Muscle, myocutaneous or skin flap — only in association with items 31000
Therapeutic procedures · Group T8 — Surgical operations · Bypass or anastomosis for occlusive arterial disease
| Benefit | Amount | Gap to fee |
|---|---|---|
| 85% | $421.10 | $74.30 |
| 75% | $371.55 | $123.85 |
Benefit amounts as published in the schedule, not recalculated.
Fee current from 1 Jul 2026.
(Anaes.) — anaesthesia may be claimed separately in association with this item.
A flap repair is claimable only once per defect, and only in association with the excision items 45201 names. Many of the commonest GP excision items - 31356, 31357, 31361, 31362, 31377 among them - are NOT on that list and say 'not in association with item 45201', so no flap is separately payable with them. Where 45201 does not apply, check 45202 before assuming a second flap can be billed.
TN.8.93 Local Skin Flap - Definition
Medicare benefits for flaps are only payable when clinically appropriate. Clinically appropriate in this instance means that the flap or graft is required to close the defect because the defect cannot be closed directly, or because the flap is required to adapt scar position optimally with regard to skin creases or landmarks, maintain contour on the face or neck, or prevent distortion of adjacent structures or apertures.
A local skin flap is an area of skin and subcutaneous tissue designed to be elevated from the skin adjoining a defect requiring closure. The flap remains partially attached by its pedicle and is moved into the defect by rotation, advancement or transposition, or a combination of these manoeuvres. A benefit is only payable when the flap is required for adequate wound closure. A secondary defect will be created which may be closed by direct suture, skin grafting or sometimes a further local skin flap. This later procedure will also attract benefit if closed by graft or flap repair but not when closed by direct suture.
By definition, direct wound closure (e.g. by suture) does not constitute skin flap repair. Similarly, angled, curved or trapdoor incisions which are used for exposure and which are sutured back in the same position relative to the adjacent tissues are not skin flap repairs. Undermining of the edges of a wound prior to suturing is considered a normal part of wound closure and is not considered a skin flap repair.
A "Z" plasty is a particular type of transposition flap repair. Although 2 flaps are created, benefit will be paid on the basis of Item 45201, claimable once per defect. Additional flaps are to be claimed under Item 45202, if clinically indicated.
Note: refer to TN.8.126 for MBS item 45202 for circumstances where other services might involve flap repair.
| Item number | 45201 |
|---|---|
| Category | 3 — Therapeutic procedures |
| Group | T8 — Surgical operations |
| Subheading | Bypass or anastomosis for occlusive arterial disease |
| Item type | S |
| Fee type | N |
| In schedule since | 1 Nov 2016 |
| Fee current from | 1 Jul 2026 |
| GP scope | Yes · tier 3 |