Document ID: chunk:federal_register_of_legislation:F2024L01386:schedule:1:p64
Version: federal_register_of_legislation:F2024L01386
Segment Type: schedule
Provision Reference: sch 1 (pt 64/696)
Character Range: 1380031–1405333

in a delivery magazine with a loading of up to 20 seeds                                                                                                                                                                                                                                                                                                                                                                                     $73.00
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

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

     PALETTE LIFE SCIENCES AUSTRALIA PTY LTD
RW003                                                           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
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
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

     PALETTE LIFE SCIENCES AUSTRALIA PTY LTD
RW004                                                           Barrigel                                                                                             Biodegradable gel of 9ml hyaluronic acid supplied in a kit of three 3 ml syringes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           One size only                                                                                                                                                                                                                                                                                                                                                                                                                                                $1,730.00

03.02 - DRUG DELIVERY DEVICES
03.02.01 - Infusion Ports
  03.02.01.01 - Single Lumen
     B BRAUN AUSTRALIA PTY LTD
BB086                                                           Celsite Epoxy Peritoneal Port                                                                        Epoxy/titanium                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              32x27x13mm                                                                                                                                                                                                                                                                                                                                                                                                                                                   $424.00
BB385                                                           Celsite Access Port                                                                                  Single Access Port                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Standard 32 x 27 x 12.2mm  Small  26 x 22 x 9.7mm  Baby/Brachial 22 x 18 x 8.7mm                                                                                                                                                                                                                                                                                                                                                                             $424.00

  03.02.01.02 - Multiple Lumen
     B BRAUN AUSTRALIA PTY LTD
BB083                                                           Celsite Epoxy Dual Access Port                                                                       Dual lumen power injectable implanted port                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Standard/small/baby                                                                                                                                                                                                                                                                                                                                                                                                                                          $555.00

03.02.06 - Pharmaceutical Beads
  03.02.06.01 - Single Units
     BOSTON SCIENTIFIC PTY LTD
BS371                                                           DC Bead                                                                                              Drug delivery embolisation system                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           100-500 (microns)                                                                                                                                                                                                                                                                                                                                                                                                                                            $1,760.00
BS373                                                           DC Bead LUMI                                                                                         Drug delivery embolisation system                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           70-150 microns (black)                                                                                                                                                                                                                                                                                                                                                                                                                                       $1,760.00
BS372                                                           DC Bead M1                                                                                           Drug delivery embolization system                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           70-150um                                                                                                                                                                                                                                                                                                                                                                                                                                                     $1,760.00

     MERIT MEDICAL AUSTRALIA PTY LTD
OW001                                                           Hepasphere                                                                                           Expanding microspheres designed for chemic0-embolisation with chemotherapeutic agents such as Ethiodil, Cisplatin, Epirubicin, Mitomycin, etc.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              30 – 200 micron, 25mg or 50mg of microspheres                                                                                                                                                                                                                                                                                                                                                                                                                $1,760.00

     Varian