Document ID: chunk:federal_register_of_legislation:F2025L00198:schedule:1:p67
Version: federal_register_of_legislation:F2025L00198
Segment Type: schedule
Provision Reference: sch 1 (pt 67/706)
Character Range: 281840–284786

I 125 contained in a sealed titanium capsule of 4.5 mm length and 0.8 mm in diameter.  $5,766.00

  03.01.02.02 - Single Seed or Partial Dose
     Alphaxrt Pty Ltd
CL003  Advantage I-125 Seed  The Advantage I-125 seed is a sealed radioactive source containing Iodine-125 for interstitial brachytherapy  3mm x 0.5mm silver rod within 4.5 x 0.8mm sealed titanium capsule  $73.00

     BARD AUSTRALIA PTY. LIMITED
BA251  BrachySource® I-125 seeds  Single BrachySource® Seeds supplied either loose, in Cartridges or needles or as a calibration source.  To be used only if more than 120 seeds are used per patient.  Seeds are a 4.5mm x 0.8mm welded titanium capsule.  $73.00

     RQSOLUTIONS MEDICAL DEVICES DISTRIBUTION SUPPORT PTY LTD
RQ077  TheraStrand RX with I-Seed AgX100 I125 implants  AgX100 I-125 Seeds pre-loaded. The billing code is to be applied only if more than 100 seeds are used per patient. Benefit is per seed.  One representation with a loading of more than 100 seeds. The seed includes a silver rod with I 125 contained in a sealed titanium capsule of 4.5 mm length and 0.8 mm in diameter  $73.00

RQ076  Theragenics C20 IsoLoader Magazines in TPSII Individual - 20 seeds per magazine - sterile  The C20 IsoLoader cartridge is a shielded cartridge holding up to 20 I125 seeds, supplied in accordance with the surgeon's requirements.  Benefit is per seed.  1 representation in a delivery magazine with a loading of up to 20 seeds  $73.00

03.01.03 - Tissue Expander/Separator
  03.01.03.01 - Gel 3ml
     BOSTON SCIENTIFIC PTY LTD
BS370  TraceIT Gel System  TraceIT System is intended to create a temporary space within soft tissue during radiation therapy.  3mL  $843.00

     TELEFLEX MEDICAL AUSTRALIA PTY LTD
TX064  Barrigel  Biodegrable gel of hyaluronic acid supplied in a 3ml syringe  3ml  $843.00

  03.01.03.02 - Gel 10mL or Balloon
     BOSTON SCIENTIFIC PTY LTD
BS368  SpaceOAR System  The SpaceOAR System consists of components for preparation of a synthetic, absorbable hydrogel spacer and a delivery mechanism packaged in a single kit. The hydrogel spacer creates a temporary space between the prostate and rectum during radiation therapy.  10CC  $1,730.00

BS369  TraceIT Gel System  TraceIT System is intended to create a temporary space within soft tissue during radiation therapy.  10mL  $1,730.00

BS388  SpaceOAR VUE System  The SpaceOAR VUE System is a radiotherapy protection spacer consisting of components for preparation of synthetic absorbable hydrogel spacer and a delivery mechanism packaged in a single kit. The hydrogel spacer creates a temporary space between the prostate and rectum during radiation therapy. The hydrogel is radiopaque for visibility under computed tomography (CT) and cone beam CT.  10CC  $1,730.00

     TELEFLEX MEDICAL AUSTRALIA PTY LTD
TX065  Barrigel  Biodegradable gel of 9ml hyaluronic acid supplied in a kit of three 3 ml syringes  One size only  $1,730.00