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EXPLANATORY STATEMENT
Issued by Authority of the Minister for Health and Ageing
National Health Act 1953
Determination under subsections 73AAG (6) and (7)
(HIB 30/2006)
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.
This determination amends the determination signed by the delegate of the Minister on 12September 2006 (HIB 22/2006).
This determination commences on 13October 2006.
The Schedule to this determination has two parts:
- Part A – Prostheses; and
- Part B – Human Tissue List.
This determination updates the previous Prostheses List by:
- amendingthe minimum and maximum benefit amounts of 316 prosthesesin Part A, as detailed at Attachment A;
- amending the product descriptions of 47 prostheses in Part A, as detailed at Attachment B;
- deleting14 prostheses from Part A, as detailed at Attachment C;
- adding40 prostheses to Part A, as detailed at Attachment D; and
- adding seven items to Part B, as detailed atAttachment E.
The determination is consistent with the recommendations of the Prostheses and Devices Committee.
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.
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
OCTOBER 2006
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Benefit(s) Updated Items for Prostheses List August 2006Attachment A
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
Advanced Surgical Technologies
Orthopaedic
AD227Osteoset MIIG X3Injectable Calcium Sulphate Bone Void Filler, 5cc$1,795.00
Includes Syringe
American Medical Systems
Urogenital
AM005Penile Implant - MalleableAMS 600M, AMS 650Cylinders range: 12 -20cm$3,305.40
AM019MONARC Sling SystemProduct includes - mesh and two needles with One Size Only$850.00$990.00
handles attached
AM031AMS 800 Artificial Urinary Sphincter Deactivation Implantable plugs x 3 & straight connectorOne Size$132.00
Package
Auto Suture Company, Australia T/A Tyco Healthcare Pty
Mechanical Internal Wound Closure Products
AS025TA* Reloading Units; DST Series* Linear Stapler Premium Multifire TA* Disposable Surgical 30mm (2.5, 3.5, 4.8mm); DST TA90-3.5 $243.49
Disposable Loading UnitsStapler and Loading Unit; Titanium staples DLU; DST TA90-4.8 DLU; DST TA45-
used for hemostatic closure of specific organs 3.5 DLU; DST TA45-4.8 DLU; DST
and blood vessels (ex bowel, stomach and lung)TA60-3.5 DLU; DST TA60-4.8 DLU;
DST TA30-3.5 DLU; DST TA30-4.8
DLU; DST TA30V3 DLU.
AS115DST Series* GIA* Linear Cutter Stapler and single Single use, reloadable stapler80mm length; Sizes 3.8 and 4.8mm$470.00
use loading units
AS117DST Series* GIA* Linear Cutter Stapler and single Single use, reloadable stapler100mm length: Sizes 3.8 and 4.8mm$460.00
use loading units
B Braun Australia Pty Ltd
Neurosurgical
BB007Spine System EvolutionClamp for Cross PlateFor 5.2 and 6mm rods$480.00
BB108Aneurysm ClipYasargil4.5mm x 150g to 25.0mm x 200g$215.00$230.00
BB159Bone ScrewMACS Polyaxial & Stabilisation, TitaniumDia 6.5 - 7mm, length 30 - 50mm$541.82
BB160Bone ScrewHMA Polyaxial, TitaniumDia 12mm, length 26 - 38mm$1,800.00
BB161Bone ScrewHMA Monoaxial, TitaniumDia 12mm, length 26 - 38mm$1,150.00
Benefit(s) Updated Items for Prostheses List Report Page 1 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
BB174MACS TL Bone ScrewsPolyaxial screw - XL30mm and 40mm$1,800.00
BB211KLA Anterior Lumbar Cage SystemAnterior Lumbar Cage - PEEK9mm x 5 degrees, 11mm x 5 degrees, $4,250.00
13mm x 5 degrees, 11mm x 9 degrees,
13mm x 9 degrees, 15mm x 9 degrees,
13mm X 13 degrees, 15mm X 13 degrees
BB219S4 Spinal SystemS4 Straight Rod - Titanium35mm - 60mm$600.00
BB220S4 Spinal SystemS4 Straight Rod - Titanium70mm - 180mm$600.00
BB224S4 Spinal SystemPolyaxial Screw - titanium various sizesDiameter 4.5mm & 5mm - all lengths 25 -$1,550.00
60mm
BB225S4 Spinal SystemPolyaxial Screw - Titanium various sizesDiameter 6.0mm, 7.0mm & 8.0mm - all $1,550.00
lengths 25 - 60mm
BB226S4 Spinal SystemMonoaxial Screw - titanium various sizesDiameter 4.5mm & 5mm - all lengths 25 $1,200.00
- 60mm
BB227S4 Spinal SystemMonoaxial Screw - titanium various sizesDiameter 6.0mm, 7.0mm & 8.0mm - all $1,200.00
lengths 25 - 60mm
BB228S4 Spinal SystemS4 Cross Connector - titaniumRigid 22mm - 41mm$1,250.00
BB229S4 Spinal SystemS4 Cross Connector - titaniumVariable 43mm - 75mm$1,500.00
BB230S4 Spinal SystemSet Screw - titaniumone size$225.00
Vascular
BB027Vascular Uni - Graft - BifurcatedVascular graft12x7 to 12x12$375.00
Bard Australia Pty Ltd
Vascular
BA090Impra PTFE Vascular Grafts ePTFE Cardiovascular, Patch 0.6mm, Circular100 x 150mm$748.00
Biomet Australia Pty Ltd
Orthopaedic
BI937GPS Bone BiologicsTCP Granules/GPS, TCP20ml$2,150.00
BI942Peritrochanteric Nail SystemTrochanteric Nail Ti24cm - 48cm$2,060.00
Plastic and Reconstructive
BI397Lactosorb Resorbable Craniomaxillofacial Fixation Bone Screw, Lactosorb 1.5mm, 2mm system; (1.5, 2.0, 2.5, 2.8) x (3 - 17mm)$360.00
Systempkt 2, PGA/PLA
BI415Lactosorb Resorbable Craniomaxillofacial Fixation Bone Screw, 2 Pack, Endobrow, Lactosorb. 2 x 5mm$160.00
SystemPGA/PLA
Benefit(s) Updated Items for Prostheses List Report Page 2 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
BI602Lactosorb Resorbable Craniomaxillofacial Fixation Bone Screw, Lactosorb, 4 pack. PGA/PLA(1.5, 2.0mm) x (3, 4, 5 ,7mm)$444.00
System
BI791Lactosorb Resorbable Craniomaxillofacial Fixation Screw, 1.5mm System, PLLA/PGALength 3-5mm (pack 10)$910.00
System
Biotronik Australia Pty Ltd
Vascular
BT035PEIRONFlexible coated stent with delivery systemDia 5-8mm, length 18-38mm$2,500.00
Boston Scientific Pty Ltd
General/Miscellaneous
BS101Polyflex Airway StentPoylester braided material encapsulated with Stent inner diameters up to 22mm, stent $2,040.00
silicone, self expanding stentlengths up to 80mm
BS102Polyflex Oesophageal StentPoylester braided material encapsulated with Stent inner diameters up to 22mm, stent $2,040.00
silicone, self expanding stentlengths up to 80mm
Urogenital
BS086Polaris Ultra Ureteral StentThis ureteral stent is made from Percuflex Sizes up to 7Fr, lengths up to 30cm$315.00
material with a Hydro Plus Coating
Vascular
BS035Expandable Endovascular WallstentWallstent - Easy Wallstent, Iliac Wallstent (A Stent Diameter x Stent Length: 6-16mm x $1,800.00
self-expanding stent that has a cylindrical 18-70mm
braided structure composed of 24 wires with
core of either tantalum or platinum).
BS056Carotid Wall StentModel SCH64371, SCH64377, SCH64378, Fully open diameter 6.0 - 10.0mm, Fully $1,800.00
SCH64379, SCH64382, SCH64383, open length 22 - 37mm
SCH64384, Elgiloy (cobalt chromium), flexible
low profile, self expanding
Corin Australia Pty Ltd
Orthopaedic
CR057AMC Uni Condylar Tibial Component - Bonit CoatTibial Base Plate, Cobalt Chrome, Titanium 1-8$2,524.00
Nitrate Ceramic Coated, Bonit (Calcium
Phosphate) Ingrowth Surface
CR061AMC Uni Condylar, Cemented Tibial Base PlateAMC Uni Condylar Tibial Component (CoCr) Sizes 1 - 8 inclusive$1,732.00
Cemented with Titanium Nitrite Ceramic
De Puy Australia
Neurosurgical
DP299Moss Miami (Stainless Steel)Hooks - PedicleOne size only$820.00
Benefit(s) Updated Items for Prostheses List Report Page 3 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
DP300Moss Miami (Stainless Steel)Hooks - Laminar as Wide or Narrow or Angled One size only$820.00
or Reduced Distance Supra-laminar or Offset or
Extended Body
DP410Moss Miami (Titanium)Hooks - Pedicle3-5 mm$820.00
DP411Moss Miami (Titanium)Hooks - Laminar as Wide or Narrow or Angled One size only$820.00
or Reduced Distance Supra-laminar or Offset or
Extended Body
DP464Isola System (Titanium)Closed Hooks1/4" x 3/16" x 5-11mm$820.00$901.00
DP472Isola System (Stainless Steel)Open Hook Cap or Open1/4" & 3/16" x 5-11mm$820.00
DP567Peak Polyaxial Anterior Cervical Plate SystemGraft Screw or Safety Locking Screw4mm x 9 -15mm$944.00
DP843Moss Miami (Titanium)Sacral Extender5mm x 5 - 20mm length$710.00
DP845Moss Miami 4mm Anterior System (SS)Hooks4mm$820.00
DY317Isola System (Stainless Steel)Band Clamp Connector or Tandem Connector1/4" & 3/16"$1,268.00
DY333Summit Cervical Rod SystemOccipital Bone Screw4.5 - 5.25 Dia x 6 -16mm length$198.00
DY356SB Charite Disc ProsthesisEnd Plates Parallel & Oblique1 - 5$4,200.00
Orthopaedic
DP040Bone ScrewScrew Cancellous TitaniumDia 3.5 or 5 or 6.5 or 7mm length 15 -$91.00
110mm
DP766Small / Large Fragment Set S/SCancellous Screw 32 Thread - Stainless SteelDia 6.5mm x 130-140mm$54.27
DP859Songer Cable System - Stainless SteelIsola Single Cable & Crimp (Pkt 6)One size only$2,005.00
DY164Small / Large Fragment SetLow Profile Cannulated Cancellous Screw, 4mm x 10 - 50mm Length$182.85
Fully Thread
DY165Fragment Set Small/LargeLow Profile Cannulated Cancellous Screw, 4mm x 55 - 75mm$225.00
Fully Thread
DY361Conduit TCPConduit BlocksSize 1. 15x15x20mm to 25x25x20mm$1,882.00
DY403Modular Cathcart Unipolar Spacers-3 to +10mm$1,035.00
Device Technologies Australia Pty Ltd
Ophthalmic
DE263MicroCryl Acrylic Introcular lensesFoldable Monobloc Micrincision Posterior 6.D-40.0D$310.00
Chamber Lens
MC611M1
DE264MicroCryl Acrylic Introcular lensesFoldable Monobloc Posterior Chamber Lens6.0D-40.0D$350.00$390.00
MCX11ASP
Benefit(s) Updated Items for Prostheses List Report Page 4 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
Plastic and Reconstructive
DE100McGhan Style 150 Biodimensional Biocell TexturedFull height, Short Height9.5 - 16cm width x 8 - 17cm height x 4.2 -$2,294.00
Expand Gel/Saline Filled Mammary Implant, Low 7.1cm projection
Vascular
DE006Onyx SystemDSMO/Liquid Embolic Material18, 20, 34 (formulations)$2,300.00
Edwards Lifesciences Pty Ltd
Cardio-thoracic
EL031Carpentier-Edwards Perimount Pericardial Carpentier-Edwards Pericardial Bioprosthesis. Models 2900/6900 19-33mm, Model $4,900.00$5,144.00
Bioprosthesis - Models 2900/6900 Carpentier-Composition: Bovine Pericardium; Elgiloy 6900P 25, 27, 29, 31, 33mm
Edwards Perimount Plus Pericardial Bioprosthesis Alloy; Silicone Rubber, Polytetrafluoroethylene
Mitral - Model 6900P
EL039Edwards Perimount Magna Model 3000Carpentier-Edwards Perimount Magna 19MM Aortic Pericardial Tissue Valve; $4,900.00$5,690.00
composition: Glutaraldehyde treated bovine 21MM Aortic Pericardial Tissue Valve;
pericardium/elgiloy wireform stent/polyester 23MM Aortic Pericardial Tissue Valve;
band/silicone rubber suture 25MM Aortic Pericardial Tissue Valve;
ring/polytetrafluoroethylene cloth/polyester 27MM Aortic Pericardial Tissue Valve;
29MM Aortic Pericardial Tissue Valve
Vascular
EL045Lifestent - Peripheral StentStent: Stainless Steel composition. Items Stent Length 19mm - 27mm, 0.018 $2,533.33
included in delivery system: nylon balloon, compatible
stent and deployment system
EL048Lifestent Peripheral StentStent: Nitinol composition with tanilum 6-8mm Diameter, length 20-90mm$2,250.00
markers, Items included in the delivery system:
Stent, deployment system
Endotec Australia Pty Ltd
Orthopaedic
EA036BPU Revision Total Ankle ProsthesesTibial componenet ceramic coated titanium1-6$3,850.00
EA037Buechel-Pappas Total Ankle Prosthesis - Primary Polyethylene mobile bearing3mm - 11mm$925.00
Endotherapeutics Pty Ltd
Ear, Nose & Throat
ET031Serenocem CementReaction bonded polymer composite formed byOne size only - box of 2$1,560.00
the neutralisation gelletation of a basic
inorganic ionomer
General/Miscellaneous
ET001Ferx Ella Esophageal StentKit includes esophageal stent, introducer, Diam 20mm, Length 80 - 160mm$3,500.00
balloon catheter
Benefit(s) Updated Items for Prostheses List Report Page 5 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
ET042Soft Gastric Banding SystemSterile long term implant for the treatment of One size only$3,264.00
obesity. Supplied in kit format with catheter,
port and huber needles
Urogenital
ET011MacroplastiqueSterile, textured, highly cross linked 1.3 ml & 2.5 ml$988.00
polydimethylsiloxane elastomer implants
suspended in a bio-excretable carrier gel.
Vascular
ET006Embospheres-2ml per implant$610.00
ESKA Australia
Orthopaedic
EK028ESKA Modular Shoulder SystemHumeral Stem Universal$2,295.00
ev3 Australia Pty Ltd
Vascular
EE007Nexus Detachable CoilsNexus TetrisDiam 3-19mm, Length 4-29cm$1,850.00
EE008Nexus Detachable CoilsNexus Multi DiameterDiam 2-10mm, Length 1-30cm$1,850.00
Femcare Australia Pty Ltd
General/Miscellaneous
FE003Filshie Clips - SterishotWith Disposable ApplicatorOne Size$155.00$440.00
Gyrus Australasia Pty Ltd
General/Miscellaneous
GY083SprayGel Adhesion Barrier Polymer KitPK-A-6010 SprayGel Polymer Kit; PK-A-One size only; PK-A-4210 - 5 Kits/Box$300.00
4210 SprayGel Open Surgery Polymer Kit
Howmedica
Neurosurgical
HW385Xia Spine SystemMonoaxial ScrewDia 4.5 - 8.5mm Length 25 - 60mm$1,225.00
HW393Xia Spine SystemBone ScrewOne size only$577.00
Incision Pty Ltd
Vascular
IP011Jotec Flowline Bipore Vascular GraftThin Wall with Spiral Reinforcement40 & 50cm$1,700.00
Benefit(s) Updated Items for Prostheses List Report Page 6 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
IP012Jotec Flowline Bipore Vascular GraftThin Wall40 & 50cm$1,100.00
IP013Jotec Flowline Bipore Vascular GraftStandard Wall with Spiral Reinforcement70 & 80cm$1,300.00
IP014Jotec Flowline Bipore Vascular GraftStandard Wall80cm$850.00
IP015Jotec Flow Weave Vascular GraftFlow Weave30cm$550.00
IP016Jotec Flow Weave Vascular GraftFlow Weave60cm$700.00
IP017Jotec Flow Weave Vascular GraftFlow Weave BioSeal15cm$600.00
IP018Jotec Flow Weave Vascular GraftFlow Weave BioSeal30cm$750.00
IP019Jotec Flow Weave Vascular GraftFlow Weave BioSeal60cm$1,000.00
IP020Jotec Flowline Bipore Heparin ePTFE Vascular ePTFE Vascular Graft with microporous All sizes up to 50cm in length$950.00
Graft Straight, Standard Wallstructure. Standard Wall with Heparin
IP021Jotec Flowline Bipore Heparin ePTFE Vascular ePTFE Vascular Graft with microporous All sizes at over 50cm in length$1,300.00
Graft Straight, Standard Wallstructure. Standard Wall with Heparin
IP022Jotec Flowline Bipore Heparin ePTFE Vascular ePTFE Vascular Graft with microporous All sizes up to 50cm Length$1,100.00
Graft Straight, Standard Wall with Reinforcementstructure. Standard Wall with Heparin and
Reinforcement
IP023Jotec Flowline Bipore Heparin ePTFE Vascular ePTFE Vascular Graft with microporous All sizes at over 50cm in Length$1,500.00
Graft Straight, Standard Wall with Reinforcementstructure. Standard Wall with Heparin and
Reinforcement
IP024Jotec Flowline Bipore ePTFE Vascular Graft, ePTFE Vascular Graft with microporous All sizes up to 50cm in Length$870.00
Straight, Thin Wallstructure. Thin Wall
IP025Jotec Flowline Bipore ePTFE Vascular Graft, ePTFE Vascular Graft with microporous All sizes at over 50cm in length$1,100.00
Straight, Thin Wallstructure. Thin Wall
IP026Jotec Flow Nit Bioseal Polyester Vascular Grafts, Flow Nit Bioseal Straight grafts are texturised For all diameters in 30cm lengths$430.00
Straight Graftsexterior yarns for superior tissue incorporation
and healing characteristics, with the new
Bioseal impregnation to make the grafts blood
IP027Jotec Flow Nit Bioseal Polyester Vascular Grafts, Flow Nit Bioseal Straight grafts are texturised For all diameters in 15cm lengths$540.00
Straight Graftsexterior yarns for superior tissue incorporation
and healing characteristics, with the new
Bioseal impregnation to make the grafts blood
Johnson & Johnson Medical Pty Ltd
Neurosurgical
JJ252BIOPLATE Bone screwTitanium alloy long screw, 1 per pack, Dia 1.5mm, length 3, 4, 5, 6, 8, 10mm$44.00
packaged non-sterile
JJ253BIOPLATE Bone screwTitanium alloy emergency screws, 5 per pack, Dia 1.8, length 6mm; Dia 2.3mm, length $66.00
packaged non-sterile5mm
Benefit(s) Updated Items for Prostheses List Report Page 7 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
Orthopaedic
JJ532LCS Complete Revision SystemLCS Complete Revision VVC insertsmall-large+, 10 - 25mm$1,900.00
Urogenital
JJ070TVT (Tension-Free Vaginal Tape) Single use deviceUndyed Prolene (polypropylene) 11 x 450mm$850.00
nonabsorbable tape
JJ478Gynecare Prolift Pelvic Floor Repair SystemPre-cut gynemesh PS and single use PFRP01$1,295.00
instruments for mesh placement
Mathys Orthopaedics Pty Ltd
Orthopaedic
MA422Articula Shoulder ProsthesisArticula Humeral Head Bionit Ceramic (A1203)44mm, 46mm, 48mm$5,650.00
Medical & Optical Instruments Australia Pty Ltd
Orthopaedic
MO272Acumed Tap-LocVariable angle locking plate systemmedial; left and right, lateral Olecranon $1,550.00
Left and right 6-20 holes
Medical Device Alliance Pty Ltd
Plastic and Reconstructive
MP043Silimed Tissue ExpandersDouble Chamber Model # 730, 20739140/180-400/450ml$1,244.00$1,800.00
Medimen Australia Pty Ltd T/A Alpha Medical Services
Orthopaedic
MM001MOJE Toe and Finger ImplantsIncludes distal and proximal implants$1,500.00
Medtel Australia Pty Ltd
Vascular
ME133Micrus ACT Platinum Microcoil Delivery SystemCerecyteHelical Cerecyte - 2mm x 2cm - 10mm x $1,850.00$1,950.00
30cm
ME134Micrus ACT Platinum Microcoil Delivery SystemCerecyteHelical Soft Stretch Resistant Cerecyte - $1,850.00$1,950.00
2mm x 1cm - 4mm x 8cm
ME135Micrus ACT Platinum Microcoil Delivery SystemCerecyteSpherical Cerecyte - 2mm x 2.5cm - $1,850.00$1,950.00
19mm x 30cm
ME136Micrus ACT Platinum Microcoil Delivery SystemCerecyteStraight Cerecyte - 4mm x 10cm - 6mm x $1,850.00$1,950.00
30cm
Medtronic Australasia Pty Ltd
Benefit(s) Updated Items for Prostheses List Report Page 8 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
Cardio-thoracic
MC013Medtronic Hall Heart Valve Aortic Model A7700, A7700/M7700 Titanium. Pyrolite. Dacron, A7700 - Diameter 20-31mm, M7700 - $5,000.00
Medtronic Hall Heart Valve Mitral Model M7700, A7700EZ/M7700EZ Titanium. Pyrolite. PETDiameter 23-33mm, A7700EZ - Diameter
Hall Easy Fit Aortic Heart Valve Model A7700, 19-29mm, M7700EZ - Diameter 23-31mm
Hall Easy Fit Mitral Heart Valve Model M7700
MC198Medtronic Hall rotatable aortic valved collagen Titanium, pyrolite, dacron20 - 33mm$6,800.00
impregnated conduit Model R7700
MC292Advantage Heart Valve - Aortic Model A7760A7760 - Pyrolytic carbon, PETDiameter 19-31 mm$5,909.00
MC324Advantage Supra Aortic Heart ValveMechanical Heart Valve Pyrolite Carbon Diameter (mm): 19 - 25$5,909.00
leaflets Pyrolite carbon ring
MC681Advantage MitralMechanical Heart Valve23mm-33mm$5,909.00
MC701Mosaic Cinch, Aortic, MitralModels 305cxx, 310cxx19mm - 35mm$4,350.00
Ear, Nose & Throat
MC275Vent TubeFluroplastic, Silicone1.14 - 1.27mm x 0.9 - 3.0mm$14.00
Neurosurgical
MC382Colorado Spinal SystemColorado 2 Rod5.0mm and 5.5mm, length range 50 - $444.00
600mm
MC402CD HorizonPedicle ScrewsDiameter 5.5 - 7.5 Lengths 25 - 80mm$1,037.00
MC421Atlantis Anterior Cervical PlatePlate80.0 - 95.0mm$1,550.00
MC449PyrameshAngled25 - 150mm$3,605.00
MC450PyrameshCurved130mm$3,605.00
MC451PyrameshOvoid8 - 70mm$3,605.00
MC490Orion Anterior Cervical SystemLocking screwOne size only$126.36
MC503CD HorizonFixed Angle Screw (Titanium)25 - 90mm$1,037.00
MC504CD HorizonBreakoff Set Screw25 - 55mm$155.00
MC542Vertex Spinal SystemConnectorLength 10 - 13mm; diameter 3.2 - $1,385.00
MC544Vertex Spinal SystemRod80 - 240mm$491.00
MC546Vertex Spinal SystemSet screwOne size only$155.00
MC579CD HorizonSpondylolisthesis ScrewDiameter: 4.5 - 7.5, Length: 25mm - $1,500.00$1,600.00
MC586CD Horizon Sextant Percutaneous Cannulated Cannulated titanium percutaneous multi axial Dia 3.5 to 9.5mm, Length 15 to 65mm$1,530.00
Multi Axial Screwscrew
Benefit(s) Updated Items for Prostheses List Report Page 9 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
MC589Affinity Anterior cervical cage SystemThe Affinity Cage is constructed of titanium 6 x 12mm; 6 x 14mm; 7 x 12mm; 7 x $1,949.00
alloy - kit includes trials, reamers and inserters.14mm; 8 x 12mm; 8 x 14mm; 9 x 12mm; 9
x 14mm; 10 x 12mm; 10 x 14mm; 11 x
12mm; 11 x 14mm; 12 x 12mm; 12 x 14mm
MC590Vertex Reconstruction System Crosslink BarComposition - titanium alloy. The system One size only$990.00
allows for the adaptation of components from
other Sofamor Danek systems to provide for
constructs tailor made for individual cases.
MC591Vertex Reconstructive System Laminar HookComposition - titanium alloy4.5mm / 5.5mm$820.00
MC598Equation Spinal SystemScrewLength 25-55mm$1,037.00
MC608TSRH 3DConnectorSmall, Medium, Large$1,020.00
MC616Atlantis SystemElement Express Kit Includes Plate, 4 Screws, Plate 23 - 45mm$2,968.00
Screwdriver Shaft, Screwdriver Handle
MC635CD HorizonLegacy In-Line ConnectorLength 40-110mm$1,600.00
MC636CD HorizonEclipse Dual Head Screws20-60mm$1,037.00
MC637CD HorizonSpire PlateOne size$1,398.00
MC667SiLoSet ScrewOne Size only$155.00
MC690Neurostimulation System - Octad LeadsOctad Standard Lead Kit without Percutaneous 45, 60 & 75cm$4,230.00
Extension Model 3777,
Urogenital
MC180Sacral Nerve Stimulation UnilateralInterstim stimulation lead Models 3080 & 28 cm$3,330.00
3886. Platinum / Iridium, polyurethane.
MC719InterStim Neurostimulator Model 3023Titanium42g$9,350.00
Vascular
MC715Interceptor Plus Filter SystemBraided NitolFilter: 3.5 - 6.5mm; Length: 180cm; $2,022.00
Profile: 0.032 - 0.036"
Morton Surgical Pty Ltd
Orthopaedic
MG022Surgimesh WN / Surgimesh WN non-adherentSugimesh WN non-adherentTintra L 30x30x20cm$1,300.00
Nobel Biocare
Plastic and Reconstructive
NR001Branemark AbutmentsAbutment, complete3.5, 4.5, 5.0, 6.0, 7.0mm Diameter$96.00$260.00
Benefit(s) Updated Items for Prostheses List Report Page 10 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
NR009NobelDirect ImplantDental Implant Endosseous incorporating 10mm, 13mm, 16mm$617.00$625.00
abutment, Titanium
Orthocare Pty Limited
General/Miscellaneous
OC006Breg Paincare 3000100ml Continuous Infusion device (delivers 100cc reservoir$370.00
2ml/hr) with additional 4ml bolus. Code # 10314L=10.4cm, D=3.0cm, W=7.4cm
OC007Breg Paincare 3200200ml Continuous Infusion device (delivers 200cc reservoir$265.00$395.00
4ml/hr) with additional 4ml bolus Code # 11030L=10.4cm, D=6.5cm, W=7.4cm
OC008Breg Paincare 4200200ml Continuous Infusion device (delivers 200cc reservoir$265.00$395.00
2ml/hr) with additional 4ml bolus Code # 11090L=10.4cm, D=6.0cm, W=7.0cm
Orthotech Pty Ltd
Neurosurgical
OH045Synergy Spinal SystemInfant Hooks4.75mm$772.00
OH046Synergy Spinal SystemWashers Single/Double16mm - 21mm$1,040.00
OH054Interpore Bone Plate SystemTPS Locked Nut3mm$500.00
OH058Synergy Spinal SystemGrowth Rod30 - 60cm$1,345.00
OH130Non-Fusion Spine Stabilising DeviceTitanium or PEEKHeight 8 - 16mm$5,000.00
OH178Omega 21 Spine Fixation SystemScrew, Spondylolisthesis, 4.75mm, 5.5mm, 25mm - 65mm$1,480.00
6.35mm, 7.5mm diameter
OH185Spinelink Spinal Fixation SystemEnd Cap, TitaniumOne size only$360.00
OH186OMEGA 21 Spine Fixation SystemMultidirection Coupling, TitaniumOne size only$780.00
OH190Omega 21 Spine Fixation SystemScrew, Expandable, 5.5mm, 6.35mm, 7mm, 25mm - 65mm$1,480.00
Orthopaedic
OH203Altius Occipito-Cervico-Thoracic (OCT) SystemRod8 to 24cm x 3.5mm Occipital and Curved$759.00
Rod
Pacific Medical
Ear, Nose & Throat
PM074Tympo VentOtological ventilation tubes, paparella with tabLength 2.2mm$17.83
Pacing Importers Pty Ltd
Vascular
PI004Stentself StentPhynox construction, adapted sizes & Dia 5 - 9mm Length: 20 - 100mm$1,800.00
Benefit(s) Updated Items for Prostheses List Report Page 11 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
Plus Orthopedics Australia Pty Ltd
Orthopaedic
PL140POLAR CUP ACETABULAR CUP SYSTEMDUAL MOBILITY SHELL TITANIUM VPS43-67MM$2,350.00$2,600.00
Portland Orthopaedics (Aust) Pty Ltd
Orthopaedic
PD021M-COR Modular Hip SystemM-COR Uncemented Femoral Stem, Ti6AI4V29-9Z to 47-17A$2,400.00
PD022M-COR Modular Hip SystemM-COR Uncemented Femoral Neck, Ti6AI4V31Z to 51A$1,500.00
Roche Diagnostics Australia Pty Ltd
General/Miscellaneous
RO003Disetronic Administration Sets and AccessoriesAdaptor D-Tron plus10/box$13.00
RO004"Disetronic Infusion Sets"Tender II 17/30Pack 10/10$7.70$22.90
RO006Disetronic Administration Sets and AccessoriesPlastic Cartridge (H-Tron)3.15mL 25/box$7.80$11.96
RO007Disetronic Administration SetsPlastic Cartridge (D-Tron plus)3.0mL 5/box$13.00
RO010"Disetronic Infusion Sets"Tender II 17/60Pack 10/10$7.70$29.90
RO011"Disetronic Infusion Sets"Tender II 17/80Pack 10/10$7.70$29.90
RO012"Disetronic Infusion Sets"Tender I 17/60Pack 10$7.70$21.90
Scient'x Australia
Neurosurgical
SX001Isobar TTLMonoaxial ScrewD: 4.5 - 8mm, L: 25 - 50mm$1,037.00
SX002Isobar TTLPolyaxial ScrewD: 4.5 - 8mm, L: 30 - 55mm$1,600.00
SX003Isobar TTLRodL: 45-450mm$419.00
SX004Isobar TTLNutBlocker, Hemispherical$550.00
SX006Isobar TTLHooksSmall, Large, offset$820.00
SX007AntelysCageH: 9-15mm$2,750.00
SX008AntelysPlateH: 19-23mm$1,271.00
SX009AntelysScrewD: 5mm, L: 32.5 to 50mm$250.00
SX010PCB Plate-CageTitanium cervical plate-cageL: 14-16mm, W: 12-15mm, Cage Height: $3,000.00
4.5-8mm, Plate Height: 23-29mm
Benefit(s) Updated Items for Prostheses List Report Page 12 of 21
Billing Product NameDescriptionSizeMinBenefitMaxBenefit
SX011StellaAnterior cervical plate - titaniumL: 21-121mm$1,550.00
SX012StellaScrewD: 4-4.5mm, L: 12-20mm$190.00
SX014CBK CagePEEKL: 15mm, W: 13mm, H: 4.5-9mm$2,120.00
SX015EasysConnector Bar - titaniumL: 40-100mm$660.00
SX016EasysStraddler - titanium alloyone size$900.00
Smith & Nephew Surgical Pty Ltd
Orthopaedic
SN376ProfixI/M Peg Femoral or Tibial10-20mm x 100mm. 10-20x150mm 10-20$1,254.00
x 200mm
SN834Competitor DeucePatello Femoral OxiniumSm, Med Lg, XLg$3,000.00
SN838Trigen InterTAN NailNail, Titaniumdiameter 10-13mm$1,350.00
length 18-46cm
Angle 125°-135°
SN842Platform Hip StemTitanium grit blasted stem0-12$3,450.00
St. Jude Medical Australia Pty Ltd
Cardio-thoracic
SJ036St Jude Medical Coated Aortic Valved GraftCoated Aortic Valved Graft 21mm - 33mm$6,800.00$7,800.00