Document ID: chunk:federal_register_of_legislation:F2025L00198:schedule:1:p649
Version: federal_register_of_legislation:F2025L00198
Segment Type: schedule
Provision Reference: sch 1 (pt 649/706)
Character Range: 2122659–2125887

NCC72  Sclera        $420.00

     Southern Adelaide Local Health Network Incorporated
SAA02  Cornea for Endothelial Keratoplasty  Cornea for Endothelial Keratoplasty     $3,525.00

SAA03  Sclera  Sclera     $300.00

SAA01  Cornea  Cornea     $2,950.00

04 - Dermatologic
Billing Code  Product Name  Description  Size  Minimum Benefit  Condition

     AUSTRALIAN TISSUE DONATION NETWORK LIMITED
ADD42  Acellular Dermal Matrix 61 to 120cm² Dermal Matrix 61 to 120cm²  ADM is derived from full thickness human skin, that has been processed to remove cells and cellular components while preserving the extracellular matrix (ECM). The extracellular matrix is the structural framework that provides support and organization to tissues. It consists of various proteins, such as collagen, elastin, and other growth factors, that contribute to tissue strength and regeneration. The resulting acellular dermal matrix serves as a scaffold for tissue repair and regeneration. It can be used in procedures like breast reconstruction, hernia repair, wound healing, and other soft tissue reconstructions.     61cm² to 120cm²  $5,428.00

ADD41  Acellular Dermal Matrix 121 to 180cm²  ADM is derived from full thickness human skin, that has been processed to remove cells and cellular components while preserving the extracellular matrix (ECM). The extracellular matrix is the structural framework that provides support and organization to tissues. It consists of various proteins, such as collagen, elastin, and other growth factors, that contribute to tissue strength and regeneration. The resulting acellular dermal matrix serves as a scaffold for tissue repair and regeneration. It can be used in procedures like breast reconstruction, hernia repair, wound healing, and other soft tissue reconstructions.  121 to 180cm²  $8,142.00

ADD37  Acellular Dermal Matrix <25cm²  ADM is derived from full thickness human skin, that has been processed to remove cells and cellular components while preserving the extracellular matrix (ECM). The extracellular matrix is the structural framework that provides support and organization to tissues. It consists of various proteins, such as collagen, elastin, and other growth factors, that contribute to tissue strength and regeneration. The resulting acellular dermal matrix serves as a scaffold for tissue repair and regeneration. It can be used in procedures like breast reconstruction, hernia repair, wound healing, and other soft tissue reconstructions.      <25cm²  $2,036.00

ADD38  Acellular Dermal Matrix 26 to 60cm²  ADM is derived from full thickness human skin, that has been processed to remove cells and cellular components while preserving the extracellular matrix (ECM). The extracellular matrix is the structural framework that provides support and organization to tissues. It consists of various proteins, such as collagen, elastin, and other growth factors, that contribute to tissue strength and regeneration. The resulting acellular dermal matrix serves as a scaffold for tissue repair and regeneration. It can be used in procedures like breast reconstruction, hernia repair, wound healing, and other soft tissue reconstructions.          26 to 60cm²  $3,257.00

ADD39