Document ID: chunk:federal_register_of_legislation:F2024L01386:schedule:1:p550
Version: federal_register_of_legislation:F2024L01386
Segment Type: schedule
Provision Reference: sch 1 (pt 550/696)
Character Range: 18142609–18185894

23 mm; Offset: 0 mm, 2.5 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $391.00

13.02.04 - Cap/Cover Plate, Complex
     ALPHATEC AUSTRALIA PTY LTD
KN003                                                                            AMP Plate                                                                                             Antmigration Plate for ATEC Cages,  Ti Alloy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Size 4 to 23  - (19.35 to 36.3)mm length, 1 or 2 screw hole.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              $560.00

     AUSTRALIAN PACIFIC MEDICAL PTY LTD
PB039                                                                            DPS Spine System  Double Locking Cap and Nut                                                          Locking Cap and Nut                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   One size only                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             $560.00

     EMERGO ASIA-PACIFIC PTY. LIMITED
ER340                                                                            Ulrich Pedicle Screw System-Locking cap                                                               Ulrich Pedicle Screw System (uCentum/uBase)-Locking cap assembly (dual innie screw, nut, washer)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      one size                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $560.00

     Globus Medical Australia Pty Limited
LB048                                                                            ELLIPSE Stabilization System, Locking Cap                                                             Locking Cap                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           One Size                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $560.00
LB061                                                                            REVLOK Fenestrated Screw System Locking Cap                                                           Locking Cap                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           One Size                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $560.00
LB088                                                                            CREO Stabilization System Locking Cap                                                                 The CREO Stabilization System implants are non-cervical spinal fixation devices intended for posterior pedicle screw fixation, posterior hook fixation or anterolateral fixation.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     4.75 and 5.5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              $560.00          The Prostheses List (PL) billing code does not cover the use of the device for vertebral body tethering (VBT) for the management of adolescent idiopathic scoliosis (AIS).
LB019                                                                            REVOLVE Stabilization Locking Cap                                                                     Locking Cap                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           One Size                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $560.00

     JOHNSON & JOHNSON MEDICAL PTY LTD
JJ694                                                                            Mountaineer OCT Spinal System -Lateral washer plate                                                   Titanium Occipital - Lateral Washer Plate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             One size only                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             $560.00
SY448                                                                            Spinal Fixation System                                                                                Locking Cap                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           One Size                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $560.00
MN276                                                                            SYMPHONY OCT System                                                                                   Multipoint System - Adapter Connector Plate and Screws                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Standard, Angled, Left, Right, Long; 6-16mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               $560.00

13.02.05 - Block/Screw head
     ALPHATEC AUSTRALIA PTY LTD
QQ448                                                                            Invictus Modular Tulip                                                                                Polyaxial.  Ti Alloy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Std, std Reduction,  Extended tab reduction                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               $686.00

     BIOMET 3I AUSTRALIA PTY LIMITED
NW019                                                                            Virage Cable Connector                                                                                Cable Connector                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       One Size                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $686.00

     DEVICE TECHNOLOGIES AUSTRALIA PTY. LTD.
DE665                                                                            Mariner Pedicle Screw Modular Head                                                                    Polyaxial, Extended, Deformity and Trauma Heads                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       One size each                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             $686.00

     E4 SURGICAL PTY LTD
EY036                                                                            Reform MIS Tulip                                                                                      Tulip                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 5.5mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     $686.00
EY002                                                                            Reform Tulip Head                                                                                     Tulip Head                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            12.5mm/17mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               $686.00

     EMERGO ASIA-PACIFIC PTY. LIMITED
ER223                                                                            SIGNUS Diplomat Pedicle Screw System - Screw Head (Tulip)                                             SIGNUS Diplomat Pedicle Screw System - Screw Head (Tulip)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             dia 12.5 mm x height 14.9-150 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          $686.00
QQ147                                                                            Evolution Spine Whistler Modular Pedicle Screw System-Pedicle Screw Tulip                             Evolution Spine Whistler Modular Pedicle Screw System-Pedicle Screw Tulip, polyaxial, standard/MI/reduction                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           5.5 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    $686.00
QQ741                                                                            SIGNUS DIPLOMAT Pedicle Screw System - Screw Head (Tulip)                                             SIGNUS DIPLOMAT Pedicle Screw System - Screw Head (Tulip), non-sterile and sterile packed with set screw.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             dia 12.5 mm x height 14.9-150 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          $686.00
ER580                                                                            Firebird Phoenix screw heads                                                                          Modular screw heads; various sizes including reduction heads                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Body Top Loading, NXG Body Top Loading, Top loaded Body-Slotted, Body Closed, Body Reduction - All one size only  Body Offset - 8mm, 11mm, 14mm  Short, standard and tall (open and closed)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               $686.00
ER553