully automatic, wireless implantable 38cc $50,000.00
cardioverter defibrillator with Cardiac
Resynchronisation Therapy (CRT), and
therapies for ventricular and atrial
tachyarrhythmia.
BT089 Lumax 340 HF-T CRT-D 34 J with bidirectional Home One Size Only $47,840.00 $53,000.00
Monitoring
BT102 Lumax 540 HF-T High Energy, Three Chamber ICD Diamensions: 66*59*13 mm, $47,840.00 $53,000.00
(Implantable Cardiac Defibrillator) with Volume/Weight: 39.8cc/94g
Advanced Patient Management Via unique
Home Monitoring Technology
incorporating Automatic RV/LV
Threshold Monitoring and Extended
BS139 COGNIS 100 HE (DF-1/IS-1 & DF- CRT-D high energy with RF 32.5cc, 9.9mm $47,840.00
SJ128 Promote RF CRT-D 3213 Cardiac Resynchronisation Therapy 43cc, 82g $47,840.00 $49,840.00
Defibrillator with RF Telemetry
BS138 COGNIS 100 HE 4-SITE CRT-D high energy with RF IS4 32cc, 9.9mm $48,590.00
GU154 Contak Renewal 4 AVT CRT -D - Implantable Cardioverter Defibrillator 37cc; 89g $45,760.00
Model M170 and M175 with Cardiac Resynchronisation Therapy
Prostheses List by Category, Groups and Sponsor Page 19 of 866
BT088 Lumax 300 HF-T CRT-D with bidirectional Home One size only $45,760.00 $48,760.00
SJ236 Promote Accel CD3215-36Q Cardiac Resynchronisation Therapy 82g, 43cc $52,750.00
Defibrillator with RF Telemetry and SJ4
connector
MC812 Consulta CRT-D Fully Automatic, Wireless Implantable 38cc $52,000.00
cardioverter defibrillator with cardiac
resynchronization therapy (CRT), and
therapies for ventricular and atrial
tachyarrhythmia
SJ150 Promote Accel RF CD3215-36 Cardiac Resynchronisation Therapy 82g, 43cc $52,000.00
Defibrillator with RF Telemetry
SJ145 Promote Accel CD3215-30 Cardiac Resyncronisation Therapy 76g, 39cc $49,760.00
Defibrillator with RF Telemetry
Prostheses List by Category, Groups and Sponsor Page 20 of 866
EL028 Baxter Sterile Grafts, Implants & Carpentier-Edwards Classic Annuloplasty 24mm-40mm $2,200.00
Prostheses, Non-Animal Origin Ring. Composition: Titanium Alloy;
Annuloplasty: Ring-Mitral Ring with Silicone Rubber; Polyester Fabric
Holder; Mitral Cosgrove-Edwards Carpentier-Edwards Physio Annuloplasty
Annuloplasty System Model 4600; Ring. Composition: Elgiloy Bands;
Classic Annuloplasty Ring-Tricuspid Polyester Film Strips; Silicone Rubber;
Polyester Cloth, Cosgrove-Edwards
Annuloplasty Band. Composition: Silicone
Rubber; Polyester Cloth. Carpentier-
Edwards Tricuspid Ring. Composition:
Titanium Alloy; Silicone Rubber;
MC005 Medtronic Duran Annuloplasty Ring; Annuloplasty Devices - Models 610R & Model 610R 25-35mm & Model $2,200.00
Duran Ancore Ring 620R; Duran 620R Silicone / Barium Sulphate, Dacron. 620R 23-35mm
Ancore Chordal Model 620RG
SA127 AnnuloFlo Annuloplasty System Annuloflex Ring or AnnuloFlo Ring 26-36mm $2,200.00
SJ035 SJM Tailor Annuloplasty Ring Fully Flexible 25mm - 35mm $2,200.00
EL049 Edwards Etlogix Annuloplasty Ring Titanium/silicon/dacron polyester 24mm/26mm/28mm/30mm/32m $2,400.00
cloth/plastic template Mitral valve annular m/34mmd
repair device designed specifically for
patients with Ischemic Mitral regurgitation
EL057 Geoform Geoform annuloplasty ring Model 4200 26, 28, 30 and 32mm $2,400.00
with Holder
MC745 CG Future Composite Ring Semi-rigid mitral annuloplasty ring, with 24, 26, 28, 30, 32, 34, 36 & $2,400.00
anterior flexibility
MC844 Profile 3D Annuloplasty Ring 3D, rigid annuloplasty ring with Diameter (mm) 24 - 40mm $2,400.00
physiologic mitral valve shape
Prostheses List by Category, Groups and Sponsor Page 21 of 866
SJ087 St Jude Medical Rigid Saddle Ring Rigid Annuloplasty Ring 24 - 34mm $2,400.00
SJ195 Attune Flexible Adjustable Annuloplasty Flexible annuloplasty ring 25mm - 43mm $2,200.00
Ring
EL050 Edwards MC3 Tricuspid Annuloplasty Annuloplasty Ring, 26mm to 36mm in 2mm $2,400.00
System titanium/silicone/polyester velour
cloth/plastic template
MC709 Posterior Annuloplasty Band; Colvin - Annuloplasty - Model 610B & 620B Model 610B: 25-35mm; Models $2,200.00
Galloway Future Band Model 638B; Silicone / Barium Sulphate, Dacron. 620B & 620BG: 23-35mm,
Duran Ancore Band 620B; Duran Models 638B semi-regid metal alloy core, Model 638B - 26-38mm
Ancore Chordal Model 620BG silicone coating, polyester knit fabric, kit
includes-band, malleable handle, template
with suture markers, sizers
RH002 Kalangos Mitral Ring KALANGOS Mitral Ring is intended for Diameter 16mm - 36mm, Height $2,200.00 $2,500.00
heart valve repair. Each device is 10.62mm - 24.61mm
characterized by a resorbable polymeric Thickness 1.3mm - 1.5mm
curved segment, processed in poly-1,4-
dioxanone, moulded around a PVDF
suture itself ended by swaged stainless
steel needles. These three constituents are
assembled in such a way that they
cannot be shared or dismounted after
assembly without irremediably destroying
the device. For these reasons,
KALANGOS Mitral Ring should be
considered as a single device. Each
extremity of the polymeric segment is
terminated by a sharp end prolonged by
the PVDF suture with a swaged stainless
Prostheses List by Category, Groups and Sponsor Page 22 of 866
RH003 Kalangos Tricuspid Ring KALANGOS Tricuspid Ring is intended TRK16 5.10 Radius 1 (mm) $2,200.00 $2,500.00
for heart valve repair. Each device is 9.31 Radius 2 (mm) 3.1 Radius
characterized by a resorbable polymeric 3 (mm) 5.44 Height (mm) 1.30
curved segment, processed in poly-1,4- Thickness (mm)
dioxanone, moulded around a PVDF TRK18 6.1 Radius 1 (mm)
suture itself ended by swaged stainless 10.44 Radius 2 (mm) 4.1 Radius
steel needles. These three constituents are 3 (mm) 7.98 Height (mm) 1.30
assembled in such a way that they Thickness (mm)
cannot be shared or dismounted after TRK20 7.1 Radius 1 (mm) 8.92
assembly without irremediably destroying Radius 2 (mm) 5.1 Radius 3
the device. For these reasons, (mm) 8.96 Height (mm) 1.30
KALANGOS Tricuspid Ring should be Thickness (mm)
considered as a single device. Each TRK22 8.1 Radius 1 (mm) 9.27
extremity of the polymeric segment is Radius 2 (mm) 6.1 Radius 3
terminated by a sharp end prolonged by (mm) 10.05 Height (mm) 1.30
the PVDF suture with a swaged stainless Thickness (mm)
steel needle on both sides. TRK24 9.1 Radius 1 (mm)
11.21 Radius 2 (mm) 7.1 Radius
3 (mm) 10.97 Height (mm)
1.30 Thickness (mm)
TRK26 10 Radius 1 (mm) 11.21
Radius 2 (mm) 8 Radius 3
(mm) 10.37 Height (mm) 1.50
Thickness (mm)
TRK28 10.5 Radius 1 (mm)
16.71 Radius 2 (mm) 9 Radius 3
(mm) 11.02 Height (mm) 1.50
Thickness (mm)
TRK30 12 Radius 1 (mm) 11.9
Radius 2 (mm) 10 Radius 3
(mm) 12.83 Height (mm) 1.50
Thickness (mm)
TRK32 13 Radius 1 (mm) 15.45
Radius 2 (mm) 11 Radius 3
(mm) 13.15 Height (mm) 1.50
Thickness (mm)
TRK34 14 Radius 1 (mm) 16.25
Radius 2 (mm) 12 Radius 3
(mm) 13.5 Height (mm) 1.50
Thickness (mm)
TRK36 15 Radius 1 (mm) 15.85
Radius 2 (mm) 13 Radius 3
(mm) 16.09 Height (mm) 1.50
Thickness (mm)
Prostheses List by Category, Groups and Sponsor Page 23 of 866
SJ088 SJM Tailor Annuloplasty Band Flexible double-velour, polyester fabric 25 - 35mm $2,200.00
SJ053 Verity Adx Model XL SC 5056 Single Chamber multi-programmable rate- 10.5cc, 23g $4,264.00
implantable pacemaker adaptive pacing device with extended
longevity
SJ076 Verity Adx Model XL SR 5157 M/S Single Chamber multi-programmable 11cc, 23g $5,928.00
implantable pacemaker rate-adaptive pacing devices with
extended longevity
BT062 Philos II SR Multiprogrammable, Rate Responsive, One size only $5,928.00
SSIR pacemaker
BT080 Cylos VR single chamber dual sensor rate responsive one size only $5,928.00
BT106 Cylos 990 SR Single-chamber pacemaker with Closed 57 x 39 x 6mm / 27g $5,928.00
Loop Stimulation (CLS)
BT109 Entovis SR Fully automatic, extended longevity, 53 x 39 x 6.5W x H x D [mm], $5,928.00
single cFully automatic, extended Size 1 [cm3], 25 Mass[g]
longevity, single chamber pacemaker with
Closed Loop Stimulation.
BT113 Evia SR Fully automatic, extended longevity, 53 x 39 x 6.5 W x H x D [mm], $5,928.00
single chamber pacemaker with Closed Size 10[cm3], 25 Mass [g]
Loop Stimulation.
BS124 Insignia AVT 1192 Single chamber rate responsive 10cc, 23.4g $5,928.00
BS145 Altrua 20 SR Single chamber rate responsive 10cc - 15cc $5,928.00
BS147 Altrua 40 SR Single chamber rate responsive 10cc - 15cc $5,928.00
Prostheses List by Category, Groups and Sponsor Page 24 of 866
BS149 Altrua 50 SR Single chamber rate responsive 10cc - 15cc $5,928.00
BS152 Altrua 60 SR Single chamber rate responsive 10cc - 15cc $5,928.00
GU124 Insignia Entra SR Models 1195 & 1198 Single Chamber Rate Responsive One size only $5,928.00
Permanent Pacemaker
GU126 Insignia Plus SR Model 1194 Single Chamber Rate Responsive One size only $5,928.00
Permanent Pacemaker
GU139 Insignia Ultra SR Model 1190 Single Chamber Rate Responsive One size only $5,928.00
MC728 Adapta Pacemaker SR PacemakerModels ADSR01, 9.7 - 11.0cc21.5 - 22.5g $5,928.00
ADSR06, ADSR03
SA137 Symphony SR Titanium one size only $5,928.00
SA142 Reply™ SR Single chamber permenent pacemaker 37 x 41.5 x 6.1mm $5,928.00
with rate response modulation 19 Grams
7.5 cm3
SA143 ESPRIT SR Single Chamber Permanent Pacemaker Dimensions: 37.4 x 41.5 x $5,928.00
with Rate Response Modulation 6.1mm Weight: 19grams.
SJ060 Identity ADx Model SR 5180 Single Chamber multi-programmable rate- 8cc, 18g $5,928.00
implantable pacemaker adaptive pacing device
SJ077 Verity Adx Models XL SR 5156 Single Chamber multi-programmable 11cc, 23g $5,928.00
implantable pacemaker rate-adaptive pacing devices with
extended longevity
SJ090 Victory SR 5610 single chamber rate responsive 41x44x46mm 17g 8cc $5,928.00
SJ105 Zephyr SR 5620 Single Chamber Rate-Responsive 8cc, 17g $5,928.00
SJ131 Zephyr XL SR 5626 Single-Chamber Rate-Responsive 23.5g and 10.4cc $5,928.00
SJ205 Accent SR PM 1110 Single Chamber Rate Responsive 18g, 9.5cc $5,928.00
SJ027 St Jude Medical Microny II SR+ Model Single Chamber Rate Responsive Volume 5.9cc, Weight 12.8gm $5,928.00
2525T Pacemaker
Prostheses List by Category, Groups and Sponsor Page 25 of 866
BT108 Entovis SR-T Fully automatic, extended longevity, 53 x 39 x 6.5 W x H x D [mm], $5,928.00 $8,928.00
single chamber pacemaker with Closed Size 11 [cm3], 24 mass[g]
Loop Stimulation & BIOTRONIK Home
Monitoring
BT110 Evia SR-T Fully automatic, extended longevity, 53 x 39 x 6.5 W x H x D [mm], $5,928.00 $8,928.00
single chamber pacemaker with Closed Size 11 [cm3], 24 Mass [g]
Loop Stimulation & BIOTRONIK Home
Monitoring
SJ200 Accent SR RF PM1210 Single Chamber Pacemaker with RF 23g, 12.8cc $5,928.00 $7,928.00
AB066 Supple Peri-Guard (10 x 16cm) Model No PC1016SN - 10 x 16 Bovine 10 x 16cm $760.00
pericardium patch
AB067 Supple Peri-Guard (8 x 14cm) Nodel No PC0814SN - 8 x 14 Bovine 8 x 14cm $700.00
pericardium patch
AB068 Supple Peri-Guard (6 x 8cm) Model No PC0608SN -6 x 8cm Bovine 6 x 8cm $610.00
pericardium patch
AB069 Supple Peri-Guard (4 x 4cm) Model No PC0404SN - 4 x 4cm Bovine 4 x 4cm $350.00
pericardium patch
EL033 Baxter Augmentation / Substitution Edwards Pericardial Patch. Bovine 10cm x 16cm $760.00
Material, Human or Animal Origin, Pericardium.
Sterile Pericardial Patch.
TM040 Repel - CV Bioresorbable Adhesion Barrier 18cmx13.5cmx137 microns $550.00
GT117 Gore-Tex - Cardiovascular Patch ePTFE 0.4mm Thickness 2 x 9cm $240.00
Prostheses List by Category, Groups and Sponsor Page 26 of 866
GT118 Gore-Tex - Cardiovascular Patch ePTFE 0.4mm - 3 x 6cm $280.00
0.6mm - 2.5cm x 15cm & 5cm
x 7.5cm
GT120 Gore-Tex Cardiovascular Patch ePTFE 0.6mm Thickness 5 x 15cm $521.00
GT121 Gore-Tex Cardiovascular Patch ePTFE 0.6mm Thickness 10 x 15cm $945.00
GT126 Acuseal Cardiovascular Patch Vascular ePTFE 0.5mm Thickness 1 x 9cm; 0.8 $223.00
x 7.5cm
GT127 Acuseal Cardiovascular Patch Cardiac ePTFE 0.5mm Thickness 3 x 6cm & 5 $270.00
x 7.5cm
GT122 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 6 x 12cm $360.00
GT123 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 8 x 16cm $643.00
GT124 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 12 x 12cm $748.00
GT125 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 15 x 20cm $1,455.00
BS123 Insignia AVT 882 Dual chamber VDD pacemaker 10.0cc, 23.5g $5,200.00
BS150 Altrua 50 VDD Dual chamber VDD pacemaker 10cc - 15cc $5,200.00
SJ050 Verity ADx Model XL DC 5256 Dual - Dual Chamber multi-programmable rate- 11cc, 23.5g $5,200.00
Chamber pacemaker adaptive pacing devices with extended
longevity
SJ061 Identity Adx Model XL DC 5286 Dual Identity ADx Model XL DC Model 5286 11cc, 23.5g $5,200.00
Chamber Pacemaker is an implantable, multi-programmable
rate-adaptive pacing device with AF
MC713 Adapta Pacemaker VDDR PacemakerModels ADVDD01 11.1cc23.6g $6,760.00
Prostheses List by Category, Groups and Sponsor Page 27 of 866
SJ054 Identity ADx Model VDR 5480 Single Chamber multi-programmable rate- 8cc, 18g $6,760.00
implantable pacemaker adaptive pacing device with extended
longevity
SJ057 Verity ADx Model XL VDR 5456 Single Chamber multi-programmable rate- 11cc, 23.5g $6,760.00
implantable pacemaker adaptive pacing device with extended
longevity
BT060 Philos II DR Multiprogrammable, rate responsive, One size only $9,360.00
BT104 Cylos 990 DR Dual-chamber pacemaker with Closed 57* 43* 6mm/28g $9,360.00
Loop Stimulation (CLS)
BT105 Cylos 990 DR-T Dual-chamber pacemaker with Closed 57*43*6mm/28g $9,360.00 $12,360.00
Loop Stimulation (CLS) and Biotronik
Home Monitoring Technology
BS126 Insignia AVT 1292 Dual chamber rate responsive pacemaker 10.8cc, 25.4g $9,360.00
BS144 Altrua 20 DR Dual chamber rate responsive pacemaker 10cc - 15cc $9,360.00
BS146 Altrua 40 DR Dual chamber rate responsive pacemaker 10cc - 15cc $9,360.00
BS148 Altrua 50 DR Dual chamber rate responsive pacemaker 10cc - 15cc $9,360.00
BS151 Altrua 60 DR Dual chamber rate responsive pacemaker 10cc - 15cc $9,360.00
GU120 Insignia Plus DR Model 1297, Insignia Dual Chamber Rate Responsive One size only $9,360.00
Plus DR Model 1298 Permanent Pacemaker
GU121 Insignia Entra DR Models Dual Chamber Rate Responsive One size only $9,360.00
Permanent Pacemaker
GU140 Insignia Ultra DR Model 1291 Dual Chamber Rate Responsive One size only $9,360.00
GU141 Insignia Ultra DR Model 1290 Dual Chamber Rate Responsive One size only $9,360.00
SA136 Symphony DR 2550 Active Implantable pacemaker 1 size only $9,360.00
SA141 Reply™ DR Dual Chamber permanent Pacemaker 8cc, Weight: 20grams, $9,360.00
with Rate Response Modulation Dimensions:41.2 x 41.5 x
Prostheses List by Category, Groups and Sponsor Page 28 of 866
SA144 ESPRIT DR Dual Chamber Permanent Pacemaker 8cc, Weight: 20grams, $9,360.00
with Rate Response Modulation Dimensions:41.2 x 41.5 x
SJ051 Verity Adx Implantable Pacemaker, Dual - Chamber, multi-programmable, 45x52x6mm,11cc, 23g, 5mm or $9,360.00
Models XL DR 5356 and XL DR rate-responsive pacemaker withAF 6mm M/S
SJ059 Identity ADx Models DR 5380 and XL Dual-Chamber, multi-programmable, rate- ADx DR 5380: 43x44x6mm, $9,360.00
DR 5386 adaptive pacing devices with AF 18g and 8ccADx XL DR
5386: 44x52x6mm, 23.5g and
SJ089 Victory XL DR 5816 and DR 5810 Dual Chamber Rate Responsive 44x52x6mm; 23.5g; 11cc $9,360.00
MC360 EnRhythm Model P150 1DR, Rate Responsive dual 21g, 13cc $11,440.00
chamber pacemaker with Anti-
Tachycardia functions: DDDRP
MC935 EnRhythm MRI SureScan Model EMDR01, MRI Conditional, Rate 13cc, 22g $11,440.00
Responsive Dual Chamber Pacemaker
with Anti-Tachycardia functions and
BT071 Philos II DR-T Dual Chamber Rate Responsive with One size only $9,360.00 $12,360.00
Home Monitoring
BT079 Cylos DR-T Dual chamber dual sensor rate responsive one size $9,360.00 $12,360.00
with home monitoring system option
BT111 Entovis DR Fully automatic, extended longevity, Dual 53 x 43 x 6.5W x H x D [mm], $11,440.00
Chamber Pacemaker with Closed Loop Size 11 [cm3], 26 Mass [g]
stimulation & Vp Suppression
BT112 Evia DR Fully automatic, extended longevity, Dual 53 x 43 x 6.5 W x H x D [mm], $11,440.00
Chamber Pacemaker with Closed Loop Size 11 [cm3], 26 Mass [g]
stimulation & Vp Suppression.
MC726 Adapta Pacemaker DR PacemakerModels ADDR01, 11.1-14.2cc23.6g-31.3g $11,440.00
ADDRS1, ADDRL1, ADDR06, ADDR03
Prostheses List by Category, Groups and Sponsor Page 29 of 866
SJ103 Zephyr XL DR 5826 and DR 5820 Dual Chamber Rate-Responsive 5826 - 23.5g, 11cc and 5820 - $11,440.00
18g, 8.5cc
SJ193 Accent DR PM 2112 Dual Chamber Pacemaker 19g, 10.5cc $11,440.00
MC933 Advisa DR MRI SureScan Model A3DR01 Digital dual chamber 13cc, 22g $11,780.00
pacemaker with SureScan Technology
(OAE-DDDR) MR Conditional with MVP
Mode, Complete Capture Management
Diagnostic (ACM, RVCM), AT/AF Suite
Diagnostics and Therapies, OptiVol Fluid
Status Monitoring, and Therapy Guide
MC934 Advisa DR Model A5DR01 Digital dual chamber 13cc, 22g $11,780.00
MVP mode
with Complete Capture Management
AT/AF Suite
Diagnostics and Therapies, OptiVol Fluid
Status Monitoring, and Therapy Guide
BT114 Evia DR-T Fully automatic, extended longevity, Dual 53 x 44.5 x 6.5 W x H x D $11,440.00 $14,440.00
Chamber Pacemaker with Closed Loop [mm], Size 12 [cm3], 25 Mass
stimulation, Vp Suppression and
BIOTRONIK Home Monitoring
BT115 Entovis DR-T Fully automatic, extended longevity, Dual 53 x 44.5 x 6.5 W x H x D $11,440.00 $14,440.00
Chamber Pacemaker with Closed Loop [mm], Size 12 [cm3], 25 Mass
stimulation, Vp Suppression and
BIOTRONIK Home Monitoring
SJ196 Accent DR RF PM2212 Dual chamber Pacemaker with RF 236, 12.8cc $11,440.00 $13,440.00
MC680 Spyder Proximal Anastomotic Device 6-clip assembly $590.00
Prostheses List by Category, Groups and Sponsor Page 30 of 866
GU142 Contak Renewal TR2 CRT - P Model CRT-P 45x54x8.5mm, 14cc, 26gm $12,480.00
H140, Model H145
MC226 Medtronic Insync III Triple Chamber Titanium One size only $12,480.00
Pacemaker Model 8042
SJ072 Frontier II - Model 5596 Biventricular Cardiac Resynchronisation 49mm(h) x 52(1) x 6(t), 25g $12,480.00
Device with AF suppression algorithm -
Titanum
BT085 Stratos LV-T Multiprogrammable Biventricular DDDRV One size only $12,480.00 $15,480.00
with Home Monitoring
SJ194 Anthem PM3112 CRT Pacemaker Cardiac Resynchronisation Therapy 21g, 11.5cc $13,520.00 $14,560.00
Pacemaker
SJ207 Anthem RF PM3212 CRT Pacemaker with RF telemetry 25g, 13.7cc $13,520.00 $14,560.00
MC714 U-Clips (Valve Repair) Double Arm, Mitral Valve Repair 2-packs $510.00
Prostheses List by Category, Groups and Sponsor Page 31 of 866
MC765 U-Clips Nitinol Clips, 8-pack Needle Lengths: 6.5mm - $336.00
9.5mm, 8-pack
MC772 U-Clips Nitinol Clips, 2-pack Needle Lengths: 6.5mm - $84.00
9.5mm, 2-Pack
AB074 FLEXIGRIP (Various Sizes) Nitinol Sternal Closure Clips - various sizes 20mm - 40mm $80.00 $160.00
MC026 Medtronic Transvene SVC Lead Model Model 6937-35, Model 6937-52, Model 35 - 110cm x 660mm $2,340.00
6937; 6937-58, Model 6937-110; Silicone;
GU123 Endotak SQ Array XP Lead Model 0085 Sub-Q Array for high DFT 70cm $4,680.00
MC251 Implantable Subcutaneous Defibrillator Silicone and Platinum Alloy Lengths 41-85cm inclusive $4,680.00
Lead Model 6996SQ 41cm, 58cm,
BT092 Linox TD Fractal and steroid coated passive fixation 65, 74 or 100cm length and 16 $9,360.00
quadripolar ICD lead or 18mm electrode spacing
BT093 Linox T Passive fix RV bipolar fractal coated 65, 75cm length $9,360.00
steroid ICD lead
Prostheses List by Category, Groups and Sponsor Page 32 of 866
BT119 Linox SMART TD Linox SMART TD is a family of ICD Length: Linox SMART TD $9,360.00
The 65/16 65cm, Linox SMART TD
fixation helix is comprised of platinum 65/18 65cm, Linox SMART TD
75/18 75cm; Lead Body
GU115 Endotak Reliance Lead Passive Dual Coil 59cm, 64cm, 90cm $9,360.00
GU158 Endotak Reliance SG Passive Passive Single Coil wih GORE ePTFE 54cm - 90cm $9,360.00
covered coils
GU159 Endotak Reliance G Passive Passive Dual Coil with GORE ePTFE 54cm - 90cm $9,360.00
covered coils
MC002 Medtronic Sprint Quattro Lead Model Silicone and polyurethane 65-100cm $9,360.00
6944RV/SVC 65cm; Model
6944RV/SVC 75cm; or Model
6944RV/SVC 100cm; Medtronic Sprint
Quattro Lead Model 6944RV/SVC 58cm
SA148 ISOLINE 2CT Passive fixation, steroid eluting, Lead body is 7.8 French $9,360.00
intergrated bipolar, dual shock coil diameter whilst 65cm in length
SJ110 Riata ST Transvenous Tachyarrhythmia Riata ST 7040/41 Passive-Fixation True- 60 - 75cm, 6.3 Fr, 7 Fr $9,360.00
Leads 7040/41/42 and 7050/51/52 Bipolar, Dual-Coil, Steroid-eluting,
Endocardial Defibrillation Leads, 7042 -
Single Coil, 7050/51 - Integrated Bipolar,
Dual Coil, 7052 - Integrated Bipolar,
Single Coil
SJ130 Riata ST Optim 7070/1 Passive Fixation, True bipolar, Dual Coil, 60, 65 and 70cm length, 7Fr $9,360.00
Steroid Eluting, Endocardial Defibrillation introducer
Leads with Optim insulation overlay
SJ158 Durata 7170, 7171 Passive fixation, true bipolar, dual coil, 60, 65 and 70cm $9,360.00
steroid eluting, endocardial defibrillation
leads with Optium insulation overlay
BS170 Endotak Reliance S 4-SITE Passive fixation single coil defibrillation 50-70cm $9,360.00
leads & 4-SITE connector.
Prostheses List by Category, Groups and Sponsor Page 33 of 866
BS180 Endotak Reliance G 4-SITE Passive fixation dual coil defibrillation 50-70cm $9,360.00
leads with ePTFE covered coils & 4-
SITE connector
BS181 Endotak Reliance SG 4-SITE Passive fixation single coil defibrillation 50-70 $9,360.00
leads with ePTFE covered coil & 4-SITE
BS183 Endotak Reliance 4-SITE Passive fixation dual coil defibrillation 50-70cm $9,360.00
leads with 4-SITE connector
BT084 Linox SD Fractal coated and steroid electrode, 65, 75cm length, 16, 18mm elec $9,000.00 $9,360.00
active fixation quadrapolar
BT096 Linox S Active fix RV bipolar fractal coated 65, 75cm length $9,000.00 $9,360.00
steroid IC lead
BT120 Linox SMART SD Linox SMART SD is a family of ICD Length: Linnox SMART SD $9,000.00
leads with an active fixation helix for the 60/16 61.2cm; Linnox SMART
The SD 65/16 65cm; Linnox
active fixation helix is comprised of SMART SD 65/18 65cm;
Linnox SMART SD 75/18
GU163 ENDOTAK RELIANCE G Active Active Dual Coil with GORE ePTFE 59-90cm $9,000.00
covered coils
GU164 ENDOTAK RELIANCE SG Active Active Single coil with GORE ePTFE 59-90cm $9,000.00
covered coils
MC208 Medtronic Sprint Quattro Secure Lead Leads, Defibrillator, Implantable, Silicone, 58-100cm $9,000.00
Model 6947 58cm; Model 6947 65cm; polyurethane, platinized tantalum coils,
Model 6947 75cm; Model 6947 100cm steroid eluting tip
MC834 Sprint Quattro Secure S Model 6935, Active Fixation Single Coil 52 - 100cm $9,000.00
Defibrillation Lead
SA146 ISOLINE 2CR Active fixation, steroid eluting, integrated Lead body is 7.8 French $9,000.00 $9,360.00
bipolar, dual coil defibrillation lead diameter whilst 65cm in length
SJ074 Riata Transvenous tachyarrhythmia Tri-polar Active - Fixation, Steroid- 60cm, 65cm, 8F introducer $9,000.00 $9,360.00
Leads Model 1582 Eluting, Single shock Coil
Prostheses List by Category, Groups and Sponsor Page 34 of 866
SJ075 Riata Transvenous Tachyarrhythmia Quadripolar, dual-coil, steroid eluting, One size only $9,000.00 $9,360.00
Lead Model 1580, Model 1581 active fixation tachyarrhythmia leads
SJ081 Riata i Transvenous Tachyarrhythmia Active fixation leads, Steroid Eluting, 60cm, 65cm, 75cm, 8F $9,000.00 $9,360.00
Leads Model 1590/1591 Dual Shock Coil Defibrillation Lead
SJ084 Riata i Transvenous Tachyarrhythmia Active Fixation, Steroid Eluting, Single 60cm, 65cm, 75cm, 8F $9,000.00 $9,360.00
Lead Model 1592 Shock Coil Defibrillation Lead
SJ096 Riata ST 7000/7001/7002 Active-Fixation True-Bipolar, Dual-Coil, 60, 65cm 7F introducer $9,000.00 $9,360.00
(7002 - Single-Coil) Steroid-Eluting
Steroid Eluting, Endocardial Defibrillation
SJ122 Riata ST Optim 7020/1/2 and 7030/1 7020/1 - Active fixation, true bipolar, 60, 65 and 75cm length and 7Fr $9,000.00 $9,360.00
7022 - Active fixation, true bipolar - introducer
single coil, 7030/1 - Active fixation,
integrated bipolar, dual coil steroid eluting
endocardial defibrillation leads with
Optim insulation overlay
SJ157 Durata 7120, 7121, 7122, 7130, 7131 Active fixation bipolar, dual-coil/single 60, 65, 75cm $9,000.00 $9,360.00
coil Steroid-eluting Endocardial
Defibrillation Leads
BS174 Endotak Reliance SG 4-SITE Active fixation single coil defibrillation 50-70cm $9,000.00
leads with ePTFE covered coil & 4-SITE
BS178 Endotak Reliance 4-SITE Active fixation dual coil defibrillation leads 50-70cm $9,000.00
with 4-SITE connector
BS179 Endotak Reliance S 4-SITE Active fixation single coil defibrillation 50-70mm $9,000.00
leads & 4-SITE connector
BS182 Endotak Reliance G 4-SITE Active fixation dual coil defibrillation leads 50-70cm $9,000.00
with ePTFE covered coils & 4-SITE
connector.
SJ230 Durata 7120Q, 7121Q and 7122Q 7120/1Q - Adtive fixation, true bipolar; 52cm, 58cm and 65cm $9,000.00 $9,360.00
7122Q - Active fixation true bipolar -
single coil steroid eluting endocardial
defibrillation leads with Optim insulation
overlay and SJ4 quadripolar lead
Prostheses List by Category, Groups and Sponsor Page 35 of 866
SJ233 Riata ST Optim 7020Q, 7021Q, 7022Q 7020/1Q - Active fixation, true bipolar; 52cm, 58cm and 65cm $9,000.00 $9,360.00
7022Q - Active fixation true bipolar -
single coil steroid eluting endocardial
defibrillation leads with Optim insulation
overlay and SJ4 quadripolar lead
MC027 Model 6721 Unipolar Epicardial Patch Model 6721S-50, Model 6721M-50, 370, 660, 840mm $2,340.00
Leads S/M/L Model 6721L-50; Silicone
TU036 Gelweave Valsalva Graft Woven vascular prosthesis, polyester, Diameter 24 - 34 mm, Overall $3,320.00
gelatin sealed length 18.4 - 19.6cm
TU038 Gelweave Graft Straight Thoracic Graft, with antiflo side 20 -34 mm x 20-40 cm $1,715.00
branch, Polyester, woven, gelatin sealed
TU037 Gelweave Plexus Graft Multi Branched, for Aortic Arch 20 - 34 mm x 40 cm $2,150.00
reconstruction, Polyester, Woven, gelatin
sealed
BS153 Myopore Bipolar sutureless myocardial pacing lead 25-54cm $1,716.00
Prostheses List by Category, Groups and Sponsor Page 36 of 866
MC011 Capsure EPI steroid eluting bipolar Silicone 25 - 60cm $1,716.00
epicardial lead Model 4968 - ventricle
SJ132 Myodex 1084T Steroid-Eluting Bipolar Sutureless 35cm and 54cm $1,716.00
Myocardial Pacing Lead with Titanium
Nitride Electrodes
SJ140 Myodex 1084T and FasTac Flex Lead Steroid -Eluting Bipolar Sutureless 35cm and 54cm, Lead implant $1,716.00 $1,966.00
Implant Tool Myocardial Pacing Lead with Titanium tool - 44cm
Nitride Electrodes and Lead implant tool
with articulating distal end.
BT095 Corox OTW BP Coronary Sinus bipolar steroid 77, 87 cm length $6,240.00
GU138 Easytrak 2, Model 4514, 4515, 4516, Bipolar, passive fixation. $6,240.00
4517, 4518, 4519, 4520
GU153 Easytrak 2 Is-1 Lead - Models 4542, Bipolar, passive fixation 80 to 100cm $6,240.00
4543 & 4544
GU156 Easytrak 3 Lead - Models 4521, 4522, Bipolar, passive fixation 80 to 100cm $6,240.00
4523, 4524, 4525, 4526 and 4527
GU162 Easytrak 3 IS-1 Lead Bipolar, passive fixation Sizes 80 to 100cm $6,240.00
GU165 Acuity Steerable Lead Bipolar, passive fixation 80cm, 90cm ,100cm $6,240.00
MC699 Attain OTW Model 4194 Lead Model 4194 78cm, 88cm $6,240.00
MC811 Attain Ability 4196 LV Lead Over the wire dual electrode left 78, 88, and 103 cm $6,240.00
ventricular lead
SJ099 QuickSite 1056T Bipolar Steroid-Eluting, Titanium Nitride 75cm, 6F and 86cm, 6F $6,240.00
Coated Electrodes Guidewire/Stylet-
Placed Keft Heart Lead with Fast-Pass
SJ126 QuickSite XL 1058T Bipolar, Steroid-Eluting, Titanium Nitride 75-86cm $6,240.00
Coated Electrodes, Guidewire/Stylet-
Placed Left Heart Lead with Fast-Pass
Prostheses List by Category, Groups and Sponsor Page 37 of 866
SJ139 Quickflex 1156T and XL 1158T Bipolar, Steroid-Eluting, Titanium Nitride Length 75 and 86cm $6,240.00
Coated Elextrodes, Guidewire/Stylet-
Placed Left Heart Lead with Fast-PassTM
SJ208 Quick Flex µ 1258T 4F Bipolar Left Ventricular Pacing Lead 75cm, 86cm, 92cm $6,240.00
MC730 Attain StarFix LV Lead Over the wire left Ventricular Lead 78, 88, 103cm $5,000.00
MC053 Capsure EPI steroid eluting unipolar Silicone 25 - 50cm $1,544.00
epicardial lead Model 4965 ventricle
MC009 Medtronic Epicardial Pacing Leads IS-1 Silicone 35 - 53cm $1,144.00
Model 5071
MC254 CapSure Sense pacemaker lead Models Titanium Nitride 30 - 85cm $1,248.00
SJ078 IsoFlex S, Models 1645K, 1643K, Endocardial, Steroid Eluting, Silicone, 34cm, 40cm, 46cm, 52cm, $1,248.00
Passive Fixation Leads with Fast-Pass 58cm, 85cm, 7F
SJ033 Aescula LV Model 1055K Left Ventricular Pacing Lead 75cm $2,735.00
Prostheses List by Category, Groups and Sponsor Page 38 of 866
BT070 Corox OTW UP Steroid Coronary Sinus Lead 77, 87cm $3,120.00
BS133 Acuity Spiral Unipolar passive fixation 80, 90 & 100cm $3,120.00
MC225 Attain Over the Wire Model 4193 Titanium, polyurethane 78-88cm $3,120.00
SJ079 QuickSite Model 1056K Unipolar, Steroid Eluting, Titanium Nitride 75cm, 6F and 86cm, 6F $3,120.00
Electrode, Guidewire/Stylet-placed Left
Heart Lead with Fast-Pass Coating
BT066 Selox ST Transvenous Bipolar Passive Steroid 53 and 60cm lengths $1,248.00
Ventricular Pacing Lead, fractal coated
BT067 Selox JT Fractal coated steroid electrode 45 and 53cm lengths $1,248.00
BT117 Siello JT The Siello JT is a family of sub 6F, Length: Siello T 45 cm; Siello T $1,248.00
steroid-eluting, transvenous, endocardial, 53 cm; Diameter: 5.6Fr
bipolar passive-fixation leads that carries
a j-shaped distal end.
BT118 Siello T The Siello T is a family of sub 6F, Length: Siello T 53cm; Siello T $1,248.00
steroid-eluting, transvenous, endocardail, 60cm Diameter: 5.6Fr
bipolar passive-fixation leads that carries
a j-shaped distal end.
GU009 Fineline II Sterox IROX Lead Bipolar passive fixation 52cm, 58cm $1,248.00
GU011 Fineline II Sterox IROX Lead Bipolar passive fixation 52cm, 58cm $1,248.00
GU012 Fineline II Sterox IROX Lead Bipolar, passive fixation 45cm, 52cm $1,248.00
GU023 Guidant Aust Selute Picotip Steroid Model 4035, Model 4064 45cm, 52cm, 59cm $1,248.00
Eluting Bipolar Lead
Prostheses List by Category, Groups and Sponsor Page 39 of 866
MC010 Medtronic Capsure SP Novus Model Silicone Polyurethane 45 -110cm $1,144.00
5092; Capsure SP Novus Lead Model
5592; Medtronic Capsure Model 4023
Lead; Medtronic Capsure Model 4024
Lead (med.dexamethasone) Medtronic
Capsure Model 4523(MED) Medtronic
Capsure Model 4524 Lead; Medtronic
Capsure Model
MC229 Medtronic Capsure SP Novus Model Silicone, platinum 30-100cm $1,180.00
KA007 Mahurkar Subclavian Catheter Kit Chronic haemodialysis, long term 36, 40cm $184.00
vascular access for haemodialysis and
apheresis. Constructed of radiopaque
Kit contains: Catheter,
18ga Introducer Needle, J/Straight 0.038"
Guidewire, 10cc Syringe, Tunnelling
Stylet, Pull-Apart Sheath/Dilator, (4)
Gauze Sponges, (2) Wound Dressings,
(2) Injection Sealing Caps.
KA009 RAAF Dual Lumen Catheter Central Venous Catheter constructed of 4.5mm (Catheter), 95cm $139.00
radiopaque silicone rubber (Catheter Overall Length);
3.2mm (Catheter), 102cm
KA010 Triple Lumen Right Arterial Catheter Central Venous Catheter constructed of 3.9mm $209.00
radiopaque silicone rubber
Prostheses List by Category, Groups and Sponsor Page 859 of 866
KA012 Mahurkar Subclavian Catheter Kit Acute haemodialysus, short term vascular 11.5 Fr, 13.5cm Straight $130.00
access. Catheters constructed of Extension, 11.5 Fr, 16cm
radiopaque polyurethane. Tips are made Straight Extension, 11.5 Fr
of polyvinyl chloride and are more 19.5cm Straight Extension, 10
radiopaque than the rest of the catheter. Fr 12cm Curved Extension, 10
Kit contains: 10 or 11.5 Fr Catheter, 18ga Fr 15cm Curved Extension, 11.5
Introducer Needle, J/Straight Guidewire, Fr 16cm Curved Extension,
10 Fr Dilator, 12 Fr Dilator, 2 x Adhesive 11.5 Fr 16cm Curved Extension,
Wound Dressings. 11.5 Fr 19.5cm Curved
KA014 Mahurkar Maxid Catheters Catheters constructed of radiopaque Size, 38, 43, 48, 53cm $305.00
The
arterial lumen is shorter than the venous
lumen at the catheter's distal end in order
to reduce recirculation during
KA019 Mahurkar 12Fr Triple Lumen Catheter Mahurkar 12Fr Triple Lumen Catheter 12Fr - 13cm, 16cm, 19cm & $230.00 Temporary approval pending
Curved Extension Kit 24cm lengths available review of catheters
KA020 Mahurkar 13.5Fr Q-Plus Dual Lumen Mahurkar 13.5Fr Q-Plus Curved 13.5Fr - 13.5cm, 16cm, 19cm $127.00 Temporary approval pending
Catheter Extension Double Lumen Catheter Kit & 24cm lengths available review of catheters
BA040 VitaCuff, Hickman Catheter Dialysis/Apheresis catheter, dual lumen, 36-45cm overall length $349.00 $359.00
silicone
BA051 Hickman Catheters Dual Without VitaCuff, silicone 7 - 9 French Catheter $350.00 $361.00
BA052 Hickman Catheters Triple Without VitaCuff, silicone 13.5 French Catheter $415.00 $427.00
BA140 HemoGlide Long Term Haemodialysis Dialysis Catheter, Multiple Lumen 14.5 Fr $357.00 $368.00
Catheter
BA159 HemoSplit Long Term Haemodialysis HemoSplit is a carbothane long term dual Standard Kit (straight15cm $485.00 $500.00
catheter lumen catheter used to provide vascular to42cm and pre-curved 19cm
access for haemodialysis. It comprises of to31cm), Microintroducer Kits
a double D lumen configuration catheter (straight 19cm to 42cm & pre-
each lumen having an ID of 2.3mm) with curved 19cm to 31cm)
a fixed split tip (to 7.5cmm) which
BA209 HemoStar Long Term Haemodialysis Dialysis Catheter, Multiple Lumen 14.5Fr - 16Fr $485.00
Catheter
Prostheses List by Category, Groups and Sponsor Page 860 of 866
KA011 Permcath Dual Lumen Catheter Chronic Haemodialysis, long term 36cm, 40cm $330.00
vascular access for haemodialysis and
Constructed of radiopaque
silicone rubber. Kit contains: Catheter,
18ga Introducer Needle, J/Straight 0.038"
Guidewire, 10cc Syringe, 10Fr. Dilator
(28cm only), 12Fr. Dilator (except
28cm), #11 Scalpel, Tunnelling Stylet,
Oval Pull-Apart Sheath/Dilator, (4) Gauze
Sponges, (2) Wound Dressing, (2)
Injection Sealing Caps.
KA013 Permcath Dual Lumen Catheter Chronic haemodialysis, long term 28, 36, 40cm $290.00
vascular access for haemodialysis and
Constructed of radiopaque
KA018 Palindrome Haemodialysis catheter 14.5Fr. 19, 23, 28, 33, 55cm $485.00 $600.00
Insertion Lengths, with 36, 40,
45, 50, 72cm Overall length,
with side slots, symmetric tip
MS009 Catheterisation kits(Horizon Medical) Central Venous Catheter - right atrial 2.7 -14F $417.00
catheter, silicone
TK005 Medcomp Long Term Catheter sets for ASH, TESIO-BioFlex with cuff 10, 14 French 24,28,32 & $450.00
Haemodialysis 36cm lengths
TK006 Medcomp Long Term Catheter sets for HemoFlow HFS-Carbothane with cuff 14.5 French 24,28,32 & 36cm $295.00
Haemodialysis lengths
GA001 'GamCath Dolphin Protect HighFlow 'Haemodialysis catheter with a modified '109585 - 13Fr x 15cm double $190.00
Haemodialysis Catheter Kit anti-thrombogenic surface (polymer lumen: 109584 - 13FRx 20cm
system of polydimethysilxane blocks) and double lumen, 109705 - 13Fr x
a non-release anti-microbial coating 25cm double lumen; 109706 -
(Bismith copolymer film) on internal and 13Fr x 15cm curved double
external surfaces of catheter. lumen; 109707 - 13Fr x 20cm
curved double lumen.
Prostheses List by Category, Groups and Sponsor Page 861 of 866
WC230 Cook Spectrum CVC Catheter 3 Lumen Triple lumen CVC line with antibiotic 5Fr, 7Fr, 9Fr $120.00
with antibiotic impregnation impregnation
WC231 Cook Spectrum 5 Lumen CVC Catheter 5 lumen CVC with antibiotic impregnation 10Fr $180.00
with antibiotic impregnation
CM015 ARROWg+ard Blue Haemodialysis Haemodialysis Catheters (of various CS-22122 - 12Fr 16cm, Dual $195.00
Catheters lengths, sizes and lumen confiurations) Lumen
with antimicrobial impregnation CS-22123 – 12Fr 16cm, Triple
(chlorhexidine and silver sulphadiazine) Lumen
on the external surface of the CS-25122 – 12Fr x 20cm, Dual
Lumen
CS-22142CF – 14Fr x 15cm,
Dual Lumen, Curved, Firm
CS-22142F – 14Fr x 15cm,
Dual Lumen Firm
CS-25122 – 12Fr x 20cm,
Double Lumen
CS-25123 – 12Fr x 20cm,
Triple Lumen
CS- 25142CF – 14Fr x 20cm,
Double Lumen, Curve, Firm
CS-25142F – 14Fr x 20cm,
Double Lumen, Firm
CS-26142F – 14Fr x 25cm,
Double Lumen, Firm
CU-22122 – 12Fr x 16cm,
Double Lumen, Curved
CU-23122 – 12Fr x 13cm,
Double Lumen, Curved
CU-25122 – 12Fr x 20cm,
Double Lumen, Curved
CM017 ARROWg+ard Four & Five Lumen A polyurethane central catheter with Blue CS-22854E - 8.5 Fr x 16cm, $170.00
Central Venous Catheters FlexTip (of various lengths, sizes and Quad Lumen
lumen configurations) with antimicrobial CS-25854E - 8.5Fr x 20cm,
impregnation (chlorhexidine and silver Quad Lumen
sulphadiazine) on the external surface of CS-22855 - 8.5 x 16cm, Five
the polyurethane catheter material Lumen
CS-25855 - 8.5Fr x 20cm, Five
Lumen
Prostheses List by Category, Groups and Sponsor Page 862 of 866
CM018 ARROWg+ard Blue Double & Triple A polyurethane central venous catheter CS-24402 - 4Fr x13cm, Dual $110.00
Lumen Central Venous Catheters with Blue FlexTip (of various lengths, Lumen
sizes and lumen configurations) with CS-22502 - 5FR x 5cm, Dual
antimicrobial impregnation (chlorhexidine Lumen
and silver sulphadiazine) on the external CS-25402 - 4Fr x 8cm, Dual
surface of the polyurethane catheter Lumen
CS-25502 - 5Fr x 12cm, Dual
Lumen
CS-22702E - 7Fr x 16cm,
Double Lumen
CS-26702 - 7Fr x 20cm, Double
Lumen
CS-27702E - 7Fr x 20cm,
Double Lumen
CS-25553 - 5.5Fr x 8cm, Triple
Lumen
CS-22703E - 7Fr x 16cm, Triple
Lumen CS-26553 -5.5Fr x
13cm, Triple Lumen
CS-24703E - 7Fr x 30cm, Triple
Lumen
CS-25703E - 7Fr x 20cm, Triple
Lumen
CM019 ARROWg+ard Blue Plus QUAD Lumen Central Venous Catheters (of Various CS-42854E - 8.5Fr x 16cm, $170.00
Central Venous Catheters lengths, sizes and lumen configurations Quad Lumen
with antimicrobial impregnation on: CS-45854E - 8.5Fr x 20cm,
1. The external indwelling surface of Quad Lumen
catheter material (chorhexidine and silver
sulphadiazine)
2. The entire internal fluid pathway
including catheter, extension-lines and
hubs (chlorhexidine acetate)
CM020 ARROWg+ard Blue Plus Double & Double & Triple Lumen Central Venous CS-45802E - 8 Fr x 20cm, Dual $120.00
Triple Lumen Central Venous Catheters Catheters (of various lengths sizes and Lumen
lumen configurations) with antimicrobial CS-46702E - 7Fr x 20cm, Dual
impregnation on: Lumen
1. The external indwelling surface of CS-47702E - 7Fr x 20cm, Dual
catheter material (chlorhexidine and silver Lumen
sulphadiazine) CS-42703E - 7Fr x 16cm, Triple
2. The entire internal fluid pathway Lumen
including catheter, extension-lines and CS-45703E - 7Fr x 20cm, Triple
hubs (chlorhexidine acetate) Lumen
Prostheses List by Category, Groups and Sponsor Page 863 of 866
BA182 PowerPICC Triple Lumen Power Injector Catheter 6F, 55cm length $230.00
BA183 PowerPICC Dual Lumen Power Injector Catheters 5F, 6F, 55cm Length $225.00
CM021 Arrow double lumen pressure injectable Arrow double lumen pressure injectable 5Fr x 50cm, Double Lumen $225.00
peripherally inserted central catheter PICC (peripherally inserted central
(PICC) set
BB170 Celsite Access Port for pain relief Composition - polysulphone. Kit includes Diameter of septum:11.7mm. $495.00
tunnelling rod, filter, connectors, Height: 11.5mm. Dimension:
needles, syringe, tuohy needle 25.8 x 37.8mm
BA056 Subcutaneous Ports Titanium or MRI Implantable Port, Open- 6FR - 9.6Fr $500.00
Ended Catheter Sinlgle Chamber
BA057 Groshong Subcutaneous Ports Titanium or MRI Implatable Port, Closed- 7Fr - 8 Fr $521.00
Ended Catheter, Single Chamber
BA060 Subcutaneous Ports Low-Profile Titanium or MRI Implantable 6 - 6.6 French Catheter $534.00 $653.00
Port, Open-Ended Catheter Sinlgle
TT001 Paragon Ambulatory Drug Infusion The top of the Paragon infuser is made of Infuser - 100mL Administration $534.00
acetyl with stainless steel parts; the Sets - 0.50mL, 1mL, 2mL,
bottom is made of clear polycarbonate. 4mL, 10mL, 50mL, 100mL, or
Administration Sets - made from PVC
WC093 Cook Implantable Injection/Infusion Petite or Standard, single or multiple 3 - 12 Fr pre-attached or $500.00
chamber Polysulfone Port which may detached catheter or valve system
include micropuncture or standard
WC094 Cook Implantable Injection/Infusion Mini or Petite or Standard, single or 3 - 12 Fr pre-attached or $534.00
multiple chamber titanium Port which detached catheter or valve system
may include micropuncture or standard
Prostheses List by Category, Groups and Sponsor Page 864 of 866
WC115 Cook Implantable Injection/Infusion Mini, single or multiple chamber titanium 3 - 12 Fr pre-attached or $534.00 $652.00
Port which may include micropuncture detached catheter or valve system
introducer set
DW003 Jet Port Plus Set - Vascular Access Port Implantable injection / infusion port Port: Diameter: 28.0mm, $375.00
port chamber with silicone Height: 12.3mm; Catheter: 6.6
membrane; connectable polyurethane French, Length: 750mm
catheter; and introducer kit.
DW004 Jet Port Plus Low Profile Peripheral Set Implantable injection / infusion port Port: Length: 24.0mm, Width: $420.00
- Vascular Access Port system: low profile port chamber with 20.5mm, Height: 10.3mm
silicone membrane; connectable Catheter: 6.6 French, Length:
polyurethane catheter; and introducer kit 750mm
MS016 Injection/Infusion Ports Sterile Plastic/titanium, paediatric 5, 6, 7,8, 9.6F $771.00
MS014 Injection/Infusion Ports Sterile Plastic/titanium, single lumen 5-15F $771.00
BA181 PowerPort Sterile Titanium or MRI, subcutaneous One size, OF Catheter $630.00
implanted port with attachable radiopaque
open ended ChronoFlex polyurethane
catheter, intermediate kit
BA208 PowerPort with Groshong Catheter Titanium or MRI implantable Port, 8Fr $630.00 $750.00
Closed-Ended Catheter, Single Chamber
Prostheses List by Category, Groups and Sponsor Page 865 of 866
DW006 T-Port Contrast set - Vascular access Injection infusion port system: titanium 6163653077: Port Base 27mm x $630.00
port chamber with silicone membrane: 13mm, Catheter Diameter 1.3 x
connectable polyurethane catheter; 2.2mm, Catheter Length 75cm.
introducer kit. 6163652087: Port Base 27mm x
13mm, Catheter Diameter 1.6 x
2.6mm, Catheter Length 75cm.
6163663077: Port Base 23mm x
10mm, Catheter Diameter 1.3 x
2.2mm, Catheter Length
75cm.6163662087: Port Base
23mm x 10mm, Catheter
Diameter 1.6 x 2.6mm, Catheter
Length 75cm.
BA059 Dual Lumen Subcutaneous Ports Silicone, Polyurethane or ChronoFlex 7 - 10 French Catheter $805.00
Open-ended Catheter
WC164 Cook Implantable Injection/Infusion Dual or Multiple Chamber Titanium Port 3 - 12 Fr pre-attached or $762.00
which may include micropuncture or detached catheter or valve system
standard introducer set
DW005 Dual Port Set - Vascular Access Port Implantable injection / infusion port Port: Length: 53.0mm, Width: $580.00
dual port chamber with silicone 20.0mm, Height: 13.5mm
membranes; connectable double lumen (chamber 1), 15.5mm (chamber
polyurethane catheter; and introducer kit. 2); Catheter: Length: 500mm,
internal diameter double D,
external diameter 3mm
MS015 Injection/Infusion Ports Sterile Plastic/titanium, dual lumen 10, 10.5, 12F $786.00
Prostheses List by Category, Groups and Sponsor Page 866 of 866
PART B - Human Tissue List August 2010
TBV56 Donor Tissue Bank of Victoria $1,013.00
QHV09 The Prince Charles Hospital - Queensland Heart Valve Bank $5,499.00
SHV03 Sydney Heart Valve Bank, St. Vincent's Hospital $987.00
TBV03 Donor Tissue Bank of Victoria $1,012.00
QHV08 The Prince Charles Hospital - Queensland Heart Valve Bank $5,499.00
QHV07 The Prince Charles Hospital - Queensland Heart Valve Bank $1,448.00
QHV06 The Prince Charles Hospital - Queensland Heart Valve Bank $1,448.00
QHV03 The Prince Charles Hospital - Queensland Heart Valve Bank $1,448.00
QHV05 The Prince Charles Hospital - Queensland Heart Valve Bank $1,448.00
QHV04 The Prince Charles Hospital - Queensland Heart Valve Bank $1,448.00
TBV50 Donor Tissue Bank of Victoria $490.00
QHV11 The Prince Charles Hospital - Queensland Heart Valve Bank $1,450.00
QHV01 The Prince Charles Hospital - Queensland Heart Valve Bank $5,499.00
RPH01 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV01 Sydney Heart Valve Bank, St. Vincent's Hospital $5,350.00
Page 1 of 15
TBV01 Donor Tissue Bank of Victoria $6,598.00
QHV10 The Prince Charles Hospital - Queensland Heart Valve Bank $5,499.00
QHV02 The Prince Charles Hospital - Queensland Heart Valve Bank $5,499.00
RPH02 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV02 Sydney Heart Valve Bank, St. Vincent's Hospital $5,350.00
TBV02 Donor Tissue Bank of Victoria $6,598.00
LEM03 Lions Eye Donation Service $770.00
LEM01 Lions Eye Donation Service $2,000.00
LEN01 Lions NSW Eye Bank $1,633.00
LEW01 Lions Eye Bank of Western Australia $2,500.00
QEB01 Queensland Eye Bank $2,100.00
SAE01 The Eye Bank of South Australia $1,000.00
LEM04 Lions Eye Donation Service $2,660.00
LEN03 Lions NSW Eye Bank $980.00
LEM02 Lions Eye Donation Service $150.00
LEN02 Lions NSW Eye Bank $245.00
LEW02 Lions Eye Bank of Western Australia $250.00
QEB02 Queensland Eye Bank $298.00
SAE02 The Eye Bank of South Australia $60.00
MVS22 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $9,538.00
ORT01 Orthogen Australia Pty Ltd $11,400.00
VAP01 Verigen Australia Pty Ltd $11,400.00
Page 2 of 15
MVS23 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $1,396.00
QBB60 The Queensland Bone Bank $1,568.00
RNB02 Hunter New England Bone Bank $1,470.00
QBB56 The Queensland Bone Bank $1,986.00
TBV52 Victorian Institute of Forensic Medicine $619.00
TBV53 Victorian Institute of Forensic Medicine $1,237.00
NBB62 New South Wales Bone Bank $903.00
NBB61 New South Wales Bone Bank $1,647.00
NBB60 New South Wales Bone Bank $2,498.00
QBB09 The Queensland Bone Bank $1,609.00
QBB10 The Queensland Bone Bank $680.00
TBV09 Donor Tissue Bank of Victoria $973.00
TBV10 Donor Tissue Bank of Victoria $1,853.00
NBB65 New South Wales Bone Bank $903.00
NBB64 New South Wales Bone Bank $1,647.00
NBB63 New South Wales Bone Bank $2,498.00
Page 3 of 15
AUB08 Australian Biotechnologies $2,215.00
AUB04 Australian Biotechnologies $2,070.00
TBV55 Donor Tissue Bank of Victoria $1,049.00
TBV54 Donor Tissue Bank of Victoria $524.00
PBT37 Perth Bone and Tissue Bank $750.00
PBT08 Perth Bone and Tissue Bank $2,070.00
PBT10 Perth Bone and Tissue Bank $3,041.00
QBB45 The Queensland Bone Bank $1,993.00
QBB03 The Queensland Bone Bank $2,524.00
PBT09 Perth Bone and Tissue Bank $2,652.00
PBT38 Perth Bone and Tissue Bank $900.00
TBV11 Donor Tissue Bank of Victoria $1,165.00
TBV12 Donor Tissue Bank of Victoria $2,084.00
AUB02 Australian Biotechnologies $2,457.00
QBB68 The Queensland Bone Bank $2,022.00
Page 4 of 15
QBB67 The Queensland Bone Bank $2,524.00
NBB05 New South Wales Bone Bank $1,224.00
PBT03 Perth Bone and Tissue Bank $500.00
TBV07 Donor Tissue Bank of Victoria $691.00
TBV08 Donor Tissue Bank of Victoria $750.00
PBT11 Perth Bone and Tissue Bank $300.00
QBB12 The Queensland Bone Bank $210.00
TBV17 Donor Tissue Bank of Victoria $390.00
AUB05 Australian Biotechnologies $2,451.00
QBB52 The Queensland Bone Bank $441.00
TBV14 Donor Tissue Bank of Victoria $763.00
PBT07 Perth Bone and Tissue Bank $2,215.00
PBT48 Perth Bone and Tissue Bank $2,451.00
PBT06 Perth Bone and Tissue Bank $1,856.00
QBB04 The Queensland Bone Bank $713.00
QBB14 The Queensland Bone Bank $2,205.00
TBV18 Donor Tissue Bank of Victoria $5,247.00
NBB09 New South Wales Bone Bank $922.00
TBV21 Donor Tissue Bank of Victoria $806.00
Page 5 of 15
PBT15 Perth Bone and Tissue Bank $1,539.00
QBB11 The Queensland Bone Bank $5.00
PBT16 Perth Bone and Tissue Bank $800.00
ACT01 ACT Bone Bank $2,113.00
APH01 The Avenue Private Hospital Bone Bank $1,131.00
AUB03 Australian Biotechnologies $2,354.00
CSA01 Rachel Forster Bone Bank $802.00
DHR01 Barwon Health Bone Bank $2,113.00
HBB01 The Hobart Private Hospital Bone Bank $2,113.00
LPH01 Lingard Private Hospital Bone Bank $1,103.00
MMH01 Mater Misericordiae Hospital Bone Bank Theatres $400.00
MVS05 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $1,595.00
NBB16 New South Wales Bone Bank $2,354.00
PBT22 Perth Bone and Tissue Bank $2,354.00
QBB27 The Queensland Bone Bank $2,163.00
RNB01 Hunter New England Bone Bank $1,870.00
SVN01 Mater Hospital $731.00
TBV26 Donor Tissue Bank of Victoria $2,354.00
QBB61 The Queensland Bone Bank $2,163.00
QBB28 The Queensland Bone Bank $2,163.00
NBB59 New South Wales Bone Bank $2,271.00
PBT21 Perth Bone and Tissue Bank $2,150.00
TBV46 Donor Tissue Bank of Victoria $1,206.00
NBB17 New South Wales Bone Bank $1,606.00
PBT24 Perth Bone and Tissue Bank $1,591.00
Page 6 of 15
QBB30 The Queensland Bone Bank $1,591.00
QBB31 The Queensland Bone Bank $670.00
QBB23 The Queensland Bone Bank $2,247.00
QBB66 The Queensland Bone Bank $2,811.00
NBB57 New South Wales Bone Bank $2,778.00
NBB13 New South Wales Bone Bank $2,507.00
TBV24 Donor Tissue Bank of Victoria $2,137.00
NBB56 New South Wales Bone Bank $1,687.00
NBB55 New South Wales Bone Bank $1,687.00
PBT19 Perth Bone and Tissue Bank $2,702.00
MVS02 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT17 Perth Bone and Tissue Bank $3,253.00
TBV22 Donor Tissue Bank of Victoria $3,854.00
NBB10 New South Wales Bone Bank $2,778.00
QBB20 The Queensland Bone Bank $2,800.00
NBB11 New South Wales Bone Bank $2,606.00
MVS03 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB12 New South Wales Bone Bank $6,200.00
QBB22 The Queensland Bone Bank $4,268.00
Page 7 of 15
TBV23 Donor Tissue Bank of Victoria $6,455.00
PBT18 Perth Bone and Tissue Bank $5,512.00
MVS04 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT20 Perth Bone and Tissue Bank $3,253.00
TBV25 Donor Tissue Bank of Victoria $3,826.00
NBB15 New South Wales Bone Bank $2,921.00
QBB25 The Queensland Bone Bank $3,020.00
NBB14 New South Wales Bone Bank $1,306.00
TBV51 Donor Tissue Bank of Victoria $3,713.00
MVS07 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB18 New South Wales Bone Bank $6,041.00
PBT25 Perth Bone and Tissue Bank $2,500.00
QBB32 The Queensland Bone Bank $2,651.00
TBV27 Donor Tissue Bank of Victoria $6,222.00
NBB54 New South Wales Bone Bank $2,359.00
PBT28 Perth Bone and Tissue Bank $1,379.00
MVS14 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
TBV29 Donor Tissue Bank of Victoria $1,055.00
MVS13 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
TBV28 Donor Tissue Bank of Victoria $691.00
TBV30 Donor Tissue Bank of Victoria $2,193.00
Page 8 of 15
NBB21 New South Wales Bone Bank $2,905.00
PBT29 Perth Bone and Tissue Bank $2,756.00
QBB33 The Queensland Bone Bank $2,762.00
TBV31 Donor Tissue Bank of Victoria $2,992.00
MVS08 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB24 New South Wales Bone Bank $6,500.00
PBT30 Perth Bone and Tissue Bank $5,071.00
QBB37 The Queensland Bone Bank $4,268.00
TBV32 Donor Tissue Bank of Victoria $6,788.00
NBB22 New South Wales Bone Bank $2,705.00
PBT31 Perth Bone and Tissue Bank $1,100.00
QBB34 The Queensland Bone Bank $2,478.00
TBV33 Donor Tissue Bank of Victoria $2,705.00
NBB23 New South Wales Bone Bank $1,195.00
PBT32 Perth Bone and Tissue Bank $1,000.00
QBB35 The Queensland Bone Bank $1,195.00
TBV34 Donor Tissue Bank of Victoria $1,042.00
QBB36 The Queensland Bone Bank $735.00
TBV37 Donor Tissue Bank of Victoria $1,653.00
NBB26 New South Wales Bone Bank $1,545.00
NBB50 New South Wales Bone Bank $3,090.00
QBB39 The Queensland Bone Bank $1,612.00
Page 9 of 15
NBB51 New South Wales Bone Bank $1,671.00
MVS19 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB25 New South Wales Bone Bank $2,359.00
TBV49 Donor Tissue Bank of Victoria $2,241.00
MVS20 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB29 New South Wales Bone Bank $3,142.00
QBB43 The Queensland Bone Bank $3,035.00
NBB30 New South Wales Bone Bank $3,182.00
PBT33 Perth Bone and Tissue Bank $3,236.00
NBB27 New South Wales Bone Bank $2,769.00
PBT35 Perth Bone and Tissue Bank $1,100.00
TBV36 Donor Tissue Bank of Victoria $2,769.00
NBB28 New South Wales Bone Bank $2,778.00
MVS09 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT34 Perth Bone and Tissue Bank $2,704.00
TBV35 Donor Tissue Bank of Victoria $2,646.00
NBB53 New South Wales Bone Bank $1,448.00
NBB31 New South Wales Bone Bank $1,781.00
TBV38 Donor Tissue Bank of Victoria $1,781.00
PBT47 Perth Bone and Tissue Bank $1,800.00
QBB05 The Queensland Bone Bank $1,400.00
Page 10 of 15
TBV40 Donor Tissue Bank of Victoria $1,184.00
TBV39 Donor Tissue Bank of Victoria $2,147.00
PBT60 Perth Bone and Tissue Bank $1,000.00
QBB47 The Queensland Bone Bank $788.00
TBV41 Donor Tissue Bank of Victoria $1,020.00
PBT40 Perth Bone and Tissue Bank $2,487.00
MVS18 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB06 New South Wales Bone Bank $3,024.00
PBT13 Perth Bone and Tissue Bank $1,800.00
QBB15 The Queensland Bone Bank $2,258.00
TBV19 Donor Tissue Bank of Victoria $3,115.00
NBB49 New South Wales Bone Bank $1,854.00
NBB47 New South Wales Bone Bank $2,975.00
MVS21 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $382.00
PBT41 Perth Bone and Tissue Bank $300.00
TBV43 Donor Tissue Bank of Victoria $487.00
AUB07 Australian Biotechnologies $1,854.00
AUB10 Australian Biotechnologies $2,184.00
NBB01 New South Wales Bone Bank $1,922.00
PBT61 Perth Bone and Tissue Bank $1,922.00
Page 11 of 15
QBB62 The Queensland Bone Bank $1,922.00
TBV05 Donor Tissue Bank of Victoria $1,024.00
QBB65 The Queensland Bone Bank $1,433.00
NBB02 New South Wales Bone Bank $2,228.00
PBT01 Perth Bone and Tissue Bank $2,228.00
QBB01 The Queensland Bone Bank $1,922.00
TBV06 Donor Tissue Bank of Victoria $2,085.00
AUB09 Australian Biotechnologies $2,228.00
NBB69 New South Wales Bone Bank $2,728.00
QBB69 The Queensland Bone Bank $1,922.00
QBB59 The Queensland Bone Bank $1,922.00
QBB48 The Queensland Bone Bank $2,055.00
QBB63 The Queensland Bone Bank $1,570.00
PBT02 Perth Bone and Tissue Bank $1,857.00
NBB33 New South Wales Bone Bank $2,147.00
TBV42 Donor Tissue Bank of Victoria $2,147.00
NBB68 New South Wales Bone Bank $2,647.00
NBB72 New South Wales Bone Bank $2,184.00
Page 12 of 15
NBB73 New South Wales Bone Bank $2,184.00
NBB70 New South Wales Bone Bank $2,185.00
QBB70 The Queensland Bone Bank $1,922.00
PBT46 Perth Bone and Tissue Bank $2,060.00
NBB67 New South Wales Bone Bank $2,184.00
QBB58 The Queensland Bone Bank $1,922.00
TBV57 Donor Tissue Bank of Victoria $2,085.00
NBB71 New South Wales Bone Bank $2,184.00
QBB57 The Queensland Bone Bank $1,922.00
TBV47 Donor Tissue Bank of Victoria $1,661.00
MVS17 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
QBB51 The Queensland Bone Bank $1,892.00
TBV48 Donor Tissue Bank of Victoria $2,177.00
NBB35 New South Wales Bone Bank $2,518.00
NBB36 New South Wales Bone Bank $2,551.00
PBT45 Perth Bone and Tissue Bank $2,551.00
QBB54 The Queensland Bone Bank $2,365.00
TBV45 Donor Tissue Bank of Victoria $2,468.00
TBV44 Donor Tissue Bank of Victoria $2,562.00
MVS11 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
Page 13 of 15
AUB06 Australian Biotechnologies $2,562.00
QBB08 The Queensland Bone Bank $2,800.00
PBT44 Perth Bone and Tissue Bank $3,859.00
NBB46 New South Wales Bone Bank $3,986.00
NBB45 New South Wales Bone Bank $1,448.00
MVS16 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB37 New South Wales Bone Bank $4,065.00
QBB55 The Queensland Bone Bank $4,248.00
QBB64 The Queensland Bone Bank $4,268.00
NBB44 New South Wales Bone Bank $5,455.00
QBB53 The Queensland Bone Bank $992.00
NBB41 New South Wales Bone Bank $3,747.00
NBB43 New South Wales Bone Bank $2,450.00
NBB42 New South Wales Bone Bank $2,645.00
QBB02 The Queensland Bone Bank $872.00
NBB66 New South Wales Bone Bank $1,208.00
Page 14 of 15
MVS15 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB07 New South Wales Bone Bank $2,787.00
PBT14 Perth Bone and Tissue Bank $1,500.00
QBB16 The Queensland Bone Bank $2,258.00
TBV20 Donor Tissue Bank of Victoria $2,871.00
NBB40 New South Wales Bone Bank $1,854.00
NBB38 New South Wales Bone Bank $2,450.00
Page 15 of 15
Part C – Other Prostheses Subject to Listing Criteria
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