EXPLANATORY STATEMENT
Issued by Authority of the Minister for Health and Ageing
National Health Act 1953
Determination under subsections 73AAG (6) and (7)
(HIB 22/2006)
Subsection 73AAG(6) of the National Health Act 1953 (the Act) provides that the Minister may determine in writing the prostheses that are no gap prostheses and the benefit amount for each no gap prosthesis.
Subsection 73AAG(7) provides that the Minister may determine in writing the prostheses that are gap permitted prostheses, and the minimum and maximum benefit amounts for each gap permitted prosthesis.
The Schedule to this determination has two parts:
- Part A – Prostheses; and
- Part B – Human Tissue List.
The Schedule to this determination is known as the “Prostheses List”.
This determination commences on 14 September 2006. It replaces, in its entirety, the determination dated 28 August 2006 (HIB 19/2006).
This determination changes the previous Prostheses List by:
- adding 242 products to Part A as no gap prostheses or gap permitted prostheses, which were omitted in error from the previous determination. This will ensure that consumers are not disadvantaged by registered health benefit organisations not paying benefits for these prostheses. Details of the products are at Attachment A; and
- amending the benefit amounts of five items that were incorrectly recorded in Part A in the previous determination. Details of these products are at Attachment B.
The determination is consistent with the recommendations of the Prostheses and Devices Committee.
Benefits payable in respect of these products have been negotiated with the sponsors.
CONSULTATION
This Determination has been made having regard to advice provided by the Prostheses and Devices Committee (PDC), a ministerially appointed committee comprised of nominees from health funds, hospitals, clinicians, prostheses and devices suppliers, the Commonwealth, and consumer representatives. In making their recommendations, the PDC were advised by Clinical Advisory Groups, other clinical experts, and benefits negotiators, all appointed by the PDC.
This determination and this Explanatory Statement have been registered on the Federal Register of Legislative Instruments.
PRIVATE HEALTH INSURANCE BRANCH
DEPARTMENT OF HEALTH AND AGEING
SEPTEMBER 2006
Attachment A
Billing Code | Sponsor | Product Name | Minimum Benefit Amount | Maximum Benefit Amount |
AD319 | Advanced Surgical Technologies | Profemur Total Hip System | $1,615.00 |
|
AD320 | Advanced Surgical Technologies | Profemur Total Hip System | $1,615.00 |
|
AD321 | Advanced Surgical Technologies | Quadra-Fix Acetabular Shell | $7,000.00 |
|
AD322 | Advanced Surgical Technologies | Quadra-Fix Acetabular Shell | $380.00 |
|
AD323 | Advanced Surgical Technologies | Charlotte Foot & Ankle System | $698.00 |
|
AD324 | Advanced Surgical Technologies | Charlotte Foot & Ankle System | $235.00 |
|
AS120 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | IVS Tunneller-Intravaginal Tunneller System | $850.00 | $950.00 |
AS121 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietene-Monofilament Polypropylene mesh | $89.00 |
|
AS122 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietene-Monofilament Polypropylene mesh | $146.00 |
|
AS123 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietene-Monofilament Polypropylene mesh | $250.00 |
|
AS124 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietene-Monofilament Polypropylene mesh | $155.00 |
|
AS125 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietex-Multifilament Polyester Mesh | $200.00 |
|
AS126 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietex-Multifilament Polyester Mesh | $200.00 |
|
AS127 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietex-Multifilament Polyester Mesh | $250.00 |
|
AS128 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietex-Multifilament Polyester Mesh | $205.00 |
|
AS129 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietex-Multifilament Polyester Mesh | $185.00 |
|
AS130 | Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd | Parietex-Multifilament Polyester Mesh | $140.00 |
|
BA172 | Bard Australia Pty Ltd | Pelvisoft | $399.00 | $458.00 |
BA173 | Bard Australia Pty Ltd | Pelvisoft | $924.00 | $1,295.00 |
BA174 | Bard Australia Pty Ltd | Pelvisoft | $549.00 | $660.00 |
BA175 | Bard Australia Pty Ltd | HemoGlide Long Term Haemodialysis Catheter | $320.00 |
|
BA176 | Bard Australia Pty Ltd | Tegress | $1,490.00 |
|
BA177 | Bard Australia Pty Ltd | SlimPort Ultra Low Profile Implanted Port | $530.00 | $615.00 |
BI933 | Biomet Australia Pty Ltd | Vanguard SSK Knee System | $5,200.00 |
|
BI934 | Biomet Australia Pty Ltd | Lactosorb Distraction System | $3,500.00 |
|
BI935 | Biomet Australia Pty Ltd | Generation 4 - Polished Hip System | $2,000.00 |
|
BI936 | Biomet Australia Pty Ltd | GPS Bone Biologics | $1,936.00 |
|
BI937 | Biomet Australia Pty Ltd | GPS Bone Biologics | $2,150.00 | $2,400.00 |
BI938 | Biomet Australia Pty Ltd | GPS Bone Biologics | $3,980.00 |
|
BI939 | Biomet Australia Pty Ltd | Vanguard SSK Knee System | $1,500.00 |
|
BI940 | Biomet Australia Pty Ltd | Peritrochanteric Nail System | $896.00 |
|
BI941 | Biomet Australia Pty Ltd | Peritrochanteric Nail System | $406.00 |
|
BI942 | Biomet Australia Pty Ltd | Peritrochanteric Nail System | $2,060.00 | $2,810.00 |
BI943 | Biomet Australia Pty Ltd | Peritrochanteric Nail System | $225.00 |
|
BI944 | Biomet Australia Pty Ltd | M2a 38 Femoral Head | $2,300.00 |
|
BI945 | Biomet Australia Pty Ltd | Vanguard PFR | $2,855.00 |
|
BI946 | Biomet Australia Pty Ltd | Calcibon | $1,080.00 |
|
BI947 | Biomet Australia Pty Ltd | Calcibon | $1,545.00 |
|
BI948 | Biomet Australia Pty Ltd | Calcibon | $3,000.00 |
|
BS098 | Boston Scientific Pty Ltd | Neuroform Microdelivery Stent System | $7,500.00 |
|
BS099 | Boston Scientific Pty Ltd | Taxus Liberte Paclitaxel-Eluting Coronary Stent System | $3,350.00 |
|
BS100 | Boston Scientific Pty Ltd | Matrix Detachable Coils | $1,850.00 |
|
BT074 | Biotronik Australia Pty Ltd | Xelos DR-T | $44,000.00 |
|
BT075 | Biotronik Australia Pty Ltd | Lumos VR-T | $39,000.00 |
|
BT076 | Biotronik Australia Pty Ltd | Lumos DR-T | $42,000.00 | $44,000.00 |
BT077 | Biotronik Australia Pty Ltd | Kentrox SL steriod | $9,000.00 |
|
BT078 | Biotronik Australia Pty Ltd | Kentrox RV Steroid | $9,000.00 |
|
BT079 | Biotronik Australia Pty Ltd | Cylos DR-T | $9,000.00 | $11,000.00 |
BT080 | Biotronik Australia Pty Ltd | Cylos VR | $5,700.00 |
|
BT081 | Biotronik Australia Pty Ltd | Kronos LV-T | $39,000.00 | $44,000.00 |
BT082 | Biotronik Australia Pty Ltd | PRO-Kinetic | $1,200.00 |
|
CI001 | Cardinal Health Australia 200 Pty Ltd | Ava-Tex Radiopaque Bone Cement Kit | $299.00 |
|
CO039 | Cochlear Limited | Flangeless Fixtures | $635.00 |
|
CR092 | Corin Australia Pty Ltd | Tri Fit Stem (New Sizes) | $3,600.00 |
|
CR093 | Corin Australia Pty Ltd | Optimom Head (New Sizes) | $2,300.00 |
|
CR094 | Corin Australia Pty Ltd | Alpha Lock Cup Inly (New Sizes) | $790.00 |
|
CR095 | Corin Australia Pty Ltd | Ceramic Insert for Alpha Cera Fit Cup (New Sizes) | $2,400.00 |
|
CR096 | Corin Australia Pty Ltd | Alumina Head | $2,000.00 |
|
CR097 | Corin Australia Pty Ltd | Alumina Head | $2,000.00 |
|
DE261 | Device Technologies Australia Pty Ltd | PEEK Pushlock | $600.00 |
|
DE262 | Device Technologies Australia Pty Ltd | ALIMAXX-E Esophageal Stent System | $2,500.00 |
|
DE263 | Device Technologies Australia Pty Ltd | MicroCryl Acrylic Introcular lenses | $350.00 | $390.00 |
DE264 | Device Technologies Australia Pty Ltd | MicroCryl Acrylic Introcular lenses | $300.00 | $395.00 |
DS001 | Victorian Institute of Forensic Medicine | Serasis TO Stress Incontinence system (Trans obturator approach) | $685.00 |
|
EE007 | ev3 Australia Pty Ltd | Nexus Detachable Coils | $1,850.00 | $2,400.00 |
EE008 | ev3 Australia Pty Ltd | Nexus Detachable Coils | $1,850.00 | $2,200.00 |
EE009 | ev3 Australia Pty Ltd | NXT Detachable Coils | $2,600.00 |
|
EE010 | ev3 Australia Pty Ltd | NXT Detachable Coils | $2,266.00 |
|
EE011 | ev3 Australia Pty Ltd | NXT Detachable Coils | $1,850.00 |
|
EE012 | ev3 Australia Pty Ltd | NXT Detachable Coils | $1,850.00 |
|
EE013 | ev3 Australia Pty Ltd | NXT Detachable Coils | $1,850.00 |
|
EE014 | ev3 Australia Pty Ltd | NXT Detachable Coils | $1,850.00 |
|
EE015 | ev3 Australia Pty Ltd | Protégé RX Stent | $1,800.00 |
|
EE016 | ev3 Australia Pty Ltd | Protégé RX Stent | $1,800.00 |
|
GM100 | Global Manufacturing Technology Pty Limited | Lobe Lok Total Shoulder System | $3,200.00 |
|
GM101 | Global Manufacturing Technology Pty Limited | Lobe Lok Total Shoulder System | $5,900.00 |
|
GM102 | Global Manufacturing Technology Pty Limited | Lobe Lok Total Shoulder System | $3,230.00 |
|
GM103 | Global Manufacturing Technology Pty Limited | Lobe Lok Total Shoulder System | $2,035.00 |
|
GM104 | Global Manufacturing Technology Pty Limited | Lobe Lok Total Shoulder System | $2,875.00 |
|
GM105 | Global Manufacturing Technology Pty Limited | Lobe Lok Total Shoulder System | $1,903.00 |
|
GM106 | Global Manufacturing Technology Pty Limited | Lobe Lok Total Shoulder System | $2,940.00 |
|
GM107 | Global Manufacturing Technology Pty Limited | Apex Global Modular Hip System | $3,000.00 |
|
GU165 | Guidant Australia Pty Ltd | Acuity Steerable Lead | $6,000.00 |
|
JJ532 | Johnson & Johnson Medical Pty Ltd | LCS Complete Revision System | $1,900.00 | $2,900.00 |
JJ534 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $45.00 |
|
JJ535 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $43.00 |
|
JJ536 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $45.00 |
|
JJ537 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $107.00 |
|
JJ538 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $156.00 |
|
JJ539 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $255.00 |
|
JJ540 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $170.00 |
|
JJ541 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $195.00 |
|
JJ542 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $231.00 |
|
JJ543 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $281.00 |
|
JJ544 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $182.00 |
|
JJ545 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $178.00 |
|
JJ546 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $195.00 |
|
JJ547 | Johnson & Johnson Medical Pty Ltd | BIOPLATE Low Profile | $169.00 |
|
JJ548 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $6,800.00 |
|
JJ549 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $7,750.00 |
|
JJ550 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $4,000.00 |
|
JJ551 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $2,436.00 |
|
JJ552 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $2,482.00 |
|
JJ553 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $1,280.00 |
|
JJ554 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $5,520.00 |
|
JJ555 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $2,375.00 |
|
JJ556 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $2,290.00 |
|
JJ557 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $215.00 |
|
JJ558 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $276.00 |
|
JJ559 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $815.00 |
|
JJ560 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $815.00 |
|
JJ561 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $1,420.00 |
|
JJ562 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $2,096.00 |
|
JJ563 | Johnson & Johnson Medical Pty Ltd | DELTA Xtend | $2,508.00 |
|
JJ564 | Johnson & Johnson Medical Pty Ltd | ECHELON 60mm Endocutter Reload | $235.00 |
|
JJ565 | Johnson & Johnson Medical Pty Ltd | ULTRAPRO Mesh | $99.00 |
|
JJ566 | Johnson & Johnson Medical Pty Ltd | PROLENE Mesh | $75.00 |
|
JJ567 | Johnson & Johnson Medical Pty Ltd | PALMAZ® BLUE™ .018 Peripheral Stent System | $1,800.00 | $2,450.00 |
JJ568 | Johnson & Johnson Medical Pty Ltd | Echelon 60mm Endocutter | $595.00 |
|
JJ569 | Johnson & Johnson Medical Pty Ltd | Cougar II ALIF Cage | $4,360.00 |
|
MC713 | Medtronic Australasia Pty Ltd | Adapta Pacemaker | $6,500.00 |
|
MC714 | Medtronic Australasia Pty Ltd | U-Clips (Valve Repair) | $500.00 |
|
MC715 | Medtronic Australasia Pty Ltd | Interceptor Plus Carotid Filter System | $2,022.00 | $2,100.00 |
MC716 | Medtronic Australasia Pty Ltd | Intrathecal Catheter | $820.00 | $950.00 |
MC717 | Medtronic Australasia Pty Ltd | Intrathecal Catheter | $500.00 |
|
MC718 | Medtronic Australasia Pty Ltd | Intrathecal Catheter | $500.00 |
|
MC719 | Medtronic Australasia Pty Ltd | InterStim Neurostimulator Model 3023 | $9,217.00 | $9,350.00 |
MC720 | Medtronic Australasia Pty Ltd | Concerto CRT-D | $50,000.00 |
|
MC721 | Medtronic Australasia Pty Ltd | Virtuoso | $44,000.00 |
|
MC722 | Medtronic Australasia Pty Ltd | Virtuoso | $41,000.00 |
|
MC726 | Medtronic Australasia Pty Ltd | Adapta Pacemaker | $11,000.00 |
|
MC727 | Medtronic Australasia Pty Ltd | Adapta Pacemaker | $5,000.00 | $6,500.00 |
MC728 | Medtronic Australasia Pty Ltd | Adapta Pacemaker | $5,950.00 |
|
NQ001 | Nipro Asia Pte Ltd-Melbourne | Surefuser | $48.00 |
|
NQ002 | Nipro Asia Pte Ltd-Melbourne | Surefuser | $48.00 |
|
NQ003 | Nipro Asia Pte Ltd-Melbourne | Surefuser | $48.00 |
|
OH237 | Orthotech Pty Ltd | EUROBONE - Synthetic Bone Substitute | $1,500.00 |
|
OH238 | Orthotech Pty Ltd | EUROBONE - Synthetic Bone Substitute | $1,800.00 |
|
OH239 | Orthotech Pty Ltd | EUROBONE - Synthetic Bone Substitute | $2,400.00 |
|
OH240 | Orthotech Pty Ltd | Vuelock (Anterior Cervical Plate) | $1,040.00 |
|
OH241 | Orthotech Pty Ltd | Vuelock (Anterior Cervical Plate) | $210.00 |
|
PD021 | Portland Orthopaedics (Aust) Pty Ltd | M-COR Modular Hip System | $2,400.00 | $3,000.00 |
PD022 | Portland Orthopaedics (Aust) Pty Ltd | M-COR Modular Hip System | $1,500.00 | $2,200.00 |
PD023 | Portland Orthopaedics (Aust) Pty Ltd | M-COR Modular Hip System | $2,000.00 |
|
PL132 | Plus Orthopedics Australia Pty Ltd | POLARSTEM FEMORAL STEM SYSTEM | $4,100.00 |
|
PL133 | Plus Orthopedics Australia Pty Ltd | POLARSTEM FEMORAL STEM SYSTEM | $4,800.00 |
|
PL134 | Plus Orthopedics Australia Pty Ltd | POLARSTEM FEMORAL STEM SYSTEM | $2,200.00 |
|
PL135 | Plus Orthopedics Australia Pty Ltd | POLARSTEM FEMORAL STEM SYSTEM | $780.00 |
|
PL136 | Plus Orthopedics Australia Pty Ltd | POLARSTEM FEMORAL STEM SYSTEM | $1,600.00 |
|
PL137 | Plus Orthopedics Australia Pty Ltd | POLARSTEM FEMORAL STEM SYSTEM | $4,500.00 |
|
PL138 | Plus Orthopedics Australia Pty Ltd | PLUS HIP JOINT PROSTHESES SYSTEM | $3,450.00 | $4,040.00 |
PL139 | Plus Orthopedics Australia Pty Ltd | PLUS HIP JOINT PROSTHESES SYSTEM | $4,800.00 |
|
PL140 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $2,300.00 | $2,600.00 |
PL141 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $3,350.00 | $5,000.00 |
PL142 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $2,600.00 | $2,800.00 |
PL143 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $3,600.00 | $5,800.00 |
PL144 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $2,500.00 | $2,600.00 |
PL145 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $3,500.00 | $4,900.00 |
PL146 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $1,800.00 |
|
PL147 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $2,200.00 |
|
PL148 | Plus Orthopedics Australia Pty Ltd | POLAR CUP ACETABULAR CUP SYSTEM | $2,500.00 |
|
PL149 | Plus Orthopedics Australia Pty Ltd | Polar Cup Acetabular Cup System | $260.00 |
|
PL150 | Plus Orthopedics Australia Pty Ltd | Polar Cup Acetabular Cup System | $122.00 |
|
PL151 | Plus Orthopedics Australia Pty Ltd | Polar Cup Acetabular Cup System | $2,000.00 |
|
SJ087 | St. Jude Medical Australia Pty Ltd | St Jude Medical Rigid Saddle Ring | $2,400.00 |
|
SJ088 | St. Jude Medical Australia Pty Ltd | SJM Tailor Annuloplasty Band | $2,150.00 |
|
SJ089 | St. Jude Medical Australia Pty Ltd | Victory XL DR 5816 and DR 5810 | $9,000.00 |
|
SJ090 | St. Jude Medical Australia Pty Ltd | Victory SR 5610 | $5,700.00 |
|
SJ091 | St. Jude Medical Australia Pty Ltd | Premere PFO Closure System | $9,820.00 |
|
SK398 | Stryker Australia Pty Ltd (2) | Trochanteric Grip | $2,550.00 |
|
SK399 | Stryker Australia Pty Ltd (2) | Trochanteric Grip | $4,000.00 |
|
SK400 | Stryker Australia Pty Ltd (2) | Trochanteric Grip | $1,400.00 |
|
SK401 | Stryker Australia Pty Ltd (2) | Trochanteric Grip | $1,750.00 |
|
SK402 | Stryker Australia Pty Ltd (2) | Trochanteric Grip | $3,652.00 |
|
SK403 | Stryker Australia Pty Ltd (2) | Trochanteric Grip | $5,102.00 |
|
SK404 | Stryker Australia Pty Ltd (2) | Alumina Femoral Head 38mm-60mm | $2,000.00 | $2,436.00 |
SK405 | Stryker Australia Pty Ltd (2) | LFIT Femoral Heads | $2,436.00 |
|
SK406 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $1,100.00 | $1,600.00 |
SK407 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $1,100.00 | $1,600.00 |
SK408 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $1,350.00 | $1,600.00 |
SK409 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $1,350.00 | $1,600.00 |
SK410 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $1,770.00 | $2,000.00 |
SK411 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $590.00 | $700.00 |
SK412 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $590.00 | $700.00 |
SK413 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $590.00 | $700.00 |
SK414 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $590.00 | $700.00 |
SK415 | Stryker Australia Pty Ltd (2) | Scorpio X3 Polyethylene | $590.00 | $700.00 |
SK416 | Stryker Australia Pty Ltd (2) | Triathlon X 3 Polyethylene | $1,350.00 | $1,600.00 |
SK417 | Stryker Australia Pty Ltd (2) | Triathlon X 3 Polyethylene | $1,100.00 | $1,600.00 |
SK418 | Stryker Australia Pty Ltd (2) | Triathlon X 3 Polyethylene | $590.00 | $700.00 |
SK419 | Stryker Australia Pty Ltd (2) | Triathlon X 3 Polyethylene | $590.00 | $700.00 |
SK420 | Stryker Australia Pty Ltd (2) | Orthodontic Skeletal Anchor Plate | $220.00 |
|
SK421 | Stryker Australia Pty Ltd (2) | Orthodontic Skeletal Anchor Plate | $355.00 |
|
SK422 | Stryker Australia Pty Ltd (2) | Orthodontic Skeletal Anchor Screw | $57.00 | $110.00 |
SK423 | Stryker Australia Pty Ltd (2) | Orthodontic Skeletal Anchor Screw | $57.00 | $110.00 |
SN831 | Smith & Nephew Surgical Pty Ltd | Peri-Loc UE screws & plates | $1,500.00 |
|
SN832 | Smith & Nephew Surgical Pty Ltd | Peri-Loc UE screws & plates | $130.00 |
|
SN833 | Smith & Nephew Surgical Pty Ltd | Peri-Loc UE screws & plates | $50.00 |
|
SN834 | Smith & Nephew Surgical Pty Ltd | Competitor Deuce | $3,000.00 | $3,855.00 |
SN835 | Smith & Nephew Surgical Pty Ltd | Competitor Deuce | $5,000.00 |
|
SN836 | Smith & Nephew Surgical Pty Ltd | Competitor Deuce | $1,530.00 |
|
SN837 | Smith & Nephew Surgical Pty Ltd | Competitor Deuce | $833.00 |
|
SN838 | Smith & Nephew Surgical Pty Ltd | Trigen InterTAN Nail | $1,350.00 | $1,550.00 |
SN839 | Smith & Nephew Surgical Pty Ltd | Trigen InterTAN Nail | $410.00 |
|
SN840 | Smith & Nephew Surgical Pty Ltd | Trigen InterTAN Nail | $93.00 |
|
SN841 | Smith & Nephew Surgical Pty Ltd | Trigen META | $1,250.00 |
|
SN842 | Smith & Nephew Surgical Pty Ltd | Platform Hip Stem | $3,450.00 | $4,040.00 |
SN843 | Smith & Nephew Surgical Pty Ltd | Anthology Hip System | $5,133.00 |
|
SO033 | Spectrum Ophthalmics | IOLTECH MICS IOL | $395.00 |
|
SQ003 | Surgical Specialties Pty Ltd | Distal Radius Reconstruction System | $1,650.00 |
|
SQ004 | Surgical Specialties Pty Ltd | Distal Radius Reconstruction System | $1,200.00 |
|
SQ005 | Surgical Specialties Pty Ltd | Radius Plating System | $1,350.00 |
|
SQ006 | Surgical Specialties Pty Ltd | Radius Plating System | $1,350.00 |
|
SQ007 | Surgical Specialties Pty Ltd | Osteosynthesis Plates | $140.00 |
|
SQ008 | Surgical Specialties Pty Ltd | Osteosynthesis Plates | $240.00 |
|
SQ009 | Surgical Specialties Pty Ltd | Osteosynthesis Plates | $240.00 |
|
SQ010 | Surgical Specialties Pty Ltd | Osteosynthesis Plates | $320.00 |
|
SQ011 | Surgical Specialties Pty Ltd | Osteosynthesis Plates | $380.00 |
|
SQ012 | Surgical Specialties Pty Ltd | Osteosynthesis Plates | $500.00 |
|
SQ013 | Surgical Specialties Pty Ltd | Displacement Plate - DPS | $600.00 |
|
SQ014 | Surgical Specialties Pty Ltd | Osteosynthesis Screws | $75.00 |
|
SQ015 | Surgical Specialties Pty Ltd | Osteosynthesis Screws | $75.00 |
|
SQ016 | Surgical Specialties Pty Ltd | Osteosynthesis Screws | $100.00 |
|
SQ017 | Surgical Specialties Pty Ltd | CBS Screw | $410.00 |
|
SQ018 | Surgical Specialties Pty Ltd | CBS Screw | $330.00 | $410.00 |
SQ019 | Surgical Specialties Pty Ltd | Cannulated Screw | $155.00 |
|
SY352 | Synthes Australia Pty Ltd | Cortex Screws | $320.00 |
|
SY354 | Synthes Australia Pty Ltd | Small & Mini Fragment Plates | $1,320.00 |
|
SY355 | Synthes Australia Pty Ltd | AO/ASIF Plates | $240.00 | $400.00 |
SY356 | Synthes Australia Pty Ltd | ECD - Expandable Corpectomy Device | $5,440.00 |
|
SY357 | Synthes Australia Pty Ltd | ECD - Expandable Corpectomy Device | $300.00 |
|
TU039 | Terumo Corporation Australia | Rapidax™ Rapid Access Haemodialysis | $1,300.00 | $1,400.00 |
TU040 | Terumo Corporation Australia | Rapidax™ Rapid Access Haemodialysis | $1,300.00 | $1,400.00 |
ZI527 | Zimmer | Optima Spinal Fixation System - Hooks | $1,130.50 |
|
ZI528 | Zimmer | Zimmer Trabecular Metal Reverse Shoulder System | $3,799.00 | $5,000.00 |
ZI529 | Zimmer | Zimmer Trabecular Metal Reverse Shoulder System | $1,100.00 |
|
ZI530 | Zimmer | Zimmer Trabecular Metal Reverse Shoulder System | $1,420.00 |
|
ZI531 | Zimmer | Zimmer Trabecular Metal Reverse Shoulder System | $1,000.00 |
|
ZI532 | Zimmer | Zimmer Trabecular Metal Reverse Shoulder System | $1,200.00 | $1,500.00 |
ZI533 | Zimmer | Zimmer Trabecular Metal Reverse Shoulder System | $2,100.00 | $3,500.00 |
ZI534 | Zimmer | Zimmer Trabecular Metal Reverse Shoulder System | $145.00 |
|
ZI535 | Zimmer | Optima Spinal Fixation System -Connectors | $1,000.00 |
|
Attachment B
Billing Code | Sponsor | Product Name | Minimum Benefit Amount | Maximum Benefit Amount |
EK080 | ESKA Australia | Adapter GHE Long Stem Cemented | $2000.00 |
|
EK081 | ESKA Australia | Adapter GHE Long Stem Cemented | $4000.00 |
|
EK082 | ESKA Australia | PE Insert 32mm BS | $850.00 |
|
DP663 | DePuy Australia | Small / Large Fragment Set S/S | $131.91 |
|
MN002 | Mentor Medical Systems | Skin Expanders | $1,000.00 |
|