Standalone mastopexy (breast lift without significant tissue reduction) may attract a Medicare item number where specific clinical criteria are met. The criteria are stricter than those for breast reduction and eligibility is assessed individually.

Item 45558: Correction of bilateral breast ptosis by mastopexy — applicable where at least two-thirds of the breast tissue, including the nipple, lies inferior to the inframammary fold and the nipple is at the most dependent, inferior part of the breast contour. Photographic evidence (anterior, left lateral and right lateral views, with a marker at the inframammary fold level) demonstrating the clinical need must be documented in the patient record. This item is applicable only once per lifetime and cannot be claimed alongside oncoplastic breast surgery items. Where mastopexy is performed primarily for cosmetic reasons without meeting these criteria, no item number applies.

The majority of standalone mastopexy procedures are performed without a Medicare item number and are therefore self-funded. Dr Cameron will assess your eligibility at consultation and advise whether your procedure qualifies for item number billing.

All surgeon fees include the surgical assistant fee.

If you hold private health insurance, we recommend contacting your health fund before booking to confirm:

• Your level of cover for the relevant item number(s)
• Whether your policy has any applicable waiting periods
• Your excess and any co-payment amounts
• Whether pre-authorisation is required

Even if your procedure is eligible for health fund cover, it is important to understand that out-of-pocket costs are still significant. In most cases, private health insurance primarily contributes to hospital-related costs. You may also receive rebates from Medicare and your health fund towards the surgeon’s and anaesthetist’s fees; however, these rebates are limited in comparison to the overall specialist fees.

Dr Cameron will consult with you to determine whether you are medically indicated and advise on the relevant item number for your procedure for you to confirm with your health fund. Our team will provide a formal personalised quote detailing all expected out-of-pocket costs before you commit to surgery.

We understand that navigating the financial aspects of surgery can feel overwhelming. Our aim is to provide clarity and transparency around the costs involved.

Medicare sets a Benefits Schedule (MBS) fee for surgical procedures. However, the MBS fee has not kept pace with the actual costs of delivering specialist plastic surgery care. Medicare reimburses 75% of the MBS fee for in-hospital procedures, and your private health fund typically contributes an additional 25% — together covering only a portion of the scheduled fee, not the actual cost of surgery.

Dr Cameron’s surgical fee reflects the complexity of your procedure, operative time, his level of specialist training and experience (FRACS — Plastic and Reconstructive Surgery, PhD), consumables, surgical equipment, the surgical assistant fee, and the overhead of running a specialist surgical practice. The difference between what Medicare and your health fund contribute and Dr Cameron’s fee is your out-of-pocket gap, and will be clearly outlined in your personalised quote prior to surgery.

Your final surgical plan must be confirmed before a formal quote can be finalised and your booking secured. Our team will guide you through all costs prior to proceeding.

All surgical quotes are based on the planned procedure. In some cases, additional costs may arise if:

• Unforeseen surgical complexity requires a longer operative time or additional procedures
• Post-operative complications require further treatment, dressings, revision surgery or hospital admission
• Additional pathology, imaging or specialist review is required
• Wound care, compression garments or post-operative support beyond the standard recovery period is needed
• ICU admission or an ICU specialist review is required
• Medications on discharge beyond the standard supply

Where possible, Dr Cameron will discuss any anticipated complexity at your consultation. Our team will contact you promptly if any unexpected costs arise during your care.

Please note that post-operative compression garments are a mandatory part of recovery for most surgical procedures. These are not covered by Medicare or private health insurance and are an additional out-of-pocket cost. Garment costs are listed separately in the cost overview above.