List of Prostheses and Specialised Equipment

Effective 3 November 2025

This List of Prostheses and Specialised Equipment forms part of your Southern Cross health insurance policy (except HealthEssentials). It sets out the prostheses and specialised equipment types and associated maximums covered by your policy. For a prosthesis or specialised equipment to be covered as part of an eligible surgical treatment it must be listed below. The maximums listed are inclusive of GST and all costs associated with the item, for example bone cement or prosthesis handling fees.

Please note maximums below do not apply to UltraCare Base and UltraCare 400.

Important: Wellbeing Starter does not provide cover for surgical treatment or other healthcare services for gynaecology, urology and orthopaedics (referred to in the policy document as restricted specialties), unless they are directly required for the treatment of cancer. This means that the prosthesis and specialised equipment listed that relates to a restricted specialty will not be covered unless it is directly required for the treatment of cancer.

This list may change from time to time as we continuously review how we cover healthcare services and certain technology.

Oral surgery

Code Name Maximum
0001358 Temporomandibular joint prosthesis, unilateral $26,000 per operation
0001359 Temporomandibular joint prosthesis, bilateral $45,000 per operation

Breast surgery

Code

Name

Maximum

0001130

Breast implant prosthesis

$3,300 per body side

0001275

Post-mastectomy tissue expander

$3,000 per body side

Cardiac surgery

Code

Name

Maximum

0001079

Aortic valved conduit for Bentall procedure

$12,850 per conduit

0001492

Annuloplasty ring or band

$3,625 per ring/band

0001082

Maze pen

$6,133 per operation

0001084

Occluder

$12,275 per operation

0001401

Pacemaker device, single chamber

$2,760 per operation

0001402

Pacemaker device, dual chamber

$4,485 per operation

0001403

Pacemaker device, biventricular

$10,260 per operation

0001080

Surgically implanted heart valve

$7,000 per valve

0001081

Transcatheter heart valve

$32,775 per operation

General surgery

Code

Name

Maximum

0001258

Anal fistula plug prosthesis

$2,000 per plug

0001656

Caecostomy button or tube
Chait tube; C-tube

$650 per operation

0001655

Gastrointestinal stent prosthesis

$3,500 per stent

0001255

Hepatic or biliary stent

$3,350 per stent

Gynaecological surgery

Code

Name

Maximum

0001230

Endometrial ablation device

$2,250 per operation

0001229

Gynaecological mesh

$2,500 per mesh

0001810

Hysteroscopic morcellation device

$1,538 per operation

0001225

Pubovaginal sling prosthesis

$1,900 per operation

Neurosurgery

Code

Name

Maximum

0001508

Balloon kit for compression of trigeminal nerve

$873 per operation

0001653

Dura substitute

$1,500 per operation

0001356

Ventriculoperitoneal / ventriculoatrial shunt

$4,250 per operation

Ophthalmology / Eye surgery

Code

Name

Maximum

0001107

Artificial eye implant

$5,000 per body side

0001930

Amniotic membrane, piece

$600 per body side

0001900

Cornea, intact button

$4,900 per body side

0001910

Cornea, pre-cut

$5,700 per body side

1192000

Glaucoma drainage tube

$1,250 per body side

0001108

Intrastromal corneal ring segment prosthesis

$1,600 per body side

0001195

Lacrimal tube prosthesis (includes Crawford tubes)

$1,000 per body side

1192001

MIGS specialised equipment, category 1
(Kahook Dual Blade, Tanito Microhook)

$1,000 per body side

1192002

MIGS specialised equipment, category 2
(iTrack canaloplasty microcatheter, MicroPulse P3 Delivery Device, Streamline)

$1,500 per body side

1192003

MIGS specialised equipment, category 3
(XEN gel Stent, iStent Trabecular Micro-Bypass Stent, PreserFlo MicroShunt, iStent Infinite, Hydrus Microstent)

$2,500 per body side

0001406

Prosthetic iris device

$10,250 per body side

0001920

Sclera, whole

$650 per body side

0001100

Standard monofocal intraocular lens

$368 per body side

Oral surgery

Code

Name

Maximum

0001358

Temporomandibular joint prosthesis, unilateral

$26,000 per operation

0001359

Temporomandibular joint prosthesis, bilateral

$45,000 per operation

Orthopaedic surgery

Code

Name

Maximum

0001240

Allograft bone or tendon

$3,500 per operation

0001085

Ankle prosthesis

$10,300 per body side

0001493

Biofoam wedge

$2,875 per wedge

0001245

Bone graft substitute, including bone morphogenic protein (BMP) and demineralised bone matrix (DBM) (other than spinal)

$10,000 per operation

0001246

Bone graft substitute, including bone morphogenic protein (BMP) and demineralised bone matrix (DBM) (spinal)

$16,000 per operation

0001353

Cervical disc, 1 level

$10,000 per operation

0001357

Cervical disc, 2 levels

$20,000 per operation

0001175

Digital joint replacement prosthesis

$3,000 per joint

0001120

Elbow prosthesis

$12,266 per body side

1001176

First MTP joint implant

$2,300 per body side

0001290

Hip prosthesis, primary

$10,050 per body side

0001280

Hip prosthesis, revision

$14,500 per body side

0001295

Knee prosthesis, primary

$10,050 per body side

0001296

Knee prosthesis, partial

$10,625 per body side

0001285

Knee prosthesis, revision, total

$26,000 per body side

0001286

Knee prosthesis, revision, partial

$10,625 per body side

1282000

Patella button, including cement

$1,469 per body side

0001210

Screws and plates

$4,000 per body side

0001110

Shoulder prosthesis, primary

$13,500 per body side

1112000

Shoulder prosthesis, revision

$18,125 per body side

0001495

Shoulder prosthesis, reverse

$18,750 per body side

0001490

Silastic implant (for hallux rigidus)

$1,534 per body side

0001140

Spinal prostheses, 1 level

$14,250 per operation

0001141

Spinal prostheses, 2 levels

$19,000 per operation

0001142

Spinal prostheses, 3 levels

$24,500 per operation

0001614

Spinal prostheses, 4 levels

$30,000 per operation

0001615

Spinal prostheses, 5 levels

$34,000 per operation

0001616

Spinal prostheses, 6 levels

$38,000 per operation

0001617

Spinal prostheses, 7 levels

$42,000 per operation

0001618

Spinal prostheses, 8 or more levels

$48,000 per operation

0001186

Suture anchors / soft tissue fixation devices

$4,000 per body side

0001095

Wrist prosthesis

$8,500 per body side

Other

Code

Name

Maximum

0001652

Acellular dermal matrix or biological mesh

$3,500

0001491

Adhesion barrier

$1,534

0001450

Botulinum toxin type A for approved procedures only (1 ampoule/100 units)

$600

0001451

Botulinum toxin type A for approved procedures only (2 or more ampoules/200+ units)

$1,200

0001507

CUSA (Cavitron ultrasonic surgical aspirator) or Sonopet ultrasonic aspirator

$2,500

0001494

Facial or laryngeal nerve monitoring equipment

$1,250

0001151

Mesh general surgery prosthesis

$1,533

0001510

Microwave ablation device

$4,200

0001613

Post-op support garment

$150

0001509

Radiofrequency ablation device

$4,800

0001506

Spinal nerve monitoring equipment

$2,875

0001505

Stealth image guidance

$2,200

0001220

Tissue expander prosthesis (other than breast)

$2,617

Otolaryngology / Ear, Nose and Throat surgery

Code

Name

Maximum

0001238

Coblation wand

$625

0001404

Cochlear implant internal device (receiver/stimulator)

$17,000

0001609

Extratympanic or subannular T-tube

$136

0001611

Grommet

$28

0001237

Laser fibres for ear, nose and throat procedures

$2,200

0001620

Medpor polyethylene graft or polydioxanone (PDS) plate

$860

0001630

Nasal septal button

$1,500

0001612

Ossicular replacement prosthesis (including stapes piston)

$1,375

0001265

Vocal fold implant

$560

Urological surgery

Code

Name

Maximum

0001352

Artificial urinary sphincter

$16,000

0001405

Periurethral bulking agent (Bulkamid)

$3,000

0001235

Laser fibres for prostate resection

$1,840

0001236

Laser fibres for urological procedures (other than prostate)

$1,840

0001227

Male sling prosthesis

$5,300

0001350

Penile prosthesis, rigid

$3,000

0001351

Penile prosthesis, inflatable

$19,300

0001354

Testicular prosthesis

$1,244

0001250

Urological stent prosthesis (includes pigtail stents)

$800

Vascular surgery

Code

Name

Maximum

0001650

Endoluminal stent

$28,000

0001355

Implantable vascular access device

$1,278

0001651

Peripheral endoluminal stent / graft

$5,000

0001205

Synthetic arterial graft prosthesis

$2,556