Private Health Insurance (Prostheses) Rules 2011 (No. 1) (Cth)
I, PENNY SHAKESPEARE, delegate of the Minister for Health and Ageing, make these Rules under item 4 of the table in section 333-20 of the
31st January 2011
Penny Shakespeare
Assistant Secretary
Private Health Insurance Branch,
Medical Benefits Division
Department of Health and Ageing
1. Name of Rules These Rules are the
Private Health Insurance (Prostheses) Rules 20 11 (No. 1) .
These Rules commence on 21 February 2011.
These Rules revoke the
Private Health Insurance (Prostheses) Rules 2010 (No. 2) as amended by thePrivate Health Insurance (Prostheses) Amendment Rules 2010 (No. 1) and thePrivate Health Insurance (Prostheses) Amendment Rules 2010 (No. 2).
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 of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and a different amount is set out 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.
listed prosthesis means a kind of prosthesis listed in the Schedule to these Rules.
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 of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and no amount is set out 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 the General Medical Services Table being the table prescribed under section 4 of theHealth Insurance Act 1973 .
professional service has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973 .
public 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 public 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.
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 kinds of prostheses:
(i) in relation to which the Minister has granted an application for listing under subsection 72-10 (5) of the Act; or
(ii) which are listed in accordance with section 12 of the
Private 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.(aa) circumstances in which a listed prosthesis is provided for the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5A; and
(ab) conditions that must be satisfied in relation to the provision of a listed prosthesis for the purposes of paragraphs (c) and (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5B; and
(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; 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.
For purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) of the Act, the following circumstances are set out:
(a) the provision of a listed prosthesis which is associated with podiatric treatment by an accredited podiatrist.
Note: Paragraph (c) of Item 4 of subsection 72-1(2) deals with the provision of a listed prosthesis in circumstances in which a medicare benefit is payable.
For the purposes of paragraph (c) and (d) of item 4 of the table in subsection 72-1(2) of the Act, conditions that must be satisfied in relation to the provision of a listed prosthesis in the circumstances covered by paragraph (c) or (d) of that item, as the case may be, are:
(a) in relation to any kind of prosthesis where there is a statement of a requirement under the heading 'Condition' in the Schedule under the listing for that kind of prosthesis, that requirement; and
(b) in relation to a listed prosthesis that is an insulin infusion pump, also:
(i) the professional service associated with the provision of the insulin infusion pump must be a professional attendance by a consultant physician in the practice of his or her specialty; and
(ii) the professional service must be provided as a certified Type C procedure or certified overnight Type C procedure; and
(iii) the insulin infusion pump must be provided for the purpose of administering insulin.
Note: Item 4 of the table in subsection 72-1(2) of the Act states other requirements in relation to benefits for the provision of prostheses that a policy that covers hospital treatment must meet. These requirements relate to benefits for hospital treatment and, if the policy covers hospital-substitute treatment, to the benefits of that coverage as well.
(1) For a no gap prosthesis provided as part of an episode of hospital treatment by a private hospital, 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:
(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:
(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:
(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.
Note: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.
(1) For a no gap prosthesis provided as part of an episode of hospital-substitute treatment 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:
(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 1: 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 ― see paragraph 121-10 (3) (a) of the Act.Note 2: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.
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 kind of 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 kind of 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 List Advisory Committee.
(2) In setting the minimum and the maximum (if any) benefits for a kind of prosthesis, the Minister may have regard to the benefits as negotiated between the Negotiating Oversight Committee and the applicant.
For a listing application to be granted to list a kind of prosthesis in Part C of the Schedule, the listing criterion is that the kind of prosthesis is an:
(i) insulin infusion pump; or
(ii) implantable cardiac event recorder.
Note: 1. The power to make listing criteria is in subsection 72-10(6) of the Act.
2. Under subsection 72-10(7) of the Act the Minister must not grant a listing application if any applicable listing criteria are not satisfied in relation to the application.
3. Under the Act the Minister may refuse to grant a listing application even if the listing criteria are satisfied. See Note to subsection 72-10(7) of the Act.
Note 1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the
Legislative Instruments Act 2003 .SeeA - Prostheses February 2011
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
Group 1- Cardiothoracic Mechanical Valves
Group 1c - Bi-Leaflet, rotatable
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
MC980 Open Pivot Heart Valve (Model 500FA) Pyrolythic Carbon, Double Velour 16-33mm $6,000.00
Polyester, Titanium
Open Pivot Heart Valve (Model 500DM)
MC981 Open Pivot Heart Valve (Model Pyrolythic Carbon, Double Velour 16-33mm $6,000.00
501DA) Polyester, Titanium
Open Pivot Heart Valve (Model 501DM)
Reid Healthcare RH001 Aortic On-X Prosthetic Heart Valve 27-29mm, 19mm, 21mm, $6,000.00
Models ONXA-19; ONXA-21; 23mm, 25mm, 25-33mm, 27-
ONXA-23; ONXA-25; ONXA-27/29; 29mm, 31-33mm, 23mm,
ONXM-23; ONXM-25; ONXM- 25mm
27/29; ONXM31/33; ONXMC25/33
Sorin Group SA129 Optiform Mechanical Valve 19mm to 33mm $6,000.00
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 Rotatable Cuff -27mm, Rotatable 17 - 33mm
Cuff Heart Valve; St Jude Medical
Mechanical Heart Valve Masters Series
Prostheses List by Category, Groups and Sponsor Page 1 of 920
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations 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 A7700/M7700 Titanium. Pyrolite. Dacron, A7700 - Diameter 20-31mm, $5,100.00 $5,625.00
Model A7700, Medtronic Hall Heart A7700EZ/M7700EZ Titanium. Pyrolite. M7700 - Diameter 23-33mm,
Valve Mitral Model M7700, Hall Easy PET A7700EZ - Diameter 19-
Fit Aortic Heart Valve Model A7700, 29mm, M7700EZ - Diameter
Hall Easy Fit Mitral Heart Valve Model 23-31mm
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;
Volume: 32.6cc
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
Prostheses List by Category, Groups and Sponsor Page 2 of 920
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations SJ121 Current VR 1107-36 Single Chamber Cardioverter Defibrillator 38cc 76g $42,640.00
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
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, d, e
Boston Scientific Australia Pty Ltd BS132 Teligen 100 HE VR 4-SITE Single chamber ICD, high energy with RF 30.5cc, 9.9mm $43,390.00
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
Prostheses List by Category, Groups and Sponsor Page 3 of 920
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
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
monitoring
Generation 4
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
MI015 PROTECTA XT VR D354VRG Single chamber implantable cardioverter Volume 37cc, Mass 68g $43,920.00
defribillator with SmartShock Technology,
OptiVol 2.0 Fluid Status Monitoring and
Complete Capture Management
Specifications (DF-1)
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
SJ242 Fortify VR CD1233-40 Single chamber cardioverter defibrillator 35cc, 75g $43,920.00
with 40J delievered energy
SJ251 Fortify ST VR CD1235-40 Single chamber cardioverter defibrillator 35cc, 75g $43,920.00
with 40J delivered energy and ST segment
monitoring
Prostheses List by Category, Groups and Sponsor Page 4 of 920
CARDIO-THORACIC
Minimum Maximum
Billing Code Product Name Description Size Benefit Benefit Notations
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.
SJ240 Fortify VR CD1233-40Q Single chamber cardioverter defribillator 35cc, 75g $44,670.00
with 40J delivered energy with SJ4
connector
SJ247 Fortify ST VR 1235-40Q Single chamber cardioverter defibrillator 35cc, 75g $44,670.00
with 40J delivered energy and ST segment
monitoring and SJ4 connector
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
monitoring
SJ213 Current Accel VR RF CD1215-30 Single chamber cardioverter defibrillator 73g, 37cc $41,820.00 $44,560.00
with RF telemetry
MC831 Medtronic Lead Extender Kit Model: Silicone 37 - 50cm $530.00
6984M, 6981M, 6985M,6986m
Prostheses List by Category, Groups and Sponsor Page 5 of 920
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
5866-45, Model 5866-46
AY023 Xience Everolimus Eluting Stent System Everolimus Eluting Stent System 2.25mm to 4.0mm widths, 8mm $3,450.00
to 28mm lengths
AY037 Xience PRIME LL Everolimus Eluting Coronary Artery Stent, Drug Eluting XIENCE PRIME LL 2.50; $3,450.00
Coronary Stent; Xience PRIME 2.75; 3.00; 3.50; 4.0 x 33MM;
XIENCE PRIME LL 2.50;
Xience PRIME SV Everolimus Eluting 2.75; 3.00; 3.50; 4.0 x 38MM;
Coronary Stent XIENCE PRIME SV 2.25 x
08; 12; 15; 18; 23; 28MM;
XIENCE PRIME 2.50 x 08;
XIENCE PRIME 2.75 x 08;
XIENCE PRIME 3.00 x 08;
XIENCE PRIME 3.50 x 08;
XIENCE PRIME 4.00 x 08;
12; 15; 18; 23; 28MM
BS099 Taxus Liberte Paclitaxel-Eluting 316L Stainless Steel Stent with Translute 2.0mm-5.0mm & 8.0mm- $3,450.00
Coronary Stent System Polymer and Paclitaxel 38mm
Prostheses List by Category, Groups and Sponsor Page 6 of 920
BS125 Promus Everolimus Coronary Stent Cobalt chromium alloy stent coated with a 2.25mm to 4.0mm diameter, $3,450.00
System blended polymer mixed with Everolimus. 8mm to 28mm length
BS175 PROMUS Element Platinum chromium alloy stent coated with 8mm to 38mm with a reference $3,450.00
a blended polymer mixed with everolimus. vessel diameter of 2.25mm -
4.0mm.
BS176 Taxus Element Platinum chromium alloy stent coated with (8mm to 38mm) with a $3,450.00
a blended polymer mixed with Paclitaxel reference vessel diameter of
2.25mm - 4.5mm
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, struts
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 $3,450.00
Stent & Delivery System Sirolimus (an immunosuppressive and anti- 8 - 33mm
proliferative drug) bound to the stent by a
polymer. Model CRA-23300, 08225,
08250, 08275, 08300, 28225, 28250,
28275, 28300, 33225, 33250, 33275,
33300, 13225, 13250, 13275, 182
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 System 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 Polymer Diameter:2.25mm-4.0mm; $3,450.00
Coronary Stent System Length: 8.00mm-30.0mm
Prostheses List by Category, Groups and Sponsor Page 7 of 920
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 - Vision Cobalt chrome stent 2.25mm to 4.0mm widths, 8mm $1,248.00
to 38mm lengths
AY039 MULTI-LINK 8 Coronary Stent The MULTI-LINK 8, MULTI-LINK 8 MULTI-LINK 8: Diam: 2.5, $1,248.00
System, MULTI-LINK 8 SV Coronary SV, MULTI-LINK 8 LL Coronary Stent 2.75, 3.0, 3.5, 4.0mm, Stent
Stent System and MULTI-LINK 8 LL System (CSS) is comprised of two main Length: 8, 12, 15, 18, 23,
Coronary Stent System components: the cobalt chromium (CoCr) 28mm; MULTI-LINK 8 SV
stent and the balloon expandable delivery CSS: Diam: 2.25mm, Stent
system. Length: 8, 12, 15, 18, 23,
28mm; MULTI-LINK 8 LL
CSS: Diam: 2.5, 2.75, 3.0, 3.5,
4.0mm, Stent Length: 33 and
38mm
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 25mm
premounted on a rapid exchange system
BE001 Gazelle Coronary Stent Stainless Steel Diam 2.25-4.0mm Length 8- $1,248.00
28mm
BT082 PRO-Kinetic Cobalth Chromium coronary stent system 8-40mm length 2-5mm $1,200.00
diameter
Prostheses List by Category, Groups and Sponsor Page 8 of 920
BT107 PRO-Kinetic Energy The PRO-Kinetic Energey stent is a The PRO-Kinetic Energy stent $1,248.00
tubular, balloon-expandable stent sculpted is available in 66 different
by laser from a single tube of L-605 cobalt diameter/length combinations.
The stent It 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
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 carbide
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
and was subject to extensive clinical testing.
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:
delivery catheter. 2.25, 2.5, 2.75, 3.0, 3.5, 4.0,
4.5 & 5.0 mm
Prostheses List by Category, Groups and Sponsor Page 9 of 920
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
DY534 Presillion Plus CoCr Coronary Stent on Cobalt Chromium, bare metal coronary Stent length 8 - 40mm x Stent $1,248.00
RX System stent Diameter 2.5 - 5.0 mm
JJ026 BX Velocity with Hepacoat System Balloon expandable, stainless steel, heparin. $1,220.00
coated
JJ200 BX Velocity Stent and Delivery System Stainless steel stent Diameter: 2.25-5.0 mm; Length $1,220.00
8 - 33 mm
JJ239 BX Sonic Stainless steel coronary stent mounted on a Dia 2.25 - 4.0mm, lengths 8 - $1,220.00
balloon delivery system 33mm
JJ670 Presillion CoCr Coronary Stent on RX Cobalt Chromium, bare metal coronary Stent Length (mm) x Stent $1,248.00
System stent 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, 4.0;
MS058 Arthos Pico Stent Implantation System Cobalt Chromium Stent Premounted on a Diameter: 2-4mm; Length: 8- $1,248.00
Rapid Exchange Delivery System 38mm
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 -
24mm)
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; $1,248.00
Length: 8 - 30mm
Prostheses List by Category, Groups and Sponsor Page 10 of 920
NM004 Blazer Coronary Stent Delivery System L605 Cobalt Chromium alloy balloon Expanded Stent Diameter 2.5 $1,248.00
expandable vascular prosthesis to 4.0mm, Stent Length 9 to
33mm
TU001 Tsunami Gold Stainless Steel mounted on balloon catheter Diameter 2.0mm - 4.0mm, $1,248.00
Length 8mm - 30mm length
TU044 Kaname Coronary Stent System BMS Coronary Stent Diameter: 2.5mm; 2.75mm; $1,248.00
x
Lengths: 9mm; 12mm; 15mm;
18mm; 24mm; 28mm.
AY012 JoStent Coronary Stent Graft Stainless Steel/PTFE 9 - 26 mm x 2.5 - 5 mm $3,222.00
AY027 Multilink Coronary Stent System - 316L Stainless steel stent Length 1.5 - 8.0mm $2,200.00
Frontier
IX002 Nile CroCo Intracoronary stent pre-mounted on two Diameter: 2.50 - 3.50mm. $1,750.00
rapid exchange delivery systems for MB and 2.00-3.00mm SB
bifurcation lesions treatment Lengths 18 mm and 24 mm
IX003 Minvasys Nile Delta Coronary Stent Balloon expandable Amazonia Nile Delta 2.50mm diameter x $1,248.00
System 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 11 of 920
JT001 Occlutech Figulla Flex ASD Occluder The Occlutech Figulla® Flex ASD 6, 7.5, 9, 10.5, 12, 15, 18, 21, $10,000.00
occluder is an implant for closure of an 24, 27, 30, 33, 36, 39, 40
Atrial Septal Defect of the heart (ASD
II=ASD of the Secundum Type) and is
deployed via a minimally invasive catheter
delivery system.
The Occlutech Figulla® Flex ASD is
intended for patients with substantiated
Left-Right-Shunt and a clear indication for
closure of the defect.
JT002 Occlutech Figulla Flex PFO Occluder The Figulla® Flex PFO is an implant for 16/18, 23/25, 27/30 and 31/35 $10,000.00
closure of a patent foramen ovale (PFO)
defect in the heart and is deployed via a
minimally invasive catheter delivery system.
The Figulla® Flex PFO is intended for
patients with substantiated Right-Left-
Shunt in the contrast agent
echocardiography under Valsalva
maneuver and presence of a "cryptogenic",
paradoxical thromboembolism.
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 mesh Waist diameter 3-6mm, $10,200.00
PDA occlusion device Nominal length 4-6mm
Prostheses List by Category, Groups and Sponsor Page 12 of 920
PI020 'STARflex Rapid Transport Plus System The STARFlex Rapid Transport Plus 23mm, 28mm, 33mm and $10,200.00
System consists of two primary 38mm
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
single end item.
SJ091 Premere PFO Closure System Percutaneous, transcatheter, self- Left Atrial Anchor diameter $10,036.00
expanding, dual anchor, occlusion and 20mm, 25mm and 30mm
apposition device
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
AY038 Coherex FlatStent EF PFO Closure In-tunnel PFO closure device and delivery 13mm & 19mm $10,200.00
System system
Prostheses List by Category, Groups and Sponsor Page 13 of 920
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,
6.0mm, 6.5mm
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:
4.5; 5.0; 6.0
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
fibrillation monitoring.
SJ159 SJM Confirm Model DM2100 Implantable cardiac monitor 6.5cc, 12g $3,900.00
Prostheses List by Category, Groups and Sponsor Page 14 of 920
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
position 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 15 of 920
SJ069 St Jude Medical Biocor Porcine St Jude Medical Biocor Porcine Prosthetic Aortic Valves - Tissue Annulus $4,445.00
Prosthetic Heart Valve Heart Valve is manufactured from Diameter - 21-29mm, Implant
selected procine aortic valve cusps that Height - 11-15c; Mitral Valves
have been cross-linked with a - Tissue Annulus Diameter -
glutaraldehyde solution 25-35mm, Implant Height - 8-
10mm
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 valve 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 valve Tissue Annulus Diameter - $4,445.00
for supra-annular placement in the aortic 19mm-23mm. Total Height
position 14mm-16mm.
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 Alloy;
Bioprosthesis Model 6650 Mitral Valve Silicone Rubber, Polytetrafluoroethylene
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
MI007 Hancock II Aortic Valve Aortic bioprosthesis 21mm to 29mm $4,445.00
MI008 Hancock II Mitral Valve Mitral bioprosthesis 25mm to 33mm $4,445.00
Prostheses List by Category, Groups and Sponsor Page 16 of 920
MI009 Hancock II Ultra Aortic Valve Small aortic root bioprosthesis 21mm to 29mm $4,445.00
EL056 Magna Mitral Carpentier-Edwards PERIMOUNT 25, 27, 29, 31 and 33mm $5,000.00 $5,690.00
Magna Mitral Bioprosthesis, Model
7000TFX
SA130 Mitroflow Pericardial Bioprosthesis 19-27mm $5,000.00
EL058 Magna Ease Carpentier - Edwards PERIMOUNT 19, 21, 23, 25, 27 and 29mm $5,000.00 $6,100.00
Magna Ease Bioprosthesis, Model
3300TFK
SA155 Mitroflow Mitroflow Aortic Pericardial Heart Valve 19, 21, 23, 25, 27mm $5,000.00
(Model LX)
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 33mm
Perimount Plus Pericardial Bioprosthesis Rubber, Polytetrafluoroethylene
Mitral - Model 6900P
EL039 Edwards Perimount Magna Model 3000 Carpentier-Edwards Perimount Magna 19MM Aortic Pericardial $5,000.00 $5,690.00
composition: Glutaraldehyde treated Tissue Valve; 21MM Aortic
bovine pericardium/elgiloy wireform Pericardial Tissue Valve;
stent/polyester band/silicone rubber suture 23MM Aortic Pericardial
ring/polytetrafluoroethylene cloth/polyester Tissue Valve; 25MM Aortic
cloth. Pericardial Tissue Valve;
27MM Aortic Pericardial
Tissue Valve; 29MM Aortic
Pericardial Tissue Valve
Prostheses List by Category, Groups and Sponsor Page 17 of 920
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
MC982 3f Aortic Bioprosthesis (Model 1000) Model 1000 - EQUINE Pericardium 19 - 29 mm $5,000.00
Bioprostheseis (non stented)
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 response 32.6cc; Dimensions: 58.4 x
73.4 x 11mm
SJ115 Atlas II+ DR V-268 Dual Chamber Cardioverter Defibrillator 39cc, 78g $45,760.00
Prostheses List by Category, Groups and Sponsor Page 18 of 920
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
Threshold Monitoring
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
Monitoring
BS134 TELIGEN 100 HE DR 4-SITE Dual Chamber ICD, high energy with RF 31.55cc, 9.9mm $46,510.00
IS4
GU157 Vitality AVT - Model A155 Dual Chamber ICD with atrial therapies 30cc $43,680.00
Prostheses List by Category, Groups and Sponsor Page 19 of 920
BT091 Lumax 300 DR-T ICD-DR with bidirectional Home One size only $43,680.00 $46,680.00
Monitoring
SJ215 AnalyST DR CD2217-30 Dual chamber cardioverter defribillator 74g, 38cc $43,680.00 $45,680.00
with RF telemetry and ST segment
monitoring
MC814 Secura DR Fully Automatic, Wireless Implantable 37cc $47,130.00
cardioverter defibrillator with high energy
capability and therapies for ventricular and
atrial tachyarrhythmia
MI016 PROTECTA XT DR D354DRG Dual chamber implantable cardioverter Volume 37cc, Mass 68g $47,130.00
defribillator with SmartShock Technology,
OptiVol 2.0 Fluid Status Monitoring and
Complete Capture Management
Specifications (DF-1)
SJ143 AnalyST Accel DR CD2219-36 Dual Chamber cardioverter defibrillator 80g, 42cc $47,130.00 $48,480.00
with RF telemetry and ST Segment
Monitoring
SJ153 Current Accel DR RF CD2215-36 Dual Chamber Cardioverter Defibrillator 80g, 42cc $47,130.00 $48,480.00
with RF Telemetry
SJ241 Fortify DR CD2233-40 Dual chamber cardioverter defibrillator 35cc, 76g $47,130.00
with 40J delivered energy
SJ248 Fortify ST DR CD2235-40 Dual chamber cardioverter defibrillator 35cc, 76g $47,130.00
with 40J delivered energy and ST segment
monitoring
Prostheses List by Category, Groups and Sponsor Page 20 of 920
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
SJ249 Fortify DR CD2233-40Q Dual chamber cardioverter defibrillator 35cc, 76g $47,880.00
with 40J delivered energy
SJ250 Fortify ST DR CD2235-40Q Dual chamber cadioverter defibrillator with 35cc, 75g $47,880.00
40J delivered energy and ST segment
monitoring
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
monitoring
MC198 Medtronic Hall rotatable aortic valved Titanium, pyrolite, dacron 20 - 33mm $6,950.00
collagen impregnated conduit Model
R7700
MC979 Open Pivot Aortic Valved Graft (Model Pyrolythic Carbon, Double Velour 21- 33mm $6,950.00
502AG) Polyester, Titanium
Prostheses List by Category, Groups and Sponsor Page 21 of 920
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
Graft
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
MC012 Medtronic Hancock Valved Conduit Porcine bioprosthesis, dacron 12, 14, 16, 18, 20, 22, 25, $5,900.00 $6,800.00
Model 100/150 30mm.
BS129 LIVIAN CRT-D CRT-D with RF 40cc, 79.5g, 14.5mm $45,760.00
GU147 Contak Renewal 4 CRT-D Model CRT-D One Size only $45,760.00
H190, 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
Prostheses List by Category, Groups and Sponsor Page 22 of 920
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 with 34cc, 94 grams; 61.8 x 73.4 x $47,840.00
Cardiac Resynchronisation therapy, High 11mm
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
GU155 Contak Renewal 4 AVT HE CRT - D - Implantable Cardioverter Defibrillator with 40cc; 89g $47,840.00
Model M177, M179 cardiac resynchronisation Therapy
MC720 Concerto CRT-D Implantable Cardioverter Defibrillator with 38cc $47,840.00 $50,000.00
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
Prostheses List by Category, Groups and Sponsor Page 23 of 920
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 Longevity.
BS139 COGNIS 100 HE (DF-1/IS-1 & DF- CRT-D high energy with RF 32.5cc, 9.9mm $47,840.00
1/LV-1)
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 with 37cc; 89g $45,760.00
Model M170 and M175 Cardiac Resynchronisation Therapy
BT088 Lumax 300 HF-T CRT-D with bidirectional Home Monitoring One size only $45,760.00 $48,760.00
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
Prostheses List by Category, Groups and Sponsor Page 24 of 920
MI017 Protecta XT CRT-D D354TRG Implantable Cardioverter Defibrillator with Volume 38cc, Mass 68g $52,000.00
Cardiac Resynchronisation therapy,
SmartShock Technology, OptiVol 2.0
Fluid Status Monitoring and Complete
Capture Management Specifications (DF-
1)
SJ150 Promote Accel RF CD3215-36 Cardiac Resynchronisation Therapy 82g, 43cc $52,000.00
Defibrillator with RF Telemetry
SJ246 Unify CRT CD3235-40 Cardiac Resynchronisation Therapy 36cc, 78g $52,000.00
Defibrillator with 40J delivered
SJ236 Promote Accel CD3215-36Q Cardiac Resynchronisation Therapy 82g, 43cc $52,750.00
Defibrillator with RF Telemetry and SJ4
connector
SJ244 Unify CRT CD3235-40Q Cardiac Resynchronisation Therapy 36cc, 77g $52,750.00
Defibrillator with 40J delivered energy and
SJ4 connector
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 25 of 920
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; Polyester
Fabric
MC005 Medtronic Duran Annuloplasty Ring; Annuloplasty Devices - Models 610R & Model 610R 25-35mm & $2,200.00
Duran Ancore Ring 620R; Duran 620R Silicone / Barium Sulphate, Dacron. Model 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/32 $2,400.00
cloth/plastic template Mitral valve annular mm/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
Prostheses List by Category, Groups and Sponsor Page 26 of 920
EL059 Carpentier-Edwards PHYSIO ll Mitral PHYSIO II is a semi rigid mitral 24, 26, 28, 30, 32, 34, 36, 38, $2,400.00
Annuloplasty Ring annuloplasty ring, with an improved saddle 40mm
shape and global disease based design
MC745 CG Future Composite Ring Semi-rigid mitral annuloplasty ring, with 24, 26, 28, 30, 32, 34, 36 & $2,400.00
anterior flexibility 38mm
MC844 Profile 3D Annuloplasty Ring 3D, rigid annuloplasty ring with physiologic Diameter (mm) 24 - 40mm $2,400.00
mitral valve shape
SA150 MEMO 3D Memo 3D Semirigid Mitral Annuloplasty 24-38mm $2,400.00
Ring, with 3D flexibility and coasted with
Carbofilm
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 increment
cloth/plastic template
MC709 Posterior Annuloplasty Band; Colvin - Annuloplasty - Model 610B & 620B Model 610B: 25-35mm; $2,200.00
Galloway Future Band Model 638B; Silicone / Barium Sulphate, Dacron. Models 620B & 620BG: 23-
Duran Ancore Band 620B; Duran Models 638B semi-regid metal alloy core, 35mm, Model 638B - 26-
Ancore Chordal Model 620BG silicone coating, polyester knit fabric, kit 38mm
includes-band, malleable handle, template
with suture markers, sizers
Prostheses List by Category, Groups and Sponsor Page 27 of 920
RH002 Kalangos Mitral Ring KALANGOS Mitral Ring is intended for Diameter 16mm - 36mm, $2,200.00 $2,500.00
heart valve repair. Each device is Height 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 steel needle on both sides.
Prostheses List by Category, Groups and Sponsor Page 28 of 920
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
steel needles. These three constituents are Radius 3 (mm) 7.98 Height
assembled in such a way that they cannot (mm) 1.30 Thickness (mm)
be shared or dismounted after assembly TRK20 7.1 Radius 1 (mm)
without irremediably destroying the device. 8.92 Radius 2 (mm) 5.1 Radius
For these reasons, KALANGOS 3 (mm) 8.96 Height (mm) 1.30
Tricuspid Ring should be considered as a Thickness (mm)
single device. Each extremity of the TRK22 8.1 Radius 1 (mm)
polymeric segment is terminated by a sharp 9.27 Radius 2 (mm) 6.1 Radius
end prolonged by the PVDF suture with a 3 (mm) 10.05 Height (mm)
swaged stainless steel needle on both 1.30 Thickness (mm)
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 29 of 920
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 rate- 11cc, 23g $5,928.00
implantable pacemaker 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, single 53 x 39 x 6.5W x H x D [mm], $5,928.00
cFully automatic, extended longevity, single Size 1 [cm3], 25 Mass[g]
chamber pacemaker with Closed Loop
Stimulation.
BT113 Evia SR Fully automatic, extended longevity, single 53 x 39 x 6.5 W x H x D [mm], $5,928.00
chamber pacemaker with Closed Loop Size 10[cm3], 25 Mass [g]
Stimulation.
BS124 Insignia AVT 1192 Single chamber rate responsive pacemaker 10cc, 23.4g $5,928.00
Prostheses List by Category, Groups and Sponsor Page 30 of 920
BS145 Altrua 20 SR Single chamber rate responsive pacemaker 10cc - 15cc $5,928.00
BS147 Altrua 40 SR Single chamber rate responsive pacemaker 10cc - 15cc $5,928.00
BS149 Altrua 50 SR Single chamber rate responsive pacemaker 10cc - 15cc $5,928.00
BS152 Altrua 60 SR Single chamber rate responsive pacemaker 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
Pacemaker
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 with 37 x 41.5 x 6.1mm $5,928.00
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.
Volume: 7.5 cm3
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 rate- 11cc, 23g $5,928.00
implantable pacemaker adaptive pacing devices with extended
longevity
SJ090 Victory SR 5610 single chamber rate responsive pacemaker 41x44x46mm 17g 8cc $5,928.00
SJ105 Zephyr SR 5620 Single Chamber Rate-Responsive 8cc, 17g $5,928.00
Pacemaker
Prostheses List by Category, Groups and Sponsor Page 31 of 920
SJ131 Zephyr XL SR 5626 Single-Chamber Rate-Responsive 23.5g and 10.4cc $5,928.00
Pacemaker
SJ205 Accent SR PM 1110 Single Chamber Rate Responsive 18g, 9.5cc $5,928.00
Pacemaker
SJ027 St Jude Medical Microny II SR+ Model Single Chamber Rate Responsive Volume 5.9cc, Weight 12.8gm $5,928.00
2525T Pacemaker Pacemaker
BT108 Entovis SR-T Fully automatic, extended longevity, single 53 x 39 x 6.5 W x H x D [mm], $5,928.00 $8,928.00
chamber pacemaker with Closed Loop Size 11 [cm3], 24 mass[g]
Stimulation & BIOTRONIK Home
Monitoring
BT110 Evia SR-T Fully automatic, extended longevity, single 53 x 39 x 6.5 W x H x D [mm], $5,928.00 $8,928.00
chamber pacemaker with Closed Loop Size 11 [cm3], 24 Mass [g]
Stimulation & BIOTRONIK Home
Monitoring
SJ200 Accent SR RF PM1210 Single Chamber Pacemaker with RF 23g, 12.8cc $5,928.00 $7,928.00
telemetry
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
Prostheses List by Category, Groups and Sponsor Page 32 of 920
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
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
Prostheses List by Category, Groups and Sponsor Page 33 of 920
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
suppression
MC713 Adapta Pacemaker VDDR PacemakerModels ADVDD01 11.1cc23.6g $6,760.00
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, DDDR 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
Prostheses List by Category, Groups and Sponsor Page 34 of 920
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
1294,1295,1296 Permanent Pacemaker
GU140 Insignia Ultra DR Model 1291 Dual Chamber Rate Responsive One size only $9,360.00
Pacemaker
GU141 Insignia Ultra DR Model 1290 Dual Chamber Rate Responsive One size only $9,360.00
Pacemaker
SA136 Symphony DR 2550 Active Implantable pacemaker 1 size only $9,360.00
SA141 Reply™ DR Dual Chamber permanent Pacemaker with 8cc, Weight: 20grams, $9,360.00
Rate Response Modulation Dimensions:41.2 x 41.5 x 6.1mm
SA144 ESPRIT DR Dual Chamber Permanent Pacemaker with 8cc, Weight: 20grams, $9,360.00
Rate Response Modulation Dimensions:41.2 x 41.5 x 6.1mm
SJ051 Verity Adx Implantable Pacemaker, Dual - Chamber, multi-programmable, 45x52x6mm,11cc, 23g, 5mm $9,360.00
Models XL DR 5356 and XL DR rate-responsive pacemaker withAF or 6mm M/S
5357M/S suppression
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
suppression 5386: 44x52x6mm, 23.5g and
11cc
SJ089 Victory XL DR 5816 and DR 5810 Dual Chamber Rate Responsive 44x52x6mm; 23.5g; 11cc $9,360.00
Pacemakers
Prostheses List by Category, Groups and Sponsor Page 35 of 920
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 MVP
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
SJ103 Zephyr XL DR 5826 and DR 5820 Dual Chamber Rate-Responsive 5826 - 23.5g, 11cc and 5820 - $11,440.00
Pacemaker 18g, 8.5cc
SJ193 Accent DR PM 2112 Dual Chamber Pacemaker 19g, 10.5cc $11,440.00
Prostheses List by Category, Groups and Sponsor Page 36 of 920
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
Feature
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
Feature
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 [g]
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 [g]
BIOTRONIK Home Monitoring
SJ196 Accent DR RF PM2212 Dual chamber Pacemaker with RF 236, 12.8cc $11,440.00 $13,440.00
telemetry
MC680 Spyder Proximal Anastomotic Device 6-clip assembly $590.00
Prostheses List by Category, Groups and Sponsor Page 37 of 920
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
MI012 Consulta CRT-P Cardiac Resynchronisation Therapy One size only $13,520.00
Pacemaker, Model C3TR01
SJ207 Anthem RF PM3212 CRT Pacemaker with RF telemetry 25g, 13.7cc $13,520.00 $14,560.00
Prostheses List by Category, Groups and Sponsor Page 38 of 920
MC714 U-Clips (Valve Repair) Double Arm, Mitral Valve Repair 2-packs $510.00
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 $140.00
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, 85cm
Prostheses List by Category, Groups and Sponsor Page 39 of 920
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
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
fixation helix is comprised of platinum TD 65/18 65cm, Linox
iridium alloy. SMART TD 75/18 75cm;
Lead Body Diameter: 7.8Fr
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, intergrated Lead body is 7.8 French $9,360.00
bipolar, dual shock coil defibrillation lead. 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, Introducer
Endocardial Defibrillation Leads, 7042 -
Single Coil, 7050/51 - Integrated Bipolar,
Dual Coil, 7052 - Integrated Bipolar,
Single Coil
Prostheses List by Category, Groups and Sponsor Page 40 of 920
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.
BS180 Endotak Reliance G 4-SITE Passive fixation dual coil defibrillation leads 50-70cm $9,360.00
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
connector
BS183 Endotak Reliance 4-SITE Passive fixation dual coil defibrillation leads 50-70cm $9,360.00
with 4-SITE connector
SJ245 Durata 7170Q, 7171Q and 7172Q 7170Q/7171Q - passive fixation, bipolar, 52, 58 and 65cm, 7F $9,360.00
dual coil, 7172Q - passive fixation, bipolar introducer
- single coil steroid eluting endocardial
defibrillation leads with Optim insulation
overlay and SJ4 quadripolar lead connector
BT084 Linox SD Fractal coated and steroid electrode, 65, 75cm length, 16, 18mm $9,000.00 $9,360.00
active fixation quadrapolar elec dis
BT096 Linox S Active fix RV bipolar fractal coated steroid 65, 75cm length $9,000.00 $9,360.00
IC lead
Prostheses List by Category, Groups and Sponsor Page 41 of 920
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;
platinum iridium alloy. Linnox SMART SD 75/18
75cm; Lead Body Diameter:
7.8Fr
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
Tachyarrhythmia; Lead
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, Dual 60cm, 65cm, 75cm, 8F $9,000.00 $9,360.00
Leads Model 1590/1591 Shock Coil Defibrillation Lead introducer
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 introducer
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
Leads
Prostheses List by Category, Groups and Sponsor Page 42 of 920
SJ122 Riata ST Optim 7020/1/2 and 7030/1 7020/1 - Active fixation, true bipolar, 60, 65 and 75cm length and $9,000.00 $9,360.00
The
arterial lumen is shorter than the venous
lumen at the catheter's distal end in order
to reduce recirculation during haemodialysis
BA040 VitaCuff, Hickman Catheter Dialysis/Apheresis catheter, dual lumen, 36-45cm overall length $349.00 $359.00
silicone
BA140 HemoGlide Long Term Haemodialysis Dialysis Catheter, Multiple Lumen 14.5 Fr $357.00 $368.00
Catheter
Prostheses List by Category, Groups and Sponsor Page 915 of 920
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 a to31cm), Microintroducer Kits
double D lumen configuration catheter (straight 19cm to 42cm & pre-
each lumen having an ID of 2.3mm) with a curved 19cm to 31cm)
fixed split tip (to 7.5cmm) which enables
blood flo
KA011 Permcath Dual Lumen Catheter Chronic Haemodialysis, long term vascular 36cm, 40cm $330.00
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 vascular 28, 36, 40cm $290.00
Constructed of radiopaque silicone rubber.
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
CM023 Arrow Cannon II Plus Chronic Dual Lumen, Retrograde Tunneled, 15Fg x 24 - 55cm $450.00
Haemodialysis Catheter Set Cuffed, Tip First, Chronic Haemodialysis
Catheter Set
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 & $295.00
Haemodialysis 36cm lengths
Prostheses List by Category, Groups and Sponsor Page 916 of 920
CM015 ARROWg+ard Blue Haemodialysis Haemodialysis Catheters (of various CS-22122 - 12Fr 16cm, Dual $195.00
Catheters lengths, sizes and lumen confiurations) with Lumen
antimicrobial impregnation (chlorhexidine CS-22123 – 12Fr 16cm, Triple
and silver sulphadiazine) on the external Lumen
surface of the polyurethane catheter CS-25122 – 12Fr x 20cm,
material. 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
BB170 Celsite Access Port for pain relief Composition - polysulphone. Kit includes Diameter of septum:11.7mm. $495.00
tunnelling rod, filter, connectors, needles, Height: 11.5mm. Dimension:
syringe, tuohy needle 25.8 x 37.8mm
BA056 Subcutaneous Ports Titanium or MRI Implantable Port, Open- 6FR - 9.6Fr $500.00
Ended Catheter Single Chamber
Prostheses List by Category, Groups and Sponsor Page 917 of 920
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 Single
Chamber
TT001 Paragon Ambulatory Drug Infusion System The top of the Paragon infuser is made of Infuser - 100mL Administration $534.00
acetyl with stainless steel parts; the bottom Sets - 0.50mL, 1mL, 2mL,
is made of clear polycarbonate. Diam: 4mL, 10mL, 50mL, 100mL, or
Administration Sets 200mL/hr
- made from PVC and acrylic
components.
WC093 Cook Implantable Injection/Infusion Ports 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
introducer set
WC094 Cook Implantable Injection/Infusion Ports Mini or Petite or Standard, single or 3 - 12 Fr pre-attached or $534.00
multiple chamber titanium Port which may detached catheter or valve system
include micropuncture or standard
introducer set
WC115 Cook Implantable Injection/Infusion Port 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
introducer set system
DW003 Jet Port Plus Set - Vascular Access Port Implantable injection / infusion port system: Port: Diameter: 28.0mm, $375.00
port chamber with silicone membrane; Height: 12.3mm; Catheter: 6.6
connectable polyurethane catheter; and French, Length: 750mm
introducer kit.
DW004 Jet Port Plus Low Profile Peripheral Set Implantable injection / infusion port system: Port: Length: 24.0mm, Width: $420.00
- Vascular Access Port low profile port chamber with silicone 20.5mm, Height: 10.3mm
membrane; connectable polyurethane Catheter: 6.6 French, Length:
catheter; and introducer kit 750mm
MS016 Injection/Infusion Ports Sterile Plastic/titanium, paediatric 5, 6, 7,8, 9.6F $771.00
Prostheses List by Category, Groups and Sponsor Page 918 of 920
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
DW006 T-Port Contrast set - Vascular access Injection infusion port system: titanium port 6163653077: Port Base 27mm $630.00
port. chamber with silicone membrane: x 13mm, Catheter Diameter
connectable polyurethane catheter; 1.3 x 2.2mm, Catheter Length
introducer kit. 75cm. 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 Ports 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
Prostheses List by Category, Groups and Sponsor Page 919 of 920
DW005 Dual Port Set - Vascular Access Port Implantable injection / infusion port system: 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 920 of 920
PART B - Human Tissue February 2011
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 $2,134.00
PBT10 Perth Bone and Tissue Bank $3,135.00
QBB45 The Queensland Bone Bank $1,993.00
QBB03 The Queensland Bone Bank $2,524.00
PBT09 Perth Bone and Tissue Bank $2,734.00
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 $2,284.00
PBT48 Perth Bone and Tissue Bank $2,451.00
PBT06 Perth Bone and Tissue Bank $1,914.00
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 $825.00
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 $2,050.00
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 $2,217.00
TBV46 Donor Tissue Bank of Victoria $1,206.00
NBB17 New South Wales Bone Bank $1,606.00
PBT24 Perth Bone and Tissue Bank $1,606.00
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 $3,354.00
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 $5,683.00
MVS04 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT20 Perth Bone and Tissue Bank $3,354.00
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 $2,577.00
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 $1,422.00
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 $2,841.00
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 $5,228.00
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 $1,134.00
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 $1,031.00
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 $1,134.00
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 $2,788.00
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 $1,856.00
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 $1,031.00
QBB47 The Queensland Bone Bank $788.00
TBV41 Donor Tissue Bank of Victoria $1,020.00
PBT40 Perth Bone and Tissue Bank $2,564.00
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 $2,124.00
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
Page 13 of 15
MVS11 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
AUB06 Australian Biotechnologies $2,562.00
QBB08 The Queensland Bone Bank $2,800.00
PBT44 Perth Bone and Tissue Bank $3,979.00
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
Page 14 of 15
NBB66 New South Wales Bone Bank $1,208.00
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 February 2011
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