Billing Code Product Name Description Size
9.1.1 - Bi-Leaflet, rotatable
Benefit
Benefit
Condition
Billing Code Product Name Description Size
9.1.1 - Bi-Leaflet, rotatable
Benefit
Benefit
Condition
Livanova Australia Pty Limited
SA129 Optiform Mechanical Valve 19mm to 33mm $6,000.00
Medtronic Australasia Pty LtdMC980 | Open Pivot Heart Valve (Model 500FA)Open Pivot Heart Valve (Model 500DM) | Pyrolythic Carbon, Double Velour Polyester, Titanium | 16-33mm | $6,000.00 |
MC981 | Open Pivot Heart Valve (Model 501DA)Open Pivot Heart Valve (Model 501DM) | Pyrolythic Carbon, Double Velour Polyester, Titanium | 16-33mm | $6,000.00 |
Reid Healthcare
RH001 Aortic On-X Prosthetic Heart Valve
Models ONXA-19; ONXA-21; ONXA-23; ONXA-25; ONXA- 27/29; ONXM-23; ONXM-25; ONXM-27/29; ONXM31/33;
Bileaflet Mechanical Heart Valve 27-29mm, 19mm, 21mm, 23mm, 25mm, 25-
33mm, 27-29mm, 31-33mm, 23mm, 25mm
$6,000.00
St Jude Medical Australia Pty LtdSJ037 | Masters Series Heart Valve Mitral and Aortic - Expanded Cuff/Hemodynamic Plus | Aortic Expanded Cuff, Aortic Hemodynamic Plus Cuff, Mitral hemodynamic Cuff, Aortic & Mitral Rotatable Cuff | Aortic Expanded 19 - 31mm, Aortic Hemodynamic 17 - 27mm, Mitral Hemodynamic 17 - 27mm, Rotable 17 - 33mm | $6,000.00 |
SJ317 | Regent Prosthetic Heart Valve | Standard Cuff | Standard cuff - 17-23mm/25mm-29mm, Flex cuff - 17-23mm/25mm-29mm | $6,000.00 |
Advanced Biomedical Pty Ltd
AB077 CardiaMed Prosthetic Heart Valve Intra-supra-annular position Aortic and Mitral
bileaflet mechanical heart valve made from solid pyrolitic carbon. Models: ADM.XX-1In and MDM.XX-1In
AB078 CardiaMed Prosthetic Heart Valve Supra-annular position Aortic and Mitral
bileaflet mechanical heart valve made from solid pyrolitic carbon. Models: ADM.XX-1Su and MDM.XX-1Su
19 – 29mm (Aortic) 25 – 33mm (Mitral)
17 - 23mm (Aortic) 25 - 33mm (Mitral)
$6,000.00
$6,000.00
Billing Code Product Name Description Size
Medtronic Australasia Pty Ltd
Benefit
Benefit
Condition
MI124 Open Pivot Heart Valve AP360 -
Mitral
MI125 Open Pivot Heart Valve AP360 -
Aortic
9.1.2 - Tilting Disc, rotatable
Supra-annular mechanical valve; Pyrolythic Carbon, Double Velour Polyester, Titanium
Supra-annular mechanical valve; Pyrolythic Carbon, Double Velour Polyester, Titanium
Mitral: 16, 18, 20, 22, 24, 26, 28 and 30 mm $6,000.00
Aortic: 16, 18, 20, 22, 24, 26 and 28 mm $6,000.00
MC013 Medtronic Hall Heart Valve Aortic
Model A7700, Medtronic Hall Heart Valve Mitral Model M7700, Hall Easy Fit Aortic Heart Valve Model A7700, Hall Easy Fit Mitral Heart Valve Model M7700
9.2.1 - Stented, anatomical
A7700/M7700 Titanium. Pyrolite. Dacron, A7700EZ/M7700EZ Titanium. Pyrolite. PET
A7700 - Diameter 20-31mm, M7700 - Diameter 23-33mm, A7700EZ - Diameter 19- 29mm, M7700EZ - Diameter 23-31mm
$5,100.00
Edwards Lifesciences Pty Ltd
EL056 Carpentier-Edwards PERIMOUNT
Magna Mitral Bioprosthesis (Model: 7000TFX)
Stented Bovine Pericardial Mitral Tissue Valve with a reduced profile height and assymetric sewing band design
25mm, 27mm, 29mm, 31mm, 33mm $5,000.00
EL058 Carpentier-Edwards PERIMOUNT
Magna Ease Aortic Bioprosthesis (Model: 3300TFX)
Stented Bovine Pericardial Aortic Tissue Valve with a reduced profile height
19mm, 21mm, 23mm, 25mm, 27mm and 29mm
$5,000.00
Edwards Lifesciences Pty Ltd
EL030 CE Supra Annular Aortic Valve
Model 2650 Carpentier-Edwards
S.A.V Bioprosthesis Model 6650 Mitral Valve
Medtronic Australasia Pty Ltd
Carpentier-Edwards SAV Bioprosthesis. Composition: Porcine Valve; Elgiloy Alloy; Silicone Rubber, Polytetrafluoroethylene
19mm-33mm $5,000.00
MC701 Mosaic Cinch, Aortic, Mitral Models 305cxx, 310cxx 19mm - 35mm $5,000.00
MC950 Mosaic Ultra Cinch II Small Aortic Root Bioprosthesis 19mm - 29mm $5,000.00
MC962 Mosaic Cinch II Aortic Bioprosthesis 19mm -29mm $5,000.00
Billing Code Product Name Description Size
Benefit
Benefit
Condition
MC993 Hancock II Aortic Cinch II Aortic valve bioprosthesis 21mm to 29mm $5,000.00
MI007 Hancock II Aortic Valve Aortic bioprosthesis 21mm to 29mm $5,000.00
MI008 Hancock II Mitral Valve Mitral bioprosthesis 25mm to 33mm $5,000.00
MI009 Hancock II Ultra Aortic Valve Small aortic root bioprosthesis 21mm to 29mm $5,000.00
St Jude Medical Australia Pty LtdSJ136 SJM Biocor Heart Valve Stented Porcine tissue valve Aortic Valves - Tissue Annulus Diameter -
21 -
29mm
$5,000.00
Mitral Valves - Tissue Annulus Diameter - 25-35mm
SJ192 Epic Flexfit Triple-composite Bioprosthetic heart valve Aortic Valves 21-29mm tissue annulus diameter, 14-20mm total height. Mitral Valves 25-33mm tissue annulus diameter, 15-20mm total height.
$5,000.00
SJ201 Epic FlexFit Supra Triple-composite Bioprosthetic heart valve for supra-annular placement in the aortic position
Tissue Annulus Diameter - 19mm-23mm. Total Height 14mm-16mm.
$5,000.00
Edwards Lifesciences Pty Ltd
EL031 Carpentier-Edwards Perimount
Pericardial Bioprosthesis - Models 2900/6900 Carpentier-Edwards Perimount Plus Pericardial Bioprosthesis Mitral - Model 6900P
EL039 Edwards Perimount Magna Model
3000
Carpentier-Edwards Pericardial Bioprosthesis. Composition: Bovine Pericardium; Elgiloy Alloy; Silicone Rubber, Polytetrafluoroethylene
Carpentier-Edwards Perimount Magna composition: Glutaraldehyde treated bovine pericardium/elgiloy wireform stent/polyester band/silicone rubber suture ring/polytetrafluoroethylene cloth/polyester cloth.
Models 2900/6900 19-33mm, Model 6900P 25, 27, 29, 31, 33mm
19MM Aortic Pericardial Tissue Valve; 21MM Aortic Pericardial Tissue Valve; 23MM Aortic Pericardial Tissue Valve; 25MM Aortic Pericardial Tissue Valve; 27MM Aortic Pericardial Tissue Valve; 29MM Aortic Pericardial Tissue Valve
$5,000.00
$5,000.00
| Livanova Australia Pty Limited |
| ||
SA130 | Mitroflow | Pericardial Bioprosthesis | 19-27mm | $5,000.00 |
SA155 | Mitroflow | Mitroflow Aortic Pericardial Heart Valve (Model LX) | 19, 21, 23, 25, 27mm | $5,000.00 |
Billing Code Product Name Description Size
St Jude Medical Australia Pty Ltd
SJ284 Trifecta Valve Tri-leaflet, stented pericardial valve. 19-29mm Annulus diameter and 15-20mm
height
Benefit
$5,000.00
Benefit
Condition
b bovine
Edwards Lifesciences Pty Ltd
EL060 Carpentier-Edwards PERIMOUNT
Magna Mitral Ease Tissue Valve
9.2.3 - Non-Stented
The Carpentenier-Edwards PERIMOUNT Magna Mitral Ease Tissue is comprised of Bovine Pericardial Tissue and is bioengineered to withstand the higher pressures encountered in the mitral position, whilst maximising implantation ease.
25, 27, 29, 31, 33mm $5,000.00
Medtronic Australasia Pty Ltd
MC982 3f Aortic Bioprosthesis (Model 1000) Model 1000 - EQUINE Pericardium
Bioprostheseis (non stented)
19 - 29 mm $5,100.00
Medtronic Australasia Pty Ltd
MC015 Freestyle bioprosthesis Models 995xx, 995MSxx 19 - 35mm $5,100.00
9.2.4 - Rapid deployment aortic valve with dedicated single use tools
Edwards Lifesciences Pty Ltd
EL062 EDWARDS INTUITY Elite Aortic
Valve System
Livanova Australia Pty Limited
Rapid Deployment Aortic Valve System 19mm - 27mm $9,450.00
SA170 Perceval S Sutureless Aortic Heart
Valve
Sutureless Aortic Pericardial Heart Valve S (19-21mm), M (21-23mm), L(23-25mm),
XL (25-27mm)
$9,450.00
Billing Code Product Name Description Size
9.3.1 - Mechanical Valve
Benefit
Benefit
Condition
Livanova Australia Pty Limited
SA128 CarboSeal Ascending Aortic
Prosthesis, sterile, CarboSeal Ascending Aortic Prosthesis with Handle Model AP21, Model AP23, Model AP25, Model AP27, Model AP29, Model AP31, Model AP33, Carboseal Valsalva
Medtronic Australasia Pty Ltd
Mechanical Conduit AP 21-33mm, CP 21 - 33mm $6,950.00
MC979 Open Pivot Aortic Valved Graft (Model 502AG)
Pyrolythic Carbon, Double Velour Polyester, Titanium
21- 33mm $6,950.00
St Jude Medical Australia Pty Ltd
SJ036 St Jude Medical Coated Aortic Valved Graft
Coated Aortic Valved Graft 21mm - 33mm $6,950.00
SJ104 SJM Masters Series Aortic Valved Prosthesis - VAVGJ
St Jude Medical Mechanical Heart Valve sewn into the base of a woven polyester fibre graft which has been impregnated with bovine- derived gelatin
Annulus Diameter 19-29mm $6,950.00
9.3.2 - Tissue Valve, stented anatomical
Medtronic Australasia Pty Ltd
MC012 Medtronic Hancock Valved Conduit
Model 100/150
Porcine bioprosthesis, dacron 12, 14, 16, 18, 20, 22, 25, 30mm. $6,800.00
Billing Code Product Name Description Size
9.4.4 - Ring or Band, Standard
Benefit
Benefit
Condition
Edwards Lifesciences Pty Ltd
EL028 Baxter Sterile Grafts, Implants &
Prostheses, Non-Animal Origin Annuloplasty: Ring-Mitral Ring with Holder; Mitral Cosgrove-Edwards Annuloplasty System Model 4600; Classic Annuloplasty Ring-Tricuspid
Livanova Australia Pty Limited
Carpentier-Edwards Classic Annuloplasty Ring. Composition: Titanium Alloy; Silicone Rubber; Polyester Fabric Carpentier-Edwards Physio Annuloplasty Ring. Composition: Elgiloy Bands; Polyester Film Strips; Silicone Rubber; Polyester Cloth, Cosgrove-Edwards Annuloplasty Band. Composition: Silicone Rubber; Polyester Cloth. Carpentier-Edwards Tricuspid Ring. Composition: Titanium Alloy; Silicone Rubber; Polyester Fabric
24mm-40mm $2,200.00
SA127 AnnuloFlo Annuloplasty System Annuloflex Ring or AnnuloFlo Ring 26-36mm $2,200.00
Medtronic Australasia Pty LtdMC005 Medtronic Duran Annuloplasty Ring; Duran Ancore Ring 620R; Duran Ancore Chordal Model 620RG
Annuloplasty Devices - Models 610R & 620R Silicone / Barium Sulphate, Dacron.
Model 610R 25-35mm & Model 620R 23- 35mm
$2,200.00
MI181 SIMULUS Flexible Annuloplasty
Ring
MI182 SIMULUS Flexible Annuloplasty
Band
Flexible mitral/tricuspid annuloplasty ring Ring size (mm): 23, 25, 27, 29, 31, 33, 35, 37,
39
Flexible mitral/tricuspid annuloplasty band Band size (mm): 23, 25, 27, 29, 31, 33, 35,
37, 39
$2,200.00
$2,200.00
MI192 Duran Ancore Band 620B Silicone / Barium Sulphate, Dacron 23-35mm $2,200.00
St Jude Medical Australia Pty LtdSJ035 SJM Tailor Annuloplasty Ring Fully Flexible 25mm - 35mm $2,200.00
9.4.5 - Ring or Band, Modified
EL049 McCarthy-Edwards IMR Etlogix
Annuloplasty Ring (Model: 4100)
Rigid mitral annuloplasty ring with an assymetric design
24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm
$2,400.00
EL050 Edwards MC3 Tricuspid Ring
Annuloplalsty System (Model: 4900)
3D rigid annuloplasty ring with a tricuspid specific design
26mm, 28mm, 30mm, 32mm, 34mm, 36mm $2,400.00
Billing Code Product Name Description Size
Benefit
Benefit
Condition
EL057 Geoform Geoform annuloplasty ring Model 4200 with Holder
26, 28, 30 and 32mm $2,400.00
EL059 Carpentier-Edwards PHYSIO ll
Mitral Annuloplasty Ring
EL061 Carpentier-Edwards Physio Tricuspid Annuloplasty Ring
Livanova Australia Pty Limited
PHYSIO II is a semi rigid mitral annuloplasty ring, with an improved saddle shape and global disease based design
The Carpentier-Edwards Physio Tricuspid annuloplasty ring, model 6200 is intended for use in patients with tricuspid valvular insufficiency. Designed with selective flexibility and 3D waveform shape.
24, 26, 28, 30, 32, 34, 36, 38, 40mm $2,400.00
24, 26, 28, 30, 32, 34, 36mm $2,400.00
SA150 Memo 3D Mitral Semirigid Annuloplasty Ring
Medtronic Australasia Pty Ltd
Memo 3D Semirigid Mitral Annuloplasty Ring with 3D flexibility and coated with Carbofilm with or without Rechord system
24mm, 26mm, 28mm, 30mm, 32mm, 34mm, 36mm, 38mm
$2,400.00
MC745 CG Future Composite Ring Semi-rigid mitral annuloplasty ring, with
anterior flexibility
MC844 Profile 3D Annuloplasty Ring 3D, rigid annuloplasty ring with physiologic
mitral valve shape
24, 26, 28, 30, 32, 34, 36 & 38mm $2,400.00
Diameter (mm) 24 - 40mm $2,400.00
MI121 Contour 3D Tricuspid Annuloplasty
Ring
Annuloplasty Ring: Titanium core encapsulated with silicone, covered with polyester fabric
26, 28, 30 32, 34, 36mm $2,400.00
MI183 SIMULUS Semi-Rigid Annuloplasty Ring
MI184 SIMULUS Semi-Rigid Annuloplasty Band
Semi-rigid mitral annuloplasty ring Ring size (mm): 24, 26, 28, 30, 32, 34, 36, 38,
40
Semi-rigid mitral annuloplasty band Band size (mm): 24, 26, 28, 30, 32, 34, 36,
38, 40
$2,400.00
$2,400.00
MI191 Colvin - Galloway Future Band
Model 638B
Semi-rigid metal alloy core, silicone coating, polyester knit fabric
26-38mm $2,400.00
SJ087 St Jude Medical Rigid Saddle Ring Rigid Annuloplasty Ring 24 - 34mm $2,400.00
9.5.1 - Tissue
BX292 Supple Peri-Guard (4 x 4cm) Model No PC0404SN - 4 x 4cm Bovine
pericardium patch
4 x 4cm $350.00
Billing Code Product Name Description Size
9.5.1.2 - 25-75cm²
Benefit
Benefit
Condition
Baxter Healthcare Pty Ltd
BX293 Supple Peri-Guard (6 x 8cm) Model No PC0608SN -6 x 8cm Bovine
pericardium patch
6 x 8cm $550.00
BX294 Supple Peri-Guard (10 x 16cm) Model No PC1016SN - 10 x 16 Bovine
pericardium patch
BX295 Supple Peri-Guard (8 x 14cm) Nodel No PC0814SN - 8 x 14 Bovine
pericardium patch
10 x 16cm $760.00
8 x 14cm $760.00
EL033 Baxter Augmentation / Substitution
Material, Human or Animal Origin, Sterile Pericardial Patch.
9.5.2 - Synthetic
W L Gore & Associates
Edwards Pericardial Patch. Bovine Pericardium. 10cm x 16cm $760.00
GT271 | Cardiovascular Patch | ePTFE | 0.5mm Thickness 0.8 - 3 x 6-8cm | $240.00 |
GT275 | Cardiovascular Patch | ePTFE | 0.4-0.6mm Thickness, 2-3cm x 7-15cm | $240.00 |
9.5.2.2 - Cardiovascular ≥ 75cm²
W L Gore & AssociatesGT120 | Gore-Tex Cardiovascular Patch | ePTFE | 0.6mm Thickness 5 x 15cm | $521.00 |
GT121 | Gore-Tex Cardiovascular Patch | ePTFE | 0.6mm Thickness 10 x 15cm | $521.00 |
9.5.3 - Biologically Engineered
9.5.3.1 - < 75cm²
Livanova Australia Pty Limited
SA163 CorMatrix ECM for Pericardial
Closure
CorMatrix Extracellular Matrix indicated for Pericardial Closure
7cm x 10cm $1,050.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
SA164 | CorMatrix ECM for Cardiac Tissue Repair | CorMatrix Extracellular Matrix indicated for Cardiac Tissue Repair | 7cm x 10cm | $1,050.00 |
|
|
SA165 | CorMatrix ECM for Cardiac Tissue Repair | CorMatrix Extracellular Matrix indicated for Cardiac Tissue Repair | 4cm x 7cm | $1,050.00 |
|
|
9.5.3.2 - ≥ 75cm²
SA162 CorMatrix ECM for Pericardial
Closure
CorMatrix Extracellular Matrix indicated for Pericardial Closure
7cm x 15cm $1,540.00
GT122 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 6 x 12cm $360.00
9.6.2 - Non-cardiovascular ≥100cm² and <200cm²
GT274 Preclude Percardial Membrane ePTFE 0.1mm Thickness, 12-16cm $643.00
9.6.3 - Non-cardiovascular ≥200cm²
GT125 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 15 x 20cm $1,455.00
09.08.02 - Surgical closure devices (atrial appendage)
MQ001 TigerPaw System II A compliant, implantable occlusion fastener to be placed on the Ostium of the Left Atrial Appendage (LAA).
35mm, 45mm $1,024.00
Billing Code Product Name Description Size
9.9.1 - Modified Tube (end modified eg valsalva)
Benefit
Benefit
Condition
Terumo Australia
TU036 Gelweave Valsalva Graft Woven vascular prosthesis, polyester, gelatin
sealed
9.9.2 - Tube with one side branch
Diameter 24 - 34 mm, Overall length 18.4 - 19.6cm
$3,320.00
TU038 Gelweave Graft Straight Thoracic Graft, with antiflo side branch, Polyester, woven, gelatin sealed
9.9.3 - Tube with multiple side branches (more than 1)
TU037 Gelweave Plexus Graft Multi Branched, for Aortic Arch reconstruction,
Polyester, Woven, gelatin sealed
9.9.4 - Hybrid stent graft (unbranched)
20 -34 mm x 20-40 cm $1,715.00
20 - 34 mm x 40 cm $2,150.00
RH011 E-vita open plus stentgraft system
(with or without collar)
Hybrid device consisting of a conventional vascular graft incorporated with and endovascular stent graft that allows treatment of the ascending aorta, the arch and the descending aorta, in one procedure.
Overall length: 100-160mm. Vascular graft length 50-70mm; Stent graft length 80- 240mm; Stent graft diameter 20-40mm; Collar width 2-40mm.
$20,000.00
AB074 FLEXIGRIP (Various Sizes) Nitinol Sternal Closure Clips - various sizes 20mm - 40mm $140.00
Billing Code Product Name Description Size
Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes
Benefit
Benefit
Condition
SY688 Sternal ZipFix System Sternal Closure Tie with Needle One Size $140.00
9.11.1 - Ventricular Assist System
CQ001 HeartWare Ventricular Assist System Implant and patient sets include: 1. The HVAD
pump, the HVAD strain relief, the HVAD sewing ring, and the HVAD driveline Cap; 2. The HVAD pump surgical tools; 3. the HVAD pump outflow graft; 4. the HVAD driveline extension cable; 5. The HVAD controller kits (2); 6. The DC adapter, the battery charger and the batteries (4); and 7. Shower bag, patient pack, shoulder pack and waist pack.
St Jude Medical Australia Pty Ltd
n/a $100,000.00
SJ383 | HeartMate II Left Ventricular Assist System - Implant Kit - Unsealed Grafts | Implant Kit with Unsealed Grafts | One size only | $100,000.00 |
SJ386 | HeartMate II Left Ventricular Assist System - Implant Kit - Sealed Grafts | Implant Kit with Sealed Grafts | One size only | $100,000.00 |
9.11.2 - External ComponentsSt Jude Medical Australia Pty Ltd
SJ384 HeartMate II Left Ventricular Assist
System - System Controller
9.11.2.3 - Battery Set
System controller One size only $4,500.00
SJ385 HeartMate II Left Ventricular Assist System - Battery Set
Rechargeable HeartMate II-specific batteries One size only, set of 4 $2,500.00
Billing Code Product Name Description Size
9.11.2.4 - Battery Clip Set
St Jude Medical Australia Pty Ltd
Benefit
Benefit
Condition
SJ375 HeartMate II Left Ventricular Assist
System - Battery Clip Set
Battery clip set one size only $1,600.00
St Jude Medical Australia Pty Ltd
SJ381 HeartMate II Left Ventricular Assist
System - Stabilization Belt
9.11.3.2 - Modular Belt
Fabric belt for Stabilizing percutaneous lead Small / medium; set of 2
large; set of 2
$100.00
SJ382 HeartMate II Left Ventricular Assist System - Modular Belt
Modular belt to hold System Controller and Batteries
Small / Medium Large
$345.00
SJ380 HeartMate II Left Ventricular Assist System - Shower Bag
9.12.1 - Pectus Bar
Shower Bag One size only; set of 2 $450.00
RH016 Park Modified Pectus Bar Park Modified Pectus bar available in titanium
alloy and stainless steel
Zimmer Biomet Pty Ltd
6" - 152mm, 7" - 178mm, 8" - 203mm, 9" -
228mm, 10" - 254mm, 11" - 279mm, 12" -
305mm, 13" - 330mm, 14" - 356mm, 15" =
381mm, 16" - 406mm, 17" - 432mm
$1,256.00
BI472 Pectus Bar Pectus Bar, Stainless Steel 80-432mm $1,256.00
Billing Code Product Name Description Size
9.12.2 - Stabilisers
No subgroup
Benefit
Benefit
Condition
Reid Healthcare
RH017 Park Pectus Hinge Plate Stabiliser Stabilisation of Pectus Bar - optional use in
asymmetric or adult pectus excavatum to prevent bar displacement stripping of intercostal muscles
65mm $505.00
RH018 Park Bridge Stabiliser Stablisation of Pectus Bar - optional use for
multiple bar placement
3 sizes: 6 hole - 60mm, 8 hole 80mm, 10 hole - 100mm
$505.00
RH019 Park Claw Fixator, Clip and Nut
Stabiliser
Zimmer Biomet Pty LtdStabilisation of Pectus Bar Park Claw Fixator - Small (20mm x 12mm), Medium (23mm x 15mm), Large (25mm x 18mm), Extra Large (30mm x 18mm). Fixator Clip - 15mm.
Nut - 7mm.
$505.00
BI483 Pectus Bar Stabilizer, Triangular or Elongated, Stainless Steel
09.13.01 - Chordal Replacement Devices, fixed and adjustableReid Healthcare
One size only $505.00
RH024 Chord-X ePTFE chordal repair Five (5) loop lengths -(0mm/adjustable, 12mm, 16mm, 20mm and 24mm),
Two (2) sutures (2-0 ePTFE or 3-0 ePTFE),
Two (2) needle shapes (1/2 circle and 3/8 circle),
Two (2) needle lengths (18mm and 22mm).
$270.00
Billing Code Product Name Description Size
10.1.1 - Bare Metal Stents
10.1.1.1 - Balloon Expandable
Benefit
Benefit
Condition
Abbott Australasia Pty Ltd
AY022 Cobalt Chromium Balloon
Expandable Peripheral Stent
Cobalt Chromium Diameter 4-10mm, Length 12-58mm $1,800.00
AY024 Omnilink Stainless Steel Balloon
Deployable Peripheral Stent
B Braun Australia Pty Ltd
Stainless Steel Balloon Expandable Peripheral Stent on 018/035 system
018 & 035 system: 5-10mm diameter by 12,
16, 18, 28, 38, 58mm length
$1,800.00
BB244 Coroflex Blue Cobalt Chromium Alloy L605 2-4mm diameter, 8-25mm length $1,800.00
Bard Australia Pty LtdBA218 Lifestent Valeo Stainless Steel Balloon Expandable Peripheral Stent
6-10mm diameter 17-56mm length $1,800.00
BT094 Dynamic PTA Balloon Expandable Stent Diameters: 5-10mm, Lengths: 15, 25, 38, 56mm
$1,800.00
BS059 Express Vascular LD Stent; Express Vascular SD Stent
Stainless Steel, Balloon Expanding Stent Stent Diameters up to 10mm and lengths up to
60mm
$1,800.00
JJ305 Palmaz Genesis Peripheral Stent on Opta Pro (Medium)
JJ306 Palmaz Genesis Peripheral Stent on
Opta Pro (Large)
JJ567 PALMAZ® BLUE™ .018 Peripheral Stent System
Stainless steel balloon expandable stent mounted on an Opta Pro Balloon
Stainless steel balloon expandable stent mounted on an Opta Pro Balloon.
L605 Cobalt Chromium Alloy Balloon Expandable Stent
Diameter 4-8mm, length 12-39mm $1,800.00
Diameter 4-12mm, length 11-79mm $1,800.00 12, 15, 18, 24mm length 4, 5, 6, 7mm diameter $1,800.00
JJ688 Palmaz Blue .014 Renal Stent System (on Aviator Plus)
Medtronic Australasia Pty Ltd
CoCr balloon expandable stent 12, 15, 18, 24mm
Lengths 40, 50, 60,
70mm diameters 80,
142cm shaft lengths
$1,800.00
MC328 Racer Renal Stent System Cobalt Alloy Diameter: 4-7mm; Lengths: 12 &18mm $1,800.00 MC773 Assurant Cobalt Stent Iliac balloon expandable stent system             Diameter: 6 - 10mm , Length: 20 - 80mm             $1,800.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
MC959 | Hippocampus Renal Stent System | Hippocampus Renal Rapid Exchange Stainless Steel Stent system, 5F sheath, 0.014" guide wire compatible | Diameter 4.0mm - 7.00mm Length: 10mm - 24mm | $1,800.00 |
|
|
MC977 | Chromis deep cobalt Chromium, infrapopliteal OTW stent | Chromis deep - Cobalt Chromium, pre- mounted balloon expandable, 0.014" | Diameter: 2.0 mm 4.0mm Length: 10mm - 76mm | $1,800.00 |
|
|
WILLIAM A COOK AUSTRALIA PTY LTDWC234 Formula 414 Rx Renal Stent System Balloon Expandable Vasc/Biliary Stent Rapid exchange 014/018, 80-135cm delivery
system. Diameters 4-10mm, lengths 0.8 - 4cm
$1,800.00
10.1.1.2 - Self Expandable, <150mm
AY015 Xact/ Xact Flex Carotid Stent Nitinol Self-Expanding stent on rapid exchange
delivery system
Diameter 7-10mm Length 20 + 30mm Straight; Diameter 8-6, 9-7, 10-8mm Length 20 + 30mm Tapered
$1,800.00
AY031 Xpert Xpert is a laser cut nitinol self expanding stent, used to treat peripheral vessel disease, Xpert is a low profile system designed for small vessels and is 4 french.
3 - 8mm in diameter, 20 - 80mm in length $1,800.00
AY032 ACCULINK Peripheral Stent System Nickel-Titanium Intra-vascular stent 4-10mm diameter, 13-56mm length $1,800.00
AY041 Absolute Self Expanding Peripheral
stent
Laser cut nitinol self expanding stent, 20mm - 120mm lengths
Size ranges from:
5.0X20MM, 80CM - 8.0x120MM, 135CM
$1,800.00
AY043 Supera Peripheral Stent System Interwoven Self-Expanding Nitnol Stent 20mm x 4,5,6,7mm
30mm x 4,5,6,7mm 60mm x 4,5,6,7mm 80mm x 4,5,6,7mm 100mm x 4,5,6,7mm 120mm x 4,5,6,7mm 40mm, x 4, 5, 6, 7mm 40mm x 8mm diameter 60mm x 8mm diameter 80mm x 8mm diameter 100mm x 8mm diameter
$1,800.00
BA178 Peripheral Vascular Bare Metal Stent Nitonol self expanding stent 4mm - 14mm diameters,
2cm - 12cm lengths
$1,800.00
BA199 Lifestent Laser cut nitinol self expanding stent, used to treat peripheral disease
Diameter: 6-8mm, Length: 120mm $1,800.00
BA216 Lifestent Lifestent cut nitinol self expanding stent 6-10mm diameter 20mm-120mm length $1,800.00
Billing Code Product Name Description Size
Biotronik Australia Pty Ltd
Benefit
Benefit
Condition
BT072 Astron Peripheral self expanding nitinol, coated stent Diameters: 6 - 12mm, Lengths: 30 - 100mm $1,800.00
BT103 Astron Pulsar Astron Pulsar is a 4F compatible, Nitinol self expanding stent (OTW design) used to treat peripheral vessel disease.
4-7mm by 20-80mm $1,800.00
BT126 Pulsar 18 Peripheral self expanding Nitinol stent system
Pulsar 18 self expanding Nitinol stent system Stent: Ø 4- 7mm length: 20-120mm Catheter
length: 90-135mm
$1,800.00
BT133 Pulsar 35 Peripheral self-expanding Nitinol stent system
Pulsar 35 Peripheral self-expanding Nitinol stent system
Diameter: 5-7mm; Length: 30-120mm; Catheter length: 90cm
$1,800.00
BS035 Expandable Endoprosthesis Biomedical superalloy, self expanding stent Stent Diameters up to 30mm and lengths up to
100mm
BS056 Carotid Wall Stent Elgiloy self expanding stent Stent diameters up to 10mm and lengths up to
40mm
BS137 EPIC Nitinol Stent Nitinol self expanding stent Stent diameters up to 14mm and lengths up to
120mm
$1,800.00
$1,800.00
$1,800.00
BS167 Placehit Wallstent Biomedical cobalt-based alloy, self expanding stent
Stent diameters up to 19mm and lengths up to 100mm
$1,800.00
BS168 Wallstent RP Tracheobronchial, Iliac, Biomedical Superalloy Wire, Braided Mesh, Stainless Steel Stent with Unistep Delivery System
Diameter up to 10mm; lengths up to 100mm $1,800.00
BS189 Adapt Monorail Carotid Stent System Nitinol self expanding stent 21-40mm length, 4-9mm diameter $1,800.00 BS196 Innova Self-Expanding Stent Nitinol, self expanding stent             Diameters up to 8mm, lengths less than             $1,800.00
AS189 Protégé GPS Peripheral Stent Protégé RX Peripheral Stent Diameter 6-10mm Length 20-60mm $1,800.00
AS194 EverFlex Peripheral Stent EverFlex is a self expanding Nitinol stent
premounted on an OTW delivery system.
Diameter 5-8, Length 20-120mm $1,800.00
ER266 Veniti VICI Venous Stent System VICI Venous Stent System dia (12-16 mm) x length (60-120 mm) $1,800.00
Endotherapeutics Pty LtdET037 SX-Ella Endovascular Stent Uncovered, self-expanding nitinol stent Dia 6-16mm, length 22-77mm $1,800.00
Johnson & Johnson Medical Pty LtdJJ419 SMART Control Peripheral Stent System
SMART Control is a laser cut nitinol self expanding stent, used to treat peripheral vessel disease.
Dia 6 – 14mm; Length 20 – 100mm $1,800.00
Billing Code Product Name Description Size
JJ592 SMART Nitinol Stent System Long 120mm Stent, 6F compatible 6-8mm diameter, 120mm stent length, 120cm
delivery system
JJ646 Precise Pro Rx Nitinol Stent System Nitinol self expanding stent Diameter: 5, 6, 7, 8, 9, 10mm; Length: 20,
30, 40mm
Benefit
$1,800.00
$1,800.00
Benefit
Condition
MN173 S.M.A.R.T. Flex Vascular Stent
System
Medtronic Australasia Pty Ltd
A fully connected, laser cut nitinol stent 5-8mm diameter, 30-120mm length $1,800.00
MC743 Complete SE Stent Nitinol 20mm - 80mm $1,800.00
MC744 Complete SE Stent Nitinol 100mm - 120mm $1,800.00
MC978 Cristallo Ideale Carotid Self
Expanding Stent System
Cristallo Ideale Nitinol, Carotid Self Expanding Hybrid Stent system, 5F introducer sheath compatible, Rapid Exchange design,
.014" guide wire compatible.
Cylinder Diameter: 7.0mm - 11.0 mm. Taper Diameter 6.0/9.0 - 7.0/10.0. Length 20mm - 40 mm.
$1,800.00
MI010 Maris Plus Peripheral Self-Expanding Stent System
Nitinol, self expanding, peripheral stent system Diameter: 6.0-12.0mm; Length: 30-120mm $1,800.00
PY028 Sinus-XL Stent Self-expanding Nitinol stent Diameter 14mm - 24mm, Length 30-100mm
nominal; 32-100mm expanded.
$1,800.00
PY031 Optimed Sinus Stents Sinus-wave nitinol stent 3-14mm Diameter x 20-130mm Length $1,800.00
PY036 Sinus-Venous Stents Sinus-Venous Stent used for treating venous insufficiency, occlusion and stenosis
Diameter: 10, 12, 14, 16, 18mm
Length: 60, 80, 100, 120mm
$1,800.00
RH022 E-xl Aortic Stent The E-xl Aortic Stent is a self-expandable, nickeltitanium-alloy stent especially designed for the endoluminal treatment of lesions in the descending aorta, particularly aortic coarctation and dissections, and for the treatment of vena cava syndrome.
Total Length: 70, 100mm Flare Length: 20, 30mm Diameter: 14, 16, 18, 20, 24 Flare
Diameter: 18, 20, 22, 24, 28 Design: single- or double-flared
$1,800.00
TU056 MISAGO Rapid Exchange, Self-
Expanding Peripheral Stent
Bare Metal, Rapid Exchange, Self-Expanding Peripheral Stent
6mm - 12mm Diameter; length 20mm - 140mm $1,800.00
WC168 Cook Vascular/Biliary Stent Vascular/Biliary stent 5/6 Fr delivery system, 4 - 14mm diameter, 2 -
8cm length
$1,800.00
Billing Code Product Name Description Size
Benefit
Benefit
Condition
WC287 Zilver® Flex 35™ Vascular Stent The Zilver® Flew 35™ Stent (ZFV) is a self-
expandable stent made of nitinol. The special laser-cut pattern of the nitinol tube provides a construction with a strong radial force and high flexibility. The stent has radiopaque markers at both ends. The stent is supplied preloaded in a
6.0 French inducer catheter. A radiopaque marker on the distal tip of the sheath is used to visualize deployment of the stent. Stent deployment is controlled by means of a hand held device.
WC290 Zilver® Vena ™ Venous Stent The Zilver® Vena™ Venous Stent is a self-
expanding, flexible, slotted-tube nitinol stent. Post-deployment, the stent is designed to impart an outward radial force upon the inner lumen of the vessel, establishing patency in the stented region.
The Zilver® Flex 35™ Stent is available in the following sizes: stent outer diameters of 5 - 10mm and stent lengths of 20 -140mm.
14mm and 16mm diameters, and 60mm/100mm/140mm lengths.
$1,800.00
$1,800.00
PY029 Sinus-XL Stent ≥25mm Ø Self-expanding Nitinol stent Diameter: 25mm - 36mm. Length: 30-100mm
nominal; 32-100mm expanded.
$2,970.00
RH023 E-xl Aortic Stent The E-xl Aortic Stent is a self-expandable, nickeltitanium-alloy stent especially designed for the endoluminal treatment of lesions in the descending aorta, particularly aortic coarctation and dissections, and for the treatment of vena cava syndrome.
Abbott Australasia Pty Ltd
Total Length: 70, 130mm Flare Length: 20, 30, 35mm Diameter: 28, 32 Flare Diameter:
32, 36 Design: single- or double-flared
$2,970.00
AY036 | Absolute Pro (Long Length) | Laser cut nitinol self expanding stent ≥150 | Diameter 5mm to 10mm; length 150mm, 170mm, 200mm | $2,970.00 |
AY042 | Supera Peripheral Stent System | Interwooven Self-Expanding Nitinol Stent | 150mm x 4, 5, 6mm 180mm x 4, 5, 6mm 200 x 4, 5, 6mm | $2,970.00 |
Bard Australia Pty LtdBA217 Lifestent Laser cut nitinol self expanding stent Diameter 5mm to 10mm; length 150mm - 200mm
$2,970.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
| Biotronik Australia Pty Ltd |
|
|
|
|
|
BT127 | Pulsar 18 Peripheral self expanding Nitinol stent system | Pulsar 18 self expanding Nitinol stent system | Stent: 4-7mm Stent length: 150-200mm Catheter length: 90-135mm | $2,970.00 |
|
|
BT132 | Pulsar 35 Peripheral self-expanding Nitinol stent system | Pulsar 35 Peripheral self-expanding Nitinol stent system | Diameter: 5-7mm; Length: 150-200mm; Catheter length: 90cm, 135cm | $2,970.00 |
|
|
Boston Scientific Australia Pty LtdBS197 Innova Self-Expanding Stent Nitinol, self expanding stent Diameters up to 8mm, Lengths greater than
150mm
$2,970.00
AS195 EverFlex Peripheral Stent EverFlex is a self expanding Nitinol stent
premounted on an OTW delivery system.
Johnson & Johnson Medical Pty Ltd
Diameter 5-8mm, Length 150-200mm $2,970.00
JJ617 SMART Nitinol Stent System Long 150mm stent, 6F compatible 6-8mm diameter, 150mm length, 120cm
delivery system
$2,970.00
MN174 S.M.A.R.T. Flex Vascular Stent
System
Medtronic Australasia Pty Ltd
A fully connected, laser cut nitinol stent 5-8mm diameter, 150-200mm length $2,970.00
MC760 Complete SE Stent Nitinol 150mm $2,970.00
MI011 Maris Plus Peripheral Self-Expanding Stent System
Nitinol, self expanding, peripheral stent system Diameter: 6.0-12.0mm; Length: 150mm $2,970.00
PY016 Optimed Iliac Sinus Stent - extra long Sinus-wave nitinol stent - extra long 6-8 mm x 150-200mm $2,970.00
PY037 Sinus-Venous Stent Sinus-Venous stent used for treating venous insufficiency, occlusion and stenosis
Diameter: 10, 12, 14, 16, 18mm Length: 150mm
$2,970.00
TU055 MISAGO Self-expanding, Rapid
Exchange Peripheral Stent
Bare metal, Self Expanding, Rapid Exchange Peripheral Stent
6mm - 12mm Diameter; length 150mm - 200mm
$2,970.00
WC285 Zilver® Flex35™ Vascular Stent The Zilver® Flex35™ Stent (ZFV) is a self-
expandable stent made of nitinol. The special laser-cut pattern of the nitinol tube provides a construction with a strong radial force and high flexibility. The stent has radiopaque markers at both ends.
Diameter: 5-8mm; Length:170mm and 200mm $2,970.00
Billing Code Product Name Description Size
10.1.1.4 - Self-Expanding, large diameter for treatment of aortic dissection disease
Benefit
Benefit
Condition
Reid Healthcare
RH020 E-xl Aortic Stent The E-xl Aortic Stent is a self-expandable, nickeltitanium-alloy stent especially designed for the
endoluminal treatment of lesions in the descending aorta, particularly aortic coarctation and
dissections, and for the treatment of vena cava syndrome.
WC288 Zenith Dissection Endovascular Stent The Zenith Dissection Endovascular Stent with
the H&L-B One-Shot Introduction System is indicated for the endovascular treatment of patients with aortic dissection distal to the left subclavian artery.
Total Length: 70, 130mm Flare Length: 20, 35mm Diameter: 36 Flare Diameter: 40 Design: single- or double-flared
Diameter: 46mm (designed for vessel diameters 24-38mm). Length: 82, 123, 164mm
$4,650.00
$4,650.00
WC316 Zenith Dissection Endovascular Stent with the Z-Trak Plus Introduction System
10.01.02 - Drug Eluting Stents
Dissection Endovascular Stent Diameter: 36mm and 46mm
Lengths: 80mm, 120mm, 180mm, 185mm
$4,650.00
WC289 Zilver PTX The Zilver PTX Drug Eluting Peripheral Stent is a self-expanding stent made of nitinol and coated with the drug Paclitaxel. The stent is preloaded in a 6.0 French delivery catheter.
6French: 5, 6, 7, 8, 9, 10mm diameters in 20,
30, 40, 60, 80, 100, 120mm lengths
$2,400.00
MS052 Relay Thoracic Stent Graft Duralloy Nitinol Surgical Graft Material
Braided Polyester PFTE impregnated Suture Dual Sheath Delivery System
Diameter 22 - 46mm, Length 103 - 179mm $11,027.00
Billing Code Product Name Description Size
Medtronic Australasia Pty Ltd
Benefit
Benefit
Condition
MC206 Talent Thoracic Stent Graft Talent Endoluminal Stent Graft - Thoracic
Stent Graft System
22 - 46mm x 130mm $11,027.00
MC747 Valiant Endovascular Stent Graft Nitinol and polyester system 22-46mm diameter, 110mm length $11,027.00 MC748 Valiant Endovasculat Stent Graft Nitinol and polyester system 22-46mm diameter, 150mm length $11,027.00 MC809 Valiant Endovascular Stent Graft Nitinol and polyester system 24 - 46 diameter, up to 179mm $11,027.00
MC952 Valiant Captivia Valient Stent Graft with Captivia Delivery System
22-46mm diameter, 150mm length $11,027.00
MC960 Valiant Captivia Valiant Stent Graft with captivia delivery system 22 - 46 mm diameter: 100mm length $11,027.00
MI149 Valiant Thoracic FreeFlo Tapered
stent graft
W L Gore & Associates
Valiant Thoracic FreeFlo Tapered Stent Graft with Captivia Delivery System
Proximal diameter: 26 to 46 mm; distal diameter: 22 to 42 mm; stent graft covered length: 152 to 162 mm. Catheter outer diameter: 22 to 25F
$11,027.00
GT191 Excluder Endovascular Prostheses Thoracic Stent Graft Nitinol & ePTFE Diameter 26-40mm x 10cm Length $11,027.00
GT259 Conformable GORE TAG Thoracic
Endoprosthesis
GT260 Conformable GORE TAG Thoracic
Endoprosthesis
Conformable GORE TAG Straight Stent Grafts:
Diameters (mm): 21, 26, 28, 31, 34, 37, 40, 45
Length (cm): 10 Tapered Stent Grafts:
Diameters (mm): 26x21; 31x26
Lengths (cm): 10
Conformable GORE TAG Diameters (mm): 28, 31, 34, 37, 40, 45
Length (cm) 15
$11,027.00
$11,027.00
WC240 Zenith Thoracic Endovascular Graft Thoracic Distal Graft 26mm to 42mm diameter, 127mm to 179mm Length
$11,027.00
WC275 Zenith TX2 TAA Endovascular Graft with Pro_Form and the Z-Trak Plus Introduction System Short Proximal Component
WC307 Zenith TX2 Dissection Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (Short proximal component)
Short Thoracic Proximal Graft Diameter 22mm - 42mm Length 115mm - 167mm
Short Thoracic Proximal Graft Diameter 22mm - 42mm Length 117mm - 165
$11,027.00
$11,027.00
WC322 Zenith Alpha Thoracic Endovascular Graft Distal Component
Thoracic Distal Graft (short) Diameter: 28-46mm. Length: 142-160mm. $11,027.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
WC324 | Zenith Alpha Thoracic Endovascular Graft Proximal Component | Straight Thoracic Proximal Graft (short) | Diameter: 18-46mm. Length: 105-179mm. | $11,027.00 |
|
|
WC326 | Zenith Alpha Thoracic Endovascular Graft Proximal Tapered Component | Tapered Thoracic Proximal Graft (short) | Proximal diameter: 32-46mm. Length: 161- 179mm. | $11,027.00 |
|
|
10.2.1.2 - ≥180mm length
MS053 Relay Thoracic Stent Graft Duralloy Nitinol Surgical Graft Material
Braided Polyester PFTE impregnated Suture Dual Sheath Delivery System
Diamter 22 - 46mm, Length 180 - 271mm $14,500.00
MC810 Valliant Endovascular Stent Graft Nitinol and polyester system 24 - 46 diameter, 180 - 227mm length $14,500.00
MC958 Valiant Captivia Valiant Stent Graft with Captivia Delivery System
24-46mm diameter, 200mm length $14,500.00
GT023 Excluder Endovascular Prostheses Thoracic Stent Graft Nitinol & ePTFE 34, 37 & 40mm Diameter x 20cm Lengths $14,500.00
GT261 Conformable GORE TAG Thoracic
Endoprosthesis
Conformable GORE TAG Diameters (mm): 34, 37, 40, 45
Length (cm): 20
$14,500.00
WC241 Zenith Thoracic Endovascular Graft Thoracic Distal Graft 26mm to 42mm diameter, 180mm to 207mm Length
$14,500.00
WC276 Zenith TX2 TAA Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System - Long Proximal Component
Long Thoracic Proximal Endovascular Graft Diameter: 22mm-42mm Length: 192mm-
216mm
$14,500.00
WC305 Zenith TX2 Dissection Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (Long proximal component)
WC323 Zenith Alpha Thoracic Endovascular Graft Distal Component
WC325 Zenith Alpha Thoracic Endovascular Graft Proximal Component
Long thoracic proximal graft Diameter 28mm-42mm; Length 194mm-218 $14,500.00
Thoracic Distal Graft (long) Diameter: 28-46mm. Length: 190-229mm. $14,500.00 Straight Thoracic Proximal Graft (long) Diameter: 28-46mm. Length: 201-233mm.             $14,500.00
WC327 Zenith Alpha Thoracic Endovascular Graft Proximal Tapered Component
Tapered Thoracic Proximal Graft (long) Proximal diameter: 32-46mm. Length: 201-
233mm.
$14,500.00
Billing Code Product Name Description Size
10.2.2 - Tube (Abdominal Aorta)
Benefit
Benefit
Condition
Medtronic Australasia Pty Ltd
MC850 Endurant AAA Abdominal Tube Endurant Endoluminal Stent Graft System -
Abdominal Tube
23 - 36mm X 85mm $4,850.00
MI060 Endurant II AAA Abdominal Tube Endurant II Endoluminal Stent Graft System -
Abdominal Tube
Proximal diameter: 23 to 36mm; Distal diameter: 23 to 36mm; Covered length: 70mm
$4,850.00
ER204 Endologix AFX Endovascular AAA
Stent Graft System-Aortic extensions
Endologix AFX Endovascular AAA Stent Graft System-Aortic extensions
Covered diameter (22-28 mm) x length (55- 100 mm); open length 20 mm.
$4,850.00
WC232 Zenith Renu AAA Ancillary Graft - Main Body Extension
10.2.3 - Tube (Aorto-uni-iliac)
Stent graft indicated for the repair of in situ AAA stent grafts
Proximal diameter 22 - 36mm, Length (covered section) 43 - 100mm
$4,850.00
MC153 Talent AAA Aorto Uni lliac Stent
Graft
Talent Endoluminal Stent Graft System - AUI Tapered System.
22 - 36mm x 75 - 310mm $10,200.00
MC847 Endurant Aorto-Uni-Iliac (AUI) Endurant Endoluminal Stent Graft System - AUI 23 - 36mm X 120mm $10,200.00
MC998 Endurant II AAA Aorto-Uni-Iliac Endurant II Endoluminal Stent Graft System -
AUI
WILLIAM A COOK AUSTRALIA PTY LTD
Proximal diameter: 23 to 36mm; Distal daimeter: 14mm; Covered length: 102mm
$10,200.00
WC235 Zenith Renu AAA Ancillary Graft -
Converter
Stent graft indicated for the repair of in situ AAA stent grafts
Proximal diameter 22-36mm, distal diameter 12mm, lengths 91-161mm
$10,200.00
MQ036 Nellix EndoVascular Aneurysm
Sealing System - Nellix Catheter
Nellix EndoVascular Aneurysm Sealing System - Aorto-uni-Iliac CoCr stent grafts with attached polymer endobag
8-10mm x 100-180mm $10,200.00
Billing Code Product Name Description Size
10.2.4 - Bifurcated
10.2.4.1 - Body and 2 limbs
Emergo Asia Pacific Pty Ltd
Benefit
Benefit
Condition
ER191 | Ovation Prime Abdominal Stent Graft System | Bifurcated Aortic System, PTFE graft, nitinol stent and markers | 20, 23 26, 29 and 34 mm | $12,405.00 |
ER203 | Endologix AFX Endovascular AAA Stent Graft System-Bifurcated Stent Graft | Endologix AFX Endovascular AAA Stent Graft System-Bifurcated Stent Graft | Aortic main body diameter (22-28 mm) x length (60-120 mm); iliac limb diameter (13- 20 mm)x length (30-55 mm) | $12,405.00 |
Terumo Australia
TU002 Anaconda Endovascular Graft System Bifurcated Aortic System, Ultra thin woven
polyester, nitinol ring stents, tantalum markers
18 - 34mm $12,405.00
10.2.4.2 - Body and 1 limb
MC845 | Medtronic Australasia Pty Ltd Endurant AAA Stent Graft Bifurcation |
Endurant Endoluminal Stent Graft System - |
23 - 36mm x 13 - 20mm x 135 -185mm |
$8,955.00 |
|
| Bifurcated Graft |
|
|
MC997 | Endurant II AAA Stent Graft | Endurant II Endoluminal Stent Graft System - | Proximal diameters: 23 to 36mm; Distal | $8,955.00 |
| Bifurcation | Bifurcated Graft | diameters: 13 to 20mm; Covered lengths: 124 |
|
|
|
| to 166mm |
|
MI173 | Endurant IIs AAA Stent Graft | Endurant IIs Endoluminal Stent Graft System - | Proximal diameters: 23 to 36 mm; Distal | $8,955.00 |
|
| Bifurcated Graft (body + single limb | diameters: 14 mm; Covered length: 103 mm |
|
|
| configuration), shorter ipsilateral leg |
|
|
Billing Code Product Name Description Size
Regional Health Care Group
Benefit
Benefit
Condition
RG001 Aorfix AAA Flexible Stent Graft
System with Aorflex Delivery Device HBB Main Body Stent Graft and HBL Contralateral Leg
W L Gore & Associates
The Lombard Medical bifurcated stent-graft system (Aorfix) is used to treat aortic, aorto- iliac and iliac aneurysms. The device is supplied in its delivery system.
Aorfix stent graft is a two-part modular implant comprising a bifurcated main body section and a straight contralateral limb section (the "plug- in"). The main body section bifurcates into a full-length ipsilateral iliac section and a contralateral short leg mating section (the "socket"). The plug-in is mated intraoperatively to the socket to form the complete bifurcated system.
Each of the two components is supplied pre- loaded into a delivery system comprising a catheter with built-in deployment handle. The catheter for the main body section has a hydrophilic coating on its outer surface. The self-expanding implant is fabricated from nitinol (an alloy of nickel and titanium) and a woven polyester fabric (synthetic textile). Proximal hooks, also fabricated from nitinol, are provided in the main body section to resist migration.
SG-HBB-D1-L1-L2-D2-A12-22, where: D1 (mm): 24, 25, 26,27, 28, 29, 30 31
L1 (mm): 81, 96, 111, 126
L2 (mm): 63, 80, 97
D2 (mm): 12, 14, 16, 18, 20
SG-HBL-L3-D3-A13-20, where: D3 (mm): 10, 12, 14, 16, 18, 20
L3 (mm): 56, 64, 73, 81, 90, 98,106
$8,955.00
GT024 Excluder AAA Endovascular
Prostheses
AAA Abdominal Stent Graft Nitinol & ePTFE - two piece system (1/2) Trunk - Ipsilateral Limb
23-28.5mm Diameter, 14-18cm Length $8,955.00
GT263 GORE EXCLUDER AAA
Endoprosthesis
10.2.4.3 - Body only
AAA Stent Graft Nitinol & ePTFE Two piece system (1/2) Trunk-ipsilateral component
Diameters: 23, 26, 28.5, 35mm
Lengths: 12, 14, 16, 18cm Diameters: 31mm Lengths: 13, 15, 17cm Diameters: 35mm Lengths: 14, 16, 18cm
$8,955.00
MN178 InCraft AAA Stent-Graft System - Aortic Bifurcate
Bifurcated main body 22-34mm diameter, 86-94mm length $5,794.00
Billing Code Product Name Description Size
WILLIAM A COOK AUSTRALIA PTY LTD
Benefit
Benefit
Condition
WC261 Zenith Fenestrated AAA
Endovascular Graft with Flexor
Distal Bifurcated Body with Flexor sheath Diameter 12 - 24mm, 1st length 28 - 62mm,
2nd length 76 - 121mm
$5,794.00
WC277 Zenith Flex AAA Endovascular Graft with the Z-Trak Introduction
System - main body
Zenith Flex with Z-trak main body - AAA endovascular graft
Diameter - 22mm - 36mm. Length 82mm - 149mm.
$5,794.00
WC293 Zenith Low Profile AAA
Endovascular Graft - Bifurcated Main Body
WC332 Zenith Alpha Abdominal
Endovascular Graft
10.2.5 - Branched
Bifurcated main body graft Diameter: 22-36mm, Length: 70-128mm $5,794.00
Bifurcated main body graft Diameters:22-36mm. Lengths: 70-128mm $5,794.00
WC233 Zenith Branch Endovascular Graft -
Iliac Bifurcation
Bifurcated branch vessel stent graft with openings to connect the common iliac, sidebranch, and external iliac segments. Made of stainless steel and nitinol z-stents and woven polyester, mounted on H&LB one shot delivery system
Common iliac lengths 45 or 61mm, external iliac lengths 41 or 58mm and distal cuff diameters 10 or 12mm
$7,500.00
W L Gore & AssociatesGT276 GORE EXCLUDER Iliac Branch Endoprosthesis
The GORE EXCLUDER IBE provides an endovascular option for treatment allowing preservation of perfusion to the internal iliac, versus occlusion and covering the internal iliac or open surgical alternatives. The The GORE EXCLUDER IBE consists of two components (Iliac Branch Component: 1 of 2).
CEB231010 - Internal Iliac Diameter: 6.50- 9mm
CEB231210 - Internal Iliac Diameter: 10-
11mm
CEB231410 - Internal Iliac Diameter: 12 - 13.5mm
$7,500.00
Billing Code Product Name Description Size
10.02.05.02 - Multiple Branch
WILLIAM A COOK AUSTRALIA PTY LTD
Benefit
Benefit
Condition
WC312 Zenith Universal Distal Body
Endovascular Graft
L
The Zenith Universal Distal Body Endovascular Graft (Unibody) consists of a bifurcated graft loaded into the H&L-B One-Shot delivery system
Diameters: 22 - 24mm Lengths: 81 - 32mm
$7,500.00
WC313 Zenith t-Branch Endovascular Graft The t-Branch is an endovascular graft designed
for use in the thoracabdominal aorta.
Diameter: 34mm Length: 202mm
$14,500.00
WC263 Zenith Fenestrated AAA
Endovascular Graft with Flexor
Proximal Fenestrated body with Flexor sheath 1 or 2 internal stents, 24 - 36mm Diameter,
73 - 129mm Length
$8,561.00
WC188 Zenith Thoracic Endovascular Graft Thoracic Body Extension 22mm to 42mm diameter; 77mm to 81mm
length
$6,300.00
WC274 Zenith TX2 TAA Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (thoracic body extension)
WC306 Zenith TX2 Dissection Endovascular Graft with Pro-Form and the Z-Trak Plus Introduction System (thoracic body extension)
Thoracic Proximal Extension Diameter - 22mm - 42mm Length - 77mm - 81mm
Thoracic Proximal Extension Diameter 22mm - 42mm; Length 79mm - 83mm
$6,300.00
$6,300.00
WC328 Zenith Alpha Thoracic Endovascular Graft Distal Extension
Thoracic Distal Extension Diameter: 18-46mm. Length: 91-160mm $6,300.00
Billing Code Product Name Description Size
10.2.7.2 - Abdominal
Benefit
Benefit
Condition
Medtronic Australasia Pty Ltd
MC158 Talent Aortic Extension Stent Graft Talent Endoluminal Stent Graft - Aortic
Extension
MC849 Endurant AAA Aortic Extension Endurant Endoluminal Stent Graft System -
Aortic Extension
22 - 36mm x 26 - 30mm $2,555.00
23 - 36mm x 60mm $2,555.00
MI061 Endurant II AAA Aortic Extension Endurant II Endoluminal Stent Graft System -
Aortic Extension
Proximal diameter: 23 to 36mm; distal diameter: 23 to 36mm; Covered length: 49mm
$2,555.00
RG004 Aorfix AAA Flexible Stent Graft
System with Aorflex Delivery Device HPE Helical Proximal Extender
Terumo Australia
The proximal extender (cuff) is supplied in the same delivery system as the main aortic implant and
includes a hydrophilic coating.
The cuff is a short implant which has four pairs of barbs, a seam and a fishmouth shape identical to the
primary graft. The fishmouth at the proximal end of the cuff should be deployed with the same
orientation as that of the primary graft.
The cuff has radio-opaque marker wires around the proximal and distal circumferences and down its
seam.
The apex of the fishmouth which contains the longitudinal seam is slightly stiffer than the opposite apex
and tends to lie slightly higher in the artery. The cuff can be placed with the seam lying either anteriorly
or posteriorly.
The cuff is prepared identically to the primary graft and is introduced over a guidewire.
SG-HPE-D4-L4-A12-22, where:
D4 (mm): 24, 25, 26, 27, 28, 29, 30, 31
L4 (mm): 38
$2,555.00
TU003 Anaconda Endovascular Graft System Aortic Extension Cuff. Ultrathin woven
polyester, nitinol ring stents, tantalum markers
18 - 34mm $2,555.00
Billing Code Product Name Description Size
W L Gore & Associates
Benefit
Benefit
Condition
GT189 GORE EXCLUDER AAA
Endoprosthesis
Abdominal Stent Graft Nitinol & ePTFE - Aortic Extender
Diameters: 23, 26, 28.5mm Lengths: 3.3cm
Diameters: 32mm Length: 4.5cm Diameter: 36mm Length: 4.5cm
$2,555.00
WC045 Zenith Endovascular Graft Converter Diameter 20 through 36 Length 80-85
$2,555.00
WC048 Zenith Endovascular Graft Body Extensions Diameter 22 through 36 $2,555.00
WC302 Zenith Low Profile AAA
Endovascular Graft - Converter
WC303 Zenith Low Profile AAA
Endovascular Graft - Main Body Extension
Converter Proximal Diameter: 24-36mm, Distal Diameter: 12mm, Working Length: 66mm
Main Body Extension Diameter: 22-36mm, Working Length: 45- 58mm
$2,555.00
$2,555.00
MC846 Endurant AAA Contralateral Iliac
Limb
Endurant Endoluminal Stent Graft System - Contralateral Iliac Limb
10 - 28mm X 80 - 120mm $3,308.00
MC848 Endurant AAA Iliac Extension Endurant Endoluminal Stent Graft System -
Iliac Extension
10 - 28mm x 80mm $3,308.00
MC994 Endurant II AAA Contralateral Iliac
Limb
Endurant II Endoluminal Stent Graft System - Contralateral Iliac Limb
Proximal diameter: 16mm; Distal diameter: 10 to 28mm; Covered length: 82mm; 93mm; 124mm
$3,308.00
MC995 Endurant II AAA Iliac Extension Endurant II AAA Iliac Extension Proximal diameter: 10 to 28mm; Distal
diameter: 10 to 28mm; Covered length: 82mm
$3,308.00
TU004 Anaconda Endovascular Graft System Iliac Extension Cuff. Ultrathin woven polyester,
nitinol ring stents, tantalum markers
TU005 Anaconda Endovascular Graft System Iliac Leg, Ultrathin woven polyester, nitinol
ring stents, tantalum markers
8 - 18mm $3,308.00
8 - 23mm $3,308.00
TU041 Anaconda Endovascular Graft System Flared iliac limb, Ultrathin woven polyester,
nitinol ring stents, tantalum markers
Diameter: Proximal end 10-17mm, distal end 12-23mm: Length 80-130mm
$3,308.00
Billing Code Product Name Description Size
W L Gore & Associates
Benefit
Benefit
Condition
GT188 EXCLUDER AAA Endovascular
Prostheses
GT190 Excluder AAA Endovascular
Prostheses
AAA Stent Graft Nitinol & ePTFE Two piece system (2/2) Contralateral Limb
Abdominal Stent Graft Nitinol & ePTFE - Iliac Extender
Diameters: 12, 14.5, 23, 27mm
Lenghts: 10, 12, 14cm
Diameters: 16, 18, 20mm
Lenghts: 9.5, 11.5, 13.5cm
Diameters: 10, 12, 14.5mm Lengths: 7cm
$3,308.00
$3,308.00
WC259 Zenith AAA Endovascular Graft
Contralateral/Ipsilateral Iliac Legs
WC286 Zenith® Spiral-Z AAA lliac Legs
with Z-Trakâ„¢ Introduction System
L (long length)Medtronic Australasia Pty Ltd
Leg extension with Captor valve Diameters from 8 to 24mm, lengths from 37 to 122mm
Zenith® Spiral-Z AAA lliac Leg Proximal Diameter - 13mm Distal Diameter - 9mm to 24 mm
Working Length - 39 mm to 122 mm
$3,308.00
$3,308.00
MC996 Endurant II AAA Contralateral Iliac
Limb
Endurant II Endoluminal Stent Graft System - Contralateral Iliac Limb
Proximal diameter: 16mm; Distal diameter: 10 to 28mm; Covered length: 156mm, 199mm
$4,350.00
ER192 Ovation Prime Abdominal Stent Graft System - "Iliac Limb"
ER193 Ovation Prime Abdominal Stent Graft System - "Iliac Extension"
ER205 Endologix AFX Endovascular AAA
Stent Graft System-Iliac limb extensions
Ovation Prime Abdominal Stent Graft System - "Iliac Limb"
Ovation Prime Abdominal Stent Graft System - "Iliac Extension"
Endologix AFX Endovascular AAA Stent Graft System-Iliac limb extensions
Diameter: 10mm, 12mm, 14mm, 16mm, 18mm, 22mm
Length: 80-140mm
Diameter: 10mm, 12mm, 14mm, 16mm, 18mm, 22mm
Length: 45mm
Covered diameter straight or flared or stepped (16-25 mm) x length (55-88 mm)
$3,308.00
$3,308.00
$3,308.00
MN179 InCraft AAA Stent-Graft System - Iliac Limb/Extension
Contralateral/Ipsilateral lliac limbs and extensions
10-24mm diameter, 80-140mm length $3,308.00
Billing Code Product Name Description Size
Regional Health Care Group
Benefit
Benefit
Condition
RG002 Aorfix AAA Flexible Stent Graft
System with Aorflex Delivery Device HBC Helical Converter
The Lombard Medical bifurcated stent-graft system (Aorfix) is used to treat aortic, aorto- iliac and iliac aneurysms. Standard techniques for the use of vascular access sheaths, angiography, guidewires and contrast media should be employed.The device is supplied in its delivery system, sterilised by means of ethylene oxide (EtO). It is packaged in peel- open pouches.
Aorfix stent graft is a two-part modular implant comprising a bifurcated main body section and a straight contralateral limb section (the "plug- in"). The main body section bifurcates into a full-length ipsilateral iliac section and a contralateral short leg mating section (the "socket"). The plug-in is mated intraoperatively to the socket to form the complete bifurcated system.
Each of the two components is supplied pre- loaded into a delivery system comprising a catheter with built-in deployment handle. The catheter for the main body section has a hydrophilic coating on its outer surface. The self-expanding implant is fabricated from nitinol (an alloy of nickel and titanium) and a woven polyester fabric (synthetic textile). Proximal hooks, also fabricated from nitinol, are provided in the main body section to resist migration.
Converters are used after implantation of the bifurcated body, if implantation of the contralateral limb proves impossible. The system converts the bifurcated main body into an aorto uni-iliac stent graft. If revising to a mono-iliac approach, use a femero-femoral cross-over graft to perfuse the contralateral side and occlude the contralateral common iliac artery. The converter delivery system is identical to the body delivery system.
SG-HBC-D6-A12-22, where: D6(mm): 25, 27, 29, 31
$3,308.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
RG003 | Aorfix AAA Flexible Stent Graft | The Lombard Medical bifurcated stent-graft | SG-HDE-D5-L5-A13-20, where: | $3,308.00 |
|
|
| System with Aorflex Delivery Device | system (Aorfix) is used to treat aortic, aorto- | D5 (mm): 10, 12, 14, 16, 18, 20 |
|
|
|
| HDE Distal Extender | iliac and iliac aneurysms. Standard techniques | L5 (mm): 51, 82 |
| ||
|
| for the use of vascular access sheaths, |
| |||
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| angiography, guidewires and contrast media |
| |||
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| should be employed.The device is supplied in |
| |||
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| its delivery system, sterilised by means of |
| |||
|
| ethylene oxide (EtO). It is packaged in peel- |
| |||
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| open pouches. |
| |||
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| Aorfix stent graft is a two-part modular implant |
| |||
|
| comprising a bifurcated main body section and |
| |||
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| a straight contralateral limb section (the "plug- |
| |||
|
| in"). The main body section bifurcates into a |
| |||
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| full-length ipsilateral iliac section and a |
| |||
|
| contralateral short leg mating section (the |
| |||
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| "socket"). The plug-in is mated intraoperatively |
| |||
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| to the socket to form the complete bifurcated |
| |||
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| system. |
| |||
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| Each of the two components is supplied pre- |
| |||
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| loaded into a delivery system comprising a |
| |||
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| catheter with built-in deployment handle. The |
| |||
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| catheter for the main body section has a |
| |||
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| hydrophilic coating on its outer surface. The |
| |||
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| self-expanding implant is fabricated from |
| |||
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| nitinol (an alloy of nickel and titanium) and a |
| |||
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| woven polyester fabric (synthetic textile). |
| |||
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| Proximal hooks, also fabricated from nitinol, |
| |||
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| are provided in the main body section to resist |
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| migration. |
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| Distal extenders for extending the distal legs, |
| |||
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| are supplied pre-packed in delivery systems. |
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| The distal extender system is identical to the |
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| plug in leg delivery system. |
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W L Gore & AssociatesGT277 GORE EXCLUDER Iliac Branch Endoprosthesis
The GORE EXCLUDER IBE provides an endovascular option for treatment allowing for preservation of perfusion to the internal iliac, versus occlusion and covering the internal iliac or open surgical procedures.
The GORE EXCLUDER IBE consists of two components (Internal Iliac Component: 2 of 2).
HGB 161007 - Internal Iliac Diameter: 6.5 - 9mm
HGB 161207 - Internal Iliac Diameter: 10- 11mm
HGB 161407 - Internal Iliac Diameter: 12 - 13.5mm
$3,308.00
Billing Code Product Name Description Size
WILLIAM A COOK AUSTRALIA PTY LTD
Benefit
Benefit
Condition
WC330 Zenith Alpha Spiral-Z Endovascular
Leg
Accessory KitMaquet Australia Pty Ltd
Iliac leg graft Distal Diameters: 9-24mm. Graft lengths: 42- 125mm.
$3,308.00
MQ037 Nellix EndoVascular Aneurysm
Sealing System Accessory Kit, Dispensor and Polymer
Accessory Kit (console, reciprocal connectors with caps and four mixers, pressure tranducers), Dispensor (with insufflator and syringes), and dual chamber polypropylene cartridge filled with aqueous polyethylene glycol based solution that are designed to be mixed at the time of the procedure
40ml (up to 80ml provided) $3,770.00
Billing Code Product Name Description Size
L (long length, >150mm) Terumo Australia
Benefit
Benefit
Condition
TU057 Anaconda AAA Stent Graft System Ultrathin woven polyester, nitinol ring stents,
tantalum markers (longer legs lengths >150mm).
Long limbs have not got ARTG, but the Anaconda Stent Graft System does with regular limbs (ARTG173321 and 172404).
The Anaconda AAA Stent Graft System is a device support structure that expands and stays in place inside a blood carrying vessel for isolated iliac aneurysm repair and a component of the AAA stent graft system. It is delivered to the intended landing zone by a delivery system, where the stent is expanded to provide support for the vessel The stent graft remains in place as a permanent implant.
The patient is hospitalised and undergoing invasive surgery of implantation of the stent graft.
Tapered Legs
Outer Diameter (Proximal 12mm; Distal 10mm) x Length 150mm
Outer Diameter (Proximal 12mm; Distal
10mm) x Length 170mm
Flared Legs
Outer Diameter (Proximal 12mm; Distal 13mm) x Length 150mm
Outer Diameter (Proximal 12mm; Distal
13mm) x Length 170mm
Outer Diameter (Proximal 12mm; Distal 15mm) x Length 150mm
Outer Diameter (Proximal 12mm; Distal 15mm) x Length 170mm
Outer Diameter (Proximal 12mm; Distal 17mm) x Length 150mm
Outer Diameter (Proximal 12mm; Distal 17mm) x Length 170mm
Outer Diameter (Proximal 12mm; Distal 19mm) x Length 150mm
Outer Diameter (Proximal 12mm; Distal
19mm) x Length 170mm
Outer Diameter (Proximal 12mm; Distal 21mm) x Length 150mm
Outer Diameter (Proximal 12mm; Distal
21mm) x Length 170mm
Outer Diameter (Proximal 12mm; Distal 23mm) x Length 150mm
Outer Diameter (Proximal 12mm; Distal 23mm) x Length 170mm
$4,350.00
Emergo Asia Pacific Pty Ltd
ER194 Ovation Prime Abdominal Stent Graft System - Fill Polymer Kit
Ovation Prime Abdominal Stent Graft System - Fill Polymer Kit
Straight Legs
Outer Diameter 12mm x Length 160mm Outer diameter 12mm x Length 180mm
N/A $680.00
Billing Code Product Name Description Size
10.2.9 - Iliac Graft Plug
Benefit
Benefit
Condition
Medtronic Australasia Pty Ltd
MC203 Talent Occluder System Nitinol stents attached to polyester graft sealed
both ends
Standard Sizes, 8 - 24mm x 31 - 35mm $2,555.00
WC103 Zenith Iliac Plug Zenith AAA Endovascular Graft Diameter 14, 16, 18, 20, 22, 24mm $2,555.00
10.2.10 - Tube, Peripheral, Balloon Expandable
BA264 LifeStream Balloon Expandable Covered Stent
Maquet Australia Pty Ltd
The LifeStream Balloon Expandable Vascular Covered Stent is comprised of an ectropolished balloon-expandable stent made from 316L stainless steel, encapsulated between two layers of ePTFE.
Implant Length: 16mm, 26mm, 37/38mm*,58mm
Implant Diameter: 5mm, 6mm, 7mm, 8mm,
9mm, 10mm, 12mm
* Diameters 5-8mm are offered in 37mm length, and diameters 9-12 are offered in 38mm length
$4,185.00
MQ006 Advant PTFE V12 Stent Graft System Balloon Expandable PTFE Encapsulated
Stainless Steel Peripheral Vascular Stent
5mm - 12mm Diameter $4,185.00
PY039 BeGraft Peripheral Stent Graft System Balloon Expandable "One layer" Biocompatible
CoCr Alloy and Micro-porous ePTFE Peripheral Vascular Stent
Diameter: 5mm - 12mm length: 18mm - 58mm
$4,185.00
MQ035 Advanta V12 Stent Graft System Balloon Expandable PTFE Encapsulated
Stainless Steel Vascular Stent
Large Diameter 12 -16mm. 80 and 120cm catheter lengths
$5,695.00
Billing Code Product Name Description Size
10.2.11 - Tube, Peripheral, Self Expandable
10.2.11.1 - <150mm length
Benefit
Benefit
Condition
Bard Australia Pty Ltd
BA219 Encapsulated Carbon Lined Stent
Graft
W L Gore & Associates
PTFE covered nitinol self-expanding stent 4mm - 13.5mm diameter, 2cm - 12cm length $3,395.00
GT029 Gore Tips Endoprosthesis ePTFE 8-12mm Diameter 4-8cm Graft-Lined Length 2cm Unlined Length
$3,395.00
W L Gore & Associates
GT225 Gore Viabahn ® endoprosthesis with heparin bioactive surface
GT227 Gore Viabahn ® endoprosthesis with heparin bioactive surface
Gore Viabahn ® endoprosthesis with heparin bioactive surface is a flexible, self expanding endoluminal device consisting of an ePTFE lining with external nitinol support
Gore Viabahn ® endoprosthesis with heparin bioactive surface is a flexible, self expandinbg endoluminal device consisting of an ePTFE lining with external nitinol support
5mmx2.5cm 120cm 5mmx5cm 120cm 6mmx2.5cm 120cm 6mmx5cm 75cm 6mmx5cm 120cm 7mmx2.5cm 120cm 7mmx5cm 75cm
7mmx5cm 120cm 8mmx2.5cm 120cm 8mmx5cm 75cm 8mmx5cm 120cm 9mmx 5cm 75cm 9mmx 5cm 120cm 10mmx 5cm 75cm
10mmx 5cm 120cm 11mmx 5cm 75cm 11mmx 5cm 120cm 13mmx 5cm 75cm 13mmx 5cm 120cm
5mmx 10cm 120cm 6mmx 10cm 75cm 6mmx 10cm 120cm 7mmx 10cm 75cm 7mmx 10cm 120cm 8mmx 10cm 75cm 8mmx 10cm 120cm 9mmx 10cm 75cm 9mmx 10cm 120cm 10mmx 10cm 75cm 10mmx 10cm 120cm 11mmx 10cm 75cm 11mmx 10cm 120cm 13mmx 10cm 75cm 13mmx 10cm 120cm
$3,495.00
$3,495.00
Billing Code Product Name Description Size
10.2.11.2 - 150-249mm length
H
Benefit
Benefit
Condition
W L Gore & Associates
GT226 Gore Viabahn ® endoprosthesis with heparin bioactive surface
10.2.11.3 - ≥250mm length
Gore Viabahn ® endoprosthesis with heparin bioactive surface is a flexible, self expanding endoluminal device consisting of an ePTFE lining with external nitinol support
5mmx 15cm 120cm, 6mmx 15cm 75cm 6mmx 15cm 120cm 7mmx 15cm 75cm 7mmx 15cm 120cm 8mmx 15cm 75cm 8mmx 15cm 120cm 9mmx 15cm 75cm 9mmx 15cm 120cm 10mmx 15cm 75cm, 10mmx 15cm 120cm 11mmx 15cm 75cm 11mmx 15cm 120cm 13mmx 15cm 75cm 13mmx 15cm 120cm
$4,125.00
GT262 GORE VIABAHN® Endoprosthesis with Heparin Bioactive Surface
10.3.1 - Tube
GORE VIABAHN® Endoprosthesis with Heparin Bioactive Surface is a flexible, self expanding endoluminal device consisting of an ePTFE lining with external nitinol support
5mm x 25cm x 120CATH 6mm x 25cm x 120CATH 7mm x 25cm x 120CATH 8mm x 25cm x 120CATH
$5,625.00
BB025 Vascular Uni - Graft Vascular graft 10cm $245.00
Emergo Asia Pacific Pty LtdER168 LifeSpan ePTFE vascular grafts-
straight, regular or thin wall-10cm
W L Gore & Associates
LifeSpan ePTFE vascular grafts-straight, regular or thin wall-5-8 mm dia x length 10cm
5-8 mm dia x 10 cm long $245.00
GT272 Gore-Tex Vascular Grafts Vascular Grafts - Aorto-Pulmonary & Synthetic-
Pulmonary Shunts (ePTFE) Stretch & Non Stretch Standard wall & Thin Wall
GT284 Gore-Tex Vascular Grafts Vascular Grafts - Aorto - Pulmonary and
Systemic Pulmonary Shunts (ePTFE) Stretch & Non Stretch Standard Wall & Thin Wall.
Diameter 3.5 - 5mm, Length 5-10cm $245.00
Diameter 3 - 12mm, Length 10cm $245.00
Terumo Australia
TU029 SEALPTFE Graft Standard Wall, Straight, Sealed, Externally Reinforcement, PTFE
5 to 10mm x 10 to 40cm $655.00
Billing Code Product Name Description Size
10.3.1.2 - 11-20cm length
Benefit
Benefit
Condition
B Braun Australia Pty Ltd
BB023 Vascular Uni - Graft Vascular graft 20cm $800.00
BB024 Vascular Uni - Graft Vascular graft 15cm $800.00
BB126 Vascugraft Thin Wall Straight Dia 3 - 8mm, length10 - 40cm $800.00
BB127 Vascugraft Thin Wall Straight Dia 3 - 8mm, length 10 - 40cm $800.00
Bard Australia Pty LtdBA020 Impra PTFE Vascular Grafts ePTFE graft - thin wall, 10 - 50cm long 3mm - 10mm diameter $800.00 BA025 Impra PTFE Vascular Grafts ePTFE graft - regular wall, 10-50cm long             3 - 19mm diameter             $800.00
BN004 Omniflow II Vascular Prosthesis -
Straight
Emergo Asia Pacific Pty LtdER169 LifeSpan ePTFE vascular grafts-
straight-regular or thin wall-20cm
LH006 Thoratec, Vectra Vascular Graft -
Synthetic
Biosynthetic vascular prosthesis for peripheral revascularisation and vascular access
LifeSpan ePTFE vascular grafts-straight-regular or thin wall; 5-8mm dia x 20 cm long
Vectra, Biocompatible Polyurethane Vascular Access Graft
3 - 4 mm x 20 cm $800.00
5-8 mm dia x 20 cm long $800.00
Length 20cm $800.00
MQ029 Intergard W - Woven Straight Woven Straight 15cm $800.00
Terumo AustraliaTU048 Gelweave Graft Straight Polyester Knitted 6-38mm x 15-20cm $800.00 TU049 SEALPTFE Graft Standard Wall, Straight, Sealed, PTFE             5 to 10mm x 10 to 20cm             $800.00
GT009 Gore-Tex Vascular Grafts Vascular Grafts - Aorto -Pulmonary &
Systemic-Pulmonary Shunts (ePTFE) Stretch & Non Stretch Standard Wall & Thin Wall
3.5-5mm Diameter x 15-20cm Length $800.00
GT146 Gore-tex Vascular Grafts Standard Wall Grafts Stretch (ePTFE) Diameter 12 - 24mm, Length 20cm $800.00
GT283 Gore Tex Vascular Grafts Standard Wall, Thin Wall and Stretch and Non
Stretch (ePTFE)
Diameters: 3 - 10mm Length: 11-20cm
$800.00
Billing Code Product Name Description Size
R
Benefit
Benefit
Condition
B Braun Australia Pty Ltd
BB120 Vascugraft Straight Standard Wall with Helix Support Dia 6 - 10mm, length 10 - 50cm $1,520.00
Bard Australia Pty LtdBA019 Impra PTFE Vascular Grafts ePTFE graft - radially supported, thin wall, 10 -
50cm long
BA022 Impra PTFE Vascular Grafts ePTFE graft - radially supported, regular wall,
10-50cm long
4mm - 8mm diameter $1,520.00
4 - 19mm diameter $1,520.00
MQ020 Advanta PTFE Vascular Graft Trilaminate PTFE Graft with Graft Deployment
System
4mm - 8mm 11cm - 20cm length $1,520.00
Maquet Australia Pty Ltd
MQ018 Advanta PTFE Vascular Graft with
Graft Deployment System
10.3.1.3 - 21-49cm length
Trilaminate PTFE. Vascular Access PTFE 4mm - 8mm diameter 11cm - 20cm length $1,720.00
BB021 Vascular Uni - Graft Vascular graft 40cm $870.00
BB022 Vascular Uni - Graft Vascular graft 30cm $870.00 BB119 Vascugraft PTFE, Straight Standard Wall Dia 4 - 10mm, length 40 - 50cm $870.00 BB142 Vascugraft Easy Glide - Standard Wall Straight Dia 6mm, length 40 - 60cm $870.00 BB144 Vascugraft Easy Glide - Thin Wall Straight Dia 6 - 8mm, length 40 - 70cm $870.00
BN026 Omniflow II Vascular Prosthesis Biosynthetic vascular prosthesis for peripheral
revascularisation and vascular access
BN027 Omniflow II Vascular Prosthesis Biosynthetic vascular prosthesis for peripheral
revascularisation and vascular access
BN028 Omniflow II Vascular Prosthesis Biosynthetic vascular prosthesis for peripheral
revascularisation and vascular access
BN029 Omniflow II Vascular Prosthesis Biosynthetic vascular prosthesis for peripheral
revascularisation and vascular access
9 and 10mm internal diameter, 20 to 40cm length
5, 6, 7 and 8mm internal diameter; 45 to 65cm length
9 and 10mm internal diameter; 45 to 85cm length
5, 6, 7 and 8mm internal diameter; 20 to 40cm length
$870.00
$870.00
$870.00
$870.00
Billing Code Product Name Description Size
Lifehealthcare Pty Ltd
Benefit
Benefit
Condition
LH004 Thoratec, Vectra Vascular Graft -
Synthetic
Maquet Australia Pty Ltd
Vectra, Biocompatible Polyurethane Vascular Access Graft
Length 40cm $870.00
MQ030 Maquet InterVascular Straight vascular Grafts
Terumo Australia
Straight Vascular Grafts 5mm - 24mm diameter, 21 -49am length $870.00
TU008 Fluoropassiv Graft Straight Graft - Thin Wall, Crimped.
Fluoropolymer/polyester, Knitted
5 to10mm x 30 to 40cm $870.00
TU020 Gelsoft Plus Graft Straight, Polyester, Knitted 6 - 24mm x 12.5 - 30cm $870.00 TU025 SEALPTFE Graft Thin Wall, Straight, Sealed, PTFE 5 to 10mm x 30 to 40cm $870.00 TU047 Gelweave Graft Straight Polyester Knitted 6-38mm x 25-40cm $870.00 TU050 SEALPTFE Graft Standard Wall, Straight, Sealed, PTFE 5 to 10cm x 20 to 40cm $870.00
GT281 Gore Tex Vascular Grafts Standard Wall, Thin Wall and Stretch and Non
Stretch (ePTFE)
GT282 Gore-Tex Vascular Grafts Stretch Vascular Grafts - Large Diameter
(ePTFE)
Diameters: 3 - 10mm Length: 21-49cm
Diameters: 12 - 24mm Lengths: 21 - 49cm
$870.00
$870.00
W L Gore & Associates
GT221 Gor-Tex Propaten Vascular Graft Stretch wall, Thin Wall Stretch and Non Stretch
Graft (ePTFE) - Heparin Bonded
6-8mm diameter, non-Ringed 40cm length $970.00
Terumo Australia
TU040 Rapidaxâ„¢ Rapid Access Haemodialysis Graft
R
Triple layered self sealing haemodialysis Access Graft. ePTFE internal and external layer with proprietary elastomer inner layer - Straight and Per-curved
6mm x 45-50cm $1,300.00
BB132 Vascugraft Thin Wall Centre Helix Dia 6mm, length 45cm $1,520.00 BB133 Vascugraft Thin Wall Centre Helix             Dia 5 - 6mm, length 45 - 50cm             $1,520.00
BB146 Vascugraft Easy Glide - Thin Wall Straight with Helix Support
Dia 6 - 8mm, length 40 - 80cm $1,520.00
Billing Code Product Name Description Size
Maquet Australia Pty Ltd
Benefit
Benefit
Condition
MQ009 Advantra PTFE Vascular Graft Trilaminate PTFE Aortic Graft with hydrostatic
membrane
MQ021 Advanta PTFE Vascular Graft Trilaminate PTFE Graft with Graft Deployment
System
12mm - 24mm diameter 30cm length $1,520.00 4mm - 8mm diameter 21cm - 49cm length $1,520.00
TU010 Fluoropassiv Graft Straight Graft, Thin Wall, Externally Reinforced. Fluoropolymer/polyester, Knitted
TU019 Gelsoft Plus Graft Femoro-femoral, Polyester, Knitted, Externally reinforced
5 to10mm x 30 to 40cm $1,520.00
6mmx30cm to 8mmx40cm $1,520.00
R (ringed)W L Gore & Associates
GT211 | Gore-Tex Intering Vascular Graft | Internally radially supported vascular graft (ePTFE) | Diameter 6-8mm, 40cm radial supported length x 40cm length | $1,520.00 |
GT252 | Gore-Tex Stretch Removable Ringed Vascular Graft | Stretch Removable Ringed Thin Walled Graft (ePTFE) | 5-8mm diameter, 40cm length, 30cm removable ringed section | $1,520.00 |
R, H
W L Gore & Associates
GT264 | Gore-Tex Propaten Vascular Graft | Stretch Thin Walled Graft, Removable Rings | 8mm diameter, 30cm ringed length | $1,620.00 |
|
| (ePTFE) Heparin Bonded |
|
|
R, ID
Maquet Australia Pty Ltd
MQ019 | Advanta PTFE Vascular Graft with | Trilaminate PTFE. Vascular Access PTFE | 4mm - 8mm diameter 21cm - 49cm length | $1,720.00 |
| Graft Deployment System |
|
|
|
10.3.1.4 - ≥50cm length
B Braun Australia Pty Ltd
BB018 | Vascular Uni - Graft | Vascular graft | 100cm | $970.00 |
BB019 | Vascular Uni - Graft | Vascular graft | 60cm | $970.00 |
BB020 | Vascular Uni - Graft | Vascular graft | 50cm | $970.00 |
BB123 | Vascugraft | PTFE - Straight Standard Wall | Dia 5 - 10mm, length 80cm | $970.00 |
BB124 | Vascugraft | PTFE - Straight Standard Wall | Dia 5 - 8mm, length 90 - 100cm | $970.00 |
BB125 | Vascugraft | Thin Wall Straight | Dia 3 - 8mm, length 70 - 100cm | $970.00 |
BB141 | Vascugraft | Easy Glide - Standard Wall Straight | Dia 6mm, length 70 - 80cm | $970.00 |
Billing Code Product Name Description Size
Bard Australia Pty Ltd
Benefit
Benefit
Condition
BA254 Bard Vascular Graft PTFE graft 50 cm or > 50cm $970.00
Emergo Asia Pacific Pty LtdER170 LifeSpan ePTFE vascular grafts-
straight-regular or thin wall, 50-100 cm
Lifehealthcare Pty LtdLH005 Thoratec, Vectra Vascular Graft -
Synthetic
Maquet Australia Pty Ltd
LifeSpan ePTFE vascular grafts-straight-regular or thin wall, 5-10 mm dia x length 50-100 cm
Vectra, Biocompatible Polyurethane Vascular Access graft
5-10 mm dia x length 50-100 cm $970.00
Length 50cm $970.00
MQ016 Advanta PTFE Vascular Graft Straight PTFE Vascular Graft 6mm - 10mm; 50cm - 90cm $970.00
MQ031 Maquet InterVascular Straight Vascular Grafts
Terumo Australia
Straight Vascular Grafts 6mm - 24mm Diameter, 50-100cm length $970.00
TU006 Twillweave Graft Straight, Polyester, Woven, Unsealed 6-24mm x 50-60cm $970.00
TU009 Fluoropassiv Graft Straight Graft - Thin Wall, Crimped.
Fluoropolymer/polyester, Knitted
5 to10mm x 50 to 70cm $970.00
TU021 Gelsoft Plus Graft Straight, Polyester, Knitted 6-24mm x 50-60cm $970.00 TU023 Gelweave Graft Straight, Polyester, Woven 6-38mm x 50-60cm $970.00 TU026 SEALPTFE Graft Thin Wall, Straight, Sealed, PTFE 5 to 10mm x 50 to 80cm $970.00 TU028 SEALPTFE Graft Standard Wall, Straight, Sealed, PTFE 5 to 10mm x 50 to 80cm $970.00
GT279 Gore-Tex Vascular Grafts Standard Wall, Thin Wall and Stretch
Technology (ePTFE)
GT280 Gore-Tex Vascular Grafts Standard Wall, Thin Wall and Stretch
Technology (ePTFE)
Diameters: 3-12mm Lengths: ≥ 50cm
Diameters: 4-12mm Lengths: ≥ 50cm
$970.00
$970.00
W L Gore & Associates
GT222 Gore-tex Stretch Propaten Graft Standard wall, Thin Wall Stretch and non
Stretch Graft (ePTFE)- Heparin Bonded
6-8mm diameter Non-Ringed 80cm length $1,070.00
B Braun Australia Pty Ltd
BB121 | Vascugraft | Straight Standard Wall with Helix Support | Dia 6 - 10mm, length 60 - 80cm | $1,630.00 |
BB122 | Vascugraft | Straight Standard Wall with Helix Support | Dia 5 - 8mm, length 90cm | $1,630.00 |
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
BB128 | Vascugraft | Straight Standard Wall with Helix Support | Dia 6mm x length 100cm | $1,630.00 |
|
|
BB129 | Vascugraft | Straight Standard Wall with Helix Support | Dia 5 - 8mm, length 80 - 90cm | $1,630.00 |
|
|
BB130 | Vascugraft | Straight Standard Wall with Helix Support | Dia 4 - 6mm, length 50 - 70cm | $1,630.00 |
|
|
BB134 | Vascugraft | Thin Wall Centre Helix | Dia 4 - 8mm, length 70 - 80cm | $1,630.00 |
|
|
BB137 | Vascugraft | Standard with Centred Helix | Dia 4 - 8mm, length 70 - 90cm | $1,630.00 |
|
|
| Maquet Australia Pty Ltd |
|
|
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|
MQ010 | Advantra PTFE Vascular Graft | Trilaminate PTFE Graft with Graft Deployment System | 4 - 8mm diameter 50cm - 100cm lengths | $1,630.00 |
|
|
MQ017 | Atrium PTFE Vascular Graft | Ringed PTFE | 4mm - 10mm; 50cm - 100cm | $1,630.00 |
|
|
| Terumo Australia |
|
|
|
|
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TU011 | Fluoropassiv Graft | Straight Graft, Thin Wall, Externally Reinforced. Fluoropolymer/polyester, Knitted | 5 to10mm x 50 to 70cm | $1,630.00 |
|
|
TU030 | SEALPTFE Graft | Standard Wall, Straight, Sealed, Externally Reinforcement, PTFE | 5 to 10mm x 50 to 80cm | $1,630.00 |
|
|
TU045 | Gelsoft Plus Graft | Polyester, Externally Reinforced, Knitted | 6 to 10cm x 75 to 100cm | $1,630.00 |
|
|
TU046 | SEALPTFE Graft | Thin Wall, Straight, Sealed, Externally Reinforced, PTFE | 5 to 10mm x 50 to 80cm | $1,630.00 |
|
|
R (ringed)
Bard Australia Pty Ltd
BA255 | Bard Vascular Grafts | PFTE Graft - radial support | 50cm or > 50cm | $1,630.00 |
| Emergo Asia Pacific Pty Ltd |
|
|
|
ER171 | LifeSpan ePTFE vascular grafts- straight-supported-regular or thin wall, 50-80 cm | LifeSpan ePTFE vascular grafts-straight- supported; regular and thin wall; 6-10 mm dia x 50-80 cm length; 10-80 cm external spiral support length | 6-10 mm dia x 50-80 cm length; 10-80 cm external spiral support length | $1,630.00 |
| Maquet Australia Pty Ltd |
|
|
|
MQ032 | Maquet InterVascular redially Supported Vascular Grafts | Radially Supported Vascular Grafts | 5mm - 24mm diameter, 50 -100m length | $1,630.00 |
| W L Gore & Associates |
|
|
|
GT278 | Gore-Tex Stretch Vascular Graft - Removable Rings | Thin Walled Removable Ring Stretch (ePTFE) | Diameters: 5-8mm Lengths: ≥ 50cm | $1,630.00 |
GT286 | Gore-Tex Intering Stretch Vascular Graft | Stretch Thin Walled ePTFE graft with Integrated Rings | 6-8mm diameter, 60-80 mm intergrated ringed section, ≥50cm length | $1,630.00 |
R, H
W L Gore & Associates
GT285 Gore-Tex Stretch Propaten with
Removable Rings Vascular Graft
10.3.2 - Bifurcated
Stretch Thin Walled (ePTFE), Heparin Bonded, Graft with Removable Rings
6-8mm diameter, 30-70 mm ringed section, > 50cm length
$1,730.00
BB027 Vascular Uni - Graft - Bifurcated Vascular graft 12x7 to 12x12 $975.00
Maquet Australia Pty LtdMQ033 Maquet InterVascular Bifurcated Vascular Grafts
Terumo Australia
Bifurcated Vascular Grafts 6mm - 24mm diameter, 50cm length $975.00
TU007 Twillweave Graft Bifurcated, Polyester, Woven, Unsealed 12mm x 6mm x 45cm to 24mm x 12mm x
45cm
$975.00
TU013 Gelweave Graft Bifurcated, Polyester, Woven 12mmx 6mmx 45 cm to 24mmx12mm x 45cm $975.00 TU014 Gelsoft Plus Graft Bifurcated, Polyester, Knitted             12mmx6mmx45cm to 24mmx12mmx45cm             $975.00
GT006 Gore-Tex Stretch Bifurcated Graft Stretch Bifurcated Graft with Thin Walled
Limbs (ePTFE)
10.3.3 - Branched or Fenestrated
Maquet Australia Pty Ltd
12x6mm to 24x12mm 40-50cm long $975.00
MQ027 | Intergard W | Woven Aortic Arch | 24mm x 10mm x 8mm x 8mm x 50cm - 30mm x 10mm x 8mm x 8mm | $1,950.00 |
MQ028 | Intergard K | Knitted Axillobifemoral | Diameter (mm) Length (cm) 8 x 8 100/60; 10 x 10 100/60; 8 x 6 x 6 85/55; 8 x 8 85/55; 8 x 8 100/55 | $1,950.00 |
Terumo AustraliaTU018 Gelsoft Plus Graft Axillo-bifemoral, Polyester, Knitted, Externally reinforced
8x8mm/100x60cm; 8x7mm/90x40cm; 10x8mm/90x40cm
$1,950.00
W L Gore & AssociatesGT216 Gore-Tex Axillobifemoral Vascular
Graft
Stretch vascular graft with removable rings (ePTFE)
Diameter 8mm x 90cm 40cm $1,950.00
BB026 Vascular Uni - Graft - Tapered Vascular graft 12x6 to 24x12 $875.00 BB131 Vascugraft Thin Wall Tapered Dia 4 - 8mm, length 40 - 90cm $875.00 BB136 Vascugraft Standard Tapered Dia 4 - 8mm, length 70 - 90cm $875.00 BB138 Vascugraft Standard with Short Taper Dia 4 - 8mm, length 30 - 70cm $875.00 BB139 Vascugraft Standard with Short Taper Dia 4 - 8mm, length 80cm $875.00
BB143 Vascugraft Easy Glide - Standard Wall with Helix Short Taper
Dia 6 - 8mm, length 40 - 70cm $875.00
BB145 Vascugraft Thin Wall Centred Helix Tapered Dia 4 - 7mm, length 70cm $875.00 BB155 Vascugraft Standard Tapered Dia 4 - 7mm, length 30 - 70cm $875.00 BB156 Vascugraft Standard Wall with Tapered Centre Helix Dia 4 - 8mm, length 40 - 45cm $875.00 BB157 Vascugraft Standard Wall Stepped Taper Dia 4 - 8mm, length 40 - 45cm $875.00
MQ011 Advantra PTFE Vascular Graft Tapered Trilaminate PTFE Graft with Graft
Deployment System
MQ012 Advantra PTFE Vascular Graft Tapered Trilaminate PTFE Graft with Graft
Deployment System
4mm - 8mm diameter 50cm - 80cm lengths $875.00 4mm - 8mm diameter, 10 - 40cm lengths $875.00
TU033 SEALPTFE Graft Standard Wall, Tapered, Sealed, PTFE 4 to 7mm Taper x 45 to 50cm $875.00
IDMaquet Australia Pty Ltd
MQ013 Advantra PTFE Vascular Graft with
Graft Deployment System
Trilaminate PTFE. Vascular Access Graft 4mm - 8mm diameter. 50 - 80cm length $3,000.00
R (ringed)Getz Healthcare Pty Ltd
ME195 Spiral Laminar Flow â„¢ graft Spiral Laminar flow graft Length (cm) 50,60,70,80,50,60,70,80
Diameter(mm) 6, 6, 6, 6, 8, 8, 8, 8
$875.00
BA256 Bard Vascular Graft PTFE graft 6-10mm diameter, 40 - 80cm length
4mm - 8mm diameter, 10cm - 50cm length
7 & 8mm diameter. 50, 60, 70, 80cm lengths
$875.00
ER172 LifeSpan ePTFE vascular grafts-
tapered or end modified-regular or thin wall, 40-70 cm
LifeSpan ePTFE vascular grafts-unsupported, tapered or end modified, 4-7 mm dia x 40-70 cm long
4-7 mm dia x 40-70 cm long; $875.00
GT273 Standard Wall Grafts Standard Wall Grafts Stretch Tapered (ePTFE) Diameter 4-6mm & 4-7mm, Length 45 48cm $875.00
R (ringed)Emergo Asia Pacific Pty Ltd
ER173 LifeSpan ePTFE vascular grafts-
supported, tapered or end modified 50-80 cm
W L Gore & Associates
LifeSpan ePTFE vascular grafts-supported, end modified or tapered, regular or thin wall, 4-7 mm dia x 50-80 cm length; spiral length 5-70 cm
4-7 mm dia x 50-80 cm length; spiral length 5- 70 cm
$875.00
GT214 Gore-Tex Intering Vascular Graft Internally radially supported vascular graft
(ePTFE)
10.4.1 - Vascular Patches
4-6 tapered diameter 38cm radial support length 45cm length; 4-7 tapered diameter 38cm radial support length 45cm length; 6mm diameter 40cm radial support length 40cm length
$875.00
BB017 Vascular Patch Vascular patch 12x9 to 3x4 $205.00
Billing Code Product Name Description Size
Bard Australia Pty Ltd
BA257 Bard Vascular Graft Vascular Graft Patch 3x6cm, 2.5x1.5cm, 2x9cm, 5x7.5cm, 2.5x2.5cm, 10x10cm, 5.1x10.2cm, 6x5.1cm, 1.2x10cm, 5x5cm
Benefit
$205.00
Benefit
Condition
Bio Nova International Pty Ltd
BN020 Omniflow II Vascular Prostheses -
Straight
BN021 Omniflow II Vascular Prostheses -
Straight
Terumo Australia
Vascular Patch 1.5cm x 5cm (less than 8 sq. Cm) $205.00
Vascular Patch 2.5cm x 10cm (more than 8 sq. cm $205.00
TU042 Fluoropassiv Patch Thin wall, Fluoropolymer/polyester, Koper Knitted
6-15mm x 5-7.5cm $205.00
| W L Gore & Associates |
| ||
GT012 | Soft Tissue Patch | ePTFE | 1mm Thickness 5 x 10cm | $205.00 |
GT016 | Soft Tissue Patch | ePTFE | 2mm Thickness 5 x 10cm | $205.00 |
10.4.1.2 - 101 - 150 sq cm
BA258 Bard Vascular Graft Vascular Graft Patch 101 - 150sq cm $295.00
Terumo AustraliaTU043 Fluoropassiv Patch Thin wall, Fluoropolymer/polyester, Koper Knitted
10-15mm x 7.5-10cm $295.00
GT013 Soft Tissue Patch ePTFE 1mm Thickness 10 x 15cm $295.00
GT017 Soft Tissue Patch ePTFE 2mm Thickness 10 x 15cm $295.00
10.4.1.3 - >150 sq cm
BA259 Bard Vascular Graft Vascular Graft Patch 15 x 15cm $400.00
W L Gore & AssociatesGT014 Soft Tissue Patch ePTFE 1mm Thickness 15 x 20cm $400.00
GT015 Soft Tissue Patch ePTFE 1mm Thickness 20 x 30cm $400.00
GT018 Soft Tissue Patch ePTFE 2mm Thickness 15 x 20cm $400.00
GT019 Soft Tissue Patch ePTFE 2mm Thickness 20 x 30cm $400.00
10.4.1.4 - Pledgets
BA039 Grafts Vascular Polyester pledgets Rectangle, Oval, Circle, Square 2.9mm-8mm x 6mm - 9.5mm
$87.00
VA001 Venous Valve Ring Dacron/silicone variable diameter ring 52mmx15mmx0.09 mm $1,065.00
10.6.1 - Venous
BB106 Temporary Vena Cava System Phynox/ combination of various metals inc.
Nickel,Copper, Molubden,Steel
One size, expands to Max length 38mm/Max diameter 30mm
$2,348.00
BB169 Vena Cava Filter System PHYNOX Introducer system, 'J' Guidewire,
Seldinger needle, disposable scalpel
Diameter 28 mm $2,348.00
BA010 Bard Inferior Vena Cava Filter Nitinol self expanding vena cava filter For IVC with a diameter less than or equal to
28mm diameter
$2,348.00
IZ001 ALN Vena Cava Filter The ALN Vena Cava Filter is implanted into
the SVC via the femoral, brachial and jugular vein to prevent pulmonary emboli (PEs).
One size, diameter up to 32mm $2,348.00
WC096 Cook Vena Cava Filter Universal Filter Diameter up to 40mm, Length up to 60mm $2,348.00
WC283 | Vena Cava Filter with NavAlign | The filter consists of a non-magnetic filter | Filter measures 30mm in diameter and 48mm | $2,348.00 |
| Delivery System | (30mm diameter, 48mm long) preloaded on a | long |
|
|
| femoral filter introducer and/or a jugular filter |
|
|
|
| introducer, an 8.5 French coaxial introducer |
|
|
|
| system (compatible with a .035 inch wire |
|
|
|
| guide) for introduction and a hydrophilic coated |
|
|
|
| dilator. |
|
|
Culpan Medical PtyCB019 Option ELITE Vena Cava Filter The Option ELITE Vena Cava Filter is
designed for the prevention of recurrent pulmonary embolism via percutaneous delivery in the inferior vena cava.
JJ423 OPTEASE retrievable vena cava filter OPTEASE is a laser cut nitinol vena cava filter,
used to treat patients at high risk of pulmonary embolisation
Suitable for vessels up to 32mm $2,348.00
Suitable for vessels up to 30mm $2,348.00
WC329 Cook Celect Platinum Vena Cava
Filter
10.6.2 - Arterial
Abbott Australasia Pty Ltd
The Cook Celect Platinum Vena Cava Filter is made of a biocompatible cobalt chromium alloy. Platinum markers are located on the end of the primary legs for increased radiopacity.
Length: 49mm Diameter: 30mm
$2,348.00
AY018 | Emboshield | Embolic Protection Device, including delivery system, device specific procedural wire, filter for capturing embolic matter and retrieval system | Large and small. Two wire lengths: 190cm for Monorail system and 315cm for Over the wire | $2,100.00 |
AY030 | Accunet | Embolic Protection Device, including delivery system, device specific procedural wire, filter for capturing embolic matter and retrieval system. | 4.5 - 7.5; 190cm, 300cm length catheter | $2,100.00 |
Boston Scientific Australia Pty LtdBS085 Filterwire EZ Embolic Protection Device Vessel compatibility 3.5mm - 5.5mm and
delivery system lengths up to 300cm.
$2,100.00
AS192 Spider FX Embolic Protection Device The Spider FX is a rapid exchange device
percutaneously delivered distal embolic protection device with components designed to capture and remove debris from vessels during interventional procedures in the vasculature.
Filter: 3.0 - 7.0mm; Capture Wire: 190 and 320cm
$2,100.00
Johnson & Johnson Medical Pty LtdJJ480 | Angioguard RX Emboli Capture Guidewire System | Distal protection device and delivery system | Length 180cm, Diameter 0.014"; basket sizes 4mm, 5mm, 6mm, 7mm and 8mm | $2,100.00 |
| Medtronic Australasia Pty Ltd |
|
|
|
MC954 | Mo.Ma Proximal Cerebral Protection Device | Mo.Ma Proximal Cerebral Protection Device. Protects the brain from embolisation, blocking antigrade blood flow from the common Carotid Artery and retrograde blood flow from the External Carotid Artery. | Minimum sheath size = 8F or 9F, Minimum diameter of inner working channel = 0.069"/1.76mm (8F sheath) or 0.083"/2.12mm (9F sheath); 0.035" guide wire compatible | $2,100.00 |
MI035 | Mo.Ma Ultra Proximal Cerebral Protection Device | Cerebral embolic protection device: blocks antegrade blood flow from the common carotid artery and retrograde blood flow from the external carotid artery. Embolic protection is established before the lesion is crossed. | Minimum sheath size = 8F (5F inner working channel) or 9F (6F inner working channel) | $2,100.00 |
10.07.01 - Arterial Closure Devices
Abbott Australasia Pty Ltd
AY017 Starclose 6 Fr Exchange Sheath, Dilator, Guidewire, implantable nitinol clip pre-mounted on a Clip Applier
6 Fr $410.00
AY033 Proglide Suture Mediated Closure Device 5 - 8 French $410.00
Johnson & Johnson Medical Pty LtdJJ823 EXOSEAL (TM) Vascular Closure
Device
Vascular Closure Device 5 - 7F $410.00
MB008 Mynx Vascular Closure Device Water-soluble synthetic sealant made of a
polyethylene glycol (PEG) The sealant is resorbed by the body within 30 days
St Jude Medical Australia Pty Ltd
5F, 6/7F $410.00
SJ014 | Angio-Seal Vascular Closure Device - STS Platform and STS Plus | Angio-Seal Haemostatic Puncture Closure Device, Models 6F-STS Platform and 6F STS Plus | 6F | $410.00 |
SJ015 | Angio-Seal Vascular Closure Device - STS Platform and STS Plus | Angio-Seal Haemostatic Puncture Closure Device, Models 8F-STS Platform and 8F STS Plus | 8F | $410.00 |
Billing Code Product Name Description Size
Benefit
Benefit
Condition
SJ094 Angio-Seal VIP Angio-Seal Haemostatic Puncture Closure Device Models 6F STS Platform, 6F STS Plus and 7F VIP
SJ095 Angio-Seal VIP Angio-Seal Haemostatic Puncture Closure Device Models 8F STS Platform, 8F STS Plus and 8F VIP
6F $410.00
8F $410.00
SJ155 Angio-Seal Evolution Haemostatic Puncture Closure Device 6F-8F 6F and 8F $410.00
SJ218 FemoSeal Vascular Closure System Haemostatic Puncture Closure Device One Size $410.00
large
Abbott Australasia Pty Ltd
AY034 Prostar Suture Mediated Closure Device - Closure of Large holes
Up to 24 French $750.00
BS034 Contour PVA, Contour SE Polyvinyl Alcohol (PVA) embolization
particles spherical-shaped PVA
Up to 1200 micron, volume up to 2ml. $204.00
DE294 Bead Block Polyvinyl Alcohol hydrogel microspheres in pre-loaded syringe
2ml- (100 - 300, 300 - 500, 500 - 700, 700 -
900, 900 - 1200 microns
$204.00
WC044 PVA Embolisation particles Embolisation & Occlusion Particle Size Ranges (microns) 50-100, 100-
200, 200-300,300-500, 500-700, 700-1000,
1000-1500, 1500-2000, 2000-2800
$204.00
WC190 Detachable Mreye Embolization Coils Standard Mreye Diameters: .035 and .038, Extended Lengths: 1cm to 20cm, Coil Diameters: 3mm to 20mm
$66.00
Billing Code Product Name Description Size
P
Benefit
Benefit
Condition
Boston Scientific Australia Pty Ltd
BS026 VortX and Pushable Coils Pushable coils Diameters up to 30mm and lengths up to 60mm
$143.00
JJ224 TruFill Pushable coil Platinum pushable coil of 1. Straight, 2. C, 3.
Flat spiral and 4. Complex shapes. Embolic coil and delivery tube.
Size .014" outer diameter. Size 2 - 10mm and length 2 - 100mm
$143.00
PY008 Platinum Spirale and Cirrus embolisation coils <100mm
PY009 Platinum Spirale and Cirrus embolisation coils 100-150mm
Embolisation coils with or without fibers Spiral diameter 2mm - 16mm; length 25mm -
80mm; coil diameter 0.27mm - 0.82mm
Embolisation coils with or without fibers Spiral diameter 4mm - 10mm; length 100mm -
150mm; coil diameter 0.27mm - 0.82mm
$143.00
$143.00
WC038 Coil - Embolisation Coils MWCE-
TORNADO
P (Platinum)Tornado Platinum Diameters: .018, .035 and .038, Coil Taper Diameters: 2mm to 10mm
$143.00
WILLIAM A COOK AUSTRALIA PTY LTDWC039 | Cook Embolization Coil | Hilal Platinum | Diameters: .018, Extended Lengths: .5cm to 6cm, Coil Diameters: Straight to 10mm | $143.00 |
WC173 | Cook Embolisation Coils | Nester Platinum | Recommended catheter ID and end hole diameter inch: .018 and .035inch. Coiled embolus diameters: 2mm to 20mm. Extended embolus lengths: 30 to 200mm. | $143.00 |
P, Gel, repositionable Terumo Australia
TU053 AZUR Peripheral HydroCoil AZUR Peripheral Coil, detachable 3-20mm diameter, length 3-50cm $1,293.00
P, ids (Platinum, integral delivery system) Boston Scientific Australia Pty LtdBS021 Interlock Detachable Coils Platinum-tungsten, Fibered Occlusion System Coil diameters up to 30mm and lengths up to
100cm. Delivery system lengths up 200cm
$1,250.00
TU052 AZUR Peripheral Framing Coil AZUR Peripheral Coil,detachable, Framing
Coil three dimensional complex shape
8-20mm diameter, length 20-50cm $1,250.00
Billing Code Product Name Description Size
P, repositionable (Platinum, repositionable) Penumbra Neuro Australia Pty Ltd
Benefit
Benefit
Condition
PN012 Penumbra Ruby Coil System The Ruby Coil System is comprised of a
platinum embolisation coil attached to a composite pusher with a radiopaque positioning marker. The coil is transferred onto the microcatheter and the coil should be advanced under fluoroscopic guidance. The detachment handle is attached and advanced over the proximal end of the delivery pusher and then the coil is detached by using the retraction button on the handle into the preferred site.
Diameter.mm. - Length .cm.
3 x 5 6 x 12
6 x 20 6 x 30
7 x 25 7 x40
8 x 25 8 x 40
9 x 30 10 x 35
12 x 40 12 x 60
14 x 40 14 x 60
16 x 60 18 x 57
20 x 60 24 x 57
28 x 60 32 x 60
2 x 1 2 x 2
2 x 4 3 x 5
3 x 15 4 x 6
4 x 15 6 x 20
6 x 30 8 x 35
8 x 60 10 x 35
12 x 40 16 x 50
20 x 60 3 x 12
3 x 20 4 x 10
4 x 15 4 x 20
4 x 30 4 x 35
5 x 12 5 x 20
5 x 30 6 x 12
6 x 20 6 x 30
7 x 25 7 x40
8 x 25 8 x 40
9 x 30 10 x 35
12 x 40 12 x 60
14 x 40 14 x 60
16 x 60 18 x 57
20 x 60 24 x 57
28 x 60 32 x 60
2 x 1 2 x 2
2 x 4 3 x 5
3 x 15 4 x 6
4 x 15 6 x 20
6 x 30 8 x 35
8 x 60 10 x 35
12 x 40 16 x 50
20 x 60
$1,250.00
Billing Code Product Name Description Size
WILLIAM A COOK AUSTRALIA PTY LTD
Benefit
Benefit
Condition
WC319 | Detach Coil with Fibers | The Detach Coil with Fibers consists of a Teflon coated stainless delivery wire with a premounted platinum detachable coil with fibers. | Diameters: 3-20mm Length: 4-30cm | $1,250.00 |
WC320 | Retracta Detachable Embolization Coil | The Retracta Detachable Embolization Coil is a platinum coil with spaced synthetic fibers, and is attached to a delivery wire. | Coiled embolus diameters: 4-20mm Length: 7-14cm | $1,250.00 |
10.8.2.2 - >200mm length
P
Pyramed Pty Limited
PY010 Platinum Spirale and Cirrus embolisation coils 200-450mm
10.8.3 - Polymer
Embolisation coils with and without fibers Spiral diameter 5mm - 16mm; length 200mm -
450mm; Coil diameter 0.82mm.
$286.00
ET008 Embospheres - .5ml per implant $320.00
10.8.3.2 - 1ml
ET007 Embospheres - 1ml per implant $420.00
10.8.3.3 - 2ml
BS314 Embozene Microspheres Uniquely colour-coded microspheres used in
the embolization of hypervascular tumours and arteriovenous malformations
In between the range of 40 - 1130 micron - 2ml
$630.00
ET006 Embospheres - 2ml per implant $630.00
10.8.4 - Complex Occlusion Devices, including detachable balloon, sph
St Jude Medical Australia Pty Ltd
SJ265 Amplatzer Vascular Plug Self expandable nitinol wire mesh Diameter 4mm - 16mm, Length 7 & 8mm $1,900.00
SJ268 Amplatzer Vascular Plug III AVP III is a self-expanding, Nitinol mesh
occlusion device.
SJ269 AMPLATZER Vascular Plug 4 The AMPLATZER Vascular Plug 4 (AVP4) is
a self-expanding, Nitinol mesh occlusion device. The Device has a radiopaque marker band at each end and a micro screw attachment at one end for attaching to the delivery wire. The AVP4 fits through a 0.038 guidewire compatible diagnostic catheter allowing the use of the same catheter throughout the procedure rather than having to exchange the diagnostic catheter for a second delivery catheter to place a plug.
Size: (mm): 4, 6, 8, 10, 10, 12, 12, 14, 14
Long Axis (mm): 4, 6, 8, 10, 10, 12, 12, 14,
14 Length (mm): 6.5
4mm 4 diameter 10.0 length
5mm 5 diameter 10.5 length
6mm 6 diameter 11.0 length
7mm 7 diameter 12.5 length
8mm 8 diameter 13.5 length
$1,900.00
$1,900.00
ids
St Jude Medical Australia Pty Ltd
SJ266 AMPLATZER Vascular Plug - II The AMPLATZER Vascular Plug II is a self-
expandable, multi-lobed cylindraical device made from a nitinol wire mesh.
9-AVP2-003, 3mm Diameter, 6mm Plug Length, 9-AVP2-004, 4mm Diameter, 6mm Plug Length, 9-AVP2-006, 6mm Diameter, 6mm Plug Length, 9-AVP2-008, 8mm Diameter, 7mm Plug Length, 9-AVP2-010, 10mm Diameter, 7mm Plug Length, 9-AVP2- 012, 12mm Diameter, 9mm Plug Length, 9- AVP2-014, 14mm Diameter, 10mm Plug Length, 9-AVP2-016, 16mm Diameter, 12mm Plug Length, 9-AVP2-018, 18mm Diameter, 14mm Plug Length, 9-AVP2-020, 20mm Diameter, 16mm Plug Length, 9-AVP2-022, 22mm Diameter, 18mm Plug Length
$2,100.00
Penumbra Neuro Australia Pty LtdPN016 Penumbra POD Occlusion Device The Peripheral Occlusion Device (POD) is
comprised of a platinum embolisation coil attached to a composite pusher with a radiopaque positioning marker. The coil is transferred onto the microcatheter and the coil should be advanced under fluoroscopic guidance. The detachment handle is attached and advanced over the proximal end of the delivery pusher and then the coil is detached by using the retraction button on the handle into the preferred site.
30cm Length 3.25-4mm diameter, 30cm Length 4-5mm diameter, 50 cm Length 5- 6mm diameter, 60 cm Length 6-8 mm diameter
$1,900.00
Medtronic Australasia Pty Ltd
MI185 MVP Microvascular Plug System MVP Microvascular Plug can be delivered
through a microcatheter to enable rapid occlusion.
Unconstrained device diameter (mm): 5.3, 6.5,
9.2, & 13.0
$2,100.00
AS190 Onyx DSMO/Liquid Embolic Material 18, 20, 34 (formulations) $2,300.00
ids (integral delivery system)Covidien Pty Ltd
AS191 Onyx System DSMO Liquid Embolic Material 500 Formulation $4,950.00
10.8.6 - Delivery Device For Occlusion Media
BS028 GDC and PVA Delivery Catheters Microcatheter Delivery Systems Delivery system lengths up to 175cm $700.00
WILLIAM A COOK AUSTRALIA PTY LTDWC296 Cantata Superselective Microcatheter Cantata 2.5, Cantata 2.8, Cantata 2.5 Duo and
Cantata 2.8 Duo Microcatheters
2.5F and 2.8F. Length: 100-150cm $700.00
10.8.6.2 - Detachment Controller
PN017 Penumbra Ruby Coil System,
Detachment Handle
Terumo AustraliaTU054 AZUR Peripheral Coil Detachment
Controller
The Ruby Coil System is comprised of a platinum embolisation coil attached to a composite pusher with a radiopaque positioning marker and a Detachment Handle. The coil is transferred onto the microcatheter and the coil should be advanced under fluoroscopic guidance. The detachment handle is attached and advanced over the proximal end of the delivery pusher and then the coil is detached by using the retraction button on the handle into the preferred site.
Hand held battery powered coil detachment controller
N/A $350.00
One size only $350.00
KA008 Single Lumen Right Atrial Catheter Central Venous Catheters constructed of
radiopaque silicone rubber
84cm, 1.3mm OD, 94cm 2.2mm OD, 94cm 3.2mm OD
$119.00
TX026 Arrow Peripherally Inserted Central Catheterisation Sets
TX027 Arrow Peripherally Inserted Central Catheterisation Sets
Range of Polyurethane single lumen peripherally inserted central catheters with or without stylet
Range of Polyurethane single lumen peripherally inserted central catheters with or without stylet
3 Fr, range of lengths $119.00
4 Fr, range of lengths $119.00
WC111 Cook Central Venous Catheterisation Kit
WC113 Cook Central Venous Catheterisation Kit
Single lumen peripherally inserted catheter set, which may include catheter, standard or micropuncture introducer set
Single lumen peripherally inserted catheter set, includes catheter, needle, J-wire, MPIS wire and introducer
3 - 6 Fr, 40 - 80cm $119.00
Fr 3, 4, 5 and Length 50 and 60cm $119.00
WC201 Cook Central Venous Catherisation
Kits
WC202 Cook Central Venous Catheterisation Kits
WC204 Cook Central Venous Catheterisation Kits
WC207 Cook Central Venous Catheterisation Kits
cu
Turbo-Flo Peripherally Inserted Central Venous Catheter Set, Single Lumen Polyurethane with Micropuncture Peel-Away Sheath Introducer and Wire Guide
Turbo-Flo Peripherally Inserted Central Venous Catheter Set, Single Lumen Polyurethane with Peel Away Sheath Introducer and Wire Guide
Turbo-Flo Over-The-Wire Peripherally Inserted Central Venous Catheter Set, Single Lumen Polyurethane with Micropuncture Peel-Away Sheath Introducer and Wire Guide
PICC Peripherally Inserted Central Venous Catheter Set, Catheter without Clamp, Single Lumen Silicone with Micropuncture Peel-Away Sheath Introducer and Wire Guide
4Fr - 60cm and 5Fr - 60cm $119.00
5Fr - 60cm $119.00
4Fr - 60cm and 5Fr -60cm $119.00
3Fr - 50cm and 4Fr and 5Fr - 60cm $119.00
BA049 Hickman/Broviac Catheters Open-Ended CVC, Single Lumen 2.7Fr - 9.6Fr $180.00
BA125 Groshong Central Venous Catheter Closed-Ended CVC, Single Lumen 5.5Fr - 9.5Fr $180.00
BA129 Groshong Peripherally Inserted Central Catheter
Closed-Ended PICC, Single Lumen 3Fr - 5Fr $180.00
WC117 Cook Central Venous Long Term
Catheter
Cook TPN single lumen catheter set Fr 3, length 55; Fr 4, length 65cm, Fr 6.5
length 65, 90cm, Fr 9.5, length 90cm
$180.00
Bard Australia Pty Ltd
BA184 Peripherally Inserted Central Catheter Power Injectable PICC, Single Lumen 4Fr - 6Fr $165.00
BA212 Peripherally Inserted Central Catheter Valved, Power Injectable PICC, Single Lumen 4Fr - 6Fr $165.00
BA220 Groshong Peripherally Inserted Central Catheter
pi (power injection)Emergo Asia Pacific Pty Ltd
ER134 Single Lumen Peripherally Inserted
Central Catheter
Closed-Ended, Power Injectable PICC, Single Lumen
Power injectable with Pressure Activated Safely Valve (PASV) technology
5Fr $165.00
3F x55cm, 4F x 55cm, 5F x 55cm $165.00
A (Anti-infective Agent Coating) Teleflex Medical AustraliaTX030 ARROWg+ard Blue Single Lumen
Central Venous Catheters
pi (power injection)Bard Australia Pty Ltd
A polyurethane central venous catheter with Blue FlexTip (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter body.
CS-24301 - 16g x 20cm, Single Lumen, Adult CS-24306E-16g x 16cm, Single Lumen Adult CS-24701 - 14g x 20cm, Single Lumen Adult CS-24706E -14g x 16cm, Single Lumen, Adult
$150.00
BA268 PowerGlide Single lumen, power injectable percutaneous catheter
18 - 20 Gauge $165.00
TX036 Arrow single lumen pressure
injectable peripherally inserted central catheter (PICC) sets
Single lumen pressure injectable peripherally inserted central catheter (PICC) sets
3, 4, Fr single lumen Pressure Injectable PICCs various Pressure Injection rates, various lengths.
$165.00
WC279 Turbo-Ject Peripherally Inserted
Central Catheter Set ( Single Lumen)
3/4/5/6 Fr Single Lumen Polyurethane PICC with Micropuncture Peel-Away Sheath Introducer and Echogenic needle
3, 4, 5, 6 French, 40 and 60 cm catheter length, single lumen catheter
$165.00
10.9.2 - Percutaneous Catheters, Multiple Lumen
BA130 Groshong Peripherally Inserted Central Catheter
Teleflex Medical Australia
Closed-Ended PICC, Multiple Lumen 3Fr - 5Fr $119.00
TX028 Arrow Peripherally Inserted Central Catheterisation Sets
Range of Polyurethane double lumen peripherally inserted central catheters with or without stylet
4 and 5 Fr, range of lengths $119.00
WILLIAM A COOK AUSTRALIA PTY LTDWC112 Cook Central Venous Catheterisation Kit
Double or triple lumen peripherally inserted catheter set, which may include catheter, standard or micropuncture introducer set
3 - 8 Fr 40 - 80cm $119.00
WC114 Cook Central Venous Catheterisation Kit
WC203 Cook Central Venous Catherisation
Kits
WC205 Cook Central Venous Catheterisation Kits
cu
Double lumen peripherally inserted catheter set, includes catheter, needle, J-wire, MPIS wire and introducer
Turbo-Flo Peripherally Inserted Central Venous Catheter Set, Dual Lumen Polyurethane with Peel-Away Sheath Introducer and Wire Guide
Turbo-Flo Over-The Wire Peripherally Inserted Central Venous Catheter Set, Dual Lumen Polyurethane with Micropuncture Peel-Away Sheath Introducer and Wire Guide
Fr 6, 7 and Length 58 and 60cm $119.00
5Fr - 60cm $119.00
5Fr - 60cm $119.00
BA051 Hickman/Leonard Catheters Open-Ended CVC, Multiple Lumen 7Fr - 12.5Fr $361.00
BA126 Groshong Central Venous Catheter Closed-Ended CVC, Multiple Lumen 5.5Fr - 9.5 Fr $361.00
BA209 HemoStar Long Term Haemodialysis Catheter
Dialysis Catheter, Multiple Lumen 14.5Fr - 16Fr $361.00
MS009 Catheterisation kits(Horizon Medical) Central Venous Catheter - right atrial catheter,
silicone
WILLIAM A COOK AUSTRALIA PTY LTD
2.7 -14F $361.00
WC119 Cook Central Venous Long Term
Catheter Set
Cook TPN double lumen catheter set Fr 7, length 65cm, Fr 9 length 90cm, Fr 12,
90, special
$361.00
WC122 Cook Central Venous Long Term
Catheter
Cook TPN triple lumen catheter set Fr 8, length 90cm $361.00
Bard Australia Pty Ltd
BA183 Peripherally Inserted Central Catheter Power Injectable PICC, Multiple Lumen 4Fr - 6Fr $225.00
BA213 Peripherally Inserted Central Catheter Valved, Power Injectable PICC, Multiple
Lumen
4Fr-6Fr $225.00
TX040 Arrow Pressure Injectable Triple-
Lumen PICC.
pi (power injection)Emergo Asia Pacific Pty Ltd
ER135 Dual Lumen Peripherally Inserted Central Catheter
Pressure injectable triple lumen PICC (Peripherally Inserted Central Catheter) Set
Power injectable with Pressure Accivated Safety Valve (PASV) technology
6Fg x 50cm, triple lumen $225.00
5F x55cm, 6F x 55cm $225.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
ER136 | Triple Lumen Peripherally Inserted Central Catheter | Power injectable with Pressure Activated Safety Valve (PASV) technology | 6F x 55cm | $225.00 |
|
|
A (Anti-infective Agent Coating)
Teleflex Medical Australia
TX031 ARROWg+ard Four & Five Lumen
Central Venous Catheters
TX032 ARROWg+ard Blue Double & Triple Lumen Central Venous Catheters
TX033 ARROWg+ard Blue Plus QUAD
Lumen Central Venous Catheters
TX034 ARROWg+ard Blue Plus Double &
Triple Lumen Central Venous Catheters
A polyurethane central catheter with Blue FlexTip (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter material
A polyurethane central venous catheter with Blue FlexTip (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter material
Central Venous Catheters (of various lengths, sizes and lumen configurations with antimicrobial impregnation on: 1. The external indwelling surface of catheter material (chorhexidine and silver sulphadiazine) 2. The entire internal fluid pathway including catheter, extension-lines and hubs (chlorhexidine acetate)
Double & Triple Lumen Central Venous Catheters (of various lengths sizes and lumen configurations) with antimicrobial impregnation on: 1. The external indwelling surface of catheter material (chlorhexidine and silver sulphadiazine) 2. The entire internal fluid pathway including catheter, extension-lines and hubs (chlorhexidine acetate)
CS-22854E - 8.5 Fr x 16cm, Quad Lumen CS-25854E - 8.5Fr x 20cm, Quad Lumen CS-22855 - 8.5 x 16cm, Five Lumen
CS-25855 - 8.5Fr x 20cm, Five Lumen
CS-24402 - 4Fr x 13cm, Dual Lumen CS- 22502 -5Fr x 5cm, Dual Lumen CS-25402 - 4Fr x 8cm, Dual Lumen CS-25502 - 5Fr x 12cm, Dual Lumen
CS-22702E - 7Fr x 16cm, Double Lumen CS- 26702 - 7Fr x 20cm, Double Lumen CS-
27702E - 7Fr x 20cm, Double Lumen CS- 25553 - 5.5Fr x 8cm, Triple Lumen CS- 22703E - 7Fr x 16cm, Triple Lumen CS- 26553 -5.5Fr x 13cm, Triple Lumen CS- 24703E - 7Fr x 30cm, Triple Lumen
CS-25703E - 7Fr x 20cm, Triple Lumen
CS-42854E - 8.5Fr x 16cm, Quad Lumen CS- 45854E - 8.5Fr x 20cm, Quad Lumen
CS-45802E - 8 Fr x 20cm, Dual Lumen CS- 46702E - 7Fr x 20cm, Dual Lumen CS- 47702E - 7Fr x 20cm, Dual Lumen CS- 42703E - 7Fr x 16cm, Triple Lumen CS- 45703E - 7Fr x 20cm, Triple Lumen
$150.00
$150.00
$150.00
$150.00
WILLIAM A COOK AUSTRALIA PTY LTD
WC230 Cook Spectrum CVC Catheter 3
Lumen with antibiotic impregnation
Triple lumen CVC line with antibiotic impregnation
5Fr, 7Fr, 9Fr $150.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
WC231 | Cook Spectrum 5 Lumen CVC Catheter with antibiotic impregnation | 5 lumen CVC with antibiotic impregnation | 10Fr | $150.00 |
|
|
WC321 | Cook Spectrum Central Venous Catheter with antibiotic impregnation - 2 lumen | Double lumen CVC line with antibiotic impregnation | 4 Fr, 5 Fr, 8 Fr. Catheter length 5-25cm | $150.00 |
|
|
A (Anti-infective Agent Coating), pi (power injection) Teleflex Medical AustraliaTX043 Pressure Injectable ARROWg+ard®
Blue Plus Antimicrobial Multi-
Lumen Central Venous Catheters
pi (power injection)Teleflex Medical Australia
TX035 Arrow multi lumen pressure
injectable peripherally inserted central catheter (PICC) sets
Pressure Injectable Multi Lumen Central
Venous Catheters (of various lengths sizes and lumen configurations) with antimicrobial impregnation of the internal and external catheter with Chlorhexidine and Silver Sulphadiazine.
Arrow multi lumen pressure injectable PICC (peripherally inserted central catheter) sets
CS42703HP: 16cm x 7Fr Triple Lumen
Catheter
CS45703HP: 20cm x 7Fr Triple Lumen Catheter
CS42854HP: 16cm x 8.5Fr Quad Lumen
Catheter
CS45854HP: 20cm x 8.5Fr Quad Lumen Catheter
4, 5, 6Fr multi lumen Pressure Injectable PICCs various Pressure Injection rates, various lengths. Double & triple Lumen configurations.
$225.00
$225.00
WILLIAM A COOK AUSTRALIA PTY LTDWC280 | Turbo-Ject Peripherally Inserted Central Catheter Set (Double Lumen) | 4/5 Fr Double Lumen Polyurethane PICC with Micropuncture Peel-Away Sheath Introducer and Echogenic needle | 4 and 5 French, 60 cm Catheter length, double lumen catheter | $225.00 |
WC297 | Turbo-Ject Peripherally Inserted | Turbo-Ject Peripherally Inserted Central | 6Fr, Catheter length 60cm | $225.00 |
| Central Venous Catheters Set (Triple | Venous Catheters (PICC) Sets are intended for |
|
|
| Lumen) | short- or long-term use for venous pressure |
|
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| monitoring, blood sampling, administration of |
|
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| drugs (eg chemotherapy) and fluids (eg TPN), |
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| and for use with power injectors for delivery of |
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| contrast in CT studies. |
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|
10.9.3 - Percutaneous Catheters, Multiple Lumen for Haemodialysis
Bard Australia Pty Ltd
BA211 Haemodialysis Catheters Haemodialysis Catheters, multiple lumen 11Fr - 13.5Fr $127.00
Billing Code Product Name Description Size
Kendall Australasia Pty Ltd TA Covidien Pty Ltd
Benefit
Benefit
Condition
KA007 Mahurkar Subclavian Catheter Kit Chronic haemodialysis, long term vascular
access for haemodialysis and apheresis. Constructed of radiopaque silicone rubber.
36, 40cm $127.00
KA012 Mahurkar Subclavian Catheter Kit Acute haemodialysus, short term vascular
access. Catheters constructed of radiopaque polyurethane. Tips are made of polyvinyl chloride and are more radiopaque than the rest of the catheter.
11.5 Fr, 13.5cm Straight Exten, 11.5 Fr, 16cm Straight Exten, 11.5 Fr 19.5cm Straight Exten, 10 Fr 12cm Curved Exten, 10 Fr 15cm Curved Exten, 11.5 Fr 16cm Curved Exten, 11.5 Fr 16cm Curved Exten, 11.5 Fr 19.5cm Curved Exten
$127.00
KA014 Mahurkar Maxid Catheters Catheters constructed of radiopaque
polyurethans, high kink resistant. The arterial lumen is shorter than the venous lumen at the catheter's distal end in order to reduce recirculation during haemodialysis
Size, 38, 43, 48, 53cm $127.00
KA019 Mahurkar 12Fr Triple Lumen Catheter Mahurkar 12Fr Triple Lumen Catheter Curved
Extension Kit
12Fr - 13cm, 16cm, 19cm & 24cm lengths available
$127.00
KA020 Mahurkar 13.5Fr Q-Plus Dual Lumen Catheter
Mahurkar 13.5Fr Q-Plus Curved Extension Double Lumen Catheter Kit
13.5Fr - 13.5cm, 16cm, 19cm & 24cm lengths available
$127.00
Bard Australia Pty Ltd
BA140 Haemodialysis Catheters Dialysis Catheter, Multiple Lumen 12.5Fr - 16FR $330.00
Kendall Australasia Pty Ltd TA Covidien Pty LtdKA011 Permcath Dual Lumen Catheter Chronic Haemodialysis, long term vascular
access for haemodialysis and aphaeresis. Constructed of radiopaque silicone rubber.
KA013 Permcath Dual Lumen Catheter Chronic haemodialysis, long term vascular
access for haemodialysis and aphaeresis. Constructed of radiopaque silicone rubber.
36cm, 40cm $330.00
28, 36, 40cm $330.00
KA018 Palindrome Haemodialysis catheter 14.5Fr. 19, 23, 28, 33, 55cm Insertion
Lengths, with 36, 40, 45, 50, 72cm Overall length, with side slots, symmetric tip
$330.00
| Tekmed Pty Ltd |
| ||
TK005 | Medcomp Long Term Catheter sets for Haemodialysis | ASH, TESIO-BioFlex with cuff | 10, 14 French 24,28,32 & 36cm lengths | $330.00 |
TK006 | Medcomp Long Term Catheter sets for Haemodialysis | HemoFlow HFS-Carbothane with cuff | 14.5 French 24,28,32 & 36cm lengths | $330.00 |
Billing Code Product Name Description Size
Teleflex Medical Australia
Benefit
Benefit
Condition
TX037 Arrow Cannon II Plus Chronic
Haemodialysis Catheter Set
Dual Lumen, Retrograde Tunneled, Cuffed, Tip First, Chronic Haemodialysis Catheter Set
15Fg x 24 - 55cm $330.00
Bard Australia Pty Ltd
BA215 Haemodialysis Catheter Power Injectable, Triple Lumen Haemodialysis
Catheter
13Fr $368.00
BX338 GamCath High Flow Catheter Kit GamCath High Flow Catheter is a
polyurethane, kidney elliptical multi lumen, staggered tipped catheter kit, which ensures flows up to 430ml/min
WILLIAM A COOK AUSTRALIA PTY LTD
11.5fr and 13fr guage. Available in 150mm, 175mm, 200mm and 250mm length and straight and curved configuration.
$127.00
WC333 Turbo-Flo HD Catheter Haemodialysis catheter, double lumen. 12 French with a length of 15, 20, or 25 cm $127.00
A (Anti-infective Agent Coating)Baxter Healthcare Pty Ltd
BX339 GamCath Dolphin Protect HighFlow Haemodialysis Catheter Kit
Haemodialysis catheter with a modified anti- thrombogenic surface (polymer system of polydimethysilxane blocks) and a non-release anti-microbial coating (Bismith copolymer film) on internal and external surfaces of catheter.
109585 - 13Fr x 15cm double lumen: 109584 - 13FRx 20cm double lumen, 109705 - 13Fr x 25cm double lumen; 109706 - 13Fr x 15cm curved double lumen; 109707 - 13Fr x 20cm curved double lumen.
$158.00
Billing Code Product Name Description Size
Teleflex Medical Australia
Benefit
Benefit
Condition
TX029 ARROWg+ard Blue Haemodialysis
Catheters
Haemodialysis Catheters (of various lengths, sizes and lumen configurations) with antimicrobial impregnation (chlorhexidine and silver sulphadiazine) on the external surface of the polyurethane catheter material.
CS-22122 - 12Fr 16cm, Dual Lumen CS- 22123 – 12Fr 16cm, Triple Lumen CS-25122 – 12Fr x 20cm, Dual Lumen CS-22142CF –
14Fr x 15cm, Dual Lumen, Curved, Firm CS- 22142F – 14Fr x 15cm, Dual Lumen Firm CS-
25122 – 12Fr x 20cm, Double Lumen CS- 25123 – 12Fr x 20cm, Triple Lumen CS- 25142CF – 14Fr x 20cm, Double Lumen, Curve, Firm CS-25142F – 14Fr x 20cm, Double Lumen, Firm CS-26142F – 14Fr x 25cm, Double Lumen, Firm CU-22122 – 12Fr x 16cm, Double Lumen, Curved CU-
23122 – 12Fr x 13cm, Double Lumen, Curved CU-25122 – 12Fr x 20cm, Double Lumen, Curved, Dueal Lumen CS-22142CF - 14Fr x 15cm, Dual Lumen, Curved, Firm CS- 22142F - 14Fr x 15cm, Dual Lumen Firm CS- 25122 - 12Fr x 20cm
$158.00
BB170 Celsite Access Port for pain relief Composition - polysulphone. Kit includes
tunnelling rod, filter, connectors, needles, syringe, tuohy needle
Diameter of septum:11.7mm. Height: 11.5mm. Dimension: 25.8 x 37.8mm
$500.00
BA057 Groshong Subcutaneous Ports Titanium or MRI Implatable Port, Closed-
Ended Catheter, Single Chamber
BA221 Implanted infusion Port Titanium or MRI Implanted Port, Open-Ended
Catheter, Single Chamber
WILLIAM A COOK AUSTRALIA PTY LTD
7Fr - 8 Fr $500.00
6Fr - 9.6Fr $500.00
WC093 | Cook Implantable Injection/Infusion Ports | Petite or Standard, single or multiple chamber Polysulfone Port which may include micropuncture or standard introducer set | 3 - 12 Fr pre-attached or detached catheter or valve system | $500.00 |
WC115 | Cook Implantable Injection/Infusion Port | Mini, single or multiple chamber titanium Port which may include micropuncture introducer set | 3 - 12 Fr pre-attached or detached catheter or valve system | $500.00 |
Billing Code Product Name Description Size
Benefit
Benefit
Condition
WC299 Vital-Port Mini, petite or standard, single chamber Titanium port which may include micropuncture or standard introducer set
5-6.5Fr pre-attached catheter or valve system $500.00
Bard Australia Pty Ltd
BA181 PowerPort Titanium or MRI implantable port, Open-ended Catheter, Single Chamber
BA208 PowerPort with Groshong Catheter Titanium or MRI implantable Port, Closed-
Ended Catheter, Single Chamber
Medical Specialties Australia Pty Ltd
6Fr - 8Fr $630.00
8Fr $630.00
MS014 | Injection/Infusion Ports Sterile | Plastic/titanium, single lumen | 5-15F | $630.00 |
MS016 | Injection/Infusion Ports Sterile | Plastic/titanium, paediatric | 5, 6, 7,8, 9.6F | $630.00 |
WILLIAM A COOK AUSTRALIA PTY LTDWC300 Vital-Port Standard, power-injectable single chamber titanium Port which may include micropuncture or standard introducer set
7.5-9.5Fr pre-attached or detached catheter or valve system
$630.00
Fresenius Kabi Australia Pty Ltd
FK007 Ambix Intraport CP Powerflow &
Ambix Intraport T Powerflow
Ambix Intraport® systems are completely implantable catheter systems. They consist of a casing, a medicine compartment with a silicone membrane and a catheter which can be connected to the port casing.
Port: 8086012 Ambix Intraport CP Powerflow Material: PEEK casing with aluminium oxide ceramic medicine compartment
Diameter of port base: 30mm Port Weight: 7.8/7.6g
Port filling volume: 0.21/0.25ml Port: 8086442
Material: Titanium Diameter of port: 30mm Port Height: 13.8mm Port weight: 12.6g
Port filling volume: 0.56ml
$630.00
Billing Code Product Name Description Size
10.9.5 - Infuser Ports, Multiple Chamber
Benefit
Benefit
Condition
Bard Australia Pty Ltd
BA059 Dual Lumen Subcutaneous Ports Silicone, Polyurethane or ChronoFlex Open-
ended Catheter
Medical Specialties Australia Pty Ltd
7 - 10 French Catheter $786.00
MS015 Injection/Infusion Ports Sterile Plastic/titanium, dual lumen 10, 10.5, 12F $786.00
WILLIAM A COOK AUSTRALIA PTY LTDWC164 Cook Implantable Injection/Infusion
Ports
Dual or Multiple Chamber Titanium Port which may include micropuncture or standard introducer set
3 - 12 Fr pre-attached or detached catheter or valve system
$786.00
10.10.01 - Peritoneal Dialysis, Long Term Implantable Catheters
Kendall Australasia Pty Ltd TA Covidien Pty Ltd
KA001 Tenckhoff Peritoneal Dialysis
Catheter
Adult 2 cuff, Adult 1 cuff, Adult 0 Cuff 42cm to 47cm length. All Peritoneal Catheters
excluding the Swan Neck Fast Flow Catheter, have an internal diameter of 2.67mm and an external diameter of 4.95 mm.
$175.00
KA002 Tenckhoff Peritoneal Dialysis
Catheter
Paediatric 2 cuff, Paediatric 1 cuff, Neonatal 1 cuff
31cm to 37 cm length. All Peritoneal Catheters excluding the Swan Neck Fast Flow Catheter, have an internal diameter of 2.67mm and an external diameter of 4.95 mm.
$175.00
KA003 Fast Flow Peritoneal Dialysis Catheter Swan Neck, 2 cuff Int.diam: 3.2mm; ext diam 5.49mm.All Peritoneal Catheters excluding the Swan Neck Fast Flow Catheter, have an internal diameter of 2.67mm and an external diameter of 4.95 mm.
$175.00
KA004 Swan Neck Curl Peritoneal Dialysis
Catheter
Adult 2 cuff, left 62 cm length. All Peritoneal Catheters excluding the Swan Neck Fast Flow Catheter, have an internal diameter of 2.67mm and an external diameter of 4.95 mm.
$175.00
Billing Code | Product Name | Description | Size | Benefit | Benefit | Condition |
KA005 | Swan Neck or Swan neck Tenckhoff | Adult-left, Adult-right, Adult, 2 cuff-left, Adult, | 20 to 25cm external segment or 43cm length. | $175.00 |
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| Peritoneal Dialysis Catheter | 2 cuff-right | All Peritoneal Catheters excluding the Swan |
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| Neck Fast Flow Catheter, have an internal |
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| diameter of 2.67mm and an external diameter |
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| of 4.95 mm. |
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KA006 | Tenckhoff Peritoneal Dialysis | Adult, 2 cuffs | 57 to 62cm length. All Peritoneal Catheters | $175.00 |
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| Catheter, Curl |
| excluding the Swan Neck Fast Flow Catheter, |
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| have an internal diameter of 2.67mm and an |
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