9Indexation

9 Indexation

(1) At the start of 1 July 2025 (the indexation time), each amount covered by subsection (2) is replaced by the amount worked out using the following formula:

1.024 multiplied by the amount immediately before the indexation time

Note: The indexed fees could in 2025 be viewed on the Department of Health and Aged Care’s MBS Online website (https://www.mbsonline.gov.au).

(2) The amounts covered by this subsection are the fee for each item in Schedule 1 of this Determination.

(3) An amount worked out under subsection (1) is to be rounded up or down to the nearest 5 cents (rounding down if the amount is an exact multiple of 2.5 cents).

Schedule 1—Specified health services

<table cellspacing="0" cellpadding="0" style="width:100%; border-collapse:collapse"><thead><tr><td colspan="3" style="border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-size:10pt; font-weight:bold">Group C1</span><span style="font-size:10pt; font-weight:bold">­</span><span style="font-size:10pt; font-weight:bold">—Cleft and Craniofacial Services</span></p></td></tr><tr><td style="width:9.1%; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-size:10pt; font-weight:bold">Item</span></p></td><td style="width:74.48%; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; page-break-after:avoid; line-height:10pt"><span style="font-size:10pt; font-weight:bold">Service</span></p></td><td style="width:16.42%; border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; page-break-after:avoid; line-height:10pt"><span style="font-size:10pt; font-weight:bold">Fee ($)</span></p></td></tr></thead><tbody><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75002</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Initial professional attendance, in a single course of treatment (other than a service associated with a service to which item 75009, 75012, 75015 or 75023 applies)</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">94.10</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75005</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Subsequent professional attendance in a single course of treatment (other than a service associated with a service to which item 75009, 75012, 75015 or 75023 applies)</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">47.35</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75007</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Production of dental study models (other than a service associated with a service to which item 75002 or 75005 applies) prior to provision of a service to which:</span><span style="font-size:10pt"></span></p><p style="margin-left:26.65pt; margin-bottom:3pt; text-indent:-26.65pt; line-height:12pt"><span style="width:0pt; text-indent:0pt; font-size:10pt; display:inline-block"></span><span style="font-size:10pt"></span><span style="font-size:10pt">(a) </span><span style="font-size:10pt"></span><span style="font-size:10pt">item 75030, 75032, 75039, 75045 or 75051 apply; or</span><span style="font-size:10pt"></span></p><p style="margin-left:26.65pt; margin-bottom:3pt; text-indent:-26.65pt; line-height:12pt"><span style="font-size:10pt"></span><span style="font-size:10pt">(b) </span><span style="font-size:10pt"></span><span style="font-size:10pt">an item in Group T8 or Groups O3 to O9 apply; or</span><span style="font-size:10pt"></span></p><p style="margin-left:26.65pt; margin-bottom:3pt; text-indent:-26.65pt; line-height:12pt"><span style="font-size:10pt"></span><span style="font-size:10pt">(c) </span><span style="font-size:10pt"></span><span style="font-size:10pt">item 52321, 53212 or 75618 apply; or</span><span style="font-size:10pt"></span><span style="font-size:10pt"></span></p><p style="margin-left:26.65pt; margin-bottom:3pt; text-indent:-26.65pt; line-height:12pt"><span style="font-size:10pt"></span><span style="font-size:10pt">(d) </span><span style="font-size:10pt"></span><span style="font-size:10pt">any of items 52330 to 52382, 52600 to 52630, 53400 to 53409 or 53415 to 53429 apply;</span><span style="font-size:10pt"></span></p><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">in a single treatment</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">83.85</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75009</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Orthodontic radiography—orthopantomography (panoramic radiography), including any consultation on the same occasion</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">75.05</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75010</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Orthodontic radiography – anteroposterior or lateral cephalometric radiography, with cephalometric tracings, and orthopantomography, including any consultation on the same occasion</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">151.80</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75011</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Orthodontic radiography – anteroposterior and lateral cephalometric radiography, with cephalometric tracings, and orthopantomography, including any consultation on the same occasion</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">197.90</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75012</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Orthodontic anteroposterior cephalometric radiography with cephalometric tracings or lateral cephalometric radiography with cephalometric tracings, including any consultation on the same occasion</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">118.95</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75015</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Radiography</span><span style="font-size:10pt"> </span><span style="font-size:10pt">anteroposterior and lateral cephalometric radiography with cephalometric tracings, including any consultation on the same occasion</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">163.50</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75023</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Intraoral radiography—single area, periapical or bitewing film</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">51.10</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75024</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Pre</span><span style="font-size:10pt">‑</span><span style="font-size:10pt">surgical infant maxillary arch repositioning including nasoalveolar moulding, supply of appliances and all adjustments of appliances, and supervision of all components of the service—if 1 appliance is used</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">660.55</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75027</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Pre</span><span style="font-size:10pt">‑</span><span style="font-size:10pt">surgical infant maxillary arch repositioning including nasoalveolar moulding, supply of appliances and all adjustments of appliances, and supervision of all components of the service—if 2 appliances are used</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">905.75</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75030</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Maxillary arch expansion (other than a service associated with a service to which item 75039, 75042, 75045 or</span><span style="font-size:10pt"> </span><span style="font-size:10pt">75048 applies), including supply of appliances and all adjustments of appliances, removal of appliances and retention</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">806.45</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75032</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Mixed dentition treatment including incisor alignment (mandibular and/or maxillary) lateral arch expansion, including supply of appliances and all adjustments of appliances, removal of appliances and retention</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">1815.80</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75034</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Mixed dentition treatment—incisor alignment with or without lateral arch expansion using a removable appliance in the maxillary arch, including supply of all appliances, and associated adjustments and retention</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">672.80</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75039</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Permanent dentition treatment—single arch (mandibular or maxillary) treatment (correction and alignment) using orthodontic fixed appliances or aligners, including supply of</span><span style="font-size:10pt; font-style:italic"> </span><span style="font-size:10pt">appliances and aligners—initial 3</span><span style="font-size:10pt"> </span><span style="font-size:10pt">months of active treatment</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">611.20</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75042</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Permanent dentition treatment—single arch (mandibular or maxillary) treatment (correction and alignment) using orthodontic fixed appliances or aligners, including</span><span style="font-size:10pt; font-style:italic"> </span><span style="font-size:10pt">supply of appliances and aligners—each subsequent 3</span><span style="font-size:10pt"> </span><span style="font-size:10pt">months of active treatment (including all adjustments and maintenance and removal of the appliances) after the initial three months of active treatment for a maximum of a further 33 months</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">228.45</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75045</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Permanent dentition treatment—2 arch (mandibular and maxillary) treatment (correction and alignment) using orthodontic fixed appliances or aligners, including</span><span style="font-size:10pt; font-style:italic"> </span><span style="font-size:10pt">supply of appliances or aligners—initial 3</span><span style="font-size:10pt"> </span><span style="font-size:10pt">months of active treatment</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">1,223.50</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75048</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Permanent dentition treatment—2 arch (mandibular and maxillary) treatment (correction and alignment) using orthodontic fixed appliances or aligners, including supply of appliances or aligners—each subsequent 3 months of active treatment (including all adjustments and maintenance, and removal of the appliances) after the initial three months of active treatment for a maximum of a further 33</span><span style="font-size:10pt"> </span><span style="font-size:10pt">months</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">313.75</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75049</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Retention, fixed or removable, single arch (mandibular or maxillary)—supply of retainer and supervision of retention</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">367.25</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75050</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Retention, fixed or removable, 2</span><span style="font-size:10pt">‑</span><span style="font-size:10pt">arch (mandibular and maxillary)—supply of retainers and supervision of retention</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">708.90</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75051</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Jaw growth guidance using removable or functional appliances, including supply of appliances and all adjustments to appliances</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">1,088.20</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75200</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Removal of tooth or tooth fragment (other than treatment to which item 75402 or 75405 applies)</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">60.45</span></p></td></tr><tr><td style="width:9.1%; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75203</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Removal of tooth or tooth fragment under general anaesthesia (H)</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">90.70</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75206</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Removal of each additional tooth or tooth fragment if provided in association with a service to which item</span><span style="font-size:10pt"> </span><span style="font-size:10pt">75200 or 75203 applies</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">30.10</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75400</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Surgical removal of erupted tooth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">181.35</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75402</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p class="TableParagraph" style="margin-right:13.05pt; margin-left:1.3pt; line-height:104%; font-size:10pt"><span>Surgical removal of tooth, or tooth fragment requiring incision of soft tissue only</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">179.25</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75405</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Surgical removal of tooth, or tooth fragment requiring removal of bone, where the patient is referred by a referring dentist or medical practitioner</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">229.20</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75600</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Surgical exposure and packing of unerupted tooth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">255.40</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75603</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Surgical exposure of unerupted tooth for the purpose of fitting a traction device or placement of a temporary anchorage device</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">300.25</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75606</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Surgical repositioning of unerupted tooth where the patient is referred by a referring dentist or medical practitioner</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">300.25</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75609</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Transplantation of tooth bud where the patient is referred by a referring dentist or medical practitioner</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">448.20</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><a id="CU_2017320"></a><span style="font-size:10pt">75610</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Surgical procedure for intraoral implantation of an osseointegrated fixture and placement of transmucosal abutments where the patient is referred by a referring dentist or medical practitioner (H)</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">380.00</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75618</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Fabrication and fitting of a bite rising appliance or dental splint for the management of temporomandibular joint dysfunction syndrome</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">254.90</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75621</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">The fabrication and fitting of surgical splint or guide in conjunction with orthognathic surgical procedures and implant treatment, if provided in association with a service to which:</span></p><p style="margin-left:26.65pt; margin-bottom:3pt; text-indent:-26.65pt; line-height:12pt"><span style="width:9.3pt; text-indent:0pt; font-size:10pt; display:inline-block"></span><span style="font-size:10pt">(a)</span><span style="width:6.25pt; text-indent:0pt; font-size:10pt; display:inline-block"> </span><span style="font-size:10pt">any item in the following series applies:</span></p><p style="margin-left:43.4pt; margin-bottom:3pt; text-indent:-43.4pt; line-height:12pt"><span style="width:26.86pt; text-indent:0pt; font-size:10pt; display:inline-block"></span><span style="font-size:10pt">(i)</span><span style="width:7.1pt; text-indent:0pt; font-size:10pt; display:inline-block"> </span><span style="font-size:10pt">any of items 46150 to 46161 apply; or</span></p><p style="margin-left:43.4pt; margin-bottom:3pt; text-indent:-43.4pt; line-height:12pt"><span style="width:19.08pt; text-indent:0pt; font-size:10pt; display:inline-block"></span><span style="font-size:10pt"></span><span style="font-size:10pt">(ii)</span><span style="width:7.1pt; text-indent:0pt; font-size:10pt; display:inline-block"> </span><span style="font-size:10pt">any of items 52342 to 52375 apply; or</span></p><p style="margin-left:26.65pt; margin-bottom:3pt; text-indent:-26.65pt; line-height:12pt"><span style="width:8.74pt; text-indent:0pt; font-size:10pt; display:inline-block"></span><span style="font-size:10pt">(b)</span><span style="width:6.25pt; text-indent:0pt; font-size:10pt; display:inline-block"> </span><span style="font-size:10pt">item 52380 or 52382 applies;</span></p><p style="margin-left:26.65pt; margin-bottom:3pt; text-indent:-26.65pt; line-height:12pt"><span style="font-size:10pt"></span><span style="font-size:10pt">(c)</span><span style="font-size:10pt"> </span><span style="font-size:10pt">item 75610 applies</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">254.90</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75800</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Attendance involving consultation, preventive treatment and prophylaxis, of not less than 30</span><span style="font-size:10pt"> </span><span style="font-size:10pt">minutes in duration</span><span style="font-size:10pt"> </span><span style="font-size:10pt">for each attendance to a maximum of 3</span><span style="font-size:10pt"> </span><span style="font-size:10pt">attendances in any 12</span><span style="font-size:10pt"> </span><span style="font-size:10pt">month period (other than a service associated with a service to which item 75009, 75012, 75015 or 75023 applies)</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">90.70</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75802</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Fabrication and fitting of acrylic base partial denture, including retainers—1 to 4 teeth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">463.20</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75815</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Fabrication and fitting of acrylic base partial denture, including retainers—5 to 9 teeth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">683.45</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75818</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Fabrication and fitting of acrylic base partial denture or complete denture or overdenture, including retainers—10 to 12 teeth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">806.45</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75820</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Fabrication and fitting of metal framework partial denture, including all components—1 to 4 teeth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt; letter-spacing:-0.1pt">803.80</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75833</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Fabrication and fitting of metal framework partial denture including all components—5</span><span style="font-size:10pt"> </span><span style="font-size:10pt">to 9 teeth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">1,164.95</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75836</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Fabrication and fitting of metal framework partial denture or complete denture or overdenture including all components—10</span><span style="font-size:10pt"> </span><span style="font-size:10pt">to 12 teeth</span><span style="font-size:10pt; text-decoration:line-through"></span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">1,333.05</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75842</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Adjustment of denture (other than a service associated with a service to which item 75802, 75815, 75818, 75820, 75833 or 75836 applies)</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">44.85</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75845</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Relining of denture by laboratory process and associated fitting</span><span style="font-size:10pt; text-decoration:line-through"></span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">224.15</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75848</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Remodelling and fitting of denture of more than 4</span><span style="font-size:10pt"> </span><span style="font-size:10pt">teeth</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">268.80</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75851</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Repair to metal framework of denture—1 or more points</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">134.45</span></p></td></tr><tr><td style="width:9.1%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">75854</span></p></td><td style="width:74.48%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; line-height:12pt"><span style="font-size:10pt">Addition of a tooth or teeth to a denture to replace extracted tooth or teeth, including taking of necessary impression</span></p></td><td style="width:16.42%; border-top:0.75pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:3pt; text-align:right; line-height:12pt"><span style="font-size:10pt">134.45</span></p></td></tr></tbody></table>