About Assistant Billing
Assistance at Operations - (Items 51300 to 51318)
Items covering operations which are eligible for benefits for surgical assistance have been identified by the inclusion of the word 'Assist' in the item description. Medicare benefits are not payable for surgical assistance associated with procedures which have not been so identified.
The assistance must be rendered by a medical practitioner other than the surgeon, the anaestheist or the assistant anaesthetist. if the surgical assistant is not medically trained (non-medical surgical assistant i.e., nurse), patients must pay for the surgical assisant out of their own pocket.
Where more than one practitioner provides assistance to a surgeon no additional benefits are payable. The assistance benefit payable is the same irrespective of the number of practitioners providing surgical assistance.
NOTE: The Benefit in respect of assistance at an operation is not payable unless the assistance is rendered by a medical practitioner other than the anaesthetist or assistant anaesthetist. The amount specified is the amount payable whether the assistance is rendered by one or more medical practitioners.
Assistance at Multiple Operations
Where surgical assistance is provided at two or more operations performed on a patient on the one occasion the multiple operation formula is applied to all the operations to determine the surgeon's fee for Medicare benefits purposes. The multiple-operation formula is then applied to those items at which assistance was rendered and for which Medicare benefits for surgical assistance is payable to determine the abated fee level for assistance. The abated fee is used to determine the appropriate Schedule item covering the surgical assistance (ie either Item 51300 or 51303).
| Multiple Operation Rule - Surgeon | Multiple Operation Rule - Assistant |
| Item A - $300@100% | Item A (Assist.) - $300@100% |
| Item B - $250@50% | Item B (No Assist.) |
| Item C - $200@25% | Item C (Assist.) - $200@50% |
| Item D - $150@25% | Item D (Assist.) - $150@25% |
The derived fee applicable to Item 51303 is calculated on the basis of one-fifth of the abated Schedule fee for the surgery which attracts an assistance rebate.
Surgeons Operating Independently
Where two surgeons operate independently (ie neither assists the other or administers the anaesthetic) the procedures they perform are considered as two separate operations, and therefore, where a surgical assistant is engaged by each, or one of the surgeons, benefits for surgical assistance are payable in the same manner as if the surgeons were operating separately.
Related Items: 51300, 51303, 51306, 51309, 51312, 51315, 51318
51300
Assistance at any operation identified by the word "Assist." for which the Medicare Schedule fee does not exceed $611.50 (effective 1 July 2023) or at a series or combination of operations identified by the word "Assist." where the fee for the series or combination of operations identified by the word "Assist." does not exceed $611.50
51303
Assistance at any operation identified by the word "Assist." for which the fee exceeds $611.50 or at a series of operations identified by the word "Assist." for which the aggregate fee exceeds $611.50 one fifth of the established fee for the operation or combination of operations
51306
Assistance at a delivery involving Caesarean section
51309
Assistance at a series or combination of operations which have been identified by the word "Assist." and assistance at a delivery involving Caesarean section one fifth of the established fee for the operation or combination of operations (the fee for item 16520 being the Schedule fee for the Caesarean section component in the calculation of the established fee)
51312
Assistance at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615, and 16627 one fifth of the established fee for the procedure or combination of procedures
51315
Assistance at cataract and intraocular lens surgery covered by item 42698,42701, 42702, 42704 or 42707, when performed in association with services covered by item 42551 to 42569, 42653, 42656, 42725, 42746, 42749, 42752, 42776 or 42779
51318
Assistance at cataract and intraocular lens surgery where patient has:
- total loss of vision, including no potential for central vision, in the fellow eye; or
- previous significant surgical complication in the fellow eye; or
- pseudo exfoliation, subluxed lens, iridodonesis, phacodonesis, retinal detachment, corneal scarring, pre-existing uveitis, bound down miosed pupil, nanophthalmos, spherophakia, Marfan's syndrome, homocysteinuria or previous blunt trauma causing intraocular damage
Assistance at Operations - (Items 51800 and 51803)
Items covering operations which are eligible for benefits for assistance by an approved dental practitioner in the practice of oral and maxillofacial surgery or surgical assistance have been identified by the inclusion of the word "Assist" in the item description. Medicare benefits are not payable for surgical assistance associated with procedures which have not been so identified. The assistance must be rendered by a practitioner other than the surgeon, the anaesthetist or the assistant anaesthetist.
Where more than one practitioner provides assistance to an approved dental practitioner no additional benefits are payable.
The assistance benefit is the same irrespective of the number of practitioners providing assistance.
Benefits payable under item 51800
Medicare benefits are payable under Item 51800 for assistance rendered at the following procedures:
51900, 51904, 52010, 52018, 52039, 52048, 52051, 52062, 52063, 52066, 52078, 52090, 52092, 52095, 52105, 52108, 52111, 52130, 52138, 52141, 52144, 52147, 52182, 52300, 52303, 52312, 52315, 52321, 52324, 52336, 52339, 52424, 52440, 52452, 52480, 52482, 52600, 52603, 52609, 52612, 52615, 52624, 52626, 52627, 52800, 52803, 52806, 52809, 52818, 52824, 52828, 52830, 53006, 53009, 53016, 53215, 53220, 53225, 53226, 53236, 53239, 53242, 53406, 53409, 53412, 53413, 53415, 53416, 53453, 53460.
Where assistance with any of the above procedures is provided by a medical practitioner, benefits are payable under item 51300.
Benefits payable under Item 51803
Medicare benefits are payable under Item 51803 for assistance rendered at the following procedures:
51906, 52054, 52094, 52114, 52117, 52120, 52122, 52123, 52126, 52129, 52131, 52148, 52158, 52184, 52186, 52306, 52330, 52333, 52337, 52342, 52345, 52348, 52351, 52354, 52357, 52360, 52363, 52366, 52369, 52372, 52375, 52378, 52379, 52380, 52382, 52430, 52442, 52444, 52446, 52456, 52484, 52618, 52621, 52812, 52815, 52821, 52832, 53015, 53017, 53019, 53209, 53212, 53218, 53221, 53224, 53227, 53230, 53233, 53414, 53418, 53419, 53422, 53423, 53424, 53425, 53427, 53429, 53455 or at a combination of procedures (including those identified as payable under item 51800 above) for which the aggregate fee exceeds the amount specified in the item.
Where assistance with any of the above procedures is provided by a medical practitioner, benefits are payable under Item 51303.
Assistance at multiple operations
Where assistance is provided at two or more operations performed on a patient on the one occasion the multi operation formula is applied to all the operations to determine the surgical fee payable to each approved dental practitioner. The multi-operation formula is then applied to those items at which assistance was rendered and for which Medicare benefits for assistance is payable to determine the abated fee level for assistance. The abated fee is used to determine the appropriate Schedule item covering the surgical assistance (ie either Items 51800/51300 or 51803/51303).
The derived fee applicable to Item 51803/51303 is calculated on the basis of one-fifth of the abated Schedule fee for the surgery.
Related Items: 51800, 51803
51800
Assistance by an approved dental practitioner in the practice of oral and maxillofacial surgery at any operation identified by the word "Assist." for which the fee does not exceed $537.15 or at a series or combination of operations identified by the word "Assist." where the fee for the series or combination of operations identified by the word "Assist." does not exceed $611.50
Assistance by an approved dental practitioner in the practice of oral and maxillofacial surgery at any operation identified by the word "Assist." for which the fee exceeds $611.50 or at a series or combination of operations identified by the word "Assist." where the aggregate fee exceeds $611.50, one fifth of the established fee for the operation or combination of operations
Nurse Practitioners
New Nurse Practitioner Assistant Item Codes effective 1 November 2025 are now populated when the Billing Entity is a Nurse Practitioner. See PDF attachment below.
Related to
Information for claiming Assistant items
- Submitting accounts with the above information will help more efficient processing and reduce rejections.
- Clearly state assisting item number, assisting doctor’s provider number and charge
- The word 'Surgeon' must be stated next to the surgeon’s name. (Do not use referring provider )
- Surgical items that the provider assisted with must be on the account
- Do not supply the breakdown of assistant’s fees for each surgical item if claiming for assistant item only
- There should be only one assisting item per operation/procedure and only one fee.
Example of how to set out an assistant item on an account:
Service provider: Dr G. Smith 0000000A
51303 – Assistance at operation $500
(Surgeon Dr Brown; items 40000, 30000)
The latest in Surgical Assistant news
MBS Review Advisory Committee Surgical Assistants – Final Report (health.gov.au)
More detail at Assistants in Surgery – Direct CONTROL Medical (DCM)