Breast reduction is one of the few cosmetic-appearing procedures that can attract Medicare and private health insurance benefits when specific clinical criteria are met. Eligibility is assessed individually by Dr Cameron at your consultation

Item 45523: Bilateral reduction mammaplasty with surgical repositioning of the nipple — applicable for patients with macromastia experiencing neck or shoulder pain. Clinical photographs and documentation of symptoms are required. This is the most commonly claimed item for bilateral breast reduction. Not claimable where any prosthesis is inserted at the same procedure.

Item 45522: Unilateral reduction mammaplasty without surgical repositioning of the nipple — applicable for single-sided reduction or staged procedures. Excludes treatment of gynaecomastia and procedures involving prosthesis insertion. Same documentation requirements apply.

Item 45520: Unilateral reduction mammaplasty with surgical repositioning of the nipple — applicable in the context of breast cancer treatment or a documented developmental abnormality of the breast (e.g. tuberous breast, significant asymmetry). Clinical and photographic documentation required.

Medicare item number eligibility is subject to individual assessment and clinical documentation. Dr Cameron will assess your eligibility at consultation and provide supporting documentation for your health fund where applicable. We recommend contacting your health fund to confirm your level of cover prior to booking surgery.

Lorem

• Ipsum
• Dolor

All surgeon fees include the surgical assistant fee.

Insured patients (where item number criteria are met) pay their hospital excess/co-payment only for the hospital component. Medicare and health fund rebates will apply towards the surgeon and anaesthetist fees, with an out-of-pocket gap remaining. Uninsured patients or those not meeting item number criteria are responsible for the full cost of all components.

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.